Rearview Mirror: Ectopic Must be Dead!

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Like me claiming Page 12!

:laugh::laugh::laugh::wow::wow::horns::horns:
 
Where the heck did you come from, anyway!
 
I am so gonna get you for this! 😡

The stupid thing wouldn't let me put 19 emoticons, and time passed 🙁
 
Was trying to make up for chumbojumbo's lackluster performance on page 11, and here you come with, "new page" 🙄
 
i need to dictate some charts. im 40 or so in the hole.. peace
 
I think this qualifies as harassment. I had clearly set myself up for the next page.
 
Dude, if you steal my page and leave I'm gonna have to press that explanation button the side and report you! 😡
 
I'll get you banned - yeah, banned! :idea:
 
Wait, we have to dictate charts in EM???!!! :scared:
 
Don't wanna dictate - what if it is already an electronic chart, though?
 
Sigh, I wonder how long it takes to dictate? 😴
 
I guess I will resume my revolutionary, patented educational post-padding 😎
 
Malaria presents with paroxysmal fever q2-3days, chills, anemia, splenomegaly, and even black urine 2/2 hemolysis (blackwater fever)
Usually incubates 6-16 days, but this can vary if the patient was given prophylatic meds (Delayed 8-12 mos)
Pts should get chloroquine 1-2 weeks before leaving and 4 weeks after returning; if going to a chloroquine-resistant area, they will need malarone/proguanil 1 day before and 1 week after returning.
Diagnosis, of course, is by blood smear
 
supposed to be studying...but studying with a computer means sdn time...
 
at least hard24forget is using her sdn time wisely
 
I am learning about mouth cancers because I don't want to study the anatomy.
 
Heroine overdose presents with stupor/coma, miotic pupuils, slow breathing, cool, mottled skin - takes 6-8 hours to wear off
They should be hit with narcan, which lasts only 1-2 hours, so you will probably have to give multiple times
Withdrawal signs include agitation, lacrimation, diarrhea, abd cramps, tachycardia, hypertension. These symptoms last 7-10 days and peak at 2-3 days
 
EM2BE said:
at least hard24forget is using her sdn time wisely
Click to expand...

Thanks, I was just learning about ecstasy:

an analogue of methamphetamine, it can cause jaw clenching/muscle spams/rhabdo, nystagmus, seizures, widely dilated pupils, arrythmias, N/V, fever, diaphoresis, and even DIC. All deaths thus far are related to thermoregulation problems
Treatment includes rapid cooling, rehydration, organ monitoring
 
Phenylcyclidine (PCP) should be the first thing you think of if someone comes in comatose with their eyes open, displayed muscle rigidity and nystagmus. Also causes tachycardia and htn. This drug can cause anything from CNS stimulation to depression (catatonia to seizures), flushed skin with dilated pupils. These patients are known for their agistation and violence, they will need benzos +/- haldol and cooling. Gastric lavage can be used and pts need to be watched for rhabdo.
 
Let's talk about the poor little old ladies, etc that overdose on prescribed meds:

Class IA drugs like quidinide, procainamide prolong the QT interval --> torsades ---> code. Treat with magnesium sulfate or pacing, avoid other QT actors

Class IB include lidocaine, tocainide, these shorten the AP and prolong the refractory period - supportive care
Class IC include flecainide and propaferone, which prolong the AP - supportive care
 
Class II meds are more high yield because they include beta-blockers, which just about everybody with CAD is on. These drugs block beta-1 receptor, which usually stimulate cAMP. Overdosers present with bradycardia and hypotension.

Bypass the Beta receptor by using glucagon. Atropine will also oppose paraympathetics so may work. Most pressors would compete with the same receptor, so they are usually used the next go round
 
I forgot to mention glucagon works b/c it directly stimulates cAMP

Class III antiarrythmics include amiodarone and bretylium (does anyone use bretylium?). Plenty of folks are on amiodarone, and they, like the Class Is, will have a prolonged QT interval --> torsades --> code. Treat the same as the Is, with mag and overdrive pacing
 
Class IVs include the ca channel blockers, which also present with bradycardia and hypotension like Class II (beta blockers). These drugs hae a prolonged release from the stomach, so lavage!
Compete with the blocked channels using calcium, glucagon and pressors are less effective than with Beta-blockers. Calcium-channel blockers are pretty fatal; people think insulin ad glucose might help to resuscitate the many organs these drugs poison.
 
Had to go season up dinner. 😀

Anyway, seems the bottom line is the even anti-arrythmics are the ones we are used to, and we treat those overdose with glucagon, calcium, and pressors, whereas the odd ones cause torsades, which you treat with Mg

Pretty simple, but good to review

In the case of digoxin, overdose causes frequent PVCs, blocks, junctional tach, and there is a digoxin Fab antibody antidote. Don't give calcium if these patients are hyperkalemic, because dig block the Na/K atpase, resulting in tons of calcium - the more you gie, the longer it takes the heart to relax (stone heart)
 
OK, I need a good book to study fractures from. Let's see what I can find on the net....
 
Is it stupid of me to hold out for a residency program to buy me a Tintinalli's? I can access it on the web but it's not the same
 
Hey, I am freakin' carrying this thread, people!
 
you guys should all be ashamed of yourselves!
 
Alright class, let's work on my ERAS application, cause I need a residency to drop all this new knowledge I've gained on
 
My personal statement is not all cutesy and corny, and I don't care.
 
Let's see, I've got a spec sheet on U of MD here, which is a 3yr program. It basts 52 beds i their ED and 20% admission rate. More importantly, it has electronic patient records!
 
Kinda weird that there's no medicine or surgery mos, but there is alot of ICU time and shock trauma. Lot's of cool trauma research - this place is definitely on my list 😀
 
Emory has 100 ED beds - WOW!
Also a 3yr program, I am diggin the varied 1st year. TBI bench research, too! I wonder if they have electronic records? Their website is super sexy, I hope I can get my hubbie to Atlanata - would hate to leave him :meanie:.
 
Ah yes, Christiana - a rotation I am very much looking forward to! 3yr program, all electronic, 56 beds, time at Wilmington, 9hr shifts - all great. Looks like they have a new PD? 😕
 
Denver, talk about a sexy time! 😀

4yr program, 42 beds integrated peds, electronic records, lots of critical care, surg, and medicine experience, interesting research (really into this id of HIV infection stuff). I suspect this place will be quite high on my list, assuuming I even get an interview :scared:
 
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