Welcome
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[elisa] hi
[elisa] anyone
[elisa] ??
[elisa] is there anybody there?
[dr_gpsbambra] elisa lets chat
[dranvita]
[Patrick_Wei] ??
[Patrick_Wei] any one here?
[romdoc] I hope i am in the right chat room. Question? What is SABA's attrition rate?
[chandra] hello
Now entering USMLE_Step_2 subroom.
dua_frank has joined subroom: USMLE_Step_2
[samantha] yeah
[dua_frank] hi all
[dua_frank] sorry i'm late
[dua_frank] be right with you
[samantha] i have to do that
[ash] hi dua
[ash] and i guess the nbme form 1 and 2 would be good too
[samantha] yes
[samantha] havn't done that yet
[ash] hey dua what are the peds topics for todays discussion?
[samantha] hi dua
[samantha] ok
[ash] for step 1 i had solved nbme form 1 and it gave the exact percentile of my usmle score
[sanz] hi dua
[sanz] sorry was away on the phone sam...
[sanz] sammy, the last 2 weeks, i;d say go thru the NMBE
[sanz] and then First Aid Step 2
[sanz] that was what i did and it worked
[ash] thanks sanz
[samantha] should i read medicine or paeds sanz?
[sanz] dont leave the NMBE too late... go thru the qs with someone
[sanz] medicine is the majority sam... but i had a lot of peds and ObGyn as well
[samantha] but i don't have the q ?
[samantha] can we write them down?
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[ash] is dua back yet?
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[ash] hello anybody here????
[dua_frank] back
[dua_frank] i was putting up the schedule, forgot to do that yesterday
[sanz] hey dua
[dua_frank] hey sanz!
[dua_frank] nice to see you here today
[sanz] how is it goin buddy!! *hugs*
[dua_frank] *hugs*, going good. how about with you
[sanz] i have been so lazy and such a bum.. so i thought i'll come in here and disturb you!
[ash] dua what do we discuss today?
[dua_frank] oh please do anytime
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[sanz] peds, according to sam
[dua_frank] 12th Apr Respiratory system, Rheumatology, Cardiovascular system, Nutrition
[ash] ok thanks
[dua_frank] welcome
[dua_frank] sanz your cds are still in the printing process, i hope you don't mind the delay
[dua_frank] i don't have a dvd writer
[dua_frank] getting one of my friends to do that for me
[ash] should we start?
[sanz] dua, take your time... i'm just reading novels at themo
[dua_frank] lol ok then good
[dua_frank] yes ash
[dua_frank] whats the mc fatal inherited disease of the whites?
[ash] cystic fibrosis?
[dua_frank] yes
[dua_frank] what is its initial manifestation?
[ash] meconium ileus
[dua_frank] right
[dua_frank] tell me the other systems it can affect and the manifestations
[ash] respiratory tract
[ash] pseudomonas
[ash] bronchiactesis
[ash] pancreas
[dua_frank] bronchiatasis, malabsoption, prolapse of rectum
[ash] malabsorption
[dua_frank] resp and gi system
[ash] diabetes
[dua_frank] right
[sanz] what organism is common in CF pt?
[sanz] in CF pt lungs...
[dua_frank] staph aureus
[ash] pseudomonas
[sanz] yup pseudo is killer
[dua_frank] mc is staph aureus in initial infection ash
[ash] fruity odour
[sanz] what Ab'ics?
[dua_frank] pseudo in later stage and yes its fatal
[ash] ok thanks dua
[dua_frank] also h influenza in initial and aspergillus in later stages
[dua_frank] welcome
[sanz] great dua
[sanz] need to know the Ab'ics for pseudo
[dua_frank] what is the metabolic abnormality produced?
[dua_frank] bactrim?
[ash] diabetes
[dua_frank] right
[sanz] pipercillin
[dua_frank] the electrolyte abnormality?
[ash] ceftriaxone
[dua_frank] uh oh
[dua_frank] antibiotics
[ash] third generation cephalosporins
[dua_frank] yeah
[ash] newer penicillins+clavulinic acid
[dua_frank] most gram negative activity by third generation cephs
[dua_frank] most gram positive by first generation cephs
[ash] remember henpeck
[dua_frank] anerobes by fourth, cefipine
[dua_frank] whats henpeck?
[sanz] or pipercillin and tobramycin for pseudomonas... also ceftazidime and cefepime
[dua_frank] thanks
[sanz] that's high yield ...
[dua_frank] hypochlorimic met alkalosis
[ash] h influ,enterobacter,neisseria,proteus,e coli,klebsiella
[dua_frank] whats henpeck for ash?
[ash] dua see the first letters of the above list of each organism,peck is second generation cefalosporins
[ash] and henpeck is for third generation cephalosporins
[dua_frank] oh ok thanks
[dua_frank] any for the first?
[ash] oh
[ash] sorry
[ash] peck is for first generation
[ash] and henpeck is for second
[dua_frank] ok
[dua_frank] third?
[dua_frank] pseudomonas i guess
[samantha] what do they stand for?
[ash] third for gram negative
[samantha] means hen and peck
[ash] and fourth for both gram positive and negative
[dua_frank] rx of aspirin induced asthma?
[ash] misoprostol
[sanz] the infectious disease chapter in Kap IM notes are more than enuf... they explain the Ab'ics well
[dua_frank] yes as well as leukotriene inhibitors
[dua_frank] zifirlukast
[ash] or montelukast
[ash] thanks sanz
[dua_frank] rx of exercise induced asthma?
[ash] i was really worried about the infectious diseases
[ash] too many in reality
[sanz] also know what to give the neutropenic pt
[ash] salmeterol
[ash] salbutamol
[dua_frank] albuterol for acute attacks and cromolyn sodium in between
[samantha] yup
[dua_frank] salmetrol is not for acute attacks ash
[ash] well albuterol belongs to the same class as salbutamol
[ash] and salmeterol
[ash] yes
[dua_frank] whats the mc cause of cerebral palsy?
[ash] salmeterol is long acting
[dua_frank] yes it does, but induction time is longer
[samantha] for neutropenic pts what do u give sanz?
[ash] so not for acute attacks
[dua_frank] plus yes it does stay for a longer time too
[samantha] drugs dua
[samantha] ?
[dua_frank] what drugs for neutropenic patients?
[ash] dua ischemia during intrauterine life
[dua_frank] depends on the kind of infections they are predisposed to getting
[sanz] it depends on the case sam...
[samantha] no cc of cerebral palsy
[dua_frank] yes ash, cerebral anoxias
[dua_frank] oh
[sanz] ok.. let me give you cases.. and you ans
[ash] ok sanz
[dua_frank] no not drugs, anoxia
[samantha] ok dua
[samantha] ok sanz
[sanz] first define febrile neutropenic pt
[sanz] temp >38.8C
[sanz] and wbc <500
[dua_frank] ok
[samantha] yes
[sanz] so let's say they said this pt had undergone some sort of chemo recently
[ash] ok
[sanz] and now temp 39 and wbc 300
[ash] ok
[ash] myelosuppression
[dua_frank] right
[sanz] then you ned to decide if he's very ill or hemodynamically unstable
[ash] ok
[dua_frank] ok
[sanz] if his BP is reasonable, like 130/80... then mono therapy
[sanz] if not, you need
[sanz] vanc
[sanz] brb
[sanz] phone
[ash] huh?
[dua_frank] lol
[samantha] what is brb?
[dua_frank] be right back
[ash] barbiturates?
[dua_frank] lol
[ash] vancomicin and phenobarbitone?
[dua_frank] if the patient is unstable, give vanco
[samantha] lol i think sanz is ans phone
[dua_frank] no ash, brb means be right back
[dua_frank] yes
[dua_frank] forget the brb)
[dua_frank] lol
[ash]
[ash] *)
[dua_frank] what kind of gait do you see in cerebral palsy patients?
[ash]
[samantha] lol lol
[ash] spastic
[ash] mostly
[samantha] apraxia of gait
[dua_frank] scissoring and yes due to spasticity of the adductors
[dua_frank] how will you rx this?
[ash] release surgery?
[dua_frank] diazepam or dantrolene
[samantha] what is apraxia of gait?
[ash] oh yes!!!duh!!spastic
[ash] so give a relaxant right
[dua_frank] apraxia of gait is when the person's cerebrum is messed up
[dua_frank] they cannot tell position
[ash] cerebellum
[dua_frank] so they have gait disturbances
[ash] not cerebrum
[samantha] thanx dua
[dua_frank] i thought it was one of the symptoms of the parietal lobe ash
[dua_frank] gait apraxias
[ash] i am doing it all wrong!so sorrt!i was talking about ataxia
[sanz] ok... sorry guys... i'm back
[ash] sorry dua
[ash]
[ash] just not my day
[sanz] anyway, if the pt just meeds monotherapy - give ceftazidime or cefepime
[sanz] if not improving or not stable... add gentamicin
[dua_frank] Apraxia is a syndrome reflecting motor system dysfunction at the cortical level, exclusive of primary motor cortex.
[sanz] if hemodynamically unstable or pt has long lines, add vanc
[dua_frank] ok sanz
[sanz] that's it
[ash] thanks sanz
[dua_frank] start cephs, then gentamicin
[dua_frank] then vanco
[dua_frank] ok
[dua_frank] thanks sanz
[sanz] FA has a good diagram and UW had a q like this
[dua_frank] please go inject hard to store information like this into our brains
[dua_frank] we need your help on this
[ash] ok i have to go now.good night all
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[sanz] dua you'r doing fine!
[dua_frank] spike and wave pattern on the EKG
[dua_frank] dx?
[samantha] absence epilepsy?
[dua_frank] yes
[samantha] temporal lobe
[samantha] dua is good sanz
[sanz] i know she is sam
[dua_frank] no i'm not
[dua_frank] i never get more than 35 on tests
[dua_frank] no matter how much i try
[samantha] with out knowing a lot u cannot prepare q's
[dua_frank] thats my problem sammy, ive never been good at tests
[sanz] 35/test on kap qbank?
[sanz] that's good
[dua_frank] i learn just for the heck of knowing things, not for exams ever
[dua_frank] and what i don't like, never gets into my head, like cephalosporins
[dua_frank] yeah q bank sanz
[sanz] dua that's even better way of learning... for life... not for just one stupid exams
[dua_frank] i have a mental block to a lot of things in medicine
[sanz] dua, everyone has... dont worry... think positive
[samantha] that's the way to do it dua after the exam u are on your own to managage pts
[sanz] you're fine *hugs*
[dua_frank] yeah but need to clear these exams to get till there sammy
[dua_frank] these exams are a real pain, can't wait to get over with them
[samantha] that u will do very well dua
[sanz] soon guys soon
[dua_frank] i hope we both do well sammy
[samantha] i am really scared i want just to pass
[sanz] yeah i'll be praying for you all
[dua_frank] nah, you're well prepared too sammy
[dua_frank] thanks sanz
[samantha] thanx sanz
[sanz] if i could do it anyone could
[sanz] dont worry... just work consistently
[dua_frank] no way, you're a genius
[samantha] i am not sure dua i have been studying reasonably well
[dua_frank] i have never known anybody to get a 99 with only 2 months prep
[samantha] but not that good
[sanz] 3 mths dua
[dua_frank] 3 months is less too sanz
[sanz] hehe... maybe 3 is my lucky number
[sanz] i did step 1 in 3 mths too
[sanz] anyway, back to the discussion...
[samantha] sanz u must have been a very bright student
[dua_frank] she sure is
[sanz] what are the cyanotic heart conditions?
[dua_frank] i'm not deluding myself by comparing myself to her
[dua_frank] i'll take my 6-7 months prep all
[dua_frank] all the Ts
[dua_frank] tricuspid atresia, TGA, TOF
[dua_frank] Eisenmengers
[samantha] agree
[dua_frank] seizures right after going to sleep?
[sanz] good
[sanz] Rx for acute TOF?
[samantha] forgot dua
[david100] hi doctors
[sanz] hi david
[dua_frank] propranolol
[dua_frank] hello david
[dua_frank] morphine oxygen
[david100] can i know which topic are you dicussing?
[samantha] hi david
[dua_frank] sodium bicarb
[sanz] good dua! See you know stuff! propranolol, knee chest position and fluids
[dua_frank] benign rolandic epilepsy
[dua_frank] i got to know those sanz, i worked in CT remember *)
[david100] all of you preparing for step2?
[dua_frank] ask me antibiotics besides vancomycin, i'd say, say what? lol
[samantha] i am getting demented
[sanz] not me david.... i'm just disturbing them... hehe
[samantha] lol
[dua_frank] clox and gentamicin and vanco is all that we used
[david100] by the way doctors i have the latest qbank if any need them tell me
[dua_frank] whats infantile spasms?
[sanz] baby seize with posture like Monro reflex... only in succession
[dua_frank] right, there is MR associated with this
[dua_frank] rx?
[sanz] gaba?
[sanz] dont rememebr
[sanz] or ACTH?
[dua_frank] no idea sanz, was hoping you would know
[samantha] diazepam?
[dua_frank] anticonvulsants for benign rolandic epilepsy
[sanz] wait... i'll go find out for ya
[dua_frank] but dunno for infantile spasms
[dua_frank] ok
[sanz] ACTH and pred
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[lanny] hi guys sorry im late
[dua_frank] baby 5 months high fever having seizues, rx?
[sanz] ACTH works for a reason...
[dua_frank] thanks sanz
[dua_frank] how does it work?
[sanz] cuz infantile spasm is thought to be due to overstimulation of CRH
[dua_frank] ohhhhhhhhhh
[dua_frank] that explains that
[sanz] actually it was strug who told us this... now i remember
[samantha] febril seizures
[dua_frank] thanks sanz
[samantha] hi lanny
[sanz] hi lanny
[dua_frank] yes sammy rx underlying cause
[dua_frank] hi lanny
[lanny] hi sammy
[lanny] hi sanz
[lanny] hey dua
[sanz] i'm messing around in here... hehe.. how have you been lanny?
[lanny] so we have a sched now
[lanny] been good getting thru kap q bank in a few days
[samantha] paeds lanny
[lanny] ok sammy thanks
[dua_frank] sanz your qs are valuable
[lanny] then will take NBME
[dua_frank] please do continue asking them
[sanz] dua i will... i have forgotten so much
[lanny] i was geting 72 cummulative now im down to 70 instead of going up dissapointed
[samantha] yes sanz please be around
[dua_frank] time to re read your notes lanny
[sanz] lanny it's alright... just go thru yr wrong qs... which i didnt have time for...
[lanny] yes sanz i make sure i read the explanations
[sanz] read thru the ones you got right too... and the other options
[lanny] ok thanks
[dua_frank] ataxia of gait, hypotonia, optic atrophy, intellectual deterioration, absent reflexes, upgoing toes, raised csf protein and dec motor nerve conduction velocity, dx?
[lanny] did your NBME score correlate with you real score sanz??
[dua_frank] age 1-2 yrs
[sanz] lanny yes
[samantha] GB synd
[lanny] thanks
[dua_frank] GB has absent babinski
[samantha] guillian barre?
[dua_frank] nope
[lanny] but any explanations in NBME?
[dua_frank] hint AR disorder
[sanz] no lanny... discuss it with someone
[lanny] ok
[samantha] MS?
[dua_frank] MS does not happen in children
[sanz] ataxix telan dua?
[samantha] oops...
[dua_frank] but you're close
[sanz] or fredriech ataxia?
[dua_frank] think of an MS variant in infants
[lanny] myotonic dyst
[dua_frank] freidrichs no hypotonia
[dua_frank] right?
[dua_frank] its the dorsal column disease
[sanz] dua yeah you're right
[dua_frank] metachromatic leukodystrophy
[dua_frank] can you believe that they asked this *)
[sanz] oh man yeah
[dua_frank] AML like symtoms in newborn, whats the disease?
[lanny] oh this is lorenzos oil
[samantha] oh...
[lanny] did you watch that movie
[dua_frank] whats lorenzos oil?
[sanz] no lanny
[samantha] werdnig hoffman
[dua_frank] good sammy
[dua_frank] the infant born is floppy here, no tone in muscles
[lanny] ok a classic movie came out a few yrs ago
[dua_frank] same clinical picture as metachromatic leukodystrophy but with hyperacusis and seizures and happening at 6 months age, dx?
[dua_frank] again an AR disease
[lanny] the actor was a boy with metachrom leukodystrophy
[samantha] it is congenital rt?
[dua_frank] does he have all those symptoms lanny?
[lanny] yep
[dua_frank] i like such pictures of rare disorders
Please rephrase your last message.
[lanny] ALS
[dua_frank] no other way can i remember the da mn names :an
[dua_frank] krabbes
[dua_frank] MLD and krabbes are both to do with myelin
[dua_frank] lipidosis
[dua_frank] so is MS in a way
[dua_frank] right?
[dua_frank] so there will be a mixed pictuer of sensory and motor symptoms
[dua_frank] go by the age
[dua_frank] old man, MS
[dua_frank] 6 months Krabbes
[dua_frank] 1-2 yrs MLD
[sanz] wow, that's good dua
[sanz] i could never get my head around white matter disease
[samantha] def of enzyme cerebroside sulfatase,causing metachromatic lipids to accumulate in white matter
[dua_frank] sammy my head is already overload with names
[samantha] peripheral nerves kidney spleen and others
[dua_frank] i don't know if those enzymes will stay now
[sanz] enz are more of step 1 anyway.. just know how to dx and rx
[dua_frank] thanks sanz, they are a pain
[samantha] progessive paralysis dementia before 2 yr fatal by age 10
[dua_frank] yeah i'd rather not learn the enzyme, i doubt they will give the enzyme in step 2
[dua_frank] not even as a hint, i;m sure
[dua_frank] thats a dead give away
[dua_frank] they are not that nice!
[sanz] hehe
[dua_frank] mottled lungs dx?
[sanz] ?
[samantha] yes dua no need for enzyme just to know it is enzyme def
[dua_frank] mottled lungs with Mental retardation, bloated up abdominal organs
[dua_frank] blind, deaf too
[dua_frank] dx?
[sanz] dont know!
[dua_frank] ok ok i throw in cherry red macula :P
[samantha] dunno
[dua_frank] coz i'm nice :P
[dua_frank] niemann pick
[samantha] tay sach?
[sanz] tay sach
[dua_frank] tay sachs only affects brain
[dua_frank] not abdominal organs
[dua_frank] neiman picks goes everywhere
[sanz] ooooooh
[dua_frank] both have cherry red macula
[sanz] yeah
[dua_frank] both in jews
[samantha] wow...
[dua_frank] both die befor 3 years
[sanz] dua is a knowledge pot
[dua_frank] gauchers is the nice one
[dua_frank] only affects liever so babies can still survive
[dua_frank] with enzyme replacement with glucocerebrosidase
[dua_frank] comparison is the only way to rememebr the da mn things sanz
[samantha] yes sanz
[dua_frank] but it does make things easier doesn't it?
[samantha] sure dua...
[sanz] dua yeah... but i'll not remember in a day or 2
[dua_frank] lol i don't think i will either
[dua_frank] lets just remember that the two resembling MS are... :
[dua_frank] ?
[sanz] krabbe
[dua_frank] and?
[sanz] and MLD
[dua_frank] right
[sanz] Krabbe is young 6 mth
[sanz] MLD older kids
[samantha] gr8
[dua_frank] the two with jews and cherry red macula, one with brain signs and other with brain plus abdomen signs and both die are?
[dua_frank] MLD like in 1-2 yrs yes
[sanz] tay sach and nieman
[dua_frank] tay is the brainy one
[dua_frank] which is the nice one affecting only liver and spleen and is treatable?
[sanz] gaucher
[lanny] nieman pick
[dua_frank] right
[sanz] i think it affects bone
[sanz] bone as well i mean
[dua_frank] guachers?
[sanz] gaucher.. i remmeber the classic sign is a flask shape of the femur head
[dua_frank] really?
[lanny] crmpled paper calls???
[lanny] crumpled
[lanny] cells is patho for gaucher
[dua_frank] It then accumulates, mostly in the liver, spleen, and bone marrow. Gaucher disease can result in pain, fatigue, jaundice, bone damage, anemia, and even death.
[sanz] lanny yeah rumpled paper cells too
[dua_frank] yes you're right, it does accumulate in the bone marrow to
[dua_frank] ok there are two variants, fabrys which affects the heart and charcot marie tooth which affects the peroneal muscle
[sanz] http://www.amershamhealth.com/medcyc...LASK_DEFORMITY
[sanz] there you go
[dua_frank] thanks
[lanny] ok ive heard this deform sanz
[sanz] dua can you clink on the links now?
[sanz] i know you had problems before...
[samantha] thanx sanz
[dua_frank] no
[sanz] oh
[sanz] type erlenmeyer flask gaucher in google images
[sanz] you'll get this link
[dua_frank] i did that
[sanz]
[samantha] stork deformity is in which?
[dua_frank] psoriasis?
[sanz] dont know sam
[samantha] charcot marie tooth
[sanz] oh yeah of cuz clever girl u!
[samantha] or peroneal muscle atropy
[dua_frank] is that whats called pes cavus?
[dua_frank] hehe i got the mental picture
[samantha] i think so dua
[sanz] pes cavus is fredriech atax i think
[dua_frank] its also mentioned in charcot marie tooth sanz
[sanz] maybe they both have it
[dua_frank] how can one differentiate between galactosemis?
[sanz] reducing sugar test
[dua_frank] explain please
[sanz] hhmm... i dont know how to explain... i just know we did it where i worked before...
[sanz] bad huh?
[dua_frank] thats okay, i don't know why the heck we do so many tests either
[dua_frank] i'm trusting the 4 years of residency to figure out those mysteries
[sanz] i doubt it dua
[sanz] but i hope we will figure out some tho
[dua_frank] sammy and lanny, any inputs?
[samantha] there are 2 types rt?
[dua_frank] i think maybe galactokinase def does not have hypoglycemia
[dua_frank] yes
[dua_frank] one is galactokinase def and the other galactose 1 phosphate uridyl transferase
[sanz] maybe they are looking for acc of galactase which is a reducing sugar
[dua_frank] the second one has a lot of symptoms with cataracts and MR
[sanz] one has cataract but the other doesnt have
[dua_frank] the other one has it too sanz
[sanz] both has cataracts?
[dua_frank] both occur after nursery that is after they start breast feeding
[dua_frank] yes
[dua_frank] at birth cataracts would point to rubella
[sanz] ok, i just went to check out my step 1 notes...
[sanz] GU
[sanz] sorry
[samantha] the accumulation of galactitol in the lens causes cataracts
[dua_frank] also please help differentiat hunters from hurlers sanz
[samantha] hunters is x linded
[sanz] GL1PUT def cause liver prob and hyperbili
[sanz] the other type of galactosemia doesnt have hyperbili
[sanz] both have cataract
[samantha] hurlers less serious and auto reccessive
[dua_frank] oh ok so the liever is imp here
[sanz] hurlers has cataract
[sanz] hunters dont
[dua_frank] one baby with hypoglycemia and reducing sugars in urine
[sanz] dua yes to differentiate the 2 types of galactosemia
[dua_frank] has hepatomeglay
[dua_frank] one without
[dua_frank] thanks sanz
[dua_frank] thanks sammy
[dua_frank] hunters is x linked
[samantha] thanx sanz and dua
[dua_frank] somethign to do with brain too in hunters
[dua_frank] MR
[sanz] well guys... gtg... see ya around and good luck with yr prep!
[dua_frank] thanks sanz
[dua_frank] bye
[sanz] bye bye
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[dua_frank] hypercalcemia, preductal AS and peculiar elephant facies, dx?
[dua_frank] i hope we remember what we learnt today sammy, today's differentiating points will help us in diagnosing those confusing and odd ped diseases
[samantha] rt dua all this helps
[samantha] to understand it does not stay
[dua_frank] yeah
[lanny] back guys sorry had to go make dinner
[dua_frank] lets keep the three words in our mind, MS like, AML like, Jews association
[samantha] if we go back and read it
[dua_frank] we have at least 6 diseases figured out right there
[samantha] rt dua
[dua_frank] then we have galactosemias with and withotu liver
[samantha] galactose 1 po4 uridyl
[samantha] is more serious?
[lanny] dua is A ML ALS you mean
[samantha] galactokinase def is one
[dua_frank] yes sorry
[lanny] what is AM
[lanny] L guys?
[dua_frank] yes sammy
[samantha] went back and read it dau
[dua_frank] leu geikes
[samantha] dua
[samantha] Amytrophic lateral sclerosis lanny
[lanny] right but is it seen in kids this young??
[samantha] yeah it is called leu gericg's dis
[dua_frank] hunters and hurlers have same presentation
[lanny] lou gerighs dz
[dua_frank] except hurlers is fast progressing and worse
[samantha] yes lanny
[samantha] dua the ans to your q is hurlers rt?
[samantha] the elephant facies
[dua_frank] ALS like in newborns is werdnig hoffman lanny
[dua_frank] no thats williams syndrome
[samantha] oh...
[dua_frank] hypercalcemia, preductal AS and elephant facies
[lanny] rught i was gonna say that in kids it is called werdnig hoff
[lanny] hallmark is hypotonia
[samantha] rt lanny
[dua_frank] we were just zeroing in our points for today
[dua_frank] MS and ALS association
[dua_frank] jews
[lanny] oh ok i see
[dua_frank] galactose
[lanny] sorry i missed it
[dua_frank] fabrys for heart
[samantha] there is a condition of mucopolysaccaridosis do u know which one?
[dua_frank] charcot marie for peroneal ms
[dua_frank] those are hunters and hurlers sammy
[samantha] they have gross facies also
[dua_frank] MPS 1 is hurlers
[dua_frank] MPS II is hunters
[dua_frank] yeah i think thats hurlers
[samantha] thanx dua
[dua_frank] welcoe
[lanny] right dua
[dua_frank] i sure hope we rememebr these
[lanny] hunter is mild mental retard
[lanny] cornea no affected
[lanny] in hurler cornea is cloudy
[dua_frank] thanks lanny
[lanny] and retard is severe
[lanny] hunter is a mans name so hes gotta be able to see to hunt
[lanny] and be clever to hunt too
[lanny] so he needs his brain
[dua_frank] in which resp condition would you see a patent ductus arteriosus?
[lanny] mild mental retard)
[samantha] nice lanny
[dua_frank] nice
[dua_frank] man blind and dumb
[dua_frank] x linked
[samantha] lol
[lanny] right
[dua_frank] are you sure we're not talking about all men in general here? :P
[dua_frank] kidding ... lol
[samantha] just joking
[lanny] hunter is a man ..............x chromrecessive
[lanny] hurler is aut dom
[dua_frank] i thougth hurlers AR
[lanny] sorry recess
[dua_frank] RDS
[samantha] u hunt on the X mark so x linked
[lanny] what s with RDS?
[dua_frank] resp disorder in kids with PDA
[lanny] oh ok
[dua_frank] sammy cool
[dua_frank] which CVS condition would you use PGE1?
[samantha] yeah dua lanny
[lanny] no time for dancing for me im depressed
[lanny] in transposition
[dua_frank] lanny, ive been having bad days at tests too, my scores came down too by 5 points
[dua_frank] maybe we are just getting tougher questions
[samantha] decided not to get worked up
[dua_frank] yes TGA
[dua_frank] time to keep your cool and tell yourself all the q you are getting wrong are new information qs
[samantha] will do what ever i can
[lanny] well what can i say will know where i stand from my NBME
[dua_frank] rx of tet spells?
[lanny] oxygen
[dua_frank] lanny you can take this exam down
[dua_frank] you got to
[lanny] oh boy may your wish come true
[dua_frank] yes o2, morphine, nahco3
[dua_frank] most importantly
[dua_frank] IV propranolol
[lanny] oh yes that q is in UW
[dua_frank] MC of CHF in first week of life?
[lanny] so how does a child with tet spells prst?
[dua_frank] blue tachypnea
[lanny] AS
[dua_frank] agitated
[dua_frank] right lanny
[dua_frank] 2nd week?
[samantha] which resp condition there is PDA dua
[lanny] ARDS sam
[dua_frank] RDS sammy
[dua_frank] not adult
[lanny] yes
[samantha] thanx
[dua_frank] 2nd can be either VSD or PDA
[dua_frank] 2nd week
[lanny] yes
[dua_frank] septum primum ASD with what syndrome?
[lanny] fetal alcohol
[dua_frank] downs
[lanny] downs is endocard cushion dua
[dua_frank] yes and ASD primum is partial endocard cushion defect lanny
[dua_frank] complete would be AV canal defects which are mc in downs yes
[samantha] yes rt
[lanny] ok du
[lanny] right
[dua_frank] hypoxias and pulmonary htn keeps pda open
[samantha] shall we leave for today?
[lanny] ok dua
[samantha] see u tom guys
[dua_frank] ok
[dua_frank] see you tomorrow bye and good night
samantha has left the chat.

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