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Halcyon Days
06-15-2008, 06:21 PM
Just some last minute questions/conflicting sources that I hope can be sorted out before my exam.

1.)Cryptochidism - should the surgery take place at 6 months or 1 yr? I have seeing varying answers to this. World vignette says 6 months...Crush says 1 yr. Neither of which decreases the risk of future testicular cancer but Crush says wait because they could descend on their own while World seems to say they aren't going to descend if they haven't by 6 months.

2.)Anaphylactic Shock - World had a vignette where they ask you whether the epinephrine should be delivered IV or SubQ. The answer was IV I believe b/c you can control the levels better. However, I'm doubting that since I've seen SubQ in other sources.


Okay, I prrrraaay someone sees this and responds soon! :confused:

gellerf
06-15-2008, 07:26 PM
cryptorchidism:

The chances of the teste descending after not moving for six months is very little; therefore, the surgery should be done before the child is 1 year old. I has a question on that subject and the kid was already 9 months or something like that so i just said consult surgery.

Epinepherine:

Whether you give it subQ or IV depends on the severity of the anaphylaxis. In the books, if its severe, you give it IV and if its not too bad, you give it subQ. In any case, my advice would be to give it IV on the exam because anaphylaxis can kill a person and the onset of action of IV drugs is immediate, so I would always pick IV on a MCQ question.

Hope this helps.

Halcyon Days
06-15-2008, 07:45 PM
Thanks gellerf. If you're in NY I'll buy you a beer sometime as you've responded twice now to my questions.

Sounds like you really know your stuff inside out...wish you could take my exam. :cool:

gellerf
06-15-2008, 08:22 PM
Thanks gellerf. If you're in NY I'll buy you a beer sometime as you've responded twice now to my questions.

Sounds like you really know your stuff inside out...wish you could take my exam. :cool:


Dont worry about it. I am actually in shreveport, LA for my psych residency. Just pm me if you have any more questions, but in general dont worry about any single subject to much. Worse comes to worse, you miss 1 question out of the 500+ that you have to answer.







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