View Full Version : chat transcript: infectious disease

01-28-2005, 09:08 PM
01/28/05 19:08:58 [USMLE_Step_2] sanz: what Ab'ics do you give for Lyme dz
01/28/05 19:09:06 [USMLE_Step_2] lanny: doxy
01/28/05 19:09:16 [USMLE_Step_2] sanz: yup, if kids or pregnant women?
01/28/05 19:09:44 [USMLE_Step_2] lanny: amox/
01/28/05 19:09:44 [USMLE_Step_2] megs: clinically how will tou ditinguish betn meningitis and encephalitis
01/28/05 19:09:55 [USMLE_Step_2] sanz: it's amoxi :) good
01/28/05 19:10:07 [USMLE_Step_2] lanny: sms
01/28/05 19:10:14 [USMLE_Step_2] sanz: menigitis has meningeal signs like nuchal rigidity
01/28/05 19:10:25 [USMLE_Step_2] lanny: enceph i thk altered mental stat
01/28/05 19:10:33 [USMLE_Step_2] sanz: encep usu doesnt and has sms of character change and so on
01/28/05 19:10:41 [USMLE_Step_2] megs: yeah
01/28/05 19:10:46 [USMLE_Step_2] megs: both right
01/28/05 19:10:49 [USMLE_Step_2] lanny: yes altered mental state
01/28/05 19:10:55 [USMLE_Step_2] sanz: what is the Ab's to treat meningitis?
01/28/05 19:11:15 [USMLE_Step_2] megs: depends on organism...but empericallu taxim
01/28/05 19:11:33 [USMLE_Step_2] lanny: ceftriax
01/28/05 19:11:34 [USMLE_Step_2] megs: till the culture report come
01/28/05 19:11:41 [USMLE_Step_2] sanz: what is taxim?
01/28/05 19:11:48 [USMLE_Step_2] megs: u can emperically give cefotaxime
01/28/05 19:11:51 [USMLE_Step_2] lanny: cefotaxim i guess
01/28/05 19:11:55 [USMLE_Step_2] sanz: oh oke
01/28/05 19:12:08 [USMLE_Step_2] lanny: either ceftriax or ceftotax
01/28/05 19:12:15 [USMLE_Step_2] sanz: yup
01/28/05 19:12:15 [USMLE_Step_2] megs: yeah
01/28/05 19:12:29 [USMLE_Step_2] sanz: usu, ceftriaxone and ampi
01/28/05 19:12:31 [USMLE_Step_2] lanny: remember these are empirical while waiting for cultur
01/28/05 19:12:35 [USMLE_Step_2] sanz: for elderly
01/28/05 19:12:47 [USMLE_Step_2] lanny: amp if pt is imm def
01/28/05 19:12:55 [USMLE_Step_2] lanny: if not no
01/28/05 19:13:03 [USMLE_Step_2] sanz: yup
01/28/05 19:13:29 [USMLE_Step_2] sanz: what is the worst complication of pseudotumour cerebri?
01/28/05 19:13:52 [USMLE_Step_2] lanny: cn lyme ds cause mening
01/28/05 19:14:08 [USMLE_Step_2] lanny: cerebral hern?
01/28/05 19:14:14 [USMLE_Step_2] sanz: oh sorry...i forgot we're doing inf dz.. that was a neuro q
01/28/05 19:14:15 [USMLE_Step_2] sanz: hehe
01/28/05 19:14:25 [USMLE_Step_2] lanny: its ok
01/28/05 19:14:33 [USMLE_Step_2] megs: whats the ans sanz
01/28/05 19:14:33 [USMLE_Step_2] sanz: blindness is the ans...
01/28/05 19:14:37 [USMLE_Step_2] megs: ok
01/28/05 19:15:27 megs Logs in
01/28/05 19:15:27 sanz Logs in
01/28/05 19:15:27 sanz Joins Subroom USMLE_Step_2
01/28/05 19:15:28 megs Joins Subroom USMLE_Step_2
01/28/05 19:15:29 lanny Logs in
01/28/05 19:15:29 lanny Joins Subroom USMLE_Step_2
01/28/05 19:15:30 strug Logs in
01/28/05 19:15:34 strug Joins Subroom USMLE_Step_2
01/28/05 19:15:39 [USMLE_Step_2] megs: hi stug
01/28/05 19:15:42 [USMLE_Step_2] strug: hey guys sorry m late
01/28/05 19:15:45 [USMLE_Step_2] lanny: got kicked out!!
01/28/05 19:15:58 [USMLE_Step_2] strug: whats going on everything looks new to me
01/28/05 19:16:01 [USMLE_Step_2] lanny: its ok strug we waited for 5 mins
01/28/05 19:16:03 [USMLE_Step_2] sanz: i gpt kicked out too
01/28/05 19:16:10 [USMLE_Step_2] lanny: wow
01/28/05 19:16:11 [USMLE_Step_2] sanz: hey strug :)
01/28/05 19:16:14 [USMLE_Step_2] megs: i too
01/28/05 19:16:17 [USMLE_Step_2] lanny: ok strug inf ds
01/28/05 19:16:24 [USMLE_Step_2] strug: thanks u so much for waiting hi everyone
01/28/05 19:16:28 [USMLE_Step_2] lanny: well were all back
01/28/05 19:16:35 [USMLE_Step_2] sanz: good... shoot strug
01/28/05 19:16:44 huli72 Logs in
01/28/05 19:16:48 [USMLE_Step_2] lanny: we left at can lyme dz cause mening
01/28/05 19:16:52 huli72 Joins Subroom USMLE_Step_2
01/28/05 19:16:55 [USMLE_Step_2] strug: is it infectious deisease or hematology
01/28/05 19:17:05 [USMLE_Step_2] lanny: infect
01/28/05 19:17:15 [USMLE_Step_2] strug: ok
01/28/05 19:17:16 [USMLE_Step_2] megs: it can cause encephalitis...i guess
01/28/05 19:17:21 [USMLE_Step_2] sanz: lanny yes...
01/28/05 19:17:32 [USMLE_Step_2] sanz: it's stage 2 i think... and we give them cef
01/28/05 19:17:39 [USMLE_Step_2] strug: meningits too
01/28/05 19:17:45 [USMLE_Step_2] megs: ok
01/28/05 19:17:54 [USMLE_Step_2] lanny: yes it can cause men so careful dont rush for lyme
01/28/05 19:18:04 [USMLE_Step_2] lanny: cause trt is diff
01/28/05 19:18:15 [USMLE_Step_2] megs: but facial palsy ..suggest lymes disease with meningitis
01/28/05 19:18:27 [USMLE_Step_2] lanny: yes
01/28/05 19:18:33 [USMLE_Step_2] sanz: what's the cut off doe CD4 ct before antiviral HAART is started?
01/28/05 19:18:36 [USMLE_Step_2] strug: is it bilateral facial fpalsy
01/28/05 19:18:44 [USMLE_Step_2] lanny: trt of men caused by lyme is ceftriax
01/28/05 19:18:45 [USMLE_Step_2] huli72: 350
01/28/05 19:18:48 [USMLE_Step_2] strug: yes
01/28/05 19:18:52 [USMLE_Step_2] megs: less than 350
01/28/05 19:18:55 [USMLE_Step_2] sanz: yup
01/28/05 19:19:07 [USMLE_Step_2] sanz: but can start if CD4 ct is <500 and symptomatic
01/28/05 19:19:08 [USMLE_Step_2] huli72: bilateral
01/28/05 19:19:10 [USMLE_Step_2] strug: and >50,000 viral load
01/28/05 19:19:13 [USMLE_Step_2] sanz: hey huli :)
01/28/05 19:19:19 [USMLE_Step_2] lanny: agree sanz
01/28/05 19:19:20 [USMLE_Step_2] huli72: hi, sanz
01/28/05 19:19:21 [USMLE_Step_2] sanz: i thought it's >55,000
01/28/05 19:19:45 [USMLE_Step_2] strug: yes sanz u right
01/28/05 19:19:56 [USMLE_Step_2] sanz: strug, unilateral?
01/28/05 19:20:12 [USMLE_Step_2] lanny: i think uni is right
01/28/05 19:20:26 [USMLE_Step_2] huli72: bilateral
01/28/05 19:20:29 [USMLE_Step_2] strug: bilateral
01/28/05 19:20:34 [USMLE_Step_2] sanz: oh oke
01/28/05 19:20:48 [USMLE_Step_2] sanz: thnx
01/28/05 19:21:00 [USMLE_Step_2] huli72: Ramsay Hunt syndrome?
01/28/05 19:21:03 [USMLE_Step_2] strug: if pt asymptomatic do we treat for lyme disease?
01/28/05 19:21:10 [USMLE_Step_2] sanz: herpes shingle
01/28/05 19:21:14 [USMLE_Step_2] huli72: yeah, doxy
01/28/05 19:21:20 [USMLE_Step_2] huli72: yeah, sanz
01/28/05 19:21:22 [USMLE_Step_2] sanz: with deafness
01/28/05 19:21:44 [USMLE_Step_2] lanny: as long as tick bite and skin manifest trt
01/28/05 19:21:45 [USMLE_Step_2] huli72: sure deafness?
01/28/05 19:22:00 [USMLE_Step_2] huli72: ear pain
01/28/05 19:22:06 [USMLE_Step_2] sanz: hhmm... i know it affects some sensory nerve... wait... i'll go check...
01/28/05 19:22:07 [USMLE_Step_2] huli72: that I got
01/28/05 19:22:21 [USMLE_Step_2] huli72: the same facial nerve
01/28/05 19:22:46 [USMLE_Step_2] huli72: hyperacusia
01/28/05 19:22:55 [USMLE_Step_2] huli72: unilateral loss of taste
01/28/05 19:23:05 [USMLE_Step_2] huli72: reduced tear formation
01/28/05 19:23:12 [USMLE_Step_2] lanny: lost you guys, my prtn shake just spilled!!!!
01/28/05 19:23:19 [USMLE_Step_2] huli72: vesicle in the ear and eardrum
01/28/05 19:23:44 [USMLE_Step_2] huli72: that is Ramsy Hunt syndrome
01/28/05 19:23:57 [USMLE_Step_2] lanny: compl of lyme
01/28/05 19:24:22 [USMLE_Step_2] huli72: Ramsay Hunt ataxia?
01/28/05 19:24:25 [USMLE_Step_2] strug: great huli i didnt know that
01/28/05 19:24:34 [USMLE_Step_2] strug: myoclonus epilepsy ataxia
01/28/05 19:24:38 [USMLE_Step_2] sanz: i checked... vesicles in ear drum may damage a sensory nerve off the facial nerve, and deafness may occur... resolution less likely from facial palsy
01/28/05 19:24:53 [USMLE_Step_2] sanz: i guess it says may... and not definitely will...
01/28/05 19:24:54 [USMLE_Step_2] huli72: yeah, strug
01/28/05 19:24:59 [USMLE_Step_2] huli72: thanks, sanz
01/28/05 19:25:29 [USMLE_Step_2] strug: what are the complications of lyme...all of them
01/28/05 19:25:30 [USMLE_Step_2] lanny: this is a compl of ltme?
01/28/05 19:25:46 [USMLE_Step_2] huli72: carditis?
01/28/05 19:25:52 [USMLE_Step_2] sanz: meningitis
01/28/05 19:25:52 [USMLE_Step_2] huli72: meningtitis?
01/28/05 19:25:53 [USMLE_Step_2] strug: caridac: 3rd degree block, myocarditis
01/28/05 19:25:54 [USMLE_Step_2] sanz: Bells' palsy
01/28/05 19:25:57 [USMLE_Step_2] huli72: arthritis?
01/28/05 19:26:08 [USMLE_Step_2] lanny: myocard
01/28/05 19:26:15 [USMLE_Step_2] strug: joint involvement
01/28/05 19:26:16 [USMLE_Step_2] huli72: liver enlargement, and incr liver function
01/28/05 19:26:21 [USMLE_Step_2] lanny: meningitis
01/28/05 19:26:28 [USMLE_Step_2] strug: mening and encephalitis
01/28/05 19:26:36 [USMLE_Step_2] sanz: lanny, we were talking abt Ramsay Hunt Sydr when your shakes spilt...
01/28/05 19:26:44 [USMLE_Step_2] strug: also facial nerve ataxa
01/28/05 19:26:54 [USMLE_Step_2] strug: sorry facial nerve involvemnt
01/28/05 19:26:54 [USMLE_Step_2] lanny: thx sanz
01/28/05 19:26:54 [USMLE_Step_2] huli72: thanks, strug
01/28/05 19:27:17 [USMLE_Step_2] huli72: now, it is Ramsay Hunt ataxia
01/28/05 19:27:38 [USMLE_Step_2] strug: when do we Rx with ceftraixone in lyme?
01/28/05 19:27:49 [USMLE_Step_2] sanz: iin late dz
01/28/05 19:27:54 [USMLE_Step_2] huli72: generalized myoclonus, cerebellar ataxia, epileptic seizure
01/28/05 19:27:56 [USMLE_Step_2] lanny: late er
01/28/05 19:28:16 [USMLE_Step_2] lanny: ie if the pt prsts later
01/28/05 19:28:23 [USMLE_Step_2] huli72: when the pt has complicated lyme disease
01/28/05 19:28:33 [USMLE_Step_2] huli72: such as meningitis...
01/28/05 19:28:33 [USMLE_Step_2] strug: myocaridits , meningits, encephalitis, 3 rd degree heart block
01/28/05 19:28:56 [USMLE_Step_2] strug: facial rash and 1st degree heart block treated with doxy or amox
01/28/05 19:29:09 [USMLE_Step_2] strug: sorry for the typo its facial palsy
01/28/05 19:29:10 [USMLE_Step_2] huli72: thanks, strug
01/28/05 19:29:23 [USMLE_Step_2] sanz: thnx strug
01/28/05 19:29:34 [USMLE_Step_2] strug: u welcome
01/28/05 19:29:39 [USMLE_Step_2] lanny: do we give proph in lyme
01/28/05 19:29:46 [USMLE_Step_2] huli72: doxy
01/28/05 19:29:46 [USMLE_Step_2] strug: no
01/28/05 19:29:48 [USMLE_Step_2] lanny: in endemic areas
01/28/05 19:29:53 [USMLE_Step_2] lanny: right
01/28/05 19:29:59 [USMLE_Step_2] strug: who right?
01/28/05 19:30:05 [USMLE_Step_2] lanny: only in one case we do who know
01/28/05 19:30:06 [USMLE_Step_2] sanz: what are complications of clamydia?
01/28/05 19:30:12 [USMLE_Step_2] strug: preg lady
01/28/05 19:30:24 [USMLE_Step_2] huli72: rectal fistula
01/28/05 19:30:28 [USMLE_Step_2] lanny: with a hx of tivk bite
01/28/05 19:31:03 [USMLE_Step_2] lanny: look for the hx of tick bite first dont give cuse she lives in New england
01/28/05 19:31:27 [USMLE_Step_2] sanz: i mean...what're the complication if someone is infected with chlamydia?
01/28/05 19:31:48 [USMLE_Step_2] strug: corneal ulceraion
01/28/05 19:31:49 [USMLE_Step_2] lanny: PID
01/28/05 19:31:58 [USMLE_Step_2] sanz: yes PID for women and infertility
01/28/05 19:32:00 [USMLE_Step_2] sanz: and men?
01/28/05 19:32:13 [USMLE_Step_2] lanny: dont know for men
01/28/05 19:32:17 [USMLE_Step_2] sanz: also can cause Fitz Hugh Curtis syndrome
01/28/05 19:32:30 [USMLE_Step_2] lanny: yep
01/28/05 19:32:31 [USMLE_Step_2] huli72: ohh, sanz
01/28/05 19:32:39 [USMLE_Step_2] sanz: for men, Reiters syndr (uveitis) and epidydimytis
01/28/05 19:32:41 [USMLE_Step_2] lanny: hes right
01/28/05 19:32:54 [USMLE_Step_2] lanny: never knoew thid for men thx
01/28/05 19:33:14 [USMLE_Step_2] sanz: i mean Reiter's urethritis
01/28/05 19:33:18 [USMLE_Step_2] strug: whats fitz hugh curtis syn>
01/28/05 19:33:33 [USMLE_Step_2] sanz: it's a perihepatic inflammation and fibrosis
01/28/05 19:33:35 doctorchamita Logs in
01/28/05 19:33:41 [USMLE_Step_2] sanz: a comlpication of chlamydia infection
01/28/05 19:33:42 doctorchamita Joins Subroom USMLE_Step_2
01/28/05 19:34:18 doctorchamita Joins Subroom USMLE_Step_1
01/28/05 19:34:21 doctorchamita Joins Subroom USMLE_Step_2
01/28/05 19:34:27 [USMLE_Step_2] huli72: complication for chamydia L1-3?
01/28/05 19:34:29 [USMLE_Step_2] sanz: treatment of chlamydia?
01/28/05 19:34:38 [USMLE_Step_2] huli72: doxy
01/28/05 19:34:40 [USMLE_Step_2] lanny: doxy
01/28/05 19:34:46 [USMLE_Step_2] huli72: or erythra
01/28/05 19:34:48 [USMLE_Step_2] doctorchamita: Hi to all
01/28/05 19:34:55 [USMLE_Step_2] lanny: hey doc cham
01/28/05 19:34:57 [USMLE_Step_2] huli72: hi doctor
01/28/05 19:35:00 [USMLE_Step_2] strug: doxy for 7 days also Rx gonorhhoea with ceftriaxone
01/28/05 19:35:00 [USMLE_Step_2] sanz: hey doc
01/28/05 19:35:08 [USMLE_Step_2] strug: hi doc chamita
01/28/05 19:35:28 [USMLE_Step_2] huli72: whaz the complication of LGV?
01/28/05 19:35:34 [USMLE_Step_2] huli72: if untreated
01/28/05 19:35:42 [USMLE_Step_2] lanny: buboes
01/28/05 19:35:59 [USMLE_Step_2] huli72: yeah, and more....
01/28/05 19:36:00 [USMLE_Step_2] strug: fistula formation?
01/28/05 19:36:00 [USMLE_Step_2] sanz: i think we dont necessarily have to treat gnorrhoea prophylactically... but if pt has gnorrhea, then we MUST treat chlamydia co-infection
01/28/05 19:36:14 [USMLE_Step_2] lanny: sanz i thoought so too
01/28/05 19:36:32 [USMLE_Step_2] lanny: if gon then trt chlam
01/28/05 19:36:47 [USMLE_Step_2] strug: ok that means if pt has gonorrhoe Rx chalmydia, vice versa is not treu
01/28/05 19:36:53 [USMLE_Step_2] sanz: that's what UW said...
01/28/05 19:36:54 [USMLE_Step_2] lanny: right
01/28/05 19:36:55 [USMLE_Step_2] strug: thanks
01/28/05 19:37:16 [USMLE_Step_2] sanz: huli, i dont know the ans to yr q
01/28/05 19:37:24 [USMLE_Step_2] lanny: mr too
01/28/05 19:37:34 [USMLE_Step_2] lanny: infertility?
01/28/05 19:37:35 [USMLE_Step_2] huli72: buboes
01/28/05 19:37:41 [USMLE_Step_2] huli72: proctocolitis
01/28/05 19:37:49 [USMLE_Step_2] huli72: rectal stricture
01/28/05 19:37:55 [USMLE_Step_2] lanny: i said buboes
01/28/05 19:38:06 [USMLE_Step_2] huli72: rectovaginal fistulas
01/28/05 19:38:14 [USMLE_Step_2] huli72: elephantiasis
01/28/05 19:38:22 [USMLE_Step_2] huli72: and what lanny said
01/28/05 19:38:49 [USMLE_Step_2] lanny: ok didnt get it early
01/28/05 19:38:57 [USMLE_Step_2] huli72: female labia painless lession, which diseases?
01/28/05 19:38:59 [USMLE_Step_2] sanz: thnx huli
01/28/05 19:39:09 [USMLE_Step_2] lanny: herpes
01/28/05 19:39:11 [USMLE_Step_2] strug: syphilis?
01/28/05 19:39:17 [USMLE_Step_2] sanz: syphilis
01/28/05 19:39:28 [USMLE_Step_2] huli72: yeah, syphilis
01/28/05 19:39:32 [USMLE_Step_2] huli72: and....
01/28/05 19:39:38 [USMLE_Step_2] sanz: ing lymph
01/28/05 19:39:41 [USMLE_Step_2] huli72: chancroid
01/28/05 19:39:43 [USMLE_Step_2] strug: granuloma inguinale
01/28/05 19:39:52 [USMLE_Step_2] huli72: yeah, sanz and strug
01/28/05 19:39:58 [USMLE_Step_2] strug: chancroid is painful
01/28/05 19:40:12 [USMLE_Step_2] sanz: i thought chancroid is from ducreyi... not syphilis
01/28/05 19:40:17 [USMLE_Step_2] lanny: thought herpes is painless
01/28/05 19:40:30 [USMLE_Step_2] sanz: yup chancre is syphilis
01/28/05 19:40:31 [USMLE_Step_2] lanny: yea hem ducreyi
01/28/05 19:40:32 [USMLE_Step_2] huli72: you are right, chancroid is painful
01/28/05 19:40:39 [USMLE_Step_2] huli72: sorry
01/28/05 19:40:55 [USMLE_Step_2] huli72: but LGV is painless
01/28/05 19:41:09 [USMLE_Step_2] lanny: there is a diff bet chancre and chancroid
01/28/05 19:41:27 [USMLE_Step_2] strug: chancre is from syphilis and chancroid from H ducreyi
01/28/05 19:41:33 [USMLE_Step_2] lanny: rught
01/28/05 19:41:52 [USMLE_Step_2] lanny: so herpes is painful
01/28/05 19:42:04 [USMLE_Step_2] huli72: yeah, lanny
01/28/05 19:42:05 [USMLE_Step_2] strug: yup
01/28/05 19:42:12 [USMLE_Step_2] lanny: thx strug
01/28/05 19:42:32 [USMLE_Step_2] strug: condyloma lata is syphilis and condyloma acuminata is warts
01/28/05 19:42:40 [USMLE_Step_2] doctorchamita: yes
01/28/05 19:42:41 [USMLE_Step_2] lanny: right
01/28/05 19:42:59 [USMLE_Step_2] doctorchamita: HPV
01/28/05 19:43:02 [USMLE_Step_2] lanny: acuminata is from HPV 13
01/28/05 19:43:05 [USMLE_Step_2] huli72: how to differientiate chancroid from lymphogranuloma venereum (LGV)
01/28/05 19:43:18 [USMLE_Step_2] lanny: pain or not
01/28/05 19:43:21 [USMLE_Step_2] strug: rolled over edges for chancroid and also its painful
01/28/05 19:43:23 [USMLE_Step_2] doctorchamita: not only 13, there are many types
01/28/05 19:43:28 [USMLE_Step_2] lanny: agree
01/28/05 19:43:45 [USMLE_Step_2] lanny: 18 31 i guess
01/28/05 19:43:47 [USMLE_Step_2] strug: Pcr is the best test for chancroid
01/28/05 19:43:49 [USMLE_Step_2] doctorchamita: yes
01/28/05 19:43:55 [USMLE_Step_2] lanny: yes
01/28/05 19:44:03 [USMLE_Step_2] huli72: in LGV, labia lession 1st, then lymph
01/28/05 19:44:09 [USMLE_Step_2] doctorchamita: question...I logged in late
01/28/05 19:44:18 [USMLE_Step_2] huli72: but in chancroid, they occur at the same time
01/28/05 19:44:29 [USMLE_Step_2] lanny: what
01/28/05 19:44:36 [USMLE_Step_2] lanny: occur..
01/28/05 19:44:41 [USMLE_Step_2] doctorchamita: about gonorrhea vs chlamydia RX?
01/28/05 19:45:09 [USMLE_Step_2] sanz: go aheah doc
01/28/05 19:45:12 [USMLE_Step_2] strug: diff betwn LGV and chancroid he is asking
01/28/05 19:45:13 [USMLE_Step_2] lanny: ceftriax add doxy for chlam
01/28/05 19:45:13 [USMLE_Step_2] doctorchamita: don" you RX both at the same time, including the partner?
01/28/05 19:45:33 [USMLE_Step_2] lanny: yes
01/28/05 19:45:55 [USMLE_Step_2] doctorchamita: ok, thanks
01/28/05 19:46:02 [USMLE_Step_2] lanny: welcome
01/28/05 19:46:31 [USMLE_Step_2] huli72: gonococcal conjunctivitis in neoborn?
01/28/05 19:46:39 [USMLE_Step_2] lanny: huli go bck to your statement bout chancroid pls
01/28/05 19:46:42 [USMLE_Step_2] strug: on day 5
01/28/05 19:46:44 [USMLE_Step_2] sanz: occurs at day 3-5
01/28/05 19:46:44 [USMLE_Step_2] huli72: when occure\?
01/28/05 19:46:57 [USMLE_Step_2] sanz: purulent discharge
01/28/05 19:47:01 [USMLE_Step_2] huli72: chancroid?
01/28/05 19:47:12 [USMLE_Step_2] sanz: for chlamydia, day 5 up to a week
01/28/05 19:47:28 [USMLE_Step_2] strug: with LGV the labial lesion occurs first then the lymphnode invol
01/28/05 19:47:28 [USMLE_Step_2] huli72: yeah, sanz
01/28/05 19:47:32 [USMLE_Step_2] sanz: i dont know chancroid can cause neonatal conjunctivitis
01/28/05 19:47:39 [USMLE_Step_2] huli72: yeah, strug
01/28/05 19:47:51 [USMLE_Step_2] lanny: no sanzwere talking bout 2 diff things
01/28/05 19:47:53 [USMLE_Step_2] strug: in chancriod noth occur together lanny
01/28/05 19:47:54 [USMLE_Step_2] sanz: oh
01/28/05 19:48:01 [USMLE_Step_2] lanny: thx strug
01/28/05 19:48:01 [USMLE_Step_2] huli72: no, gonococcal conjunctivitis
01/28/05 19:48:35 [USMLE_Step_2] sanz: what is silver nitrate for?
01/28/05 19:48:49 [USMLE_Step_2] lanny: chem conjunctiv
01/28/05 19:48:53 [USMLE_Step_2] huli72: newborn's eye
01/28/05 19:49:01 [USMLE_Step_2] sanz: it causes chem conjuntivitis
01/28/05 19:49:06 [USMLE_Step_2] huli72: 1st day
01/28/05 19:49:09 [USMLE_Step_2] sanz: it's a prophylaxis for...?
01/28/05 19:49:11 [USMLE_Step_2] strug: chem conjunctivis its used for prophylaxis against conjuctivies
01/28/05 19:49:17 [USMLE_Step_2] doctorchamita: gonococal conjuntivits
01/28/05 19:49:18 [USMLE_Step_2] lanny: yep
01/28/05 19:49:19 [USMLE_Step_2] huli72: gonococcal
01/28/05 19:49:22 [USMLE_Step_2] sanz: yup
01/28/05 19:49:39 [USMLE_Step_2] huli72: how to treat gono conjuctiv
01/28/05 19:49:40 [USMLE_Step_2] sanz: gonococcal prophylaxis
01/28/05 19:49:46 [USMLE_Step_2] sanz: erythromycin
01/28/05 19:49:52 [USMLE_Step_2] huli72: yeah,sanz
01/28/05 19:49:54 [USMLE_Step_2] strug: ceftraiaxone
01/28/05 19:49:57 [USMLE_Step_2] sanz: i think PO
01/28/05 19:50:07 [USMLE_Step_2] huli72: topical eryth
01/28/05 19:50:07 [USMLE_Step_2] sanz: to prevent gonorrhea pneumonia
01/28/05 19:50:14 [USMLE_Step_2] sanz: oh really huli?
01/28/05 19:50:19 [USMLE_Step_2] strug: for chlamyida its ery PO
01/28/05 19:50:28 [USMLE_Step_2] huli72: yeah, it is topical erythr
01/28/05 19:50:36 [USMLE_Step_2] sanz: oke... sorry...
01/28/05 19:50:37 [USMLE_Step_2] huli72: for gonococcal conjuctiv
01/28/05 19:50:46 [USMLE_Step_2] lanny: aagree top
01/28/05 19:50:47 [USMLE_Step_2] sanz: so PO for chlam and top for gonorr?
01/28/05 19:50:58 [USMLE_Step_2] huli72: but PO erythro for chlamydia conjunctiv
01/28/05 19:51:08 [USMLE_Step_2] strug: yup
01/28/05 19:51:08 [USMLE_Step_2] sanz: oke gotcha.. thnx
01/28/05 19:51:09 [USMLE_Step_2] huli72: yeah, sanz, you got it
01/28/05 19:51:57 [USMLE_Step_2] huli72: triad congenital toxoplasmosis?
01/28/05 19:52:14 [USMLE_Step_2] strug: motor an dsensory deficits
01/28/05 19:52:18 [USMLE_Step_2] sanz: chororetinitis, cerebral calcification
01/28/05 19:52:31 [USMLE_Step_2] sanz: hepatosplenomegaly
01/28/05 19:53:12 [USMLE_Step_2] strug: u r askin g about fetus or neonate?
01/28/05 19:53:27 [USMLE_Step_2] huli72: neonate
01/28/05 19:53:49 [USMLE_Step_2] lanny: is there a diag in fetus? strug
01/28/05 19:53:57 [USMLE_Step_2] strug: in neonate chorioretinits , seicures, hs megaly, thrombocytopenis and hydrocephalus
01/28/05 19:54:09 [USMLE_Step_2] huli72: lanny, it is in Kap OB
01/28/05 19:54:38 [USMLE_Step_2] huli72: yeah, strug, and 2 more very imp
01/28/05 19:54:56 [USMLE_Step_2] strug: in fetus non immune hydrops, sym IUGR, microcephaly and intracramial calci lanny
01/28/05 19:55:06 [USMLE_Step_2] huli72: no, sorry, strug, only 1 more
01/28/05 19:55:11 [USMLE_Step_2] lanny: thx
01/28/05 19:55:15 [USMLE_Step_2] sanz: calcidication
01/28/05 19:55:24 [USMLE_Step_2] huli72: yeah, that is it
01/28/05 19:55:34 [USMLE_Step_2] strug: ok
01/28/05 19:55:36 [USMLE_Step_2] strug: thanks
01/28/05 19:55:39 [USMLE_Step_2] sanz: calcification i mean..
01/28/05 19:55:47 [USMLE_Step_2] sanz: well, you guys know what i meant... hehe
01/28/05 19:55:47 [USMLE_Step_2] huli72: congenital CMV triad?
01/28/05 19:56:11 [USMLE_Step_2] sanz: petechia rash
01/28/05 19:56:16 [USMLE_Step_2] strug: petechia, meningoencephalitis,
01/28/05 19:56:25 [USMLE_Step_2] sanz: periventricular calcification cataract
01/28/05 19:56:29 [USMLE_Step_2] strug: hs megaly, thrombocytopenia
01/28/05 19:56:45 [USMLE_Step_2] strug: jaundice, perivent calcificaio
01/28/05 19:57:05 [USMLE_Step_2] huli72: yeah, they both have choriorenitis
01/28/05 19:57:37 [USMLE_Step_2] huli72: periventricular calci in CMV, but intracranial calci in toxo
01/28/05 19:57:40 step2 Logs in
01/28/05 19:57:40 step2 Joins Subroom USMLE_Step_2
01/28/05 19:57:44 [USMLE_Step_2] strug: yes
01/28/05 19:57:55 [USMLE_Step_2] lanny: agree thats the diff
01/28/05 19:58:16 [USMLE_Step_2] huli72: one more congenital>>>>> rebella
01/28/05 19:58:25 [USMLE_Step_2] strug: hey guys can we do adult internal medicine stuff today, we will have time for peds later
01/28/05 19:58:34 [USMLE_Step_2] lanny: agree
01/28/05 19:58:37 [USMLE_Step_2] strug: lets finish fubella
01/28/05 19:58:44 [USMLE_Step_2] strug: sorrry rubella
01/28/05 19:58:55 [USMLE_Step_2] huli72: deaf
01/28/05 19:59:04 [USMLE_Step_2] strug: cataract
01/28/05 19:59:05 [USMLE_Step_2] huli72: PDA, ASD
01/28/05 19:59:10 [USMLE_Step_2] huli72: yeah, that is it
01/28/05 19:59:17 [USMLE_Step_2] strug: sensineural deafness
01/28/05 19:59:34 [USMLE_Step_2] strug: blue bery muffin rash
01/28/05 19:59:42 [USMLE_Step_2] huli72: yeah
01/28/05 19:59:49 [USMLE_Step_2] strug: cong glaucoma and mental retardation
01/28/05 19:59:50 cyrus1345 Logs in
01/28/05 20:00:05 cyrus1345 Joins Subroom USMLE_Step_2
01/28/05 20:00:14 [USMLE_Step_2] strug: hi nasi
01/28/05 20:00:21 [USMLE_Step_2] sanz: and PDA
01/28/05 20:00:26 [USMLE_Step_2] sanz: hey nasi
8:00 PM [sanz] and PDA
8:00 PM [sanz] hey nasi
8:00 PM [strug] which is the most common bacterial std in us?
8:00 PM [cyrus1345] HI strug,sorry for yesterday,I don't know what happen,suddenlyI am going to disconnect
8:00 PM [lanny] pyelo when do we hospital
8:01 PM [sanz] chlamydia
8:01 PM [strug] yes sanz
8:01 PM [strug] hey nasi why sorry.....even i get kicked off
8:01 PM [cyrus1345] Hi everybody
8:01 PM [doctorchamita] hi
8:01 PM [lanny] hi cyrus
8:01 PM [strug] lanny shes nasi
8:01 PM [huli72] hi, nasi
8:01 PM [sanz] when the phyeloneph didnt repond to 3 days of Ab'ic and the pt has nausea, vomiting lanny
8:01 PM [lanny] oh thx
8:02 PM [lanny] thx
8:02 PM [cyrus1345] thanks huli
8:02 PM [strug] relly sanz?
8:02 PM [strug] i thought we admit all pt with pyelonephritis
8:02 PM [huli72] I think so too, strug
8:02 PM [sanz] yes, for pyeloneph, you can treat as out pt... but if they dont respond, we need to bring them back and do USS
8:03 PM [lanny] dome books have diff in this thats why i asked
8:03 PM [sanz] it depends on how ill the pt is at presentation...
8:03 PM usmle_guy has left the chat.
8:03 PM [lanny] whats USS urinalysis
8:03 PM [huli72] Ultrasound
8:03 PM [lanny] ultra sound
8:04 PM [lanny] ok thx
8:04 PM TTW has left the chat.
8:04 PM [lanny] whats trt fot pyelo
8:04 PM [strug] whats the most definitive test for PID?
8:04 PM [sanz] US renal tract to rule out obstruction and hydronephrosis
8:04 PM [cyrus1345] laparotomy
8:04 PM [sanz] ampi and gent IV for hospitalised pt... cipro for out pt
8:05 PM [lanny] not floroquin
8:05 PM [lanny] ok got you sanz
8:05 PM [strug] nasi correct
8:05 PM [strug] Rx of PID?
8:06 PM [lanny] agree
8:06 PM [sanz] cef and doxy
8:06 PM [lanny] doxy
8:06 PM [cyrus1345] agree with snaz
8:06 PM [lanny] sanz righ
8:06 PM [huli72] brochial asthma + eosinophils, what is it?
8:07 PM [cyrus1345] what's the indication for hospitalized paitent wiyth PID?
8:07 PM [huli72] acute PID
8:07 PM [lanny] high fever
8:07 PM [sanz] very ill pt with abdo pain, Nausea & Vomiting
8:07 PM [lanny] all right
8:07 PM [strug] high wbc and fever
8:08 PM [sanz] lofgren syndr huli?
8:08 PM [cyrus1345] primigravida
8:08 PM [cyrus1345] adolesent
8:08 PM [strug] what nasi
8:08 PM [strug] are there indications for hospital
8:08 PM [huli72] parasitic infection or hypersensitivity to fungal antigen
8:08 PM [cyrus1345] T.102.2
8:08 PM [cyrus1345] yes strug
8:09 PM [lanny] whats that nasi?
8:09 PM [lanny] oh gotcha
8:09 PM [cyrus1345] T> 102.2 F
8:09 PM [huli72] Rx for listeria?
8:09 PM [lanny] got it yea high fever
8:09 PM [cyrus1345] and evidence of pelvic absecc
8:09 PM [lanny] amox
8:09 PM [huli72] ampi
8:10 PM [strug] yes ampi and ceftiaxome too?
8:10 PM [lanny] ampi
8:10 PM [strug] ok only ampi
8:10 PM [huli72] Rx for Ehrlichiosis?
8:10 PM [huli72] no ceftria
8:10 PM [cyrus1345] dox
8:10 PM [lanny] only ampi
8:10 PM [huli72] yeah, nasi
8:11 PM [sanz] what does that cause guys?
8:11 PM [strug] Rx of chanroid?
8:11 PM [huli72] Rx for enteroibius vermicularis?
8:11 PM [doctorchamita] most specific test for CNS infection?
8:11 PM [sanz] erythro strug
8:11 PM [strug] albendazole
8:11 PM [huli72] yeah, strug
8:11 PM [sanz] LP doc
8:12 PM [strug] polymerase chain doc
8:12 PM [lanny] which is most comm entero or giardia
8:12 PM [sanz] giardia
8:12 PM [doctorchamita] yes
8:12 PM [huli72] what is the answer, strug
8:12 PM [strug] azithro or ceftriaxone or erythro
8:12 PM [lanny] think its enterob
8:12 PM [doctorchamita] indicacions for LP?
8:12 PM [huli72] thnx, strug
8:12 PM [sanz] doc, LP or PCR?
8:12 PM [doctorchamita] LP
8:13 PM [sanz] thnx
8:13 PM [strug] most speciifci is LP?
8:13 PM [lanny] whats doc
8:13 PM [doctorchamita] lumbar puncture
8:13 PM [cyrus1345] LP for what doc?
8:14 PM [doctorchamita] CNS infection
8:14 PM [strug] i dont think so doc...it cant be most specific?
8:14 PM [cyrus1345] I am not agree
8:14 PM [doctorchamita] what is it, then?
8:14 PM [strug] its either biopsy or polymerase chain wait i will check
8:14 PM [doctorchamita] ok
8:15 PM [sanz] i guess LP is the first thing to do... then we get culture and cell ct and gluc etc
8:15 PM [strug] the most accurate test for bact meningits is cultrue of CSF
8:15 PM [doctorchamita] ok
8:15 PM [lanny] do they ask these quest about spec and sens tests/
8:15 PM [doctorchamita] you are right
8:15 PM [doctorchamita] once then do cell count and differencial
8:15 PM [sanz] if it's viral picture, PCR wuld give a more specific dx on the exact organism
8:15 PM [sanz] like HSV
8:16 PM [doctorchamita] defenitley they do lanny
8:16 PM [cyrus1345] good point snaz
8:16 PM [lanny] thx
8:16 PM [huli72] Rx for babesiosis?
8:16 PM megs has left the chat.
8:16 PM [doctorchamita] most acurrate, specific, best initial...
8:16 PM [sanz] but if there're LP and PCR in the choices, i would choose LP... cuz that would be the first thing to do
8:16 PM [lanny] agree
8:16 PM [doctorchamita] yes
8:17 PM [doctorchamita] and always do CT befor LP
8:17 PM ttw has left the chat.
8:17 PM megs has left the chat.
8:17 PM [strug] not always
8:17 PM [doctorchamita] when: papiledema.
8:17 PM [lanny] always
8:17 PM [strug] only if pt confused, papilloedma
8:17 PM [doctorchamita] focal neuroogic findings
8:17 PM [strug] yes focal findings too
8:17 PM [doctorchamita] severe confusion
8:17 PM [doctorchamita] alright !!\
8:18 PM megs has left the chat.
8:18 PM [strug] hey ans to hulis q?
8:18 PM [lanny] dont think so think always do ct is correct
8:18 PM [huli72] quinine
8:18 PM [huli72] clindamycin]
8:18 PM [sanz] welcome back megs
8:18 PM [huli72] atovaquone
8:18 PM [lanny] huli lost you
8:18 PM [huli72] azithr
8:18 PM [strug] also azitho and atavaq
8:18 PM [huli72] yeah, strug
8:19 PM [lanny] huli whats your ques
8:19 PM [huli72] Rx of babesios?
8:19 PM [sanz] Rx of Legionella?
8:19 PM [huli72] eryth
8:19 PM [lanny] right
8:19 PM [doctorchamita] erytthro
8:19 PM [huli72] Rx for norcardia?
8:20 PM [megs] azitro
8:20 PM [huli72] no
8:20 PM [huli72] TMP/SMZ
8:20 PM [megs] legionella....erythro
8:20 PM [huli72] yeah, meg
8:20 PM [sanz] right megs and doc
8:20 PM [megs] babesiosis...smz trimeth
8:20 PM [cyrus1345] RX RMF in 6 years old?
8:21 PM [sanz] RMF?
8:21 PM [huli72] chlorpheno
8:21 PM [huli72] ?
8:21 PM [strug] doxy
8:21 PM [huli72] what is RMF?
8:21 PM [cyrus1345] Rocky mountain fever
8:21 PM [lanny] why 6 yr old/
8:21 PM [strug] or tetra can dalso be given
8:21 PM [lanny] trt is doxy
8:21 PM [cyrus1345] yes strug!
8:21 PM [cyrus1345] good job!
8:21 PM [strug] thanks
8:21 PM [huli72] thanks, guys
8:21 PM [doctorchamita] how to diagnose RMF?
8:21 PM [megs] doxy although stains teeth????
8:22 PM [lanny] serology
8:22 PM [lanny] biopsy
8:22 PM [huli72] agree with lanny
8:22 PM [megs] serology
8:22 PM [huli72] serology
8:22 PM [strug] rash and serrology
8:22 PM [lanny] ok gotcha
8:22 PM [cyrus1345] it's the only time you can give doxy to less than 8 ,meg
8:22 PM [sanz] oh.. i dont think you can give tetra to a 6 yr old strug...u sure?
8:22 PM [megs] thanx got the point
8:22 PM [cyrus1345] yes!pretty sure!
8:22 PM [lanny] no tetra or doxy
8:23 PM [strug] yes dear u can give because the dose is not that much that it stains teeth...
8:23 PM [sanz] thnx strug
8:23 PM [lanny] at what age then is cut off
8:23 PM [strug] it is a very imp q u must know this....thnx nasi for bringing it out
8:23 PM [huli72] thanks, Nasi
8:23 PM [doctorchamita] good to know
8:24 PM [lanny] strug what is cut off age
8:24 PM [huli72] Rx for B hanselae?
8:24 PM [doctorchamita] guys gotta go
8:25 PM [doctorchamita] bye to all
8:25 PM [lanny] bye
8:25 PM [huli72] bye doctorchamiita
8:25 PM [sanz] bye
8:25 PM doctorchamita has left the chat.
8:25 PM [megs] b hensalae...doxycycline???
8:26 PM [huli72] azithro
8:26 PM [lanny] csuse of o media right huli
8:26 PM [huli72] how to diff B henselae and P multocida?
8:26 PM cyrus1345 has left the chat.
8:27 PM [lanny] cuases of o media
8:27 PM [megs] history of cat bite in p. multicida
8:27 PM [huli72] yeah, meg
8:27 PM [megs] b. henselae..scratch
8:27 PM [huli72] what you mean? lanny
8:27 PM [lanny] p multicida is cat and dog bite
8:27 PM [huli72] yeah, meg
8:27 PM [sanz] strep pneumonia and h influ
8:28 PM [lanny] b henselae is cat scrach
8:28 PM [huli72] yeah, lanny
8:28 PM [sanz] B henselae has painful axillary nodes... p mulocida has bite site infection
8:28 PM [lanny] remember scratch s s in henselae
8:28 PM [lanny] right sanx
8:29 PM [huli72] B henselae:vesicular lesion, proximal lymphadenopathy
8:29 PM [huli72] great points, sanz
8:29 PM [huli72] that is what I am trying to type
8:29 PM [sanz] hehe
8:30 PM [huli72] what is your q, sanz?
8:30 PM [megs] how will distinguish bet n herpes genital ulcers and chancroid
8:30 PM [megs] clinically
8:30 PM [strug] yup
8:30 PM [lanny] yes
8:31 PM [strug] also can do tzanch stain for herpes if douubtful
8:31 PM [huli72] and lesion smear
8:31 PM [strug] Rx for herpes gentialis?
8:31 PM [huli72] acyclvir
8:31 PM [lanny] acyclovi
8:31 PM [megs] acyclovir
8:31 PM [strug] yes
8:32 PM [strug] for LGV and granuloma inguinale?
8:32 PM [sanz] what's the DOC in aspiration pneumonia?
8:32 PM [megs] metro
8:32 PM [strug] clinda
8:32 PM [huli72] clindo +
8:32 PM [huli72] genta
8:32 PM [sanz] metro covers only anerobe... clinda gives cover to both anerobes and gram +ves
8:32 PM [megs] basically u have to cover anaerobes
8:33 PM [lanny] agree
8:33 PM [megs] ok sanz
8:33 PM [strug] so what do u give?
8:33 PM [lanny] best for anaerobe clinda
8:33 PM [sanz] clinda
8:33 PM [megs] clinda
8:33 PM [strug] i thik above waist is clinda and below waist is metro
8:33 PM [huli72] yeah, strug
8:34 PM [sanz] yup, if abdo surg or things like that, you give metro
8:34 PM [lanny] oh yea!
8:34 PM [huli72] but clinda is used in pelvic infection too
8:34 PM [megs] yeah sanz
8:34 PM [sanz] for endometritis yes
8:34 PM [lanny] above waist is abdomen sanz
8:34 PM [sanz] below nipple line is abdo right lanny?
8:35 PM [lanny] right
8:35 PM [huli72] how to diff CMV from HSV esophagitis in AIDs pt?
8:35 PM [lanny] esophago
8:35 PM [strug] by biopsy
8:35 PM [sanz] biopsy?
8:35 PM [sanz] inclusion bodies in CMV
8:35 PM [strug] in Cmv intra cytoplasmic inclusion
8:35 PM [huli72] yeah, all are right.
8:36 PM [sanz] hehe strug, you read my mind
8:36 PM [huli72] but, how is the ulcer?
8:36 PM [strug] i am a fast typer thats it
8:36 PM [megs] rx of CMV infection
8:36 PM [lanny] i am a slow typer
8:36 PM [strug] ganciglover
8:36 PM [huli72] gancyclovir
8:36 PM [lanny] gancylco
8:36 PM [megs] if not responding to ganc
8:37 PM [lanny] foscarnet
8:37 PM [strug] forcrnet
8:37 PM [sanz] or foscarnet in AIDS pt who dont respond to acyc
8:37 PM [megs] yup
8:37 PM [sanz] s/e of foscarnet?
8:37 PM [strug] renal
8:37 PM [huli72] renal failure
8:37 PM [megs] nephtotoxic
8:37 PM [strug] huli dont remembre the ulcer chareacteristi?
8:38 PM [sanz] yup,
8:38 PM [huli72] CMV: shallow and superficial ulcer
8:38 PM [lanny] remember avoid pentamidine with foscarnet
8:38 PM [strug] why?
8:38 PM [megs] why lanny???
8:38 PM [huli72] HSV: "volcano" deep and small ulcer
8:38 PM [lanny] fatal hypocalcemia!!!!!!!
8:39 PM [huli72] aids pt on pentamidine come in with seizure, what is the problem?
8:39 PM [sanz] hypogly
8:39 PM [lanny] dont give AT THE SAME TIME
8:39 PM [huli72] yeah, sanz
8:39 PM [strug] hypoglycemia
8:39 PM [sanz] thnx lanny
8:40 PM [huli72] lyme disease how to treat in kids <9 years old?
8:40 PM [megs] to whom we give prophylaxis for tb???
8:41 PM [huli72] ppt > 15 cm
8:41 PM [sanz] who are high risks in TB? As in PPD considered +ve if >5mm?
8:41 PM [lanny] HIV
8:41 PM [strug] renal transplant
8:41 PM [strug] recent contact
8:41 PM [lanny] residents of wyoming
8:41 PM [strug] reactivation
8:42 PM [megs] on steroids
8:42 PM [sanz] lanny really wyoming?
8:42 PM [strug] whats wyoming?
8:42 PM [lanny] BCG recepients
8:42 PM [strug] no
8:42 PM [lanny] cause no immigrants go there
8:43 PM [sanz] HIV pts, pt with organ transplant and chr steroids use, close contact, pt with CXR consistent of healed TB
8:43 PM [strug] abnormal chest xray
8:43 PM [huli72] BCG won't have any effect on ppt.
8:43 PM [strug] sanz perfect
8:43 PM [megs] prophylaxis for tb...infant born to tb mother, hivpt with cd 4 ct less than 200
8:43 PM [megs] right sanz
8:43 PM [strug] <200?
8:44 PM [lanny] yes BCg has no effect on the recommends but generally they are included if ppd is>5
8:44 PM [lanny] ppd pos >10 what pop
8:45 PM [strug] we dont give prophylaxis for TB in aids pt wtih cd<200
8:45 PM [strug] megs pl clarify
8:45 PM [megs] yeah in developing country they do to hiv positive
8:45 PM [megs] sorry not in usa..
8:45 PM [strug] ok
8:45 PM [megs] as i worked there..in india
8:45 PM [strug] me too am from india
8:46 PM [megs] sorry for confusion guys
8:46 PM [strug] which place megs
8:46 PM [strug] which college?
8:47 PM [lanny] ok lets revise side eff of HIV drugs
8:47 PM [lanny] sanz shoot
8:47 PM [sanz] didanosine cause pancreatitis
8:48 PM [lanny] indinavir too
8:48 PM [lanny] what does DDC cause
8:48 PM [sanz] it also causes renal stones
8:48 PM [sanz] and jaundice
8:48 PM [sanz] wuz DDC?
8:49 PM [strug] zalcitabine
8:49 PM [lanny] zalcitabin
8:49 PM [sanz] oh zalcitabine... peripheral neuro
8:49 PM [strug] yup
8:49 PM [sanz] what is tetragenic?
8:49 PM [strug] none
8:50 PM [sanz] efavirenz
8:50 PM [lanny] agreepsychosis can cause
8:50 PM [strug] efavirenz is tertogenic?
8:50 PM [lanny] not sure about terat
8:50 PM [huli72] agree with sanz
8:50 PM [sanz] yes strug
8:50 PM [strug] thnx
8:51 PM [lanny] i know efavir is neuro and psycho
8:51 PM [huli72] yeah, it is eterogenic, strug
8:51 PM [strug] thnx huli
8:51 PM [sanz] efa cause psychosis and neuro and also proven to be a tetrogen
8:51 PM [strug] AZT causes neutropenia, anemia and GI bleeding
8:51 PM [megs] yes agree sanz
8:52 PM [megs] nevirapine.??/whats the side effect??
8:52 PM [lanny] what does all prot inh cause as a group very imp
8:52 PM [strug] rash megs
8:52 PM [megs] rash
8:52 PM [lanny] nevi is rash
8:52 PM [strug] hyperllipideimea
8:52 PM [megs] all correct
8:52 PM [strug] hypergly lanny
8:52 PM [lanny] and hyper gly
8:53 PM [strug] also elevated liver enz
8:53 PM [lanny] yes so watch in diabetics....
8:53 PM [lanny] all dorrect
8:53 PM [lanny] correct
8:53 PM [lanny] ok preg and AZT
8:53 PM [strug] lamivudine?
8:54 PM [lanny] what red in trans to fetus if mum takes azt
8:54 PM [sanz] start at 14 weeks as prophylaxis
8:54 PM [strug] yup
8:54 PM [sanz] lanny dont understand yr q
8:54 PM [megs] 8%
8:54 PM [strug] dec the rate of trns to 8
8:54 PM [sanz] oh!
8:54 PM [lanny] if mum takes azt what percent red trans of virus to bab
8:55 PM [sanz] hehe... lanny got it now
8:55 PM [lanny] good need to know was 25%
8:55 PM [lanny] so big progress with drugs
8:55 PM [lanny] correct strug
8:55 PM [lanny] breast feeding recommend for hiv
8:55 PM [megs] now a days they r using navirapin for better prevention
8:56 PM [lanny] thx megs
8:56 PM [sanz] no lanny
8:56 PM [strug] post exposure prophylaxis?
8:56 PM [megs] nevirapine has reduced the rate of transmission more than azt
8:56 PM [sanz] combi drugs for 4 wks
8:56 PM [huli72] breast feeding is not recommend?
8:56 PM [lanny] what rte of trans in breast feed
8:56 PM [sanz] i guess it also has less s/e megs
8:57 PM [strug] no breast feeding
8:57 PM [megs] combine feeding is not recommended
8:57 PM [sanz] 100%
8:57 PM [lanny] no
8:57 PM [megs] either aall breast milk
8:57 PM [megs] or all top feed
8:57 PM [lanny] 25%
8:57 PM [lanny] remember 25% nd 8%
8:58 PM [lanny] in developing countries is breast feed contra in HIV
8:58 PM [strug] correct sanz
8:58 PM [strug] when should u began Rx?
8:58 PM [sanz] right away after basline blood tests done
8:58 PM [strug] within 2 hours maxi benefit....no effect after 2 days
8:58 PM [lanny] strug trans rate is 25% last yr stats
8:59 PM [lanny] by breast feed
8:59 PM [strug] for what dear?
8:59 PM [lanny] hiv
8:59 PM [sanz] lanny, no... ppl in Africa can breast feed
8:59 PM [strug] ok i never said any rate but i say a women shoudl not feed her child
8:59 PM [lanny] yes they can
8:59 PM [megs] let me clary fy...
8:59 PM [strug] in india too women breast feed
9:00 PM [strug] but its because its a developin country
9:00 PM [sanz] yup
9:00 PM [megs] they say that formula feed destroy protective antibodies
9:00 PM [strug] and if a female dosent breast feed the child will as such die becasue of infections
9:00 PM [megs] so either give all top feed
9:00 PM [megs] or give breast feed...
9:00 PM [lanny] agree not much options apart from breast milk and poverty, so the 25 % rate can take the risk
9:00 PM [megs] that will give antibodes to baby
9:00 PM [strug] so in developing countries females can feed but in developed no
9:01 PM [sanz] yup
9:01 PM [huli72] HIV antibody is not pretective
9:01 PM [lanny] it doesnt matter in dev india africa s america they do
9:02 PM [megs] its not like that...either give only top feed or give full breast milk...dont give both at a time intermittantly
9:02 PM [lanny] ok lets do needle stick do you wait for HIV test or you give proph immed
9:02 PM [sanz] immediately
9:02 PM [lanny] good
9:02 PM [lanny] what do you give
9:02 PM [strug] it dosent take long to get a HIV test done
9:02 PM [huli72] 4 drug
9:02 PM [strug] and the antiretroviral drugs have side effects too
9:03 PM [sanz] megs, yeah, so in developing countries breast feed all... and in developed countries, bottle feed
9:03 PM [strug] i would wait for 1-2 hours
9:03 PM [lanny] whats red in risk if take azt
9:03 PM [strug] 80
9:03 PM [megs] yaeh sanz
9:03 PM [lanny] no immediately f drugs for 4 weeks remember 4!!!!
9:03 PM [huli72] 8%
9:03 PM [lanny] no huli 80 %
9:03 PM [lanny] remember 8 80 25 in HIV risks!!!!!
9:04 PM [strug] without even HIV test of patient ????
9:04 PM [sanz] strug, give prophylaxis regardless
9:04 PM [strug] really?
9:04 PM [lanny] absolutely no waiting test q
9:04 PM [strug] but if the patient is not HIV +?
9:04 PM [sanz] yes, my colleague had needle stick and she had to take it even tho the pt is HIV -ve
9:05 PM [sanz] this is in the UK tho...
9:05 PM [lanny] it doesnt matter
9:05 PM [lanny] in the USA too
9:05 PM [huli72] yeah, all pt have to receive, strug
9:05 PM [lanny] it happened to me in the UK too
9:05 PM [sanz] lanny... didnt know you are from the UK!
9:05 PM [strug] oh my God ..... so many collagues had needle stick injurey they never take any prophlaixis
9:05 PM [sanz] which uni did you go?
9:06 PM [lanny] in UK and US they do
9:06 PM [megs] good to know the point lanny
9:06 PM [strug] ok thnx for th e information
9:06 PM [lanny] pleasure
9:07 PM [lanny] ok guys im hungry good day. whats tom
9:07 PM [strug] when do we give prophylaxis for pneumo carin pneumon?
9:07 PM [sanz] CD4 ct <200
9:07 PM [megs] cd4 less than 200
9:07 PM [strug] what do we give
9:07 PM [lanny] pentami
9:07 PM [megs] smz pyrimth
9:07 PM [huli72] TMP/SMZ
9:07 PM [sanz] yup
9:07 PM [strug] side effect
9:07 PM [lanny] is pentami wrong
9:08 PM [huli72] pentami is OK
9:08 PM [sanz] it also has prophylaxis effect for toxo
9:08 PM [lanny] im confusing with pyrimeth
9:08 PM [sanz] penta can be given for sulfa allergic pt lanny
9:08 PM [strug] pentamidine is for treatment
9:08 PM [megs] rash..steven johnson..side effect
9:08 PM [lanny] ok thx sanz and strug
9:08 PM [strug] right
9:09 PM [lanny] they love ******* johnson
9:09 PM [strug] when do we use steroids
9:09 PM [megs] even i too
9:09 PM [lanny] also in the news recently child died of OTC motrin blamed on ******* j
9:09 PM [megs] in tuberculous meningitis
9:10 PM [strug] po2<70 and aa gradient > 35
9:10 PM [sanz] steroids in respr failure
9:10 PM [megs] oh..
9:10 PM [sanz] strug, thnx... cant remember the figures
9:10 PM [strug] i was talking about pneum carinii
9:10 PM [strug] me too
9:10 PM [strug] what the initial test?
9:10 PM [lanny] strug whats your ques
9:10 PM [sanz] CXR
9:11 PM [huli72] lavage
9:11 PM [strug] when do we give sterioid in pneumo carinii pneumona
9:11 PM [lanny] thx
9:11 PM [huli72] Gemsa stain
9:11 PM [megs] silver methanamine
9:11 PM [strug] first is cxray best is bronchoalveolar lavage
9:12 PM [huli72] ohh, thanks, strug
9:12 PM [strug] megs i didnt understand ur ans?
9:12 PM [lanny] agree with strug
9:12 PM [megs] is gimsa and silver metahanamine same???
9:12 PM [sanz] no
9:12 PM [huli72] no, they both are used
9:12 PM [huli72] for pneumocyst carii
9:12 PM [megs] i am not sure of gimsa....
9:12 PM [strug] CMV prophylaxis at waht cd4 count and what do we give?
9:13 PM [megs] less than 50
9:13 PM [lanny] 50
9:13 PM [megs] foscarnet
9:13 PM [strug] infection occures at < 50 but prophylaxis not given ..... gancicolvier is treatment
9:13 PM [lanny] think its gancy
9:14 PM [lanny] what vacc contra in Hiv
9:14 PM [sanz] MMR
9:14 PM [huli72] oral polia
9:14 PM [strug] no we cang ive mmr
9:14 PM [sanz] if severe immunocomp
9:14 PM [strug] yeah sanz
9:14 PM [huli72] vericella
9:14 PM [strug] all live vaccines contraindicated
9:14 PM [megs] all live vaccines
9:14 PM [sanz] all other live vaccines c/i
9:14 PM [lanny] mmr is not
9:15 PM [huli72] mmr is OK for HIV
9:15 PM [sanz] name all live vaccines
9:15 PM [strug] can give only Hep b, pneumoccus,
9:15 PM [lanny] ok guys gonna go eat...will come back in a few
9:15 PM [sanz] oke lanny... we might or might not be here... enjoy yr dinner
9:15 PM [strug] also influenz and mmr is not immuno
9:15 PM [megs] and pneumococcal
9:15 PM [lanny] if you guys are still here it was a good discuss
9:15 PM [huli72] bye lanny
9:15 PM [strug] bye lanny
9:15 PM [megs] bye lanny
9:16 PM [huli72] I will leave too
9:16 PM [strug] bye
9:16 PM [strug] do we wanna end here today?
9:16 PM [sanz] shall we stop then?
9:16 PM [huli72] bye
9:16 PM [megs] what tomorrow
9:16 PM [huli72] Hemo?
9:16 PM [sanz] dont know...
9:16 PM [lanny] thank you sanz and all i am not logging out if i dont meet you guys well be here tom, God willing..
9:16 PM [strug] hematol
9:17 PM [megs] ok will see
9:17 PM [sanz] can i ask you something... how long do you guys usu need to a block of UW qs?
9:17 PM [huli72] see you tomorrow
9:17 PM [strug] megs?
9:17 PM [strug] how to open the window? i m not able to do it?
9:17 PM huli72 has left the chat.
9:17 PM [sanz] strug, you double click on megs name on the side
9:18 PM [strug] thnx sanz bye all c u tmr
9:21 PM [sanz] bye!
9:21 PM sanz has left the chat.
9:27 PM lanny has left the chat.
9:28 PM megs has left the chat.
9:29 PM strug has left the chat.

01-28-2005, 10:21 PM

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