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Asclepius1
02-01-2005, 11:40 AM
01/31/05 19:02:17 [USMLE_Step_2] strug: hi everyone
01/31/05 19:02:22 [USMLE_Step_2] sanz: hey strug
01/31/05 19:02:33 [USMLE_Step_2] sanz: how r u?
01/31/05 19:02:33 [USMLE_Step_2] strug: hi sanz and medico
01/31/05 19:02:41 [USMLE_Step_2] strug: pretty good
01/31/05 19:02:41 [USMLE_Step_2] medico24: hi
01/31/05 19:02:52 [USMLE_Step_2] sanz: hi medico
01/31/05 19:02:58 [USMLE_Step_2] strug: we doing rheumato right
01/31/05 19:02:58 [USMLE_Step_2] medico24: hi sanz
01/31/05 19:03:06 [USMLE_Step_2] medico24: okey
01/31/05 19:03:26 [USMLE_Step_2] sanz: yup... shall we wait or start?
01/31/05 19:03:32 [USMLE_Step_2] strug: as u wish
01/31/05 19:03:50 [USMLE_Step_2] sanz: hehe!
01/31/05 19:04:30 [USMLE_Step_2] strug: ok lets start with what conditions u see polyarticualr joint involvememtn
01/31/05 19:04:54 [USMLE_Step_2] sanz: SLE
01/31/05 19:05:01 [USMLE_Step_2] sanz: RA and OA
01/31/05 19:05:13 [USMLE_Step_2] strug: RA, Sle, Sjogren syn, Scleroderma, Parvoviurs , HEp B
01/31/05 19:05:29 [USMLE_Step_2] strug: OA is monoartiucalr i guess
01/31/05 19:05:41 [USMLE_Step_2] sanz: no.. it is polyarth
01/31/05 19:05:50 [USMLE_Step_2] strug: really
01/31/05 19:06:00 lanny Logs in
01/31/05 19:06:01 lanny Joins Subroom USMLE_Step_2
01/31/05 19:06:08 [USMLE_Step_2] medico24: I think it is monoarticular
01/31/05 19:06:17 [USMLE_Step_2] sanz: dont ppl with OA have PIP and DIP involvement?
01/31/05 19:06:19 [USMLE_Step_2] lanny: hi all
01/31/05 19:06:27 [USMLE_Step_2] sanz: hi lanny
01/31/05 19:06:30 [USMLE_Step_2] strug: hi lanny
01/31/05 19:06:30 [USMLE_Step_2] medico24: hi lanny
01/31/05 19:06:46 [USMLE_Step_2] sanz: or you mean they just have either one..
01/31/05 19:06:48 [USMLE_Step_2] strug: yes its either asymm oligoarti or monoartiucal
01/31/05 19:07:05 [USMLE_Step_2] strug: most common joint invol in OA?
01/31/05 19:07:12 [USMLE_Step_2] lanny: OA have MCP and PIP
01/31/05 19:07:24 [USMLE_Step_2] sanz: weight bearing jts
01/31/05 19:07:27 [USMLE_Step_2] sanz: knee?
01/31/05 19:07:36 [USMLE_Step_2] strug: knee, second is thumb base....yes u right sanz
01/31/05 19:07:37 [USMLE_Step_2] lanny: yep most comm
01/31/05 19:07:49 [USMLE_Step_2] medico24: agree
01/31/05 19:08:05 [USMLE_Step_2] sanz: what is a heberdon nodule?
01/31/05 19:08:07 [USMLE_Step_2] strug: ok in which disease u have monoartiucalr joint invo?
01/31/05 19:08:09 fouzia Logs in
01/31/05 19:08:15 fouzia Joins Subroom USMLE_Step_2
01/31/05 19:08:28 [USMLE_Step_2] sanz: OA and gour
01/31/05 19:08:30 [USMLE_Step_2] strug: its the distal inter phalangeal joint invo in OA
01/31/05 19:08:31 [USMLE_Step_2] sanz: gout even
01/31/05 19:08:31 fouzia Logs Out
01/31/05 19:08:43 [USMLE_Step_2] strug: and?
01/31/05 19:08:48 [USMLE_Step_2] lanny: distal interphal joint is bouchard
01/31/05 19:08:53 fouzia Logs in
01/31/05 19:08:54 fouzia Joins Subroom USMLE_Step_2
01/31/05 19:09:00 [USMLE_Step_2] sanz: and Bouchard is PIP
01/31/05 19:09:06 [USMLE_Step_2] medico24: rt and proximal in haberdon
01/31/05 19:09:13 [USMLE_Step_2] lanny: sorry DIP is herbenden
01/31/05 19:09:20 [USMLE_Step_2] lanny: PIP is bouchard
01/31/05 19:09:29 [USMLE_Step_2] sanz: strug septic arthritis
01/31/05 19:09:47 [USMLE_Step_2] strug: septic arthritis yes sanz
01/31/05 19:09:50 [USMLE_Step_2] medico24: I think you are rt lanny
01/31/05 19:10:05 [USMLE_Step_2] strug: PIP is Bouchard....DIP is herbedeons
01/31/05 19:10:08 [USMLE_Step_2] medico24: confused?
01/31/05 19:10:14 [USMLE_Step_2] lanny: yes corrected myself
01/31/05 19:10:17 [USMLE_Step_2] medico24: okey
01/31/05 19:10:18 [USMLE_Step_2] sanz: strug yes
01/31/05 19:10:29 [USMLE_Step_2] strug: OLigo articular joint invo?
01/31/05 19:10:44 [USMLE_Step_2] lanny: possibly
01/31/05 19:11:08 [USMLE_Step_2] lanny: OA can affect only one joint
01/31/05 19:11:09 [USMLE_Step_2] medico24: lyme
01/31/05 19:11:24 [USMLE_Step_2] strug: Ankylosing spondylitis and seronegative arthropathy
01/31/05 19:11:38 [USMLE_Step_2] sanz: what's the diff between mono and oligoarth?
01/31/05 19:11:49 [USMLE_Step_2] lanny: think is same
01/31/05 19:11:50 [USMLE_Step_2] strug: mono means one
01/31/05 19:11:56 [USMLE_Step_2] strug: oligo means >1
01/31/05 19:11:56 [USMLE_Step_2] sanz: oligo none?
01/31/05 19:11:59 [USMLE_Step_2] lanny: oligo is greek for one
01/31/05 19:12:17 [USMLE_Step_2] sanz: but >1 is poly...
01/31/05 19:12:20 [USMLE_Step_2] strug: no
01/31/05 19:12:23 [USMLE_Step_2] lanny: yep
01/31/05 19:12:49 [USMLE_Step_2] strug: its something like oligosaccharides >1 sugar but les than 6
01/31/05 19:13:00 [USMLE_Step_2] medico24: oligo means fewer but large
01/31/05 19:13:07 [USMLE_Step_2] sanz: ok thnx
01/31/05 19:13:10 [USMLE_Step_2] strug: remember monosacchrieds are diff from oligosacc
01/31/05 19:13:36 [USMLE_Step_2] strug: Causes of Migratory ArthropathY?
01/31/05 19:13:49 [USMLE_Step_2] sanz: lyme
01/31/05 19:13:55 [USMLE_Step_2] medico24: lyme
01/31/05 19:14:05 [USMLE_Step_2] strug: Rheu Fever, LYme, Gonorrhoiea, Whipples diseas
01/31/05 19:14:14 [USMLE_Step_2] medico24: thanks
01/31/05 19:14:27 [USMLE_Step_2] sanz: which condts are associated with pseudogout?
01/31/05 19:14:46 [USMLE_Step_2] strug: hemochromatosis, hypophosp, hyperparathy,
01/31/05 19:14:47 [USMLE_Step_2] lanny: hemochromatosis
01/31/05 19:14:51 [USMLE_Step_2] lanny: siabetes
01/31/05 19:15:00 [USMLE_Step_2] sanz: yes all right
01/31/05 19:15:10 [USMLE_Step_2] strug: also hypomagnesemia
01/31/05 19:15:14 [USMLE_Step_2] sanz: DM and elderly with OA are also prone to pseudogout
01/31/05 19:15:22 [USMLE_Step_2] lanny: yes
01/31/05 19:15:39 [USMLE_Step_2] strug: thnx sanz
01/31/05 19:15:54 [USMLE_Step_2] strug: which crystals seen in pseudogout?
01/31/05 19:15:57 [USMLE_Step_2] sanz: uric acid level during acute attack of gout... high or low or normal?
01/31/05 19:16:01 [USMLE_Step_2] sanz: positive bifring
01/31/05 19:16:07 [USMLE_Step_2] strug: rhomboid and positively bifriengrent
01/31/05 19:16:20 [USMLE_Step_2] lanny: calcium dihydropyropuos
01/31/05 19:16:23 [USMLE_Step_2] strug: anything....not relable
01/31/05 19:16:44 [USMLE_Step_2] medico24: ca dihydrophosphrua
01/31/05 19:16:53 [USMLE_Step_2] sanz: normal uric acid level during attack.. so measure after dz has settled...
01/31/05 19:17:16 [USMLE_Step_2] lanny: its actually calcuim pyrophos dihydrate
01/31/05 19:17:27 [USMLE_Step_2] strug: yes lanny
01/31/05 19:17:31 [USMLE_Step_2] sanz: then can decide if it's due to overpdt or undersecretion...
01/31/05 19:18:28 [USMLE_Step_2] sanz: 55 yr old woman with bilat trigger points tenderness... what labs do you do next?
01/31/05 19:18:47 [USMLE_Step_2] strug: CKMB?
01/31/05 19:19:04 [USMLE_Step_2] lanny: fibtomyalgia
01/31/05 19:19:13 [USMLE_Step_2] sanz: yes, she's got fibromyalgia
01/31/05 19:19:20 [USMLE_Step_2] sanz: it is a Dx of exclusion
01/31/05 19:19:32 [USMLE_Step_2] sanz: so you need to rule out polymyositis by doing a CK
01/31/05 19:19:36 [USMLE_Step_2] sanz: and also do a TSH
01/31/05 19:19:40 [USMLE_Step_2] lanny: yes rule other sys dz out
01/31/05 19:19:54 [USMLE_Step_2] lanny: dg is symptomatic
01/31/05 19:19:54 [USMLE_Step_2] sanz: cuz hypothyroid can also give you a pict of mus pain...
01/31/05 19:20:02 [USMLE_Step_2] strug: good pt sanz
01/31/05 19:20:23 [USMLE_Step_2] sanz: Rx?
01/31/05 19:20:31 [USMLE_Step_2] strug: TCA
01/31/05 19:20:43 [USMLE_Step_2] strug: tricyclic anti depressants
01/31/05 19:20:57 [USMLE_Step_2] sanz: yes... can try supportive measures or TENS first before meds...
01/31/05 19:21:01 [USMLE_Step_2] lanny: dont think there is a real trt
01/31/05 19:21:06 [USMLE_Step_2] strug: whats tens
01/31/05 19:21:12 [USMLE_Step_2] lanny: boofeedback
01/31/05 19:21:14 grix Logs in
01/31/05 19:21:21 [USMLE_Step_2] sanz: transcutaneous electrical nerve stimulation
01/31/05 19:21:26 grix Joins Subroom USMLE_Step_2
01/31/05 19:21:28 [USMLE_Step_2] lanny: massage exercise all good
01/31/05 19:21:47 [USMLE_Step_2] lanny: psychothpy and TCA
01/31/05 19:22:07 [USMLE_Step_2] sanz: yup... TCA has s/e... so try other measures first
01/31/05 19:22:33 [USMLE_Step_2] lanny: Hey guys imm answering from memory here pls correct me if i am wrong thx
01/31/05 19:22:46 [USMLE_Step_2] grix: what is todays chat about?
01/31/05 19:22:57 [USMLE_Step_2] sanz: rheumatology grix
01/31/05 19:23:01 [USMLE_Step_2] grix: ty
01/31/05 19:23:02 [USMLE_Step_2] strug: rheumatology for step 2
01/31/05 19:23:15 [USMLE_Step_2] lanny: grix you need to be initiated first
01/31/05 19:23:19 [USMLE_Step_2] grix: lol
01/31/05 19:23:30 [USMLE_Step_2] grix: when is the peds chat?
01/31/05 19:23:34 [USMLE_Step_2] sanz: tmrw
01/31/05 19:23:38 [USMLE_Step_2] strug: from 1st feb
01/31/05 19:23:43 [USMLE_Step_2] grix: anyuone know what time?
01/31/05 19:23:44 [USMLE_Step_2] lanny: 500$ credit card only
01/31/05 19:23:51 [USMLE_Step_2] grix: lol..check is in the mail
01/31/05 19:24:12 [USMLE_Step_2] strug: 7pm eastern, 6 pm central time
01/31/05 19:24:14 [USMLE_Step_2] lanny: 7.00 est
01/31/05 19:24:15 [USMLE_Step_2] grix: thanks
01/31/05 19:24:21 grix Logs Out
01/31/05 19:25:00 [USMLE_Step_2] sanz: salmon pink rash and spiking temp, arthritis... what dz?
01/31/05 19:25:01 [USMLE_Step_2] strug: Pt with Sle on Rx with steroids ....get hip pain,,,,,what do u suspect?
01/31/05 19:25:11 medico24 Logs Out
01/31/05 19:25:19 [USMLE_Step_2] lanny: osteo
01/31/05 19:25:25 [USMLE_Step_2] lanny: from steroid
01/31/05 19:25:28 [USMLE_Step_2] lanny: pred
01/31/05 19:25:29 [USMLE_Step_2] sanz: avas necr of fem head
01/31/05 19:25:35 [USMLE_Step_2] strug: right sanz
01/31/05 19:26:03 [USMLE_Step_2] sanz: young pt, salmon pink rash and spiking temp, arthritis... what dz?
01/31/05 19:26:06 [USMLE_Step_2] strug: gonorrhea?
01/31/05 19:26:12 [USMLE_Step_2] sanz: Stills' disease
01/31/05 19:26:31 [USMLE_Step_2] sanz: it is a form of Juvenile Rheum arthritis
01/31/05 19:26:36 [USMLE_Step_2] lanny: yes
01/31/05 19:26:39 [USMLE_Step_2] strug: yes
01/31/05 19:27:09 [USMLE_Step_2] strug: preg what effct on lupus?
01/31/05 19:27:27 [USMLE_Step_2] sanz: will exacerbate
01/31/05 19:27:33 [USMLE_Step_2] sanz: in 2nd or 3rd tri
01/31/05 19:27:40 [USMLE_Step_2] strug: no one knows but if flare up u can treat with steroids
01/31/05 19:27:57 [USMLE_Step_2] sanz: can cause cong heart block
01/31/05 19:27:57 [USMLE_Step_2] lanny: yep child will be born with cong heart def
01/31/05 19:28:18 [USMLE_Step_2] strug: Women with lupus shoudl be screened for what?
01/31/05 19:28:29 [USMLE_Step_2] sanz: nephritis?
01/31/05 19:28:33 [USMLE_Step_2] sanz: and HTN
01/31/05 19:28:35 grix Logs in
01/31/05 19:28:35 grix Joins Subroom USMLE_Step_2
01/31/05 19:28:44 cyrus1345 Logs in
01/31/05 19:28:45 [USMLE_Step_2] strug: Anti Ro if present nenate can have heart block
01/31/05 19:28:45 [USMLE_Step_2] grix: strug, when are u taking the test
01/31/05 19:28:50 [USMLE_Step_2] lanny: agree with urinalysys
01/31/05 19:28:59 [USMLE_Step_2] strug: march 7th grix what about u?
01/31/05 19:28:59 cyrus1345 Joins Subroom USMLE_Step_2
01/31/05 19:29:03 [USMLE_Step_2] strug: hi nasi
01/31/05 19:29:04 [USMLE_Step_2] grix: end of march
01/31/05 19:29:13 [USMLE_Step_2] grix: does the chats help alot?
01/31/05 19:29:14 [USMLE_Step_2] cyrus1345: Hi every body
01/31/05 19:29:15 [USMLE_Step_2] sanz: hey Nasi :)
01/31/05 19:29:23 [USMLE_Step_2] lanny: hey nasi
01/31/05 19:29:37 [USMLE_Step_2] strug: u can read the transcropts grix and get an idea
01/31/05 19:29:41 [USMLE_Step_2] grix: cool
01/31/05 19:29:43 [USMLE_Step_2] sanz: what is felty's syndr?
01/31/05 19:29:49 [USMLE_Step_2] grix: ill see u tomorrow at the peds chat...later
01/31/05 19:29:52 grix Logs Out
01/31/05 19:30:03 [USMLE_Step_2] strug: splenomealy, arhtritis, neutropenisa
01/31/05 19:30:13 [USMLE_Step_2] sanz: good strug!
01/31/05 19:30:16 [USMLE_Step_2] strug: thanks
01/31/05 19:30:27 [USMLE_Step_2] lanny: diff diag reiters and ank spond
01/31/05 19:30:54 [USMLE_Step_2] strug: what s the q lanny?
01/31/05 19:31:17 [USMLE_Step_2] lanny: diff diag between reiter and ank dpon
01/31/05 19:31:34 [USMLE_Step_2] sanz: Reiters due to chlamydia... urethritis, uveitis and arthritis
01/31/05 19:31:51 [USMLE_Step_2] sanz: ank spond is sacroiliac jts
01/31/05 19:32:00 [USMLE_Step_2] lanny: reiter has muco cutaneous lesions ank spond none
01/31/05 19:32:00 [USMLE_Step_2] strug: if a pt of rheumatoid arthritis Rx with MTX what could flare up?
01/31/05 19:32:31 [USMLE_Step_2] sanz: dont know strug...
01/31/05 19:32:33 [USMLE_Step_2] strug: rheumatic nodules
01/31/05 19:32:41 [USMLE_Step_2] cyrus1345: good point thanks
01/31/05 19:32:44 [USMLE_Step_2] sanz: why's that?
01/31/05 19:32:48 [USMLE_Step_2] lanny: what do you give for flare up
01/31/05 19:33:08 [USMLE_Step_2] strug: Hiv and rheumatoid arthritis......rhaumatoid imprives or worsens?
01/31/05 19:33:17 [USMLE_Step_2] sanz: improves
01/31/05 19:33:18 [USMLE_Step_2] cyrus1345: improve
01/31/05 19:33:22 grix Logs in
01/31/05 19:33:22 grix Joins Subroom USMLE_Step_2
01/31/05 19:33:25 [USMLE_Step_2] strug: good guys kfeep it up
01/31/05 19:33:25 [USMLE_Step_2] fouzia: improves
01/31/05 19:33:33 dua_frank Logs in
01/31/05 19:33:35 dua_frank Joins Subroom USMLE_Step_2
01/31/05 19:33:42 [USMLE_Step_2] fouzia: actually tghey never exist together
01/31/05 19:33:42 [USMLE_Step_2] grix: anhyone heard of mo media..any good to get?
01/31/05 19:33:51 [USMLE_Step_2] dua_frank: hey all
01/31/05 19:34:00 [USMLE_Step_2] sanz: may i ask why rh nodules would flare up with MTX? cuz of imm suppression?
01/31/05 19:34:04 [USMLE_Step_2] lanny: hey dua
01/31/05 19:34:06 [USMLE_Step_2] sanz: hey dua :) howdy?
01/31/05 19:34:15 [USMLE_Step_2] cyrus1345: HI dua
01/31/05 19:34:15 [USMLE_Step_2] dua_frank: fine and dandy :P
01/31/05 19:34:16 [USMLE_Step_2] strug: hey dua, howz u?
01/31/05 19:34:35 grix Logs Out
01/31/05 19:34:38 [USMLE_Step_2] dua_frank: hope you'll are doing good too
01/31/05 19:34:42 [USMLE_Step_2] strug: sanz i dunno why.......maybe its a immunosupressivve drug that why
01/31/05 19:34:58 [USMLE_Step_2] lanny: would think so too
01/31/05 19:35:02 [USMLE_Step_2] sanz: thnx strug
01/31/05 19:35:05 [USMLE_Step_2] strug: whats the pathophysiology of RA?
01/31/05 19:35:13 [USMLE_Step_2] cyrus1345: what's side effect of methotroxate?
01/31/05 19:35:24 [USMLE_Step_2] sanz: inflammatory
01/31/05 19:35:29 [USMLE_Step_2] strug: hepatisi, pneumonitis
01/31/05 19:35:33 [USMLE_Step_2] cyrus1345: dur to increase t lymph and
01/31/05 19:35:44 [USMLE_Step_2] cyrus1345: pann synu
01/31/05 19:36:02 [USMLE_Step_2] strug: what is affected the cartilage, or bone, or synoviusm
01/31/05 19:36:10 [USMLE_Step_2] cyrus1345: and bone marrow supreesion
01/31/05 19:36:13 [USMLE_Step_2] lanny: myelosuppresion
01/31/05 19:36:16 [USMLE_Step_2] sanz: synovium
01/31/05 19:36:22 [USMLE_Step_2] strug: synovium yes
01/31/05 19:36:28 [USMLE_Step_2] lanny: thats why we give leukovorin
01/31/05 19:36:32 [USMLE_Step_2] strug: what is affected in OA?
01/31/05 19:36:34 [USMLE_Step_2] lanny: with mtrx
01/31/05 19:36:38 [USMLE_Step_2] sanz: thus pannus formation
01/31/05 19:36:45 [USMLE_Step_2] dua_frank: cartilage
01/31/05 19:36:53 [USMLE_Step_2] strug: cartilage yes
01/31/05 19:36:54 [USMLE_Step_2] sanz: yup cartilage
01/31/05 19:37:15 [USMLE_Step_2] sanz: and causes osteophytes
01/31/05 19:37:15 [USMLE_Step_2] strug: and due to loss of cartilage...the bone grows and deforms the joint
01/31/05 19:37:28 [USMLE_Step_2] cyrus1345: does age associated with OA?
01/31/05 19:37:31 [USMLE_Step_2] strug: is OA inflammatroyu?
01/31/05 19:37:33 [USMLE_Step_2] sanz: yes
01/31/05 19:37:34 [USMLE_Step_2] strug: yes
01/31/05 19:37:36 [USMLE_Step_2] sanz: no strug
01/31/05 19:37:40 [USMLE_Step_2] sanz: it's degenerative
01/31/05 19:37:42 [USMLE_Step_2] cyrus1345: no strug
01/31/05 19:37:50 [USMLE_Step_2] strug: yes sanz right u also right nasi
01/31/05 19:37:54 [USMLE_Step_2] lanny: forms osteophytes
01/31/05 19:37:59 [USMLE_Step_2] strug: yes lanny
01/31/05 19:38:00 [USMLE_Step_2] sanz: what is Caplan syndr?
01/31/05 19:38:09 [USMLE_Step_2] cyrus1345: sanz age doesnot associate
01/31/05 19:38:20 [USMLE_Step_2] strug: rheumatoid rthritis, rh nodues in lung and coalworkers pneumo
01/31/05 19:38:25 [USMLE_Step_2] dua_frank: it increases with age
01/31/05 19:38:29 [USMLE_Step_2] sanz: way to go strug!
01/31/05 19:38:41 [USMLE_Step_2] cyrus1345: no dua
01/31/05 19:38:49 [USMLE_Step_2] lanny: yes age assoc with OA 70 and old
01/31/05 19:38:57 [USMLE_Step_2] strug: age is a major risk factor for OA
01/31/05 19:39:09 [USMLE_Step_2] lanny: agree
01/31/05 19:39:13 [USMLE_Step_2] dua_frank: lets say that agining alone does not cause OA
01/31/05 19:39:18 [USMLE_Step_2] lanny: no 1 risk fact
01/31/05 19:39:26 [USMLE_Step_2] sanz: yup... Hx of maj trauma is imp
01/31/05 19:39:28 [USMLE_Step_2] dua_frank: but if you have OA and you are yuong, it's bound to increase with age
01/31/05 19:39:32 crengy Logs in
01/31/05 19:39:49 [USMLE_Step_2] lanny: it does not cause but its no 1 risk fac next is trauma obese
01/31/05 19:39:52 crengy Joins Subroom USMLE_Step_2
01/31/05 19:40:18 strug Disconnects
01/31/05 19:40:44 [USMLE_Step_2] sanz: name seronegatives arthritic dz
01/31/05 19:40:51 [USMLE_Step_2] dua_frank: reiters
01/31/05 19:40:59 [USMLE_Step_2] sanz: yup
01/31/05 19:41:04 [USMLE_Step_2] sanz: ank spondy
01/31/05 19:41:08 [USMLE_Step_2] dua_frank: ankylosing spondy
01/31/05 19:41:12 [USMLE_Step_2] sanz: psoriatic arthritis
01/31/05 19:41:12 [USMLE_Step_2] dua_frank: reactive arthritis
01/31/05 19:41:16 [USMLE_Step_2] dua_frank: psoriatic
01/31/05 19:41:29 [USMLE_Step_2] sanz: cant remember the last one... hehe
01/31/05 19:41:30 [USMLE_Step_2] dua_frank: whipples
01/31/05 19:41:33 [USMLE_Step_2] lanny: someone tells me what seronegative means plz
01/31/05 19:41:34 [USMLE_Step_2] dua_frank: behcets
01/31/05 19:41:41 [USMLE_Step_2] sanz: yup that's it
01/31/05 19:41:52 [USMLE_Step_2] sanz: lanny, it just means RF negative
01/31/05 19:42:01 [USMLE_Step_2] lanny: ok thx
01/31/05 19:42:14 [USMLE_Step_2] crengy: wipple is cosidered seroneg?
01/31/05 19:42:16 [USMLE_Step_2] sanz: HLA B27 +
01/31/05 19:42:21 [USMLE_Step_2] sanz: hey crengy
01/31/05 19:42:23 [USMLE_Step_2] dua_frank: yes crengy
01/31/05 19:42:28 [USMLE_Step_2] crengy: thanks
01/31/05 19:42:37 [USMLE_Step_2] lanny: what about SLE
01/31/05 19:42:39 spice Logs in
01/31/05 19:42:39 [USMLE_Step_2] dua_frank: welcome
01/31/05 19:42:51 [USMLE_Step_2] crengy: hello everybody
01/31/05 19:42:56 spice Joins Subroom USMLE_Step_2
01/31/05 19:43:06 [USMLE_Step_2] sanz: how are u doing?
01/31/05 19:43:06 [USMLE_Step_2] dua_frank: which is the most common joint involved in OA?
01/31/05 19:43:09 [USMLE_Step_2] crengy: i'm kind of sleepy but try to chat with u
01/31/05 19:43:10 [USMLE_Step_2] dua_frank: hey crengy
01/31/05 19:43:11 [USMLE_Step_2] sanz: knee
01/31/05 19:43:18 [USMLE_Step_2] lanny: DIP PIP knee
01/31/05 19:43:21 [USMLE_Step_2] crengy: dif
01/31/05 19:43:21 [USMLE_Step_2] dua_frank: interphalangeal
01/31/05 19:43:21 [USMLE_Step_2] sanz: ok... ask us qs... it'll keep you awake
01/31/05 19:43:28 [USMLE_Step_2] lanny: yep
01/31/05 19:43:34 [USMLE_Step_2] lanny: prox distal
01/31/05 19:43:45 [USMLE_Step_2] crengy: it's distal for sure
01/31/05 19:43:50 [USMLE_Step_2] lanny: yep
01/31/05 19:44:02 [USMLE_Step_2] crengy: prox is always for rheum
01/31/05 19:44:03 [USMLE_Step_2] sanz: DIP and PIP
01/31/05 19:44:13 [USMLE_Step_2] dua_frank: is ESR high?
01/31/05 19:44:16 [USMLE_Step_2] spice: pip most cofmmonly invovlved in which condition?
01/31/05 19:44:23 [USMLE_Step_2] crengy: assoc with hebert nodules also
01/31/05 19:44:24 [USMLE_Step_2] dua_frank: yes sanz both
01/31/05 19:44:27 [USMLE_Step_2] sanz: RA is MCP and PIP
01/31/05 19:44:34 [USMLE_Step_2] lanny: yes
01/31/05 19:44:36 [USMLE_Step_2] crengy: yes
01/31/05 19:44:43 [USMLE_Step_2] sanz: spice, RA
01/31/05 19:44:56 [USMLE_Step_2] dua_frank: ESR is always normal in OA
01/31/05 19:44:58 [USMLE_Step_2] crengy: ESR is normal in OA
01/31/05 19:44:59 [USMLE_Step_2] spice: what about psoriatic artritis
01/31/05 19:45:00 [USMLE_Step_2] lanny: PIP is bouchard \DIP is herben
01/31/05 19:45:10 [USMLE_Step_2] lanny: yes normal
01/31/05 19:45:11 [USMLE_Step_2] crengy: is high
01/31/05 19:45:13 [USMLE_Step_2] sanz: got it lanny :)
01/31/05 19:45:14 [USMLE_Step_2] dua_frank: normal
01/31/05 19:45:21 [USMLE_Step_2] lanny: OAis not an inflammation
01/31/05 19:45:37 [USMLE_Step_2] crengy: high in psoriasis
01/31/05 19:45:43 [USMLE_Step_2] sanz: psoriatic arthir has pitting nails and sausage shaped fingers spice
01/31/05 19:45:46 [USMLE_Step_2] crengy: as in RA
01/31/05 19:45:50 [USMLE_Step_2] dua_frank: right
01/31/05 19:46:04 [USMLE_Step_2] spice: got itr nxs
01/31/05 19:46:14 [USMLE_Step_2] dua_frank: ESR high in?
01/31/05 19:46:20 [USMLE_Step_2] lanny: psoriatic arthr has skin manifest lesions
01/31/05 19:46:26 [USMLE_Step_2] crengy: psoriasis and RA
01/31/05 19:46:34 [USMLE_Step_2] lanny: agree
01/31/05 19:46:50 [USMLE_Step_2] crengy: what drugs u avoid in psoriasis?
01/31/05 19:46:56 [USMLE_Step_2] sanz: Rx of Reiter?
01/31/05 19:47:09 [USMLE_Step_2] sanz: methotrexate crengy?
01/31/05 19:47:19 [USMLE_Step_2] crengy: no sanz
01/31/05 19:47:22 strug Logs in
01/31/05 19:47:25 strug Joins Subroom USMLE_Step_2
01/31/05 19:47:28 [USMLE_Step_2] sanz: ooops... hehe
01/31/05 19:47:29 [USMLE_Step_2] lanny: indomethacin
01/31/05 19:47:35 [USMLE_Step_2] strug: guys i got kicked of
01/31/05 19:47:43 [USMLE_Step_2] sanz: welcome back strug :)
01/31/05 19:47:47 [USMLE_Step_2] dua_frank: yes
01/31/05 19:47:49 [USMLE_Step_2] crengy: i'm trying to remember too
01/31/05 19:47:49 [USMLE_Step_2] strug: where are u all
01/31/05 19:47:50 [USMLE_Step_2] dua_frank: RA and gout
01/31/05 19:47:53 [USMLE_Step_2] dua_frank: and infective
01/31/05 19:47:57 [USMLE_Step_2] spice: Rx of psoriatic artritis
01/31/05 19:48:06 [USMLE_Step_2] sanz: we're talking abt psoriatic arthritis
01/31/05 19:48:11 [USMLE_Step_2] strug: ok thanks
01/31/05 19:48:12 [USMLE_Step_2] cyrus1345: NSAID
01/31/05 19:48:23 [USMLE_Step_2] strug: yup i too go for nsais
01/31/05 19:48:32 [USMLE_Step_2] lanny: trt of reiters indomethacin toc
01/31/05 19:48:39 [USMLE_Step_2] sanz: crengy asks what to avoid
01/31/05 19:48:41 [USMLE_Step_2] spice: whata bout glucocorticoids
01/31/05 19:48:49 [USMLE_Step_2] crengy: no
01/31/05 19:49:10 [USMLE_Step_2] sanz: lanny, Rx of Reiters is tetracycline... to eradicate chlamydia...
01/31/05 19:49:10 [USMLE_Step_2] crengy: i'm coming back in a minute with the answer
01/31/05 19:49:16 fouzia Logs Out
01/31/05 19:49:17 [USMLE_Step_2] sanz: ok creangy thnx
01/31/05 19:49:18 [USMLE_Step_2] lanny: crengy you know what to avoid..
01/31/05 19:49:47 [USMLE_Step_2] cyrus1345: what's initial tx for OA?
01/31/05 19:49:53 [USMLE_Step_2] strug: in entropathic arthropathey we shoudl avaoid nsaids
01/31/05 19:49:59 [USMLE_Step_2] dua_frank: what are the markers for osteoclasts?
01/31/05 19:50:03 [USMLE_Step_2] lanny: symptom
01/31/05 19:50:05 [USMLE_Step_2] lanny: trt
01/31/05 19:50:05 [USMLE_Step_2] dua_frank: and what for osteoblasts?
01/31/05 19:50:11 [USMLE_Step_2] strug: weight reduction nasi
01/31/05 19:50:17 [USMLE_Step_2] lanny: analgesics
01/31/05 19:50:18 [USMLE_Step_2] strug: and posture control
01/31/05 19:50:28 [USMLE_Step_2] dua_frank: weight loss
01/31/05 19:50:35 [USMLE_Step_2] lanny: joint rest
01/31/05 19:50:36 [USMLE_Step_2] sanz: dua, IL1
01/31/05 19:50:55 [USMLE_Step_2] sanz: i dont know abt osteoblasts
01/31/05 19:51:29 [USMLE_Step_2] strug: SLE is erosive or nonerosive?
01/31/05 19:51:34 [USMLE_Step_2] sanz: non
01/31/05 19:51:39 [USMLE_Step_2] spice: none4rosive
01/31/05 19:51:45 [USMLE_Step_2] strug: nonerosive yup sanz and spice
01/31/05 19:51:54 [USMLE_Step_2] lanny: 55 yo female ask you about OCP and orvt osteo porosis whats your best advice
01/31/05 19:52:28 [USMLE_Step_2] crengy: i'm back; hydroxiclorochine should be avoid in psor. arthr bz of exacerbations, even it's good for skin lesions; it was especialy for Sanz
01/31/05 19:52:37 [USMLE_Step_2] lanny: thx crengy
01/31/05 19:52:42 [USMLE_Step_2] crengy: welcome
01/31/05 19:52:47 [USMLE_Step_2] sanz: thnx crengy :)
01/31/05 19:52:52 [USMLE_Step_2] spice: ocp + calcium suplementation and advise not tot smoke
01/31/05 19:53:02 [USMLE_Step_2] dua_frank: osteoclsts acid phosphate
01/31/05 19:53:17 [USMLE_Step_2] lanny: i mean ask you about taking estrogen or not
01/31/05 19:53:20 [USMLE_Step_2] dua_frank: and osteoblasts alkaline phosphate and osteocalcin
01/31/05 19:53:43 [USMLE_Step_2] sanz: agree with spice lanny
01/31/05 19:53:47 [USMLE_Step_2] sanz: thnx dua
01/31/05 19:53:59 [USMLE_Step_2] strug: nasi whats ur ans?
01/31/05 19:54:05 [USMLE_Step_2] crengy: you should talk with her about pos and neg aspects of HT
01/31/05 19:54:11 lenhoxung Logs in
01/31/05 19:54:12 lenhoxung Joins Subroom USMLE_Step_1
01/31/05 19:54:27 [USMLE_Step_2] lanny: and let her decide
01/31/05 19:54:31 [USMLE_Step_2] crengy: yep
01/31/05 19:54:46 [USMLE_Step_2] lanny: been controversy the last few years!!!!!
01/31/05 19:55:00 [USMLE_Step_2] dua_frank: short term HT works
01/31/05 19:55:07 [USMLE_Step_2] dua_frank: long term out of practice these days
01/31/05 19:55:29 [USMLE_Step_2] lanny: also right but the choice is hers dua
01/31/05 19:55:36 [USMLE_Step_2] sanz: what do you have to do if you put SLE pt on hydroxychloroquine?
01/31/05 19:55:46 [USMLE_Step_2] dua_frank: yes lanny
01/31/05 19:55:51 [USMLE_Step_2] cyrus1345: sorry strug ,i just come back now,just answering phone!
01/31/05 19:55:51 [USMLE_Step_2] dua_frank: the patient comes first
01/31/05 19:56:02 [USMLE_Step_2] crengy: ophtalmo cons
01/31/05 19:56:20 [USMLE_Step_2] sanz: good crengy... regular eye check... for what?
01/31/05 19:56:29 lenhoxung Logs Out
01/31/05 19:56:46 [USMLE_Step_2] strug: retinopathy sanz
01/31/05 19:56:48 [USMLE_Step_2] sanz: macular degeneration... a side effect of hydroxychlo
01/31/05 19:57:02 [USMLE_Step_2] crengy: hmm retinal....degen?!
01/31/05 19:57:14 lenhoxung Logs in
01/31/05 19:57:28 [USMLE_Step_2] lanny: not sure about mac degen
01/31/05 19:57:34 lenhoxung Joins Subroom USMLE_Step_1
01/31/05 19:57:59 [USMLE_Step_2] sanz: i'm quite sure... it's from UW...
01/31/05 19:58:00 [USMLE_Step_2] cyrus1345: SLE and pregnancy ,make it worse or not?
01/31/05 19:58:10 [USMLE_Step_2] crengy: worse
01/31/05 19:58:12 [USMLE_Step_2] sanz: can flare up
01/31/05 19:58:14 [USMLE_Step_2] cyrus1345: thanks snaz ,good point
01/31/05 19:58:17 [USMLE_Step_2] crengy: bz of estrogens
01/31/05 19:58:31 [USMLE_Step_2] strug: no one knows but if it occurs u can treat with steroids
01/31/05 19:58:52 [USMLE_Step_2] cyrus1345: just in first trimester and immediatly postpartum!
01/31/05 19:59:05 [USMLE_Step_2] strug: nasi whats the first step in Mx of pt of OA?
01/31/05 19:59:29 [USMLE_Step_2] crengy: Mx?
01/31/05 19:59:33 [USMLE_Step_2] cyrus1345: you were right strug,but I meant what drug?
01/31/05 19:59:40 [USMLE_Step_2] sanz: what complements are low in SLE?
01/31/05 19:59:43 [USMLE_Step_2] strug: ok
01/31/05 19:59:48 [USMLE_Step_2] dua_frank: c3
01/31/05 19:59:48 [USMLE_Step_2] strug: C3
01/31/05 19:59:53 [USMLE_Step_2] strug: thanks nasi
01/31/05 20:00:08 [USMLE_Step_2] strug: are they also l;ow in drug induced lupus?
01/31/05 20:00:09 [USMLE_Step_2] sanz: yup and C4 as well... good guys!
01/31/05 20:00:13 [USMLE_Step_2] dua_frank: no
01/31/05 20:00:18 [USMLE_Step_2] crengy: no
01/31/05 20:00:19 [USMLE_Step_2] lanny: no
01/31/05 20:00:20 [USMLE_Step_2] sanz: no
01/31/05 20:00:23 [USMLE_Step_2] strug: no rigth dua all right
01/31/05 20:00:29 [USMLE_Step_2] lanny: can diff that way
01/31/05 20:00:39 [USMLE_Step_2] crengy: and no renal inv
01/31/05 20:00:47 [USMLE_Step_2] crengy: no neuro involv
01/31/05 20:00:48 [USMLE_Step_2] strug: also anithistone abtibody in drug induced
01/31/05 20:00:54 [USMLE_Step_2] crengy: right
01/31/05 20:00:55 [USMLE_Step_2] lanny: yes
01/31/05 20:00:56 [USMLE_Step_2] sanz: yup
01/31/05 20:01:00 [USMLE_Step_2] dua_frank: how do calcitonin, estrogens and biphosphonates help in OA?
01/31/05 20:01:09 [USMLE_Step_1] lenhoxung: Anybody here?
01/31/05 20:01:15 [USMLE_Step_2] lanny: what two drugs cause drug ind lup
01/31/05 20:01:19 [USMLE_Step_2] crengy: no-my oppinion
01/31/05 20:01:28 [USMLE_Step_2] sanz: bisphos inh osteoclasts dua...
01/31/05 20:01:47 [USMLE_Step_2] crengy: peniciliamine
01/31/05 20:01:48 [USMLE_Step_2] sanz: gydralazine lanny
01/31/05 20:01:49 [USMLE_Step_2] dua_frank: they help deposit bone
01/31/05 20:01:51 mmw Logs in
01/31/05 20:01:51 mmw Joins Subroom USMLE_Step_1
01/31/05 20:01:53 [USMLE_Step_2] strug: procinamide , hydralaxine, methyldopa, INH and Infliximab cause lupus
01/31/05 20:01:58 [USMLE_Step_2] sanz: hydralazine i mean
01/31/05 20:02:03 [USMLE_Step_2] lanny: right
01/31/05 20:02:07 [USMLE_Step_2] spice: aree strug
01/31/05 20:02:18 [USMLE_Step_2] cyrus1345: apiatent has long history of hydralazin,now comes with arthrits,and RBC cast in URIN and malar rash what's your diagnosis?
01/31/05 20:02:19 [USMLE_Step_2] dua_frank: and yes sanz they can do that by inhibiting osteoclastic activity
01/31/05 20:02:30 [USMLE_Step_2] dua_frank: drug induced SLE :P
01/31/05 20:02:46 [USMLE_Step_2] cyrus1345: NO :p
01/31/05 20:02:55 [USMLE_Step_2] dua_frank: ok fine :P
01/31/05 20:02:57 [USMLE_Step_2] sanz: SLE
01/31/05 20:03:04 [USMLE_Step_2] lanny: SLE
01/31/05 20:03:06 [USMLE_Step_2] crengy: no renal involv in drug induced
01/31/05 20:03:07 [USMLE_Step_2] sanz: with glomerulonephtritis
01/31/05 20:03:08 [USMLE_Step_2] cyrus1345: systemic SLE!
01/31/05 20:03:24 [USMLE_Step_2] cyrus1345: good sanz
01/31/05 20:03:35 [USMLE_Step_2] spice: renal and cns involvement is rare in drug induced sle
01/31/05 20:03:50 [USMLE_Step_2] lanny: can say non existent
01/31/05 20:03:56 [USMLE_Step_2] crengy: yep
01/31/05 20:04:02 [USMLE_Step_2] cyrus1345: yes lanny
01/31/05 20:04:14 mmw Logs Out
01/31/05 20:04:41 [USMLE_Step_2] lanny: CREST sd what antibodies
01/31/05 20:04:49 zoya Logs in
01/31/05 20:04:49 zoya Joins Subroom USMLE_Step_1
01/31/05 20:04:51 [USMLE_Step_2] strug: A pt with rheumatid arthririts come with a painful calf ? what do u suspect?
01/31/05 20:05:01 [USMLE_Step_2] strug: Anti rnp abt
01/31/05 20:05:01 [USMLE_Step_2] crengy: anti scl 70?
01/31/05 20:05:01 [USMLE_Step_2] sanz: DVT?
01/31/05 20:05:04 mmw Logs in
01/31/05 20:05:06 mmw Joins Subroom USMLE_Step_1
01/31/05 20:05:06 [USMLE_Step_2] spice: anti centromere
01/31/05 20:05:11 [USMLE_Step_2] sanz: anticentromere lanny
01/31/05 20:05:21 [USMLE_Step_2] lanny: correct
01/31/05 20:05:24 [USMLE_Step_2] dua_frank: i always miss the obvious, thanks for that questions nasi
01/31/05 20:05:30 [USMLE_Step_2] spice: ruptrued bakes cyst
01/31/05 20:05:32 [USMLE_Step_2] crengy: baker cyst
01/31/05 20:05:32 [USMLE_Step_2] cyrus1345: baker cyct
01/31/05 20:05:32 [USMLE_Step_2] lanny: bakers cyst
01/31/05 20:05:36 [USMLE_Step_2] spice: bakers i meant
01/31/05 20:05:44 [USMLE_Step_2] strug: ruptured bakers cyst right nasi and lanny spice
01/31/05 20:05:46 [USMLE_Step_2] sanz: oh... of cuz...
01/31/05 20:05:56 [USMLE_Step_2] strug: whats teh mechanism?
01/31/05 20:06:24 [USMLE_Step_2] lanny: dont u stand strug
01/31/05 20:06:27 [USMLE_Step_2] spice: extended snnyovium intot he popliteal space

01/31/05 20:06:38 [USMLE_Step_2] strug: extensionof inflammed synovium in the popliteal space...right spice
01/31/05 20:06:40 [USMLE_Step_2] lanny: oh the
01/31/05 20:06:48 [USMLE_Step_2] crengy: wauuu
01/31/05 20:06:51 [USMLE_Step_2] strug: sorry lanny for the typo
01/31/05 20:07:03 [USMLE_Step_2] lanny: no prob
01/31/05 20:07:11 [USMLE_Step_2] cyrus1345: a paitent with NHL for 1 years and treat with chemo ,comes with 1 week history of knee pain and limping what 's your DX?

01/31/05 20:07:48 [USMLE_Step_2] spice: nice one cyrus
01/31/05 20:08:02 [USMLE_Step_2] sanz: septic arthritis?
01/31/05 20:08:08 [USMLE_Step_2] strug: hyperuricemia gout
01/31/05 20:08:32 [USMLE_Step_2] spice: trauamtic arthritis
01/31/05 20:08:45 [USMLE_Step_2] cyrus1345: no avascular necrosis of femur!
01/31/05 20:08:56 [USMLE_Step_2] spice: or the one strug jsut suggested
01/31/05 20:08:56 [USMLE_Step_2] cyrus1345: why for side effect of prednison
01/31/05 20:08:57 [USMLE_Step_2] lanny: due to ehat med
01/31/05 20:09:07 [USMLE_Step_2] lanny: oh prednisone
01/31/05 20:09:25 [USMLE_Step_2] strug: ok good one....but it could be gout too.. isnt it?
01/31/05 20:09:35 [USMLE_Step_2] spice: agree
01/31/05 20:09:46 [USMLE_Step_2] cyrus1345: why gout strug?
01/31/05 20:09:50 [USMLE_Step_2] crengy: usualy is not knee
01/31/05 20:09:54 [USMLE_Step_2] dua_frank: wrong joint for gout?
01/31/05 20:09:56 [USMLE_Step_2] spice: too many cells dysig due to chemo therapy
01/31/05 20:10:01 [USMLE_Step_2] strug: due to chemo
01/31/05 20:10:10 [USMLE_Step_2] spice: increased uric acid
01/31/05 20:10:19 [USMLE_Step_2] strug: inc in uric acid....remember tumor lysis syndrome
01/31/05 20:10:30 [USMLE_Step_2] dua_frank: yeah but it should affect kidneys first
01/31/05 20:10:33 [USMLE_Step_2] dua_frank: before the joints
01/31/05 20:10:37 [USMLE_Step_2] dua_frank: i think
01/31/05 20:10:48 [USMLE_Step_2] strug: but in this case u r right knee pain and limping suggests hip invol
01/31/05 20:10:54 [USMLE_Step_2] crengy: not every high uric acid means gout
01/31/05 20:10:56 [USMLE_Step_2] spice: what about simuntaneous manifestations
01/31/05 20:10:59 [USMLE_Step_2] strug: due to avascular necrosis
01/31/05 20:11:12 [USMLE_Step_2] cyrus1345: no the paitent has limping and the pain radiate to knee i didn't mention anything aboy inflamation and swelling and red of knee joint strug
01/31/05 20:11:14 [USMLE_Step_2] lanny: right strug
01/31/05 20:11:42 [USMLE_Step_2] strug: yes i gotcha u nasi..... u right....i wrong
01/31/05 20:11:48 [USMLE_Step_2] sanz: good discussion guys
01/31/05 20:11:55 [USMLE_Step_2] spice: was a nice question
01/31/05 20:12:02 [USMLE_Step_2] crengy: very!
01/31/05 20:12:11 [USMLE_Step_2] cyrus1345: pre test harrison!
01/31/05 20:12:18 [USMLE_Step_2] lanny: TLS is a possibility but presnetation will be diff agred/
01/31/05 20:12:37 [USMLE_Step_2] lanny: agrre?
01/31/05 20:12:45 [USMLE_Step_2] strug: yes lanny dear
01/31/05 20:12:54 [USMLE_Step_2] spice: pt with RA present with occipital headaches
01/31/05 20:13:24 [USMLE_Step_2] strug: ? spice
01/31/05 20:13:25 [USMLE_Step_2] crengy: cervical involvment?
01/31/05 20:13:26 [USMLE_Step_2] spice: what do we think about???
01/31/05 20:13:35 [USMLE_Step_2] crengy: sub luxation?
01/31/05 20:13:37 [USMLE_Step_2] sanz: C1 C2 involvement?
01/31/05 20:13:40 [USMLE_Step_2] strug: atlanto occipatl joint sublaxation
01/31/05 20:13:44 [USMLE_Step_2] cyrus1345: agree
01/31/05 20:13:45 [USMLE_Step_2] spice: yes
01/31/05 20:13:52 [USMLE_Step_2] spice: good job guys
01/31/05 20:14:04 [USMLE_Step_2] lanny: first step in diag septic arthritis
01/31/05 20:14:11 [USMLE_Step_2] strug: arthrocentssis
01/31/05 20:14:14 [USMLE_Step_2] spice: culture
01/31/05 20:14:27 [USMLE_Step_2] crengy: arthrocentesis
01/31/05 20:14:30 [USMLE_Step_2] lanny: culture culture culture all orifice!!
01/31/05 20:14:31 [USMLE_Step_2] cyrus1345: agree strug
01/31/05 20:14:51 [USMLE_Step_2] sanz: blood too
01/31/05 20:15:12 [USMLE_Step_2] crengy: ?lanny?
01/31/05 20:15:41 [USMLE_Step_2] lanny: culture first then athrocent for def diag
01/31/05 20:15:42 [USMLE_Step_2] cyrus1345: but first step is arthercentesis then culture
01/31/05 20:15:52 [USMLE_Step_2] crengy: agree Cyrus
01/31/05 20:15:52 [USMLE_Step_2] strug: u cannot say its septic or not by looking at the joint....u aspirate,..do wbc coundt, gram stain, see for crystals
01/31/05 20:16:02 [USMLE_Step_2] strug: send for cultures
01/31/05 20:16:07 [USMLE_Step_2] cyrus1345: agree
01/31/05 20:16:34 barsobia99 Logs in
01/31/05 20:16:34 [USMLE_Step_2] strug: if its due to gonorrhoe u may not even get a + culture!!!!
01/31/05 20:16:36 barsobia99 Joins Subroom USMLE_Step_1
01/31/05 20:16:41 [USMLE_Step_2] crengy: so first shoul be arthroc/
01/31/05 20:16:49 [USMLE_Step_2] strug: yes arthrocenteisis first
01/31/05 20:17:24 [USMLE_Step_2] dua_frank: give me gender involvement
01/31/05 20:17:37 [USMLE_Step_2] dua_frank: osteoporosis type 1?
01/31/05 20:17:47 [USMLE_Step_2] dua_frank: ankylosing spondylitis?
01/31/05 20:17:57 [USMLE_Step_2] strug: ankylos males
01/31/05 20:17:58 [USMLE_Step_2] sanz: ank spond - male
01/31/05 20:18:05 [USMLE_Step_2] dua_frank: yes good
01/31/05 20:18:07 [USMLE_Step_2] spice: agree w
01/31/05 20:18:09 [USMLE_Step_2] sanz: osteo - female
01/31/05 20:18:15 [USMLE_Step_2] strug: are there types of osteroporis? i dunno that
01/31/05 20:18:19 [USMLE_Step_2] dua_frank: OP type 1 females- post menopausal
01/31/05 20:18:53 [USMLE_Step_2] dua_frank: yeah type 1 is due to lack of estrogens

01/31/05 20:19:20 [USMLE_Step_2] dua_frank: type II is idiopathic or can be called as primary osteoporosis
01/31/05 20:19:47 TTW Logs in
01/31/05 20:19:48 [USMLE_Step_2] spice: what is charcots joint
01/31/05 20:19:48 [USMLE_Step_2] spice: ??
01/31/05 20:20:04 [USMLE_Step_2] strug: dunno
01/31/05 20:20:21 [USMLE_Step_2] dua_frank: syphilis?
01/31/05 20:20:27 [USMLE_Step_2] dua_frank: some disease, can't remember
01/31/05 20:20:29 crengy Logs Out
01/31/05 20:20:35 [USMLE_Step_2] cyrus1345: what arrythmia you can see in Anky spond?
01/31/05 20:20:40 [USMLE_Step_2] cyrus1345: in diabetic
01/31/05 20:20:48 [USMLE_Step_2] strug: 3rd degree block?
01/31/05 20:20:50 [USMLE_Step_2] sanz: cardia block nasi
01/31/05 20:20:57 [USMLE_Step_2] cyrus1345: yep good job
01/31/05 20:21:03 [USMLE_Step_2] dua_frank: and AR too
01/31/05 20:21:07 [USMLE_Step_2] spice: neuropathic joint disease associated with diabetes syrigomyleia perepheral nerve damage
01/31/05 20:21:16 [USMLE_Step_1] mmw: we just started rox
01/31/05 20:21:25 [USMLE_Step_2] dua_frank: diabetis...
01/31/05 20:21:42 [USMLE_Step_2] dua_frank: thanks spice
01/31/05 20:21:50 [USMLE_Step_2] spice: u r welcome
01/31/05 20:21:57 [USMLE_Step_2] sanz: thnx spice
01/31/05 20:21:59 [USMLE_Step_2] lanny: rephrasing my ques.. you got to aspirate to do culture of the joint but it is not always positive so culture al orifice throat mouth rectum cervix to look for organism
01/31/05 20:22:13 [USMLE_Step_2] strug: right lanny
01/31/05 20:22:15 [USMLE_Step_2] sanz: ok lanny
01/31/05 20:22:17 [USMLE_Step_2] spice: agreee with ya lenny
01/31/05 20:22:20 [USMLE_Step_2] lanny: thanks
01/31/05 20:22:32 [USMLE_Step_2] dua_frank: ok got it now, thanks lanny
01/31/05 20:22:33 [USMLE_Step_2] cyrus1345: Aschill reflex involve which root?
01/31/05 20:22:45 [USMLE_Step_2] strug: s1 s2
01/31/05 20:22:52 [USMLE_Step_2] dua_frank: s1
01/31/05 20:22:53 [USMLE_Step_2] sanz: S1
01/31/05 20:22:55 [USMLE_Step_2] cyrus1345: yes
01/31/05 20:23:00 [USMLE_Step_2] lanny: agree with S!
01/31/05 20:23:05 [USMLE_Step_2] lanny: S1
01/31/05 20:23:13 [USMLE_Step_2] sanz: patella?
01/31/05 20:23:20 [USMLE_Step_2] dua_frank: l 4/5
01/31/05 20:23:20 [USMLE_Step_2] strug: l4l5
01/31/05 20:23:23 [USMLE_Step_2] sanz: yup
01/31/05 20:23:27 [USMLE_Step_2] lanny: l4-l5
01/31/05 20:23:34 [USMLE_Step_2] sanz: biceps?
01/31/05 20:23:42 barsobia99 Logs Out
01/31/05 20:23:43 [USMLE_Step_2] strug: t5,t6
01/31/05 20:23:46 [USMLE_Step_2] sanz: C5-C6
01/31/05 20:23:54 [USMLE_Step_2] cyrus1345: which malignancy associate with dermatomyosit?
01/31/05 20:24:03 [USMLE_Step_2] lanny: colon cancer breast
01/31/05 20:24:07 [USMLE_Step_2] lanny: cancer
01/31/05 20:24:18 [USMLE_Step_2] strug: adeno ca of esophagus?
01/31/05 20:24:19 [USMLE_Step_2] spice: test of choice to diagnose avascular necrosis of the femoral head
01/31/05 20:24:27 [USMLE_Step_2] lanny: lung cancer
01/31/05 20:24:36 [USMLE_Step_2] cyrus1345: yes lanny and ovary,good job
01/31/05 20:24:48 [USMLE_Step_2] cyrus1345: MRI
01/31/05 20:24:50 [USMLE_Step_2] sanz: spice MRI
01/31/05 20:24:54 [USMLE_Step_2] lanny: thanks never knew ovary!!!
01/31/05 20:24:55 [USMLE_Step_2] strug: its breast lung colon overy and prostsate nasi
01/31/05 20:25:00 [USMLE_Step_2] spice: yes guys its mri
01/31/05 20:25:17 [USMLE_Step_2] cyrus1345: I don't know about prostate!!
01/31/05 20:25:25 [USMLE_Step_2] strug: yes it is
01/31/05 20:25:30 [USMLE_Step_2] cyrus1345: ok thanks
01/31/05 20:25:53 [USMLE_Step_2] cyrus1345: which malignancy associate with sogern ?
01/31/05 20:26:03 [USMLE_Step_2] strug: all and aml
01/31/05 20:26:29 [USMLE_Step_2] strug: which has better prognosis ... scleroderma or CREST syndrome?
01/31/05 20:26:37 [USMLE_Step_2] cyrus1345: are you sure strug,I just thought it's lymphoma?!
01/31/05 20:26:38 [USMLE_Step_2] sanz: crest
01/31/05 20:27:01 [USMLE_Step_2] spice: crest i guess
01/31/05 20:27:23 [USMLE_Step_2] strug: look in peds of kaplan for the causes of AML and ALL u find sjogren...
01/31/05 20:27:44 [USMLE_Step_2] strug: u right guys its crest
01/31/05 20:28:10 [USMLE_Step_2] cyrus1345: ok kaplan internal medecin just mentenied lymphoma

01/31/05 20:28:14 [USMLE_Step_2] cyrus1345: any way thanks!
01/31/05 20:28:20 [USMLE_Step_2] strug: u welcome nasi

01/31/05 20:29:12 [USMLE_Step_2] spice: polymyositis is most commonly involved with which collagen vascualr disease
01/31/05 20:29:40 [USMLE_Step_2] sanz: dont know spice...
01/31/05 20:29:49 [USMLE_Step_2] dua_frank: sjorgens?
01/31/05 20:29:56 [USMLE_Step_2] sanz: dermatomysitis?
01/31/05 20:30:01 [USMLE_Step_2] spice: mixed connective tissue disease
01/31/05 20:30:06 [USMLE_Step_2] strug: pt with allergic rhinits and asthama...eosinophilia...systemic vasuclits...Panca myeloperoxidase + ....diagnosisa?
01/31/05 20:30:34 [USMLE_Step_2] sanz: PAN?
01/31/05 20:30:39 [USMLE_Step_2] dua_frank: PAN
01/31/05 20:30:43 [USMLE_Step_2] cyrus1345: Css
01/31/05 20:30:53 [USMLE_Step_2] strug: Churg Struss syndome,... amazing nasi
01/31/05 20:30:57 [USMLE_Step_2] spice: agree with cyrus
01/31/05 20:31:06 [USMLE_Step_2] lanny: someone clarify piz in sickle cell mcc of o myelitis is salmon or staph read that staph is still mcc even in sickle?

01/31/05 20:31:23 [USMLE_Step_2] strug: i dunno
01/31/05 20:31:28 [USMLE_Step_2] dua_frank: thats a controversy that will exist with USMLE forever lanny
01/31/05 20:31:33 [USMLE_Step_2] spice: its staph
01/31/05 20:31:49 [USMLE_Step_2] cyrus1345: thanks strug,nice question
01/31/05 20:31:49 [USMLE_Step_2] strug: i would go for staph
01/31/05 20:31:55 [USMLE_Step_2] spice: thats what the fischer dude in mle lectures insisted on
01/31/05 20:32:07 [USMLE_Step_2] strug: u welcome nasi/....it was a quick and correct ans..keep it up
01/31/05 20:32:22 [USMLE_Step_2] lanny: yes spice but other sources say salmon even UW
01/31/05 20:32:39 [USMLE_Step_2] lanny: wish they dont ask this kind of ques
01/31/05 20:33:13 [USMLE_Step_2] strug: Rx of SLE?

01/31/05 20:33:46 [USMLE_Step_2] cyrus1345: a piatent with acute gout ,cr 3.3 and he has lon history of IBD what's your tx?
01/31/05 20:33:54 [USMLE_Step_2] spice: nsaids for joint invlveement
01/31/05 20:33:56 [USMLE_Step_2] cyrus1345: first line is NSAID
01/31/05 20:34:09 [USMLE_Step_2] spice: antimalarials for rash
01/31/05 20:34:22 [USMLE_Step_2] lanny: Nsaid or hydroxychloro
01/31/05 20:34:23 [USMLE_Step_2] cyrus1345: if CNS ,GN and hemolytic anemia corticosteroid
01/31/05 20:34:36 [USMLE_Step_2] spice: pulse cyclophosphomide for nephritis
01/31/05 20:34:51 [USMLE_Step_2] lanny: right spice
01/31/05 20:34:53 [USMLE_Step_2] strug: all correct
01/31/05 20:35:08 [USMLE_Step_2] strug: but for kidney we give cytotoxics nasi

01/31/05 20:35:22 [USMLE_Step_2] strug: all other major org inv steroids
01/31/05 20:35:31 [USMLE_Step_2] cyrus1345: it depends which type of GN
01/31/05 20:35:31 [USMLE_Step_2] strug: nsiaids for arthrits
01/31/05 20:35:37 [USMLE_Step_2] strug: really?
01/31/05 20:36:02 [USMLE_Step_2] cyrus1345: if it's just membrano with protinuria it's ok with cortico

01/31/05 20:36:37 [USMLE_Step_2] lanny: indications for use of DMARDS in RA
01/31/05 20:36:39 [USMLE_Step_2] strug: allopurinol nasi
01/31/05 20:36:49 [USMLE_Step_2] strug: erosive joint disease lanny
01/31/05 20:36:55 [USMLE_Step_2] cyrus1345: no strug he is in acute gout!
01/31/05 20:37:06 [USMLE_Step_1] mmw: yes zoya
01/31/05 20:37:07 [USMLE_Step_2] sanz: Steroids nasi?
01/31/05 20:37:09 [USMLE_Step_2] strug: oh gosh
01/31/05 20:37:15 [USMLE_Step_2] lanny: whatd the MC dmard used MTRX or gold
01/31/05 20:37:17 [USMLE_Step_2] cyrus1345: good job snaz
01/31/05 20:37:18 [USMLE_Step_2] strug: yup i go for steroids now
01/31/05 20:37:34 [USMLE_Step_2] strug: MTZX lanny
01/31/05 20:37:35 [USMLE_Step_2] spice: mtx
01/31/05 20:37:55 [USMLE_Step_2] spice: whn o stop using gold salts
01/31/05 20:38:03 [USMLE_Step_2] lanny: what to watch for and monitor in gold
01/31/05 20:38:04 [USMLE_Step_2] strug: rash or nephritis
01/31/05 20:38:07 [USMLE_Step_2] spice: i eman indiacations for discontinuing gold
01/31/05 20:38:16 [USMLE_Step_2] cyrus1345: bone marrow
01/31/05 20:38:25 [USMLE_Step_2] cyrus1345: supression
01/31/05 20:38:27 [USMLE_Step_2] spice: rasha nd protienuria
01/31/05 20:38:31 [USMLE_Step_2] lanny: yep dec WBC
01/31/05 20:39:13 [USMLE_Step_2] lanny: spice wats yur ques
01/31/05 20:39:22 [USMLE_Step_2] sanz: Rx for Raynaud?
01/31/05 20:39:26 [USMLE_Step_2] strug: ccb
01/31/05 20:39:30 [USMLE_Step_2] cyrus1345: agree
01/31/05 20:39:39 [USMLE_Step_2] lanny: whats ccb
01/31/05 20:39:39 [USMLE_Step_2] sanz: yup
01/31/05 20:39:45 [USMLE_Step_2] sanz: Ca channel blockers
01/31/05 20:39:52 [USMLE_Step_2] cyrus1345: what's tx for SSC?
01/31/05 20:39:52 [USMLE_Step_2] lanny: oh oh oh!!!
01/31/05 20:39:58 [USMLE_Step_2] strug: whats ssc
01/31/05 20:40:25 [USMLE_Step_2] lanny: sys sclerosis
01/31/05 20:40:27 [USMLE_Step_2] cyrus1345: systemic sclerosis :)
01/31/05 20:40:38 [USMLE_Step_2] strug: for skin invo penicllamine... for HYpertension ACE-I and for raynouds ccb
01/31/05 20:40:44 [USMLE_Step_2] spice: ccb ace inhibitors h2 antagonists d pencillinamase
01/31/05 20:40:53 [USMLE_Step_2] cyrus1345: good job buddy
01/31/05 20:41:09 [USMLE_Step_2] strug: whats the most coomon cause of death for SSC?
01/31/05 20:41:21 [USMLE_Step_2] cyrus1345: renal f
01/31/05 20:41:21 [USMLE_Step_2] sanz: renal
01/31/05 20:41:25 [USMLE_Step_2] spice: renal
01/31/05 20:41:26 [USMLE_Step_2] strug: pul involvemnt
01/31/05 20:41:38 [USMLE_Step_2] cyrus1345: ohhh!ok!
01/31/05 20:41:41 [USMLE_Step_2] strug: renal incidence decreasing because of use of ACE-I
01/31/05 20:41:45 [USMLE_Step_2] cyrus1345: you right!
01/31/05 20:41:58 [USMLE_Step_2] cyrus1345: what about SLE?
01/31/05 20:42:10 [USMLE_Step_2] strug: rrenal i guess
01/31/05 20:42:10 [USMLE_Step_2] sanz: renal
01/31/05 20:42:20 [USMLE_Step_2] cyrus1345: acute or chronic?
01/31/05 20:42:33 [USMLE_Step_2] sanz: chr
01/31/05 20:42:36 [USMLE_Step_2] cyrus1345: yep
01/31/05 20:42:45 [USMLE_Step_2] strug: good pt nasi
01/31/05 20:42:51 [USMLE_Step_2] sanz: usu diffuse proliferative GN
01/31/05 20:43:15 [USMLE_Step_2] strug: what diff kind of GN with SLE?
01/31/05 20:43:45 [USMLE_Step_2] sanz: mesangial, diffuse proliferative GN and sclerosing...
01/31/05 20:43:45 [USMLE_Step_2] cyrus1345: membrano,focal,segmental and diffuse
01/31/05 20:44:04 [USMLE_Step_2] lanny: agree with sanz
01/31/05 20:44:34 [USMLE_Step_2] cyrus1345: and interstial nephritis du to imune complex

01/31/05 20:45:08 [USMLE_Step_2] strug: young pt fracture with minimal truama...what do u suspect?
01/31/05 20:45:23 [USMLE_Step_2] cyrus1345: A spondy
01/31/05 20:45:29 [USMLE_Step_2] sanz: osteosarcoma?
01/31/05 20:45:34 [USMLE_Step_2] strug: ankylosing spondylitis........good nasi!!!!!
01/31/05 20:45:48 [USMLE_Step_2] lanny: where fracture
01/31/05 20:46:00 [USMLE_Step_2] strug: whats the first sign of AS? in spine dear lanny
01/31/05 20:46:25 [USMLE_Step_2] strug: AS= ankylosing spondy
01/31/05 20:46:28 [USMLE_Step_2] lanny: bamboo spine
01/31/05 20:46:38 [USMLE_Step_2] sanz: morning stiffness
01/31/05 20:46:39 [USMLE_Step_2] lanny: sacroilitis
01/31/05 20:46:43 [USMLE_Step_2] spice: back paina nd stifness
01/31/05 20:46:44 [USMLE_Step_2] strug: sacroilities
01/31/05 20:46:56 [USMLE_Step_2] spice: juxtaarticular pain
01/31/05 20:47:09 [USMLE_Step_2] strug: in which condition u find fish mouth verterbrea?
01/31/05 20:47:18 [USMLE_Step_2] spice: inflation at insertion of tendoins and kigaments
01/31/05 20:47:35 [USMLE_Step_2] dua_frank: osteoporosis
01/31/05 20:47:46 [USMLE_Step_2] strug: Sickle cell anemia
01/31/05 20:47:47 cyrus1345 Logs Out
01/31/05 20:47:51 [USMLE_Step_2] lanny: strug young pt with min trauma can be few things
01/31/05 20:47:55 [USMLE_Step_2] dua_frank: SCA>
01/31/05 20:47:56 [USMLE_Step_2] dua_frank: ?
01/31/05 20:48:11 [USMLE_Step_2] dua_frank: ok codfish vertebrae in osteoporosis
01/31/05 20:48:52 [USMLE_Step_2] strug: i meant fracture of the spine
01/31/05 20:49:31 [USMLE_Step_2] strug: erythema nodosum found in which conditions? name 3 most common
01/31/05 20:49:42 [USMLE_Step_2] sanz: dua, codfish vertebrae seen in osteoporosis?
01/31/05 20:49:54 [USMLE_Step_2] dua_frank: yes sanz
01/31/05 20:49:59 [USMLE_Step_2] sanz: TB strug
01/31/05 20:50:00 [USMLE_Step_2] lanny: strug could you plz post todays transcipt in valueMD plz thank you i have to go but mayl be back before 9.00, if not will join you on peds tom

01/31/05 20:50:17 [USMLE_Step_2] lanny: ok strug i did not see that
01/31/05 20:50:26 [USMLE_Step_2] strug: sarcoidosis.. rheumatic fever, IBD
01/31/05 20:50:47 [USMLE_Step_2] strug: i duno how to post the trnscript but i will try...
01/31/05 20:50:50 [USMLE_Step_2] spice: good one strug
01/31/05 20:50:58 [USMLE_Step_2] dua_frank: what abotu PAN?
01/31/05 20:50:58 [USMLE_Step_2] strug: thansk
01/31/05 20:51:04 [USMLE_Step_2] lanny: sorry i thought you did the others
01/31/05 20:51:05 [USMLE_Step_2] dua_frank: doesn't that have erythema nodosum too?
01/31/05 20:51:34 [USMLE_Step_2] strug: there are many condision which have erythema nodosum...these are the most common ones
01/31/05 20:51:41 [USMLE_Step_2] dua_frank: oh ok
01/31/05 20:52:00 [USMLE_Step_2] spice: Rx of fibromyalgia
01/31/05 20:52:11 [USMLE_Step_2] dua_frank: HLA B5 in which condition?
01/31/05 20:52:14 [USMLE_Step_2] strug: TCA befor that can try TENS
01/31/05 20:52:18 [USMLE_Step_2] sanz: supportive, TENS and TCA
01/31/05 20:52:22 [USMLE_Step_2] dua_frank: NSAIDs
01/31/05 20:52:24 [USMLE_Step_2] strug: DM
01/31/05 20:52:35 [USMLE_Step_2] strug: dua DM
01/31/05 20:52:40 [USMLE_Step_2] dua_frank: behcets
01/31/05 20:52:40 [USMLE_Step_2] lanny: zdiabetes
01/31/05 20:53:09 [USMLE_Step_2] spice: ARGREE STRUG AND SANZ
01/31/05 20:53:12 [USMLE_Step_2] dua_frank: Tx of behcets?
01/31/05 20:53:20 [USMLE_Step_2] strug: nsaids
01/31/05 20:53:36 [USMLE_Step_2] dua_frank: colchicine and cyclosporin
01/31/05 20:53:37 [USMLE_Step_2] sanz: and steroids
01/31/05 20:53:42 [USMLE_Step_2] spice: but
01/31/05 20:53:44 [USMLE_Step_2] spice: ...
01/31/05 20:53:44 [USMLE_Step_2] strug: anyone from India here?
01/31/05 20:53:45 [USMLE_Step_2] spice: .0..
01/31/05 20:53:47 [USMLE_Step_2] spice: .
01/31/05 20:53:50 [USMLE_Step_2] dua_frank: <india
01/31/05 20:54:08 [USMLE_Step_2] spice: i am
01/31/05 20:54:14 [USMLE_Step_2] spice: an indian
01/31/05 20:54:25 [USMLE_Step_2] sanz: i have a few colleagues fr India :)
01/31/05 20:54:31 [USMLE_Step_2] strug: i am from gujarat , dua i know waht about u spice?
01/31/05 20:54:50 [USMLE_Step_2] spice: i am punjabi
01/31/05 20:55:06 [USMLE_Step_2] spice: where are u from dua
01/31/05 20:55:08 [USMLE_Step_2] strug: wow....my roommate in med school was from Punjab
01/31/05 20:55:42 [USMLE_Step_2] spice: u are here in states aren't ypou strug
01/31/05 20:55:57 [USMLE_Step_2] strug: yes i am
01/31/05 20:56:02 [USMLE_Step_2] spice: east coast
01/31/05 20:56:05 [USMLE_Step_2] dua_frank: sanz you a brit?
01/31/05 20:56:16 sux Logs in
01/31/05 20:56:16 sux Joins Subroom USMLE_Step_1
01/31/05 20:56:20 [USMLE_Step_2] spice: is that true sanz
01/31/05 20:56:33 [USMLE_Step_2] sanz: I graduated from Edinburgh
01/31/05 20:56:44 [USMLE_Step_2] spice: i worked in cardiff]
01/31/05 20:56:47 [USMLE_Step_2] sanz: but now in the states
01/31/05 20:56:51 [USMLE_Step_2] spice: before migrating tot he us
01/31/05 20:57:11 [USMLE_Step_2] strug: great
01/31/05 20:57:11 [USMLE_Step_2] sanz: really? where do you prefer?
01/31/05 20:57:18 [USMLE_Step_2] spice: ofcourse here
01/31/05 20:57:22 [USMLE_Step_2] sanz: hehehe
01/31/05 20:57:30 sux Leaves Subroom
01/31/05 20:57:37 [USMLE_Step_2] spice: my life story is twisted big time dude
01/31/05 20:57:41 sux Joins Subroom USMLE_Step_1
01/31/05 20:57:49 [USMLE_Step_2] sanz: well, life's a journey...
01/31/05 20:57:53 [USMLE_Step_2] dua_frank: shes a dudy
01/31/05 20:57:57 [USMLE_Step_2] dua_frank: i mean a girly
01/31/05 20:58:03 [USMLE_Step_2] strug: u graduated long back spice>
01/31/05 20:58:11 [USMLE_Step_2] spice: ia m an indian was a british citizen went to med school in russia and now in us
01/31/05 20:58:20 [USMLE_Step_2] strug: wow
01/31/05 20:58:25 [USMLE_Step_2] dua_frank: you're international
01/31/05 20:58:44 [USMLE_Step_2] spice: i graduated in 2002
01/31/05 20:58:57 [USMLE_Step_2] strug: looks like the story of jaspinder in er if u watchit
01/31/05 20:59:04 [USMLE_Step_2] dua_frank: strug :D
01/31/05 20:59:07 [USMLE_Step_2] spice: ofcourse i do
01/31/05 20:59:16 [USMLE_Step_2] strug: are u jaspinder

01/31/05 20:59:41 [USMLE_Step_2] spice: and dodnt get ideas dudes i ama male BIG TIME
01/31/05 20:59:53 [USMLE_Step_2] spice: :D
01/31/05 21:00:01 [USMLE_Step_2] dua_frank: spice :o *)

01/31/05 21:00:27 [USMLE_Step_2] spice: GUYS HAVE A HEART lol
01/31/05 21:00:28 [USMLE_Step_2] dua_frank: whats with the spice girls sort of name? :P

01/31/05 21:00:43 [USMLE_Step_2] sanz: lol
01/31/05 21:00:52 [USMLE_Step_2] spice: I DUNNO JSUT CAME THAT WAY
01/31/05 21:00:56 [USMLE_Step_2] spice: U KNOW
01/31/05 21:01:01 [USMLE_Step_2] sanz: at least now lanny wont feel so out numbered...
01/31/05 21:01:08 [USMLE_Step_2] dua_frank: sanz :D
01/31/05 21:01:10 [USMLE_Step_2] strug: ha ha
01/31/05 21:01:34 [USMLE_Step_2] spice: hey strug did ut ake ur cs
01/31/05 21:01:36 [USMLE_Step_2] lanny: ok back in time whats going on .. you guys are on a break whats this girly dudy thing need spanking all of you?
01/31/05 21:01:40 [USMLE_Step_2] strug: anyway guys and gals lets come back to rheu
01/31/05 21:01:56 [USMLE_Step_2] strug: i passed it spice
01/31/05 21:02:02 [USMLE_Step_2] dua_frank: lanny :o
01/31/05 21:02:06 [USMLE_Step_2] strug: u jealous lanny?
01/31/05 21:02:18 [USMLE_Step_2] spice: congrats strug
01/31/05 21:02:23 [USMLE_Step_2] strug: thanks spice
01/31/05 21:02:25 [USMLE_Step_2] lanny: spanking on your bare back sides
01/31/05 21:02:33 [USMLE_Step_2] sanz: lol lanny
01/31/05 21:02:37 [USMLE_Step_2] dua_frank: lol
01/31/05 21:02:44 [USMLE_Step_2] lanny: aa of you i mean!!!lol
01/31/05 21:02:44 [USMLE_Step_2] spice: dude thee mle has already spanked me big oen tiem
01/31/05 21:03:03 [USMLE_Step_2] spice: i can still feel the pain
01/31/05 21:03:08 [USMLE_Step_2] dua_frank: spice :))
01/31/05 21:03:16 [USMLE_Step_2] lanny: wow spice youre guy too
01/31/05 21:03:19 [USMLE_Step_2] dua_frank: lol
01/31/05 21:03:24 [USMLE_Step_2] spice: yeah
01/31/05 21:03:32 [USMLE_Step_2] strug: u got a company lanny
01/31/05 21:03:34 [USMLE_Step_2] lanny: oh good
01/31/05 21:03:42 [USMLE_Step_2] lanny: yep i see that
01/31/05 21:03:57 [USMLE_Step_2] strug: so we wind up today.....
01/31/05 21:03:58 [USMLE_Step_2] lanny: all alpha male !!!
01/31/05 21:04:01 [USMLE_Step_2] sanz: i'm glad this group gell so well :)
01/31/05 21:04:11 [USMLE_Step_2] strug: keep it up....
01/31/05 21:04:17 [USMLE_Step_2] lanny: i guess absolutely we need humour sometimes
01/31/05 21:04:19 [USMLE_Step_2] dua_frank: me too sanz :) i love you all :)
01/31/05 21:04:26 [USMLE_Step_2] sanz: aaaww dua *hugs*
01/31/05 21:04:29 [USMLE_Step_2] lanny: ok tom is peds right
01/31/05 21:04:33 [USMLE_Step_2] strug: hug from me too
01/31/05 21:04:36 [USMLE_Step_2] spice: dua u are a dude arent ya
01/31/05 21:04:46 [USMLE_Step_2] sanz: dua is a dudette
01/31/05 21:04:47 [USMLE_Step_2] dua_frank: spice no perv mind you :P
01/31/05 21:04:48 [USMLE_Step_2] lanny: no hugs for me
01/31/05 21:04:52 [USMLE_Step_2] spice: hugs from dude in cali have aweird meaning
01/31/05 21:05:00 [USMLE_Step_2] spice: u know what i eman
01/31/05 21:05:06 [USMLE_Step_2] spice: just jokin
01/31/05 21:05:12 [USMLE_Step_2] lanny: oh yea what about NYC !!
01/31/05 21:05:15 [USMLE_Step_2] dua_frank: lol
01/31/05 21:05:33 [USMLE_Step_2] lanny: guys in NYC are hot.. all worke out pk abs..
01/31/05 21:05:33 [USMLE_Step_2] spice: NYC is weird big time
01/31/05 21:05:57 [USMLE_Step_2] spice: but san fran is the weirest place
01/31/05 21:06:02 [USMLE_Step_2] lanny: we love it like that dude..
01/31/05 21:06:03 [USMLE_Step_2] sanz: what are your aspiration specialities?
01/31/05 21:06:07 [USMLE_Step_2] dua_frank: I'm in Oklahoma, it cannot get anymore dead than here people. NOTHING happens here
01/31/05 21:06:22 [USMLE_Step_2] dua_frank: I can't wait to get out...
01/31/05 21:06:23 [USMLE_Step_2] spice: i wanna go into psych
01/31/05 21:06:26 [USMLE_Step_2] lanny: int med for me
01/31/05 21:06:41 [USMLE_Step_2] strug: are u all citizens?
01/31/05 21:06:49 [USMLE_Step_2] spice: gc here
01/31/05 21:06:50 [USMLE_Step_2] lanny: someone pls try to post today will see you tom bye all
01/31/05 21:06:51 [USMLE_Step_2] sanz: paeds for me... i worked in Edin for a yr... loved it
01/31/05 21:06:53 [USMLE_Step_2] dua_frank: GC too
01/31/05 21:06:59 [USMLE_Step_2] dua_frank: bye lanny
01/31/05 21:07:08 [USMLE_Step_2] dua_frank: Internal med hopefully
01/31/05 21:07:11 shansmart Logs in
01/31/05 21:07:11 [USMLE_Step_2] strug: bye lanny
01/31/05 21:07:12 shansmart Joins Subroom USMLE_Step_2
01/31/05 21:07:21 [USMLE_Step_2] spice: edinburugh is a beutiful place
01/31/05 21:07:30 [USMLE_Step_2] lanny: bye.. bye pleasant dreams dears!!!!
01/31/05 21:07:31 [USMLE_Step_2] spice: loved it sanz
01/31/05 21:07:35 [USMLE_Step_2] dua_frank: bye bye lanny
01/31/05 21:07:38 [USMLE_Step_2] sanz: spice , yup... the most beautiful city in the world
01/31/05 21:07:39 [USMLE_Step_2] spice: bye lanny
01/31/05 21:07:46 [USMLE_Step_2] spice: i will agree
01/31/05 21:07:48 [USMLE_Step_2] sanz: bye lanny
01/31/05 21:07:49 [USMLE_Step_2] strug: bye all c u tomorrow
01/31/05 21:07:53 [USMLE_Step_2] dua_frank: bye strug







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