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View Full Version : Surgery Chat: Trauma



Asclepius1
02-12-2005, 10:35 AM
02/11/05 19:04:32 [USMLE_Step_2] sanz: hey sam
02/11/05 19:04:34 [USMLE_Step_2] sanz: how r u?
02/11/05 19:04:44 [USMLE_Step_2] samantha: hi sanz
02/11/05 19:05:09 [USMLE_Step_2] samantha: good how r u
02/11/05 19:05:22 [USMLE_Step_2] sanz: not too bad :)
02/11/05 19:05:33 [USMLE_Step_2] sanz: when is yr exam?
02/11/05 19:05:40 [USMLE_Step_2] samantha: looks like we are the first 2
02/11/05 19:05:50 [USMLE_Step_2] samantha: march
02/11/05 19:05:53 [USMLE_Step_2] samantha: yours?
02/11/05 19:06:00 megs Logs in
02/11/05 19:06:00 [USMLE_Step_2] sanz: oh me too... 9th
02/11/05 19:06:05 megs Joins Subroom USMLE_Step_2
02/11/05 19:06:09 [USMLE_Step_2] sanz: hey megs :)
02/11/05 19:06:16 [USMLE_Step_2] megs: hi sanz, samantha
02/11/05 19:06:20 [USMLE_Step_2] samantha: hello megs
02/11/05 19:06:21 [USMLE_Step_2] sanz: how r u megs?
02/11/05 19:06:23 [USMLE_Step_2] megs: how r u today???
02/11/05 19:06:32 [USMLE_Step_2] megs: fine dear
02/11/05 19:06:43 [USMLE_Step_2] sanz: good, considering that i just found out it's 3.5 wks to my exams
02/11/05 19:06:44 [USMLE_Step_2] sanz: hehe
02/11/05 19:06:59 [USMLE_Step_2] sanz: time passes by so fast these days!
02/11/05 19:06:59 [USMLE_Step_2] samantha: how have you read?
02/11/05 19:07:09 [USMLE_Step_2] sanz: just kaplan notes once
02/11/05 19:07:13 [USMLE_Step_2] sanz: and first aid once
02/11/05 19:07:26 [USMLE_Step_2] sanz: finsihed UW already... doing kap QBank now
02/11/05 19:07:30 [USMLE_Step_2] sanz: you sam?
02/11/05 19:07:48 [USMLE_Step_2] samantha: how much do you get in uw?
02/11/05 19:08:05 [USMLE_Step_2] sanz: not too good i think!
02/11/05 19:08:10 [USMLE_Step_2] samantha: i am doing uw did one reading of kap
02/11/05 19:08:38 [USMLE_Step_2] samantha: iam getting 40's
02/11/05 19:08:51 [USMLE_Step_2] sanz: i dont think it matters how much you get...
02/11/05 19:09:00 [USMLE_Step_2] sanz: just understand the point of the q
02/11/05 19:09:08 [USMLE_Step_2] sanz: and read up on the wrong topics
02/11/05 19:09:13 [USMLE_Step_2] samantha: yes trying
02/11/05 19:09:21 [USMLE_Step_2] samantha: ok
02/11/05 19:09:45 [USMLE_Step_2] samantha: it is v lengthy
02/11/05 19:09:51 [USMLE_Step_2] sanz: i was getting 50s but ended up with 62 when i finished... you'll improve
02/11/05 19:10:06 [USMLE_Step_2] samantha: i hope so
02/11/05 19:10:24 [USMLE_Step_2] samantha: hi meg what about u
02/11/05 19:10:31 [USMLE_Step_2] samantha: when is your exam
02/11/05 19:11:10 [USMLE_Step_2] samantha: how many months did you read?
02/11/05 19:11:15 [USMLE_Step_2] samantha: sanz
02/11/05 19:11:48 [USMLE_Step_2] sanz: i started properly on 20th dec
02/11/05 19:12:10 [USMLE_Step_2] samantha: what are we discussing today?
02/11/05 19:12:21 [USMLE_Step_2] sanz: i think trauma
02/11/05 19:12:23 [USMLE_Step_2] sanz: surgery
02/11/05 19:12:40 cyrus1345 Logs in
02/11/05 19:12:49 cyrus1345 Joins Subroom USMLE_Step_2
02/11/05 19:12:54 [USMLE_Step_2] sanz: hey nasi :)
02/11/05 19:13:00 [USMLE_Step_2] cyrus1345: Hi everybody
02/11/05 19:13:12 [USMLE_Step_2] sanz: how are you *hugs*
02/11/05 19:13:16 [USMLE_Step_2] cyrus1345: Hi sanz
02/11/05 19:13:32 [USMLE_Step_2] cyrus1345: :D I am fine dear
02/11/05 19:13:42 [USMLE_Step_2] samantha: hi cyrus
02/11/05 19:13:45 [USMLE_Step_2] cyrus1345: how is study going?
02/11/05 19:13:49 [USMLE_Step_2] megs: hi cyrus
02/11/05 19:13:53 [USMLE_Step_2] sanz: thanks for those qs in the forum... as always
02/11/05 19:14:12 [USMLE_Step_2] cyrus1345: what's your nick name snaz in forum?
02/11/05 19:14:19 [USMLE_Step_2] sanz: i'm good nasi... just realised that it's only 3.5 wks before my exams... hehe... so a little panic attack there!
02/11/05 19:14:26 [USMLE_Step_2] sanz: SS
02/11/05 19:14:35 [USMLE_Step_2] cyrus1345: oh ok!
02/11/05 19:14:44 [USMLE_Step_2] cyrus1345: oh really whne is your exam?
02/11/05 19:14:48 [USMLE_Step_2] sanz: 9th march
02/11/05 19:15:01 [USMLE_Step_2] cyrus1345: not so far from me
02/11/05 19:15:11 [USMLE_Step_2] sanz: yours is next week right?
02/11/05 19:15:16 [USMLE_Step_2] cyrus1345: 26 fef post pone it for 10 days
02/11/05 19:15:24 [USMLE_Step_2] cyrus1345: feb
02/11/05 19:15:32 strug Logs in
02/11/05 19:15:32 [USMLE_Step_2] sanz: did you do kap Qbank nasi?
02/11/05 19:15:32 strug Joins Subroom USMLE_Step_2
02/11/05 19:15:38 [USMLE_Step_2] sanz: i thought it was too derm heavy
02/11/05 19:15:47 [USMLE_Step_2] cyrus1345: yes
02/11/05 19:15:47 [USMLE_Step_2] sanz: i feel as if i'm taking dermaotlogy boards exams!
02/11/05 19:15:56 [USMLE_Step_2] cyrus1345: no it's fine
02/11/05 19:16:01 [USMLE_Step_2] cyrus1345: not like UW
02/11/05 19:16:03 iamzuhair Logs in
02/11/05 19:16:03 [USMLE_Step_2] sanz: hey strug
02/11/05 19:16:06 [USMLE_Step_2] strug: hi all
02/11/05 19:16:12 [USMLE_Step_2] sanz: i know... the qs are less picky than UW
02/11/05 19:16:12 iamzuhair Joins Subroom USMLE_Step_2
02/11/05 19:16:18 [USMLE_Step_2] cyrus1345: Hi strug
02/11/05 19:16:20 [USMLE_Step_2] iamzuhair: hi all
02/11/05 19:16:32 [USMLE_Step_2] sanz: hey zuhair ... how r u dude?
02/11/05 19:16:39 [USMLE_Step_2] cyrus1345: hi zauhair
02/11/05 19:16:43 [USMLE_Step_2] sanz: shall we start?
02/11/05 19:16:46 [USMLE_Step_2] iamzuhair: im doing good ---- how bout u
02/11/05 19:16:51 [USMLE_Step_2] iamzuhair: yes dude
02/11/05 19:16:53 [USMLE_Step_2] sanz: good
02/11/05 19:17:11 [USMLE_Step_2] sanz: trauma is a big high yield subject it seems
02/11/05 19:17:17 [USMLE_Step_2] iamzuhair: oh nasi is here today
02/11/05 19:17:34 [USMLE_Step_2] iamzuhair: when is ur exam nasi
02/11/05 19:17:39 [USMLE_Step_2] cyrus1345: 26 feb
02/11/05 19:17:47 [USMLE_Step_2] cyrus1345: postpone it for 10 days
02/11/05 19:17:50 [USMLE_Step_2] iamzuhair: oh --- great
02/11/05 19:17:58 dua_frank Logs in
02/11/05 19:18:05 dua_frank Joins Subroom USMLE_Step_2
02/11/05 19:18:08 [USMLE_Step_2] strug: pt with multiple stab wounds in er, fully conscious normal voice, expanding hematoma in neck, wghat nect?
02/11/05 19:18:09 [USMLE_Step_2] iamzuhair: so planning to give those guys a run for their answers
02/11/05 19:18:18 [USMLE_Step_2] sanz: man stabbed on the chest... exam showed subcut air in neck... what next?
02/11/05 19:18:22 [USMLE_Step_2] cyrus1345: intubate
02/11/05 19:18:26 [USMLE_Step_2] dua_frank: hi
02/11/05 19:18:38 [USMLE_Step_2] iamzuhair: hello dua
02/11/05 19:18:39 [USMLE_Step_2] strug: orotrachal intubation sanz
02/11/05 19:18:42 [USMLE_Step_2] sanz: hi dua
02/11/05 19:18:43 [USMLE_Step_2] strug: hi dua
02/11/05 19:18:45 [USMLE_Step_2] cyrus1345: intubate strug and sanz
02/11/05 19:18:50 [USMLE_Step_2] cyrus1345: hi dua
02/11/05 19:18:51 [USMLE_Step_2] strug: yup right nasi
02/11/05 19:18:55 [USMLE_Step_2] sanz: yeah... intubeation
02/11/05 19:19:39 [USMLE_Step_2] strug: gang memb with multiple gunshot wounds in abdi, in shock what next?
02/11/05 19:19:51 [USMLE_Step_2] sanz: emergency exploration
02/11/05 19:19:58 [USMLE_Step_2] cyrus1345: explor laparotomy
02/11/05 19:20:09 [USMLE_Step_2] iamzuhair: yes
02/11/05 19:20:27 [USMLE_Step_2] samantha: yeah
02/11/05 19:20:29 [USMLE_Step_2] sanz: but needs to replace fluids too
02/11/05 19:20:34 [USMLE_Step_2] cyrus1345: yes agree
02/11/05 19:20:36 [USMLE_Step_2] samantha: abc's
02/11/05 19:20:37 [USMLE_Step_2] sanz: while waiting for theatre
02/11/05 19:21:28 [USMLE_Step_2] samantha: airway breathing andcirculation
02/11/05 19:21:42 [USMLE_Step_2] sanz: how would tension pneumothorax pt present?
02/11/05 19:21:49 [USMLE_Step_2] strug: road traffic accident, in shock.....what next?
02/11/05 19:22:23 [USMLE_Step_2] samantha: dyspnoea
02/11/05 19:22:29 [USMLE_Step_2] cyrus1345: rush to ER strug!
02/11/05 19:22:41 [USMLE_Step_2] strug: sanz inc jvp, in shock, breath sounds absent on one side
02/11/05 19:22:51 [USMLE_Step_2] sanz: strug, if bleeding, take measures to stop bleeding... put in cannula and replace fluid... if ER nearby, do nth but scoop and run
02/11/05 19:23:09 [USMLE_Step_2] strug: perfect sanz and nasi also correct
02/11/05 19:23:14 [USMLE_Step_2] cyrus1345: hypotension,dyspnea hyperesonance and diminish breath sound sanz
02/11/05 19:23:18 [USMLE_Step_2] sanz: good, distended neck veins as well
02/11/05 19:23:32 [USMLE_Step_2] sanz: Rx?
02/11/05 19:23:39 [USMLE_Step_2] dua_frank: chest tube
02/11/05 19:23:40 [USMLE_Step_2] strug: i just wanted to point out that if u dunno the site of injury or bleeding next thing fluids
02/11/05 19:23:46 [USMLE_Step_2] dua_frank: water level one
02/11/05 19:23:51 [USMLE_Step_2] strug: iv needle followeb by chest tube sanz
02/11/05 19:23:52 [USMLE_Step_2] sanz: yes, or needle thoracostomy
02/11/05 19:23:59 [USMLE_Step_2] sanz: whichever you can do first
02/11/05 19:24:36 [USMLE_Step_2] strug: pt with blunt trauma to abdo, responds to fluid replacement waht next?
02/11/05 19:24:48 [USMLE_Step_2] sanz: DPL?
02/11/05 19:24:54 [USMLE_Step_2] dua_frank: whats DPL?
02/11/05 19:25:02 [USMLE_Step_2] sanz: diagnostic peritoneal lavage
02/11/05 19:25:05 [USMLE_Step_2] dua_frank: thanks
02/11/05 19:25:13 [USMLE_Step_2] strug: i think just observe sanz
02/11/05 19:25:17 [USMLE_Step_2] sanz: ok
02/11/05 19:25:25 [USMLE_Step_2] dua_frank: whats DPL used for sanz
02/11/05 19:25:27 [USMLE_Step_2] dua_frank: ?
02/11/05 19:25:30 [USMLE_Step_2] sanz: when do you do DPL... i'm not too sure on that
02/11/05 19:25:38 [USMLE_Step_2] strug: when pt unstable and bleeding
02/11/05 19:25:39 [USMLE_Step_2] sanz: i think it's when you know there's some bleeding
02/11/05 19:25:43 [USMLE_Step_2] cyrus1345: first step in plain pneumothorax?
02/11/05 19:25:47 [USMLE_Step_2] dua_frank: *)
02/11/05 19:25:50 [USMLE_Step_2] sanz: but you cannot be sure and the pt is not stable?
02/11/05 19:25:51 [USMLE_Step_2] iamzuhair: when in bleeding in peritoneum
02/11/05 19:25:52 [USMLE_Step_2] strug: chest x ray nasi
02/11/05 19:25:58 [USMLE_Step_2] samantha: laprotomy
02/11/05 19:26:13 [USMLE_Step_2] sanz: CXR and chest tube
02/11/05 19:26:14 [USMLE_Step_2] cyrus1345: coreect strug
02/11/05 19:26:34 [USMLE_Step_2] strug: when do u give fluids first and not rush to er?
02/11/05 19:26:55 [USMLE_Step_2] dua_frank: no tension
02/11/05 19:27:01 [USMLE_Step_2] sanz: ER too far... like not within 10 miles
02/11/05 19:27:01 [USMLE_Step_2] cyrus1345: long distance
02/11/05 19:27:13 [USMLE_Step_2] strug: when far away, when u cannot locate site of bleeding like multiple injuries, when blunt trauma
02/11/05 19:27:54 [USMLE_Step_2] samantha: immobize suspect spinal injury
02/11/05 19:28:03 [USMLE_Step_2] cyrus1345: blunt truma to abdoman+stable+no acute abdominal pian next step?
02/11/05 19:28:16 [USMLE_Step_2] strug: observe nasi
02/11/05 19:28:21 [USMLE_Step_2] sanz: ok, pt has hemothorax and you already put in chest tube... draining 800ml the last 5 hr... what next?
02/11/05 19:28:35 [USMLE_Step_2] cyrus1345: no strug do CT scan
02/11/05 19:28:36 [USMLE_Step_2] strug: throactomy sanz
02/11/05 19:28:42 [USMLE_Step_2] sanz: strug right
02/11/05 19:28:48 [USMLE_Step_2] sanz: why nasi?
02/11/05 19:28:48 [USMLE_Step_2] iamzuhair: yes ct done in blunt and no singns
02/11/05 19:29:08 [USMLE_Step_2] strug: i think u right nasi
02/11/05 19:29:12 [USMLE_Step_2] cyrus1345: blunt truma to stable paitent next step CT
02/11/05 19:29:14 [USMLE_Step_2] iamzuhair: never send the pt home in any blunt injury of abdomen
02/11/05 19:29:15 [USMLE_Step_2] strug: ct to rule out injuries sanz
02/11/05 19:29:26 [USMLE_Step_2] cyrus1345: blunt truma to unstable sono or DPL
02/11/05 19:29:33 [USMLE_Step_2] sanz: oooooh ok
02/11/05 19:29:39 [USMLE_Step_2] sanz: i always dont know when to do DPL or CT
02/11/05 19:29:41 [USMLE_Step_2] iamzuhair: yes spleen rupture presents as a late complication
02/11/05 19:29:58 [USMLE_Step_2] cyrus1345: blunt truma to abdoman +acute abdoman next step?
02/11/05 19:30:06 [USMLE_Step_2] strug: exp lapro nasi
02/11/05 19:30:06 [USMLE_Step_2] sanz: explore
02/11/05 19:30:11 [USMLE_Step_2] iamzuhair: exploratory lap
02/11/05 19:30:22 [USMLE_Step_2] cyrus1345: yes!good never go for sono or DPL!
02/11/05 19:30:42 diabetes Logs in
02/11/05 19:30:43 diabetes Joins Subroom USMLE_Step_2
02/11/05 19:30:45 [USMLE_Step_2] strug: young male shot in grion, comes to er himself, in shock, blood coming from wound , next step?
02/11/05 19:31:02 [USMLE_Step_2] cyrus1345: local pressure
02/11/05 19:31:05 [USMLE_Step_2] sanz: firm press to groin... replace fluids
02/11/05 19:31:13 [USMLE_Step_2] strug: yup very good
02/11/05 19:31:24 [USMLE_Step_2] dua_frank: he would bleed to death in minutes yeah
02/11/05 19:31:47 [USMLE_Step_2] cyrus1345: blunt truma to abdoman cause rupture of spleen paitent is stable next step?
02/11/05 19:32:00 [USMLE_Step_2] dua_frank: splenectomy
02/11/05 19:32:01 [USMLE_Step_2] sanz: explor laparo
02/11/05 19:32:06 [USMLE_Step_2] cyrus1345: no
02/11/05 19:32:08 [USMLE_Step_2] strug: repair spllen
02/11/05 19:32:24 [USMLE_Step_2] cyrus1345: paitent is stable!
02/11/05 19:32:28 [USMLE_Step_2] dua_frank: oh
02/11/05 19:32:34 [USMLE_Step_2] strug: u mean ct alrealy done right nasi
02/11/05 19:32:35 [USMLE_Step_2] dua_frank: key word stable
02/11/05 19:32:38 [USMLE_Step_2] cyrus1345: just observe and serial CT scan
02/11/05 19:32:40 [USMLE_Step_2] iamzuhair: head injury with no signs of hematoma what to do
02/11/05 19:32:56 [USMLE_Step_2] cyrus1345: yes strug
02/11/05 19:33:00 [USMLE_Step_2] dua_frank: CT
02/11/05 19:33:06 [USMLE_Step_2] iamzuhair: yeah
02/11/05 19:33:18 [USMLE_Step_2] iamzuhair: look for axonal injury
02/11/05 19:33:21 [USMLE_Step_2] strug: if pt has no neurolo sign and stable send home if family wakes him in next 24 hours xuhair
02/11/05 19:33:23 [USMLE_Step_2] sanz: nasi, if yr pt is unstable... what then?
02/11/05 19:33:43 [USMLE_Step_2] strug: nasi i dont agree wtih ur ans
02/11/05 19:33:49 [USMLE_Step_2] cyrus1345: do explo laparotomy
02/11/05 19:33:52 [USMLE_Step_2] strug: i have a little confusion
02/11/05 19:34:02 [USMLE_Step_2] cyrus1345: and first try to repair spleen
02/11/05 19:34:10 [USMLE_Step_2] dua_frank: rupture spleen needs to be taken out
02/11/05 19:34:11 [USMLE_Step_2] strug: u said pt has rupture spleen then shoulnt we repair
02/11/05 19:34:12 [USMLE_Step_2] cyrus1345: if impossible then splenectomy
02/11/05 19:34:13 [USMLE_Step_2] dua_frank: cannot be left there
02/11/05 19:34:17 [USMLE_Step_2] dua_frank: stable or otherwise
02/11/05 19:34:31 [USMLE_Step_2] strug: dua u should always try to repair and not remove spllen
02/11/05 19:34:39 [USMLE_Step_2] dua_frank: oh ok
02/11/05 19:34:42 [USMLE_Step_2] strug: because it has an imp funciton in body
02/11/05 19:34:43 [USMLE_Step_2] cyrus1345: yes strug you ar4e right
02/11/05 19:34:54 [USMLE_Step_2] dua_frank: but in any case, surgery is important for any splenic damage right?
02/11/05 19:34:54 [USMLE_Step_2] samantha: yes
02/11/05 19:35:09 [USMLE_Step_2] dua_frank: is nasi a girl?
02/11/05 19:35:11 [USMLE_Step_2] strug: thats what i thought
02/11/05 19:35:24 [USMLE_Step_2] cyrus1345: you do explo laparatomy to repair spleen strug
02/11/05 19:35:31 [USMLE_Step_2] dua_frank: ok
02/11/05 19:35:36 [USMLE_Step_2] strug: so my ans was right?
02/11/05 19:35:44 [USMLE_Step_2] cyrus1345: yes
02/11/05 19:35:47 [USMLE_Step_2] strug: or do we observer as u sai
02/11/05 19:35:52 [USMLE_Step_2] iamzuhair: pt taken for subclavian node biopsy and dies immediately ---- cause
02/11/05 19:36:01 [USMLE_Step_2] strug: air embo zuhari
02/11/05 19:36:02 [USMLE_Step_2] sanz: pneumothorax
02/11/05 19:36:04 [USMLE_Step_2] cyrus1345: it depend paitent is stable or not!
02/11/05 19:36:04 [USMLE_Step_2] iamzuhair: yes
02/11/05 19:36:09 [USMLE_Step_2] iamzuhair: management
02/11/05 19:36:11 [USMLE_Step_2] dua_frank: air embolus
02/11/05 19:36:13 [USMLE_Step_2] cyrus1345: stable observe
02/11/05 19:36:20 [USMLE_Step_2] iamzuhair: management?
02/11/05 19:36:28 [USMLE_Step_2] sanz: needle thoracostomy suhair
02/11/05 19:36:33 [USMLE_Step_2] iamzuhair: lol
02/11/05 19:36:38 [USMLE_Step_2] iamzuhair: pt already dead
02/11/05 19:36:39 [USMLE_Step_2] dua_frank: no idea
02/11/05 19:36:39 [USMLE_Step_2] sanz: but yr pt has died already
02/11/05 19:36:41 [USMLE_Step_2] sanz: hehe
02/11/05 19:36:43 [USMLE_Step_2] dua_frank: lol
02/11/05 19:36:46 [USMLE_Step_2] sanz: autopsy then
02/11/05 19:36:47 [USMLE_Step_2] iamzuhair: lo
02/11/05 19:36:51 [USMLE_Step_2] iamzuhair: ok if he alive
02/11/05 19:37:18 [USMLE_Step_2] sanz: ok, i just checked abt spleen rupture
02/11/05 19:37:20 [USMLE_Step_2] iamzuhair: tredengberg position and cardiac massage
02/11/05 19:37:22 [USMLE_Step_2] sanz: wanna hear abt it?
02/11/05 19:37:25 [USMLE_Step_2] dua_frank: yes
02/11/05 19:37:41 [USMLE_Step_2] dua_frank: why cardiac massage zu?
02/11/05 19:37:53 [USMLE_Step_2] sanz: if stable and minor tear suspected, you can inject local haemostatic agent and close obs
02/11/05 19:38:02 [USMLE_Step_2] sanz: if unstable, needs repair
02/11/05 19:38:03 [USMLE_Step_2] iamzuhair: i dunno strug
02/11/05 19:38:11 [USMLE_Step_2] sanz: if sangunating then splenectomy
02/11/05 19:38:16 [USMLE_Step_2] iamzuhair: no explanation
02/11/05 19:38:16 [USMLE_Step_2] samantha: oh
02/11/05 19:38:22 [USMLE_Step_2] dua_frank: there is one
02/11/05 19:38:28 [USMLE_Step_2] iamzuhair: ok
02/11/05 19:38:29 [USMLE_Step_2] dua_frank: its to prevent an MI
02/11/05 19:38:29 [USMLE_Step_2] strug: thanks sanz
02/11/05 19:38:44 [USMLE_Step_2] dua_frank: air emboli can lodge into coronary arteries
02/11/05 19:38:56 [USMLE_Step_2] dua_frank: so you turn the heart in a specific position and massage it
02/11/05 19:38:59 [USMLE_Step_2] dua_frank: to bring the air out
02/11/05 19:39:02 [USMLE_Step_2] iamzuhair: oh
02/11/05 19:39:09 [USMLE_Step_2] megs: thanx dua
02/11/05 19:39:10 [USMLE_Step_2] iamzuhair: didnt know that
02/11/05 19:39:12 [USMLE_Step_2] iamzuhair: thanks
02/11/05 19:39:15 [USMLE_Step_2] dua_frank: welcome
02/11/05 19:39:22 [USMLE_Step_2] dua_frank: they used to do that in CT surgery
02/11/05 19:39:35 [USMLE_Step_2] sanz: what was the q dua?
02/11/05 19:39:36 [USMLE_Step_2] dua_frank: to prevent air emboli causing MI
02/11/05 19:39:36 [USMLE_Step_2] strug: pt with gunshot to chest and abdo, develps tamponade, nect?
02/11/05 19:39:46 [USMLE_Step_2] sanz: pericardiocentesis
02/11/05 19:39:50 [USMLE_Step_2] cyrus1345: percadio
02/11/05 19:39:53 [USMLE_Step_2] megs: agree sanz
02/11/05 19:40:03 [USMLE_Step_2] samantha: yes me too
02/11/05 19:40:03 [USMLE_Step_2] iamzuhair: x ray with pericardiocentesis
02/11/05 19:40:06 [USMLE_Step_2] dua_frank: thanks sanz
02/11/05 19:40:10 [USMLE_Step_2] dua_frank: it was zu's q
02/11/05 19:40:16 [USMLE_Step_2] sanz: what was zu's q?
02/11/05 19:40:18 [USMLE_Step_2] strug: right guys
02/11/05 19:40:28 [USMLE_Step_2] sanz: again an abscence seizures there!
02/11/05 19:40:34 [USMLE_Step_2] dua_frank: management of air embolus before the dead guy dies
02/11/05 19:40:37 [USMLE_Step_2] strug: sanz he asked why do we do cardiac massage in air embolism
02/11/05 19:40:41 [USMLE_Step_2] iamzuhair: lol
02/11/05 19:40:48 [USMLE_Step_2] cyrus1345: what is complication of copartment syndrome of abdoman?
02/11/05 19:40:58 [USMLE_Step_2] strug: renal failure
02/11/05 19:41:03 [USMLE_Step_2] sanz: oh i didnt know we do that! Thanks zuhair for pointing it out!
02/11/05 19:41:10 [USMLE_Step_2] cyrus1345: good job man and hypoxia
02/11/05 19:41:33 [USMLE_Step_2] dua_frank: why renal failure?
02/11/05 19:41:48 [USMLE_Step_2] samantha: is there compartment syn in abd
02/11/05 19:41:48 [USMLE_Step_2] strug: compression of renal aret dua
02/11/05 19:41:59 [USMLE_Step_2] dua_frank: ahhh thanks strug
02/11/05 19:42:17 [USMLE_Step_2] dua_frank: hearing that for the first time too sammy
02/11/05 19:42:20 [USMLE_Step_2] iamzuhair: crushing injury leads to compartment syndrome
02/11/05 19:42:33 [USMLE_Step_2] megs: and why hypoxia??is it due to rep embrrassment
02/11/05 19:42:36 [USMLE_Step_2] strug: female stabbed in neck and left sternal border, develps tampnade, what next?
02/11/05 19:42:39 [USMLE_Step_2] samantha: ok
02/11/05 19:42:41 [USMLE_Step_2] iamzuhair: all the toxins and proteins and thromboplastin release
02/11/05 19:42:42 [USMLE_Step_2] strug: yup megs u right
02/11/05 19:42:45 [USMLE_Step_2] dua_frank: thanks megs
02/11/05 19:43:04 [USMLE_Step_2] strug: no zuhari comp syn in abdo is due to massive fluid repl while surgery
02/11/05 19:43:13 [USMLE_Step_2] sanz: explor neck strug?
02/11/05 19:43:37 [USMLE_Step_2] dua_frank: pericardiocentesis
02/11/05 19:43:43 [USMLE_Step_2] cyrus1345: percardio
02/11/05 19:43:46 [USMLE_Step_2] megs: agsin centesis
02/11/05 19:43:48 [USMLE_Step_2] dua_frank: or open repair
02/11/05 19:44:01 [USMLE_Step_2] iamzuhair: crushing synd is injury to body strug
02/11/05 19:44:03 [USMLE_Step_2] sanz: and do triscopy
02/11/05 19:44:15 [USMLE_Step_2] strug: rush her to or and do thoractomy and repair dont do pericardiocentereis
02/11/05 19:44:15 [USMLE_Step_2] iamzuhair: i mean compartment synd
02/11/05 19:44:36 [USMLE_Step_2] strug: in er
02/11/05 19:44:57 [USMLE_Step_2] dua_frank: thanks strug
02/11/05 19:44:57 [USMLE_Step_2] iamzuhair: mx of compartment synd
02/11/05 19:45:03 [USMLE_Step_2] sanz: fasciotomy
02/11/05 19:45:12 [USMLE_Step_2] iamzuhair: yes
02/11/05 19:45:13 [USMLE_Step_2] dua_frank: whats triscopy?
02/11/05 19:45:41 [USMLE_Step_2] samantha: does it cause adhesions?
02/11/05 19:45:45 [USMLE_Step_2] sanz: dua, from what i know, if it's inj to zone 3 of neck you do that... consists of tracheobroncho scopy and angiography
02/11/05 19:46:07 [USMLE_Step_2] strug: ooooohhhhhh yes sanz
02/11/05 19:46:10 [USMLE_Step_2] sanz: you basically scope every tube in the neck... hehe
02/11/05 19:46:56 [USMLE_Step_2] megs: then what is pan scoy
02/11/05 19:47:02 [USMLE_Step_2] sanz: i think it's same..
02/11/05 19:47:06 [USMLE_Step_2] megs: panscopy???
02/11/05 19:47:13 [USMLE_Step_2] sanz: i forgot esophagoscopy...
02/11/05 19:47:26 [USMLE_Step_2] megs: or its is the same
02/11/05 19:47:27 [USMLE_Step_2] sanz: i think they mean the same megs
02/11/05 19:47:31 [USMLE_Step_2] megs: ok
02/11/05 19:47:38 [USMLE_Step_2] sanz: strug, can u confirm?
02/11/05 19:47:48 [USMLE_Step_2] strug: pt with chest trauma, cllinically not sure if tamponade or not, what inves next?
02/11/05 19:47:56 [USMLE_Step_2] dua_frank: thanks sanz
02/11/05 19:48:12 [USMLE_Step_2] sanz: ECHO
02/11/05 19:48:20 [USMLE_Step_2] samantha: xray?
02/11/05 19:48:36 [USMLE_Step_2] cyrus1345: agree snaz
02/11/05 19:48:39 [USMLE_Step_2] iamzuhair: loss of pain & temp on both sides with proprioception intact ?
02/11/05 19:48:40 [USMLE_Step_2] strug: sanz i m not sure panendoscropy means eso , bronch, laryngo dunno about triosc
02/11/05 19:48:49 [USMLE_Step_2] dua_frank: echo
02/11/05 19:48:53 [USMLE_Step_2] strug: u do sono if not sure for tamponade guys
02/11/05 19:48:54 [USMLE_Step_2] samantha: ok
02/11/05 19:48:59 [USMLE_Step_2] sanz: thanx nasi
02/11/05 19:49:02 [USMLE_Step_2] sanz: thnx strug
02/11/05 19:49:20 [USMLE_Step_2] megs: esophageo,broncho and laryngo is tiscopy iread just now
02/11/05 19:49:28 [USMLE_Step_2] dua_frank: thanks megs
02/11/05 19:49:34 [USMLE_Step_2] dua_frank: no angio then
02/11/05 19:49:45 [USMLE_Step_2] samantha: thanks megs
02/11/05 19:49:45 [USMLE_Step_2] sanz: thnx megs
02/11/05 19:49:46 [USMLE_Step_2] strug: ant cored inj xuhari
02/11/05 19:49:55 [USMLE_Step_2] iamzuhair: yes strug
02/11/05 19:49:57 [USMLE_Step_2] dua_frank: i was thinking about the same, angio is too invasive
02/11/05 19:50:08 [USMLE_Step_2] megs: yeah dua
02/11/05 19:50:50 [USMLE_Step_2] iamzuhair: brown sequard ?
02/11/05 19:51:01 [USMLE_Step_2] megs: hemisection of cord
02/11/05 19:51:09 [USMLE_Step_2] iamzuhair: signs ?
02/11/05 19:51:21 [USMLE_Step_2] sanz: lost of pain and temp contralat and loss of vibration and weakness ipsilat
02/11/05 19:51:30 [USMLE_Step_2] megs: pain temp of opp lostand vibr of same side
02/11/05 19:51:35 [USMLE_Step_2] iamzuhair: loss of painand temp opp side and prop samme side
02/11/05 19:51:41 [USMLE_Step_2] strug: old man found unrepsonsive at home, paramedics find inc jvp and distended neck veins, pt in shock breath sounds normal, hears sounds heard....type of shock?
02/11/05 19:51:48 [USMLE_Step_2] iamzuhair: yes right snaz and megs
02/11/05 19:52:08 [USMLE_Step_2] sanz: cardio shock
02/11/05 19:52:13 [USMLE_Step_2] iamzuhair: cardio
02/11/05 19:52:14 [USMLE_Step_2] megs: cardiogenic
02/11/05 19:52:38 [USMLE_Step_2] strug: yup good job guys
02/11/05 19:52:39 [USMLE_Step_2] iamzuhair: lft hrt failure
02/11/05 19:52:46 [USMLE_Step_2] dua_frank: right heart
02/11/05 19:52:49 [USMLE_Step_2] sanz: CPWP incr or decr?
02/11/05 19:52:56 [USMLE_Step_2] strug: inc
02/11/05 19:52:57 [USMLE_Step_2] iamzuhair: inc
02/11/05 19:52:59 [USMLE_Step_2] sanz: good
02/11/05 19:53:01 [USMLE_Step_2] sanz: what abt CO?
02/11/05 19:53:05 [USMLE_Step_2] strug: dec
02/11/05 19:53:06 [USMLE_Step_2] dua_frank: dec
02/11/05 19:53:06 [USMLE_Step_2] iamzuhair: dec
02/11/05 19:53:07 [USMLE_Step_2] sanz: and PVR?
02/11/05 19:53:08 [USMLE_Step_2] megs: decr
02/11/05 19:53:10 [USMLE_Step_2] iamzuhair: inc
02/11/05 19:53:11 [USMLE_Step_2] dua_frank: dec
02/11/05 19:53:18 [USMLE_Step_2] dua_frank: oh inc
02/11/05 19:53:18 [USMLE_Step_2] strug: inc
02/11/05 19:53:19 [USMLE_Step_2] megs: pvr incr
02/11/05 19:53:22 [USMLE_Step_2] sanz: incr
02/11/05 19:53:24 [USMLE_Step_2] dua_frank: sorry
02/11/05 19:53:32 [USMLE_Step_2] sanz: good job guys! you're all very smart!
02/11/05 19:53:43 [USMLE_Step_2] iamzuhair: :ba
02/11/05 19:53:58 [USMLE_Step_2] sanz: ok, let's do the same for endogenic shock
02/11/05 19:53:59 [USMLE_Step_2] dua_frank: zu's always pooping
02/11/05 19:54:01 [USMLE_Step_2] sanz: CPWP?
02/11/05 19:54:04 [USMLE_Step_2] dua_frank: ;p
02/11/05 19:54:10 [USMLE_Step_2] dua_frank: :p
02/11/05 19:54:15 [USMLE_Step_2] iamzuhair: lol
02/11/05 19:54:15 [USMLE_Step_2] strug: dec
02/11/05 19:54:20 [USMLE_Step_2] sanz: good dec
02/11/05 19:54:21 [USMLE_Step_2] sanz: CO?
02/11/05 19:54:22 [USMLE_Step_2] samantha: how to defferentiate cardio from endo shock?
02/11/05 19:54:25 [USMLE_Step_2] strug: dec
02/11/05 19:54:37 [USMLE_Step_2] dua_frank: pvr
02/11/05 19:54:39 [USMLE_Step_2] sanz: actually incr
02/11/05 19:54:42 [USMLE_Step_2] strug: sorry infc
02/11/05 19:54:44 [USMLE_Step_2] iamzuhair: dec
02/11/05 19:54:45 [USMLE_Step_2] strug: inc
02/11/05 19:54:45 [USMLE_Step_2] sanz: CO incr
02/11/05 19:54:50 [USMLE_Step_2] sanz: PVR decr
02/11/05 19:54:53 [USMLE_Step_2] strug: dec
02/11/05 19:55:01 [USMLE_Step_2] dua_frank: yeah sanz
02/11/05 19:55:05 [USMLE_Step_2] dua_frank: agree
02/11/05 19:55:10 [USMLE_Step_2] strug: samamtha gotcha ur ans?
02/11/05 19:55:15 [USMLE_Step_2] dua_frank: all parameters opp
02/11/05 19:55:31 [USMLE_Step_2] sanz: sam, just remmeber that cadrio and endogenic is opp
02/11/05 19:55:40 [USMLE_Step_2] megs: ok sanz
02/11/05 19:55:43 [USMLE_Step_2] iamzuhair: guys i had a BIG doubt
02/11/05 19:55:51 [USMLE_Step_2] sanz: shoot zu
02/11/05 19:56:02 [USMLE_Step_2] samantha: ok sanz
02/11/05 19:56:20 [USMLE_Step_2] iamzuhair: how do u say from x ray for empyema --- pneumothorax and effusion
02/11/05 19:56:33 [USMLE_Step_2] iamzuhair: from mediastinal shift
02/11/05 19:56:41 [USMLE_Step_2] iamzuhair: and breath sounds
02/11/05 19:56:42 [USMLE_Step_2] dua_frank: pneumo and effu easy
02/11/05 19:56:58 [USMLE_Step_2] dua_frank: empyeme cannot tell from xry
02/11/05 19:57:04 [USMLE_Step_2] sanz: i dont think you can see empyema on CXR
02/11/05 19:57:06 [USMLE_Step_2] megs: tracheal shift to opp side oo
02/11/05 19:57:19 [USMLE_Step_2] sanz: pneumoon CXR doesnt have any vascular markings... so it's pitch dark
02/11/05 19:57:37 [USMLE_Step_2] sanz: effusion is white with blunting of costdiag angle
02/11/05 19:57:40 [USMLE_Step_2] dua_frank: empyema after you put in chest tube you see pus
02/11/05 19:57:42 [USMLE_Step_2] iamzuhair: trachea shift to opp side in both pneumo and emphysema ?
02/11/05 19:57:43 megs Logs in
02/11/05 19:57:44 megs Joins Subroom USMLE_Step_2
02/11/05 19:57:48 cyrus1345 Logs Out
02/11/05 19:58:00 [USMLE_Step_2] iamzuhair: oh they are getin kicked out
02/11/05 19:58:02 [USMLE_Step_2] dua_frank: he said emphysema?
02/11/05 19:58:03 [USMLE_Step_2] sanz: yes... but yr empyema gotta be pretty big t do that
02/11/05 19:58:08 [USMLE_Step_2] megs: got kick out..
02/11/05 19:58:09 mmw Logs in
02/11/05 19:58:10 mmw Joins Subroom USMLE_Step_1
02/11/05 19:58:12 [USMLE_Step_2] dua_frank: wb megs
02/11/05 19:58:17 [USMLE_Step_2] sanz: wb megs
02/11/05 19:58:26 [USMLE_Step_2] dua_frank: emphysema is bilaral
02/11/05 19:58:27 [USMLE_Step_2] sanz: zu you meant empyema or emphysema?
02/11/05 19:58:33 cyrus1345 Logs in
02/11/05 19:58:36 [USMLE_Step_2] dua_frank: AP diameter increased
02/11/05 19:58:37 [USMLE_Step_2] iamzuhair: sorry emphysema
02/11/05 19:58:37 cyrus1345 Joins Subroom USMLE_Step_2
02/11/05 19:59:03 [USMLE_Step_2] sanz: emphysema has blebs on CXR... the pt also can have hyperexpanded lungs... so the diaphragm is flat
02/11/05 19:59:11 [USMLE_Step_2] dua_frank: yeah blebs too
02/11/05 19:59:16 [USMLE_Step_2] megs: emphysema no such mediastinal shift...its trou..out
02/11/05 19:59:21 [USMLE_Step_2] dua_frank: yep
02/11/05 19:59:21 [USMLE_Step_2] megs: agree sanz
02/11/05 19:59:25 [USMLE_Step_2] iamzuhair: what about breath sounds
02/11/05 19:59:34 [USMLE_Step_2] iamzuhair: always get confused
02/11/05 19:59:37 [USMLE_Step_2] sanz: emphysema has crackles
02/11/05 19:59:41 [USMLE_Step_2] sanz: both lungs
02/11/05 19:59:43 [USMLE_Step_2] dua_frank: yeah
02/11/05 19:59:47 [USMLE_Step_2] dua_frank: related to copd
02/11/05 20:00:00 [USMLE_Step_2] iamzuhair: i mean are they dec or inc
02/11/05 20:00:09 [USMLE_Step_2] dua_frank: dec with crackles
02/11/05 20:00:12 [USMLE_Step_2] sanz: with empyema, you prolly have reduced breath sound... cuz it's full of pus
02/11/05 20:00:20 [USMLE_Step_2] megs: yeah,agree sanz, can have rhonchi too
02/11/05 20:00:27 [USMLE_Step_2] dua_frank: sanz empyema isn't even being discussed here :P
02/11/05 20:00:32 [USMLE_Step_2] dua_frank: forget empyema :P
02/11/05 20:00:32 [USMLE_Step_2] sanz: ok
02/11/05 20:00:40 [USMLE_Step_2] sanz: i dont know what he meant anymore...
02/11/05 20:00:42 [USMLE_Step_2] sanz: hehe
02/11/05 20:00:44 [USMLE_Step_2] dua_frank: lol
02/11/05 20:00:48 [USMLE_Step_2] iamzuhair: lol
02/11/05 20:00:56 [USMLE_Step_2] iamzuhair: thanks guys
02/11/05 20:00:57 samantha Logs in
02/11/05 20:00:57 samantha Joins Subroom USMLE_Step_2
02/11/05 20:01:00 [USMLE_Step_2] megs: in empyema or pleural effusion ..NO BREATH SOUNDS
02/11/05 20:01:04 [USMLE_Step_2] dua_frank: welcome
02/11/05 20:01:11 [USMLE_Step_2] sanz: to be safe, discuss all
02/11/05 20:01:12 [USMLE_Step_2] sanz: hehe
02/11/05 20:01:13 [USMLE_Step_2] dua_frank: megs caught on too with empyema now
02/11/05 20:01:15 [USMLE_Step_2] samantha: got kicked out
02/11/05 20:01:19 [USMLE_Step_2] sanz: wb sam
02/11/05 20:01:22 [USMLE_Step_2] dua_frank: zu this is all your fault :P
02/11/05 20:01:26 [USMLE_Step_2] iamzuhair: wb sam
02/11/05 20:01:27 [USMLE_Step_2] dua_frank: wb sammy
02/11/05 20:01:29 [USMLE_Step_2] samantha: thank you
02/11/05 20:01:31 [USMLE_Step_2] iamzuhair: why
02/11/05 20:01:38 [USMLE_Step_2] dua_frank: got everybody mixed up
02/11/05 20:01:38 [USMLE_Step_2] iamzuhair: what did i do
02/11/05 20:01:39 [USMLE_Step_2] megs: didnt get u dua
02/11/05 20:01:56 [USMLE_Step_2] sanz: what is a flail chest?
02/11/05 20:01:58 lenhoxung Logs in
02/11/05 20:02:00 [USMLE_Step_2] dua_frank: megs he wanted to know about emphysema not empyema, misspelled it
02/11/05 20:02:08 [USMLE_Step_2] dua_frank: trauma
02/11/05 20:02:10 [USMLE_Step_2] megs: ok
02/11/05 20:02:14 [USMLE_Step_2] strug: paradoc resp in with ins and out with exp sanz
02/11/05 20:02:18 [USMLE_Step_2] iamzuhair: trauma and flapping dead chest
02/11/05 20:02:18 [USMLE_Step_2] dua_frank: positive ITP
02/11/05 20:02:23 huli72 Logs in
02/11/05 20:02:26 [USMLE_Step_2] sanz: great strug... Rx?
02/11/05 20:02:27 huli72 Joins Subroom USMLE_Step_2
02/11/05 20:02:28 [USMLE_Step_2] dua_frank: so the lungs don't expand
02/11/05 20:02:31 lenhoxung Joins Subroom USMLE_Step_1
02/11/05 20:02:38 [USMLE_Step_2] dua_frank: CPAP?or PEEP?
02/11/05 20:02:39 [USMLE_Step_2] strug: restrick fluids, resp support sanz
02/11/05 20:02:55 [USMLE_Step_2] iamzuhair: cpap
02/11/05 20:03:00 [USMLE_Step_2] strug: also look for aortic diss because big trauma
02/11/05 20:03:05 [USMLE_Step_2] sanz: i dont know the ans!
02/11/05 20:03:06 [USMLE_Step_2] sanz: hehe
02/11/05 20:03:10 [USMLE_Step_2] dua_frank: lol
02/11/05 20:03:12 [USMLE_Step_2] strug: give diuretics sanz
02/11/05 20:03:21 [USMLE_Step_2] sanz: i only know how to recognise a flail chest
02/11/05 20:03:22 [USMLE_Step_2] sanz: hehe
02/11/05 20:03:25 [USMLE_Step_2] dua_frank: they put the oxygen into lungs with pressure sanz
02/11/05 20:03:34 [USMLE_Step_2] strug: also montir abg
02/11/05 20:03:38 [USMLE_Step_2] dua_frank: coz there's no negative intrapleural pressure anymore
02/11/05 20:03:38 [USMLE_Step_2] iamzuhair: yeah cpap
02/11/05 20:03:46 [USMLE_Step_2] iamzuhair: with surgical correction
02/11/05 20:03:50 [USMLE_Step_2] strug: if u put pt on respiration put bilateral chest tube very imp
02/11/05 20:03:56 lenhoxung Logs in
02/11/05 20:03:58 [USMLE_Step_2] sanz: ok
02/11/05 20:04:06 [USMLE_Step_2] iamzuhair: ok
02/11/05 20:04:10 [USMLE_Step_2] iamzuhair: 1 st s
02/11/05 20:04:21 [USMLE_Step_2] iamzuhair: 1st thing to check after intubation
02/11/05 20:04:31 [USMLE_Step_2] strug: breath sounds zuhari
02/11/05 20:04:35 [USMLE_Step_2] iamzuhair: laryngeal intubation
02/11/05 20:04:37 [USMLE_Step_2] iamzuhair: yes
02/11/05 20:04:44 [USMLE_Step_2] iamzuhair: right strug
02/11/05 20:04:49 [USMLE_Step_2] dua_frank: yeah
02/11/05 20:06:15 [USMLE_Step_2] sanz: hey lanny is not here!
02/11/05 20:06:26 [USMLE_Step_2] dua_frank: yeah
02/11/05 20:06:46 [USMLE_Step_2] cyrus1345: what is the pathogenes of vasomotor shock?
02/11/05 20:06:47 [USMLE_Step_2] strug: pt with chest traums, inc jvp, absent breath sounds, dull topercussion, diagnisis?
02/11/05 20:07:07 [USMLE_Step_2] cyrus1345: hemothorax
02/11/05 20:07:15 [USMLE_Step_2] iamzuhair: tamponade
02/11/05 20:07:21 [USMLE_Step_2] dua_frank: hemmorhe?
02/11/05 20:07:22 [USMLE_Step_2] strug: circulatory collapse nasi
02/11/05 20:07:26 [USMLE_Step_2] iamzuhair: sorry hemothorax
02/11/05 20:07:31 [USMLE_Step_2] sanz: heamothorax agree
02/11/05 20:07:32 [USMLE_Step_2] strug: nasi is right its hemothorex
02/11/05 20:07:45 [USMLE_Step_2] megs: vagal inhibition nasi
02/11/05 20:07:53 [USMLE_Step_2] sanz: nasi, vasodilation
02/11/05 20:08:00 [USMLE_Step_2] cyrus1345: lossof vascullar tone and massive vasodilatuion
02/11/05 20:08:15 [USMLE_Step_2] strug: rx?
02/11/05 20:08:19 [USMLE_Step_2] dua_frank: yes but etiology is?
02/11/05 20:08:29 lanny Logs in
02/11/05 20:08:29 lanny Joins Subroom USMLE_Step_2
02/11/05 20:08:35 [USMLE_Step_2] huli72: tube thoracostomy
02/11/05 20:08:38 [USMLE_Step_2] megs: atropine i think
02/11/05 20:08:39 [USMLE_Step_2] lanny: hi all
02/11/05 20:08:43 [USMLE_Step_2] dua_frank: hi lanny
02/11/05 20:08:45 [USMLE_Step_2] strug: hi huli and lanny
02/11/05 20:08:48 [USMLE_Step_2] megs: welcome lanny
02/11/05 20:08:49 [USMLE_Step_2] huli72: hi
02/11/05 20:08:51 [USMLE_Step_2] iamzuhair: mx of myoglobinuria
02/11/05 20:08:51 [USMLE_Step_2] dua_frank: hi huli
02/11/05 20:08:57 [USMLE_Step_2] cyrus1345: epinephrin subcutaneous
02/11/05 20:09:00 [USMLE_Step_2] lanny: soorry im late one of those bad work days
02/11/05 20:09:00 [USMLE_Step_2] strug: fluids xuhari
02/11/05 20:09:00 [USMLE_Step_2] dua_frank: fluids
02/11/05 20:09:06 [USMLE_Step_2] megs: ok cyrus
02/11/05 20:09:12 [USMLE_Step_2] cyrus1345: hi lanny
02/11/05 20:09:13 [USMLE_Step_2] strug: yup right nasi and also fluids
02/11/05 20:09:20 [USMLE_Step_2] iamzuhair: fluids with mannitol and alkalanize urine
02/11/05 20:09:25 [USMLE_Step_2] strug: megs she is nasi[ cyrus is nasi]
02/11/05 20:09:50 [USMLE_Step_2] sanz: hey lanny
02/11/05 20:09:52 [USMLE_Step_2] iamzuhair: cyrus = ?
02/11/05 20:09:56 [USMLE_Step_2] strug: nasi
02/11/05 20:09:57 [USMLE_Step_2] lanny: the topic is surgery?
02/11/05 20:09:57 [USMLE_Step_2] sanz: hey huli
02/11/05 20:10:00 [USMLE_Step_2] megs: ok strug
02/11/05 20:10:03 [USMLE_Step_2] huli72: hi, sanz
02/11/05 20:10:06 [USMLE_Step_2] iamzuhair: right strug
02/11/05 20:10:06 [USMLE_Step_2] sanz: yes, trauma
02/11/05 20:10:13 [USMLE_Step_2] lanny: thx sanz
02/11/05 20:10:15 [USMLE_Step_2] strug: yup surg
02/11/05 20:10:49 [USMLE_Step_2] strug: pt hit by a car, racoon eyes and nose and ear disharge..next step?
02/11/05 20:10:59 [USMLE_Step_2] iamzuhair: ct
02/11/05 20:11:02 [USMLE_Step_2] lanny: skull ct
02/11/05 20:11:09 [USMLE_Step_2] iamzuhair: for basilar fracture
02/11/05 20:11:11 [USMLE_Step_2] sanz: basal kull #
02/11/05 20:11:18 [USMLE_Step_2] huli72: antibiotics
02/11/05 20:11:20 [USMLE_Step_2] lanny: yes
02/11/05 20:11:22 [USMLE_Step_2] strug: yup ct and also evaluation of neck
02/11/05 20:11:26 [USMLE_Step_2] sanz: image and expectanat management
02/11/05 20:11:28 [USMLE_Step_2] iamzuhair: if only ear discharge -- temporal bone #
02/11/05 20:11:41 [USMLE_Step_2] megs: yup zuhair
02/11/05 20:11:42 [USMLE_Step_2] lanny: agree iamz
02/11/05 20:11:47 [USMLE_Step_2] sanz: i think Ab'ics is controversy...
02/11/05 20:12:03 [USMLE_Step_2] megs: why contraversy sanz
02/11/05 20:12:07 [USMLE_Step_2] strug: no antibiotics
02/11/05 20:12:15 [USMLE_Step_2] sanz: i dont know... i have read b4 that ab is not usus given
02/11/05 20:12:32 [USMLE_Step_2] megs: ok..any reason for that
02/11/05 20:12:37 [USMLE_Step_2] huli72: I don't know that, thanks, sanz
02/11/05 20:12:52 [USMLE_Step_2] strug: pt in head on collision, ct shows diffuse axonal inj.rx?
02/11/05 20:12:59 [USMLE_Step_2] lanny: i think a b are not indicated
02/11/05 20:13:06 [USMLE_Step_2] iamzuhair: steroids
02/11/05 20:13:10 [USMLE_Step_2] cyrus1345: what's is the management of lineat skull fracture and scalp laceceration?
02/11/05 20:13:11 [USMLE_Step_2] sanz: hyperventilate strug
02/11/05 20:13:17 [USMLE_Step_2] huli72: agree with sanz
02/11/05 20:13:17 [USMLE_Step_2] sanz: and prevent raised ICP
02/11/05 20:13:18 [USMLE_Step_2] strug: megs antibiotcs have not proved to change outcome so not given
02/11/05 20:13:20 [USMLE_Step_2] iamzuhair: dec ivp
02/11/05 20:13:28 [USMLE_Step_2] sanz: nasi, suture and observe
02/11/05 20:13:29 [USMLE_Step_2] megs: ok strug thanx
02/11/05 20:13:39 [USMLE_Step_2] strug: sutrur the lacertaion and nothing more nasi
02/11/05 20:13:51 [USMLE_Step_2] iamzuhair: first aid and observe
02/11/05 20:13:54 [USMLE_Step_2] megs: scalp laceration pressure bandage
02/11/05 20:13:58 [USMLE_Step_2] lanny: watch for rise in intrac press
02/11/05 20:13:58 [USMLE_Step_2] cyrus1345: good strug
02/11/05 20:14:07 [USMLE_Step_2] lanny: no trt ususally
02/11/05 20:14:09 [USMLE_Step_2] strug: yup u guys right dec icp is all u do in axonal injur
02/11/05 20:14:16 [USMLE_Step_2] cyrus1345: and sanz
02/11/05 20:14:57 [USMLE_Step_2] lanny: is axonal injury invoves brain and s cord??
02/11/05 20:15:05 [USMLE_Step_2] lanny: why axonal
02/11/05 20:15:08 lenhoxung Joins Subroom USMLE_Step_1
02/11/05 20:15:10 [USMLE_Step_2] iamzuhair: yes brain
02/11/05 20:15:34 [USMLE_Step_2] sanz: i think it's brain...
02/11/05 20:15:36 [USMLE_Step_2] strug: old pt with rear end collision, paralysis and burning of upper extemities.....diag?
02/11/05 20:15:37 [USMLE_Step_2] iamzuhair: cos its axonal
02/11/05 20:15:40 [USMLE_Step_2] megs: i have a query???
02/11/05 20:15:44 [USMLE_Step_2] sanz: ok megs... shoot
02/11/05 20:15:46 [USMLE_Step_2] strug: go ahead megs
02/11/05 20:15:48 [USMLE_Step_2] iamzuhair: yes megs
02/11/05 20:15:48 [USMLE_Step_2] cyrus1345: what is the indication of CT scan in paitent with ehad truma?
02/11/05 20:15:56 [USMLE_Step_2] strug: all ptnasi
02/11/05 20:15:59 [USMLE_Step_2] iamzuhair: all
02/11/05 20:15:59 [USMLE_Step_2] sanz: nasi, LOC
02/11/05 20:16:02 [USMLE_Step_2] lanny: all
02/11/05 20:16:08 [USMLE_Step_2] dua_frank: syringomyelia?
02/11/05 20:16:11 [USMLE_Step_2] lanny: must do
02/11/05 20:16:14 [USMLE_Step_2] cyrus1345: good snaz
02/11/05 20:16:16 [USMLE_Step_2] megs: does mannitol only decrease icp or axonal injury too prevented???
02/11/05 20:16:27 [USMLE_Step_2] samantha: hi i had to attend to something
02/11/05 20:16:27 [USMLE_Step_2] lanny: whats LOC
02/11/05 20:16:28 [USMLE_Step_2] strug: dec icp
02/11/05 20:16:30 [USMLE_Step_2] iamzuhair: axonal inj decreased
02/11/05 20:16:33 [USMLE_Step_2] samantha: back now
02/11/05 20:16:38 [USMLE_Step_2] sanz: megs, it only decr ICP
02/11/05 20:16:39 [USMLE_Step_2] iamzuhair: cannot prevent it
02/11/05 20:16:41 [USMLE_Step_2] huli72: what is the ans to your q
02/11/05 20:16:43 [USMLE_Step_2] cyrus1345: syringomilia strug
02/11/05 20:16:46 [USMLE_Step_2] dua_frank: dec ICP
02/11/05 20:16:47 [USMLE_Step_2] huli72: strug
02/11/05 20:16:52 [USMLE_Step_2] strug: its cental cord syn
02/11/05 20:16:55 [USMLE_Step_2] sanz: loss of conciousness = LOC
02/11/05 20:16:59 [USMLE_Step_2] megs: ok than gals
02/11/05 20:17:04 [USMLE_Step_2] dua_frank: isn't that the same as syringomyelia?
02/11/05 20:17:06 [USMLE_Step_2] lanny: strug is your ansewer reflex..something
02/11/05 20:17:10 [USMLE_Step_2] iamzuhair: no
02/11/05 20:17:26 [USMLE_Step_2] dua_frank: ok i guess thats a degen disorder
02/11/05 20:17:27 [USMLE_Step_2] cyrus1345: syringomylia is a branch of centeral cord
02/11/05 20:17:27 [USMLE_Step_2] sanz: strug, ant cord syndrome
02/11/05 20:17:35 [USMLE_Step_2] iamzuhair: diffuse axonal injury is bet gray and white matter interface
02/11/05 20:17:36 [USMLE_Step_2] strug: old pt , UL only affected, is cental cored
02/11/05 20:17:36 [USMLE_Step_2] dua_frank: central cord synd it is then
02/11/05 20:17:59 [USMLE_Step_2] strug: in syring pain and temp presevved with loss of touch
02/11/05 20:18:09 [USMLE_Step_2] dua_frank: yeah
02/11/05 20:18:16 [USMLE_Step_2] sanz: what is ant cord syndr?
02/11/05 20:18:23 [USMLE_Step_2] sanz: i gt them both mixed up all the time
02/11/05 20:18:32 [USMLE_Step_2] lanny: whats UL strug
02/11/05 20:18:36 [USMLE_Step_2] dua_frank: ventral colums
02/11/05 20:18:37 [USMLE_Step_2] sanz: upp limb
02/11/05 20:18:39 [USMLE_Step_2] strug: loss of pain and temp on both sides sanz
02/11/05 20:18:47 [USMLE_Step_2] lanny: sorry too tired to figure out thes abbrev
02/11/05 20:19:08 [USMLE_Step_2] strug: with preser of vibration and propi sanz
02/11/05 20:19:08 [USMLE_Step_2] huli72: I think it is paralysis, sanz
02/11/05 20:19:20 [USMLE_Step_2] sanz: ok
02/11/05 20:19:35 rsandhu Logs in
02/11/05 20:19:42 rsandhu Joins Subroom USMLE_Step_1
02/11/05 20:19:43 [USMLE_Step_2] iamzuhair: dorsal column preserved with lss of pain and temp both sides
02/11/05 20:19:53 [USMLE_Step_1] rsandhu: hi guys
02/11/05 20:20:05 [USMLE_Step_2] sanz: that's ant cord
02/11/05 20:20:07 [USMLE_Step_2] sanz: right zu?
02/11/05 20:20:11 [USMLE_Step_2] iamzuhair: yes
02/11/05 20:20:11 [USMLE_Step_2] dua_frank: thats post cord
02/11/05 20:20:20 [USMLE_Step_2] dua_frank: dorsal is post, isn't it?
02/11/05 20:20:24 [USMLE_Step_2] dua_frank: and ventral ant
02/11/05 20:20:29 [USMLE_Step_2] iamzuhair: no ant cord
02/11/05 20:20:56 [USMLE_Step_2] lanny: yes dorsal is posterior
02/11/05 20:20:57 [USMLE_Step_2] huli72: syringoma?
02/11/05 20:21:17 [USMLE_Step_2] dua_frank: so ant cord syn should affect ventral colums
02/11/05 20:21:26 [USMLE_Step_2] lanny: yes dua
02/11/05 20:21:28 [USMLE_Step_2] dua_frank: like pain and temp commisures
02/11/05 20:21:34 [USMLE_Step_2] sanz: i dont think so....
02/11/05 20:21:36 [USMLE_Step_2] iamzuhair: yes dua
02/11/05 20:21:38 [USMLE_Step_2] lanny: yes pores vib and pos
02/11/05 20:21:47 [USMLE_Step_2] dua_frank: them too
02/11/05 20:21:50 [USMLE_Step_2] dua_frank: laterally
02/11/05 20:21:57 [USMLE_Step_2] dua_frank: medial laterally you have the CST
02/11/05 20:22:34 [USMLE_Step_2] iamzuhair: my comp acting funny
02/11/05 20:22:42 [USMLE_Step_2] strug: ok guys we all r weak in this....i ask u ans
02/11/05 20:22:45 [USMLE_Step_2] sanz: anyway, let me summarise what i think of ant cord syndrome...you guys correct me plz?
02/11/05 20:22:46 [USMLE_Step_2] samantha: what is cst dua
02/11/05 20:22:52 [USMLE_Step_2] iamzuhair: or is the site slowed down
02/11/05 20:22:54 [USMLE_Step_2] dua_frank: corticospinal tracts
02/11/05 20:23:00 [USMLE_Step_2] strug: everyghing lost below the lesion ?
02/11/05 20:23:01 [USMLE_Step_2] dua_frank: ok sanz
02/11/05 20:23:11 [USMLE_Step_2] sanz: ant cord synd has paralysis, decr pain and temp on both side with vibration preserved
02/11/05 20:23:12 [USMLE_Step_2] dua_frank: total resection
02/11/05 20:23:16 iamzuhair Logs Out
02/11/05 20:23:17 [USMLE_Step_2] dua_frank: of sp cord strug
02/11/05 20:23:21 [USMLE_Step_2] megs: spinal shock,cord section
02/11/05 20:23:22 [USMLE_Step_2] strug: yup dua
02/11/05 20:23:27 [USMLE_Step_2] dua_frank: yes sanz
02/11/05 20:23:33 rsandhu Logs Out
02/11/05 20:23:36 [USMLE_Step_2] sanz: central cord has pain and bruning sensation, usu upp limbs
02/11/05 20:23:45 [USMLE_Step_2] dua_frank: right sanz
02/11/05 20:23:48 [USMLE_Step_2] strug: paralysis and loss of propio on one side , pain losson other side?
02/11/05 20:23:59 [USMLE_Step_2] sanz: hemisection
02/11/05 20:24:01 [USMLE_Step_2] dua_frank: brown sequard
02/11/05 20:24:02 [USMLE_Step_2] cyrus1345: yyes
02/11/05 20:24:09 [USMLE_Step_2] strug: yup dua and nasi good
02/11/05 20:24:24 [USMLE_Step_2] strug: UL only affected with paralysisi and burinig?
02/11/05 20:24:33 [USMLE_Step_2] sanz: central cord
02/11/05 20:24:36 [USMLE_Step_2] dua_frank: central cord
02/11/05 20:24:37 [USMLE_Step_2] strug: yup
02/11/05 20:24:49 [USMLE_Step_2] cyrus1345: or syringo
02/11/05 20:24:53 [USMLE_Step_2] strug: pain and temp lost with presevation of vibraion and propio
02/11/05 20:25:00 [USMLE_Step_2] strug: on both side
02/11/05 20:25:05 [USMLE_Step_2] sanz: ant cord
02/11/05 20:25:05 [USMLE_Step_2] lanny: ant cord
02/11/05 20:25:06 [USMLE_Step_2] dua_frank: synringo
02/11/05 20:25:15 [USMLE_Step_2] dua_frank: oh ant cord
02/11/05 20:25:19 [USMLE_Step_2] strug: pain and temploss and preservationof touch?
02/11/05 20:25:35 [USMLE_Step_2] sanz: syringo
02/11/05 20:25:44 [USMLE_Step_2] strug: yup thats it u gotcha sanz
02/11/05 20:25:44 iamzuhair Logs in
02/11/05 20:25:49 [USMLE_Step_2] dua_frank: syringo yes
02/11/05 20:25:53 iamzuhair Joins Subroom USMLE_Step_2
02/11/05 20:25:54 [USMLE_Step_2] sanz: thnx strug, you're a star!
02/11/05 20:26:02 [USMLE_Step_2] dua_frank: this is a good review
02/11/05 20:26:10 [USMLE_Step_2] strug: nasi why do u say syring for UL buring and paralysis?
02/11/05 20:26:12 [USMLE_Step_2] huli72: welcome back, zuhair
02/11/05 20:26:15 [USMLE_Step_2] lanny: whats diff bet syring and ant cord?
02/11/05 20:26:21 [USMLE_Step_2] iamzuhair: yeha --- thanks
02/11/05 20:26:21 [USMLE_Step_2] dua_frank: wb zu
02/11/05 20:26:56 [USMLE_Step_2] iamzuhair: ok
02/11/05 20:27:02 [USMLE_Step_2] cyrus1345: 2 disease alwayes involve pain and T?
02/11/05 20:27:08 [USMLE_Step_2] huli72: what is the difference between syringo and central cord syn?
02/11/05 20:27:11 [USMLE_Step_2] dua_frank: touch is intact in syringo i think lanny
02/11/05 20:27:15 [USMLE_Step_2] strug: lanny in syring there is preser of touch, in ant cord prev of propi and vibra
02/11/05 20:27:24 [USMLE_Step_2] sanz: ant cord and brown sequad, nasi?
02/11/05 20:27:36 [USMLE_Step_2] cyrus1345: and syringo
02/11/05 20:27:39 [USMLE_Step_2] strug: ant cord and syring
02/11/05 20:27:57 [USMLE_Step_2] cyrus1345: 2 disease never invovle pain and T?
02/11/05 20:28:04 [USMLE_Step_2] dua_frank: what does freidricks ataxia affect?
02/11/05 20:28:08 [USMLE_Step_2] dua_frank: and what is it due to
02/11/05 20:28:22 [USMLE_Step_2] strug: alpha tocopheroal tans pro dua
02/11/05 20:28:24 [USMLE_Step_2] lanny: dorsal columns in *********
02/11/05 20:28:26 [USMLE_Step_2] huli72: posterior collume
02/11/05 20:28:29 [USMLE_Step_2] dua_frank: yes
02/11/05 20:28:29 [USMLE_Step_2] sanz: tabes dorsalis and vit B12, nasi?
02/11/05 20:28:42 [USMLE_Step_2] lanny: also lateral CS tract
02/11/05 20:28:57 [USMLE_Step_2] dua_frank: AML?
02/11/05 20:28:59 [USMLE_Step_2] cyrus1345: yes sanz and also ALS
02/11/05 20:29:07 [USMLE_Step_2] dua_frank: yeah i mean ALS :P
02/11/05 20:29:08 [USMLE_Step_2] sanz: oh yeah
02/11/05 20:29:10 [USMLE_Step_2] strug: what b12 dosent invol pain?
02/11/05 20:29:14 [USMLE_Step_2] samantha: in tabes position and vibra affected
02/11/05 20:29:20 [USMLE_Step_2] strug: i though it involves everyghing
02/11/05 20:29:24 [USMLE_Step_2] lanny: in ALS no sens loss
02/11/05 20:29:31 [USMLE_Step_2] cyrus1345: not pain and T
02/11/05 20:29:32 [USMLE_Step_2] dua_frank: friedricks too in that case nasi
02/11/05 20:29:40 [USMLE_Step_2] strug: r u sure nasi?
02/11/05 20:29:41 [USMLE_Step_2] lanny: but upper and lower motor nurun
02/11/05 20:29:47 [USMLE_Step_2] sanz: no strug, it involves dorsal colum - so no vibration sense and spinocerebellar - so no balance
02/11/05 20:29:57 [USMLE_Step_2] lanny: ********* and B12 have same probs
02/11/05 20:30:08 [USMLE_Step_2] samantha: in vit b12 post colum
02/11/05 20:30:08 [USMLE_Step_2] lanny: dorsal columns and lat
02/11/05 20:30:09 [USMLE_Step_2] huli72: I think so, lanny
02/11/05 20:30:09 [USMLE_Step_2] sanz: so intact pain and temp in vit B12
02/11/05 20:30:12 [USMLE_Step_2] strug: acc to dr fischer b12 can inv everythig
02/11/05 20:30:16 [USMLE_Step_2] lanny: CS tract
02/11/05 20:30:25 [USMLE_Step_2] dua_frank: well yes strug
02/11/05 20:30:31 [USMLE_Step_2] lanny: yes
02/11/05 20:30:35 [USMLE_Step_2] cyrus1345: not pain and T strug
02/11/05 20:30:43 [USMLE_Step_2] dua_frank: i agree with dr fischer, the learned and wise one
02/11/05 20:30:52 [USMLE_Step_2] iamzuhair: syringomelia the distribution is like a cape -- what the nuns wear
02/11/05 20:30:56 [USMLE_Step_2] samantha: ok
02/11/05 20:31:03 [USMLE_Step_2] strug: good to know it nasi, can u lemme know the source....we can confirm
02/11/05 20:31:04 [USMLE_Step_2] dua_frank: yeah zu
02/11/05 20:31:26 [USMLE_Step_2] iamzuhair: ok
02/11/05 20:31:28 [USMLE_Step_2] cyrus1345: you can look neuroanatomy kaplan step 1
02/11/05 20:31:48 [USMLE_Step_2] dua_frank: are they myelinated, the dorsal colums?
02/11/05 20:31:56 [USMLE_Step_2] lanny: loss of pain and temp on right side where is the lesion in SC?
02/11/05 20:31:59 [USMLE_Step_2] strug: thanks nasi
02/11/05 20:32:01 [USMLE_Step_2] sanz: dua, i would think so...
02/11/05 20:32:04 [USMLE_Step_2] dua_frank: if they are not then vit b12 does not affect them
02/11/05 20:32:22 [USMLE_Step_2] lanny: yes dorsal col are myelin
02/11/05 20:32:23 [USMLE_Step_2] strug: right lanny
02/11/05 20:32:32 [USMLE_Step_2] strug: rt side
02/11/05 20:32:50 [USMLE_Step_2] lanny: lesion on opposite side
02/11/05 20:32:57 [USMLE_Step_2] lanny: left side
02/11/05 20:33:20 [USMLE_Step_2] strug: yup ooopppppsssssss :p
02/11/05 20:33:29 [USMLE_Step_2] sanz: yeah, pain and temp fibres cross in the same level... but CST crosses at the pyramids
02/11/05 20:33:36 [USMLE_Step_2] sanz: caught us there lanny
02/11/05 20:33:48 [USMLE_Step_2] lanny: right sanz
02/11/05 20:35:00 lenhoxung Logs Out
02/11/05 20:35:15 [USMLE_Step_2] sanz: who is this Dr ******?
02/11/05 20:35:19 [USMLE_Step_2] dua_frank: patient walks on a straight line, deviates to left
02/11/05 20:35:22 [USMLE_Step_2] dua_frank: where is the injury?
02/11/05 20:35:34 [USMLE_Step_2] lanny: cerebellar
02/11/05 20:35:35 [USMLE_Step_2] dua_frank: sanz hes a famous guy from kaplan
02/11/05 20:35:39 [USMLE_Step_2] dua_frank: which side lanny
02/11/05 20:35:41 [USMLE_Step_2] strug: :o u dunno him sanz
02/11/05 20:35:47 [USMLE_Step_2] sanz: left dua
02/11/05 20:35:51 [USMLE_Step_2] dua_frank: good yes left
02/11/05 20:35:52 [USMLE_Step_2] sanz: no strug
02/11/05 20:36:01 [USMLE_Step_2] lanny: same side
02/11/05 20:36:03 [USMLE_Step_2] samantha: on the same side
02/11/05 20:36:03 [USMLE_Step_2] megs: left cerebeller
02/11/05 20:36:07 [USMLE_Step_2] sanz: i listened to goljian... that's abt all
02/11/05 20:36:11 [USMLE_Step_2] dua_frank: yep yep yep, all good
02/11/05 20:36:11 [USMLE_Step_2] strug: he teaches inter med some topics he is awesome faculty
02/11/05 20:36:36 [USMLE_Step_2] sanz: i dont have those kap audios...
02/11/05 20:36:51 [USMLE_Step_2] dua_frank: do you have highlights at least sanz?
02/11/05 20:37:04 [USMLE_Step_2] sanz: no dua... i only have kap notes
02/11/05 20:37:20 [USMLE_Step_2] lanny: whats this highlights is it good
02/11/05 20:37:24 [USMLE_Step_2] dua_frank: i could send you the kap material tonight if you want, through internet
02/11/05 20:37:31 [USMLE_Step_2] lanny: have been hearing about it
02/11/05 20:37:38 [USMLE_Step_2] dua_frank: will send to lanny too
02/11/05 20:37:43 [USMLE_Step_2] strug: old man, alcohoic, fell of a horse a week ago, earlier was ok at preset stares and has memorey loss, diagnosis?
02/11/05 20:37:53 [USMLE_Step_2] sanz: dua, i dont have anymore time... but that's so sweet of you to offer, thanx
02/11/05 20:37:56 [USMLE_Step_2] lanny: oh thanks a lot dua you want my e mail
02/11/05 20:37:58 [USMLE_Step_2] dua_frank: welcome
02/11/05 20:38:01 [USMLE_Step_2] cyrus1345: chronic subdural hematoma
02/11/05 20:38:05 [USMLE_Step_2] huli72: chronic subdura hemotoma
02/11/05 20:38:09 [USMLE_Step_2] strug: yup nasi very good
02/11/05 20:38:15 [USMLE_Step_2] strug: Rx?
02/11/05 20:38:18 [USMLE_Step_2] dua_frank: yes lanny
02/11/05 20:38:24 [USMLE_Step_2] sanz: strug, observe
02/11/05 20:38:39 [USMLE_Step_2] dua_frank: i'll be sending as a zip file so you have to extract it after you get it
02/11/05 20:38:39 [USMLE_Step_2] huli72: surgery?
02/11/05 20:38:42 [USMLE_Step_2] samantha: subdural hematoma
02/11/05 20:38:47 [USMLE_Step_2] cyrus1345: sanz ,I recommned you to listen them ,very useful and they are not long!
02/11/05 20:38:53 [USMLE_Step_2] sanz: really?
02/11/05 20:38:57 [USMLE_Step_2] dua_frank: yeah sanz
02/11/05 20:38:58 [USMLE_Step_2] lanny: ok dua
02/11/05 20:39:06 [USMLE_Step_2] sanz: ok then dua! sne d them my way please pretty please?
02/11/05 20:39:19 [USMLE_Step_2] dua_frank: the audios would take long to hear, although i could send those too if you want
02/11/05 20:39:31 [USMLE_Step_2] dua_frank: ofcourse sanz, my pleasure, i'll send them tonight
02/11/05 20:39:33 [USMLE_Step_2] megs: watch for sighns of raised ict strug
02/11/05 20:39:39 [USMLE_Step_2] strug: nasi wahts ur ans to my q?
02/11/05 20:39:40 [USMLE_Step_2] samantha: what are those?
02/11/05 20:39:53 [USMLE_Step_2] cyrus1345: oops sorry
02/11/05 20:39:55 [USMLE_Step_2] cyrus1345: strug
02/11/05 20:40:00 [USMLE_Step_2] huli72: strug, what is the ans
02/11/05 20:40:13 [USMLE_Step_2] lanny: dua anything is appreciated will give you my e mail
02/11/05 20:40:14 [USMLE_Step_2] cyrus1345: I miss your question
02/11/05 20:40:29 [USMLE_Step_2] lanny: do you have int medicine highlights
02/11/05 20:40:39 [USMLE_Step_2] strug: i am confused, i read somewhere that if its a very old pt just observe, in kaplan surery they say surgical evacuation has dramatic cure
02/11/05 20:40:55 [USMLE_Step_2] strug: i m taling about Rx of chro subdural hematoma
02/11/05 20:40:55 [USMLE_Step_2] cyrus1345: listen to kaplan strug
02/11/05 20:41:06 [USMLE_Step_2] cyrus1345: kaplan is right
02/11/05 20:41:13 [USMLE_Step_2] megs: yeah kaplan
02/11/05 20:41:27 [USMLE_Step_2] cyrus1345: yes it's craniotomy
02/11/05 20:41:32 [USMLE_Step_2] strug: ok thanks nasi and megs
02/11/05 20:41:57 [USMLE_Step_2] samantha: other wise it will increase in size
02/11/05 20:42:02 [USMLE_Step_2] strug: gunshot wound to upper zone of neck, nex step>?
02/11/05 20:42:21 [USMLE_Step_2] cyrus1345: penetrating wound to neck paitent is unstable next step?
02/11/05 20:42:25 [USMLE_Step_2] samantha: it will draw fluids
02/11/05 20:42:26 [USMLE_Step_2] huli72: arterography
02/11/05 20:42:27 [USMLE_Step_2] megs: abc and exploration
02/11/05 20:42:41 [USMLE_Step_2] strug: exp nasi
02/11/05 20:42:46 [USMLE_Step_2] strug: explore
02/11/05 20:42:56 [USMLE_Step_2] lanny: agree with megs
02/11/05 20:43:02 [USMLE_Step_2] lanny: ABC fitrst
02/11/05 20:43:10 [USMLE_Step_2] cyrus1345: 'yes strug arterograph y for your question
02/11/05 20:43:15 [USMLE_Step_2] iamzuhair: unstable any where --- stabilize then explore
02/11/05 20:43:21 roxanita Logs in
02/11/05 20:43:23 roxanita Joins Subroom USMLE_Step_1
02/11/05 20:43:32 [USMLE_Step_2] lanny: but depends in what zone in the ne
02/11/05 20:43:34 [USMLE_Step_2] strug: right nasi
02/11/05 20:43:35 [USMLE_Step_2] lanny: neck
02/11/05 20:43:47 [USMLE_Step_2] strug: gunshot to middle zone?
02/11/05 20:44:02 [USMLE_Step_2] samantha: observe?
02/11/05 20:44:03 usmle_guy Logs in
02/11/05 20:44:04 [USMLE_Step_2] lanny: imaging
02/11/05 20:44:05 usmle_guy Joins Subroom USMLE_Step_1
02/11/05 20:44:05 [USMLE_Step_2] cyrus1345: explo
02/11/05 20:44:12 [USMLE_Step_2] huli72: triscopy, and explore
02/11/05 20:44:21 [USMLE_Step_2] strug: explore directly
02/11/05 20:44:27 [USMLE_Step_2] lanny: this is imp guys what zones we do what
02/11/05 20:44:30 [USMLE_Step_2] strug: nasi wahts the ans to ur q?
02/11/05 20:44:45 [USMLE_Step_2] megs: ok strug
02/11/05 20:44:50 [USMLE_Step_2] cyrus1345: you did correct
02/11/05 20:44:58 [USMLE_Step_2] cyrus1345: strug to my question
02/11/05 20:45:05 [USMLE_Step_2] strug: ok gotcha nasi
02/11/05 20:45:22 [USMLE_Step_2] strug: first tell me the diff zones boundaries
02/11/05 20:45:22 [USMLE_Step_2] lanny: there are 3 zones right
02/11/05 20:45:30 [USMLE_Step_2] strug: yes lanny go ahead
02/11/05 20:45:32 [USMLE_Step_2] lanny: forgot!!!!
02/11/05 20:45:43 iamzuhair Logs Out
02/11/05 20:45:44 [USMLE_Step_2] strug: :p lanny
02/11/05 20:45:46 [USMLE_Step_2] megs: hey lanny
02/11/05 20:45:47 [USMLE_Step_2] huli72: edge of submadible
02/11/05 20:46:00 [USMLE_Step_2] lanny: what megs
02/11/05 20:46:08 [USMLE_Step_2] samantha: i thought the zone 3 it where imp vessels are
02/11/05 20:46:13 [USMLE_Step_2] strug: correct me if i m wrong fuys
02/11/05 20:46:16 [USMLE_Step_2] strug: guys
02/11/05 20:46:19 [USMLE_Step_2] megs: nothing lanny :(
02/11/05 20:46:40 [USMLE_Step_2] strug: from clavicl to cricoid is zone 1
02/11/05 20:46:54 [USMLE_Step_2] cyrus1345: agree
02/11/05 20:46:55 [USMLE_Step_2] strug: cricoid to edge of mand is zon 2
02/11/05 20:47:00 [USMLE_Step_2] cyrus1345: agree
02/11/05 20:47:04 [USMLE_Step_2] strug: above that zon 3
02/11/05 20:47:07 iamzuhair Logs in
02/11/05 20:47:11 [USMLE_Step_2] cyrus1345: yep
02/11/05 20:47:13 [USMLE_Step_2] megs: ok thanx strug
02/11/05 20:47:14 iamzuhair Joins Subroom USMLE_Step_2
02/11/05 20:47:28 [USMLE_Step_2] lanny: thx strug
02/11/05 20:47:35 [USMLE_Step_2] strug: now i ask u ans
02/11/05 20:47:46 [USMLE_Step_2] strug: gunshot wound to upper zone
02/11/05 20:47:48 [USMLE_Step_2] strug: ?
02/11/05 20:47:53 [USMLE_Step_2] sanz: angio
02/11/05 20:47:55 [USMLE_Step_2] lanny: oh strug finish the good job lol
02/11/05 20:48:00 [USMLE_Step_2] strug: right sanz
02/11/05 20:48:07 [USMLE_Step_2] strug: gunshot to middle zone?
02/11/05 20:48:11 [USMLE_Step_2] sanz: explore
02/11/05 20:48:12 [USMLE_Step_2] cyrus1345: explo
02/11/05 20:48:15 [USMLE_Step_2] strug: good
02/11/05 20:48:17 [USMLE_Step_2] megs: explore
02/11/05 20:48:23 [USMLE_Step_2] strug: lower zone?
02/11/05 20:48:36 [USMLE_Step_2] sanz: triscopy?
02/11/05 20:48:43 lenhoxung Joins Subroom USMLE_Step_1
02/11/05 20:48:45 [USMLE_Step_2] megs: intubateand trioscopy
02/11/05 20:48:45 [USMLE_Step_2] sanz: and angio too
02/11/05 20:49:06 [USMLE_Step_2] strug: arterio, esophagogram, esopha, broncho is what i know
02/11/05 20:49:16 [USMLE_Step_2] sanz: great :)
02/11/05 20:49:27 [USMLE_Step_2] strug: ok now read carefully
02/11/05 20:49:34 [USMLE_Step_2] megs: what is oesophageogram strug??/
02/11/05 20:49:54 [USMLE_Step_2] strug: gunshot wound to upper zone, vital signs deteriorating?
02/11/05 20:50:03 [USMLE_Step_2] cyrus1345: explo
02/11/05 20:50:09 [USMLE_Step_2] lanny: angiography
02/11/05 20:50:15 [USMLE_Step_2] sanz: explor
02/11/05 20:50:17 [USMLE_Step_2] strug: correct nasi we dont wait to do angio pt will die
02/11/05 20:50:19 [USMLE_Step_2] cyrus1345: all zone if paitent is unstable should go for explo
02/11/05 20:50:29 [USMLE_Step_2] sanz: agree
02/11/05 20:50:30 [USMLE_Step_2] megs: agree nasi
02/11/05 20:50:32 [USMLE_Step_2] strug: wonderful nasi
02/11/05 20:50:45 [USMLE_Step_2] samantha: thanks guys
02/11/05 20:50:45 [USMLE_Step_2] strug: also if expanding heamatoma explore
02/11/05 20:50:48 [USMLE_Step_2] cyrus1345: zone 2 even if paitent is stable go for explo alwyes
02/11/05 20:51:13 [USMLE_Step_2] strug: stab wound in lower zone?
02/11/05 20:51:39 [USMLE_Step_2] sanz: observe if no sympt
02/11/05 20:51:47 [USMLE_Step_2] lanny: nasi but we explore in zon2 anyway whats your ppoint
02/11/05 20:52:00 [USMLE_Step_2] strug: explore explore in lower zone stab wound
02/11/05 20:52:06 [USMLE_Step_2] lanny: lower zone is 1
02/11/05 20:52:14 [USMLE_Step_2] sanz: lanny, we dont explore in zone 2 stab wounds
02/11/05 20:52:19 [USMLE_Step_2] strug: in upper and middle u can safely observee is pt asymp sanz
02/11/05 20:52:27 [USMLE_Step_2] cyrus1345: I mean in zone 2 don't care paitent is stable or not alwyes go for explo
02/11/05 20:52:36 [USMLE_Step_2] strug: agree
02/11/05 20:52:45 [USMLE_Step_2] dua_frank: thanks nasi
02/11/05 20:52:45 [USMLE_Step_2] cyrus1345: but in another zone first look paitent is stable or not
02/11/05 20:53:01 [USMLE_Step_2] lanny: confused sanz so what strug said is not right?
02/11/05 20:53:24 [USMLE_Step_2] dua_frank: ok i'm confused now :(
02/11/05 20:53:25 [USMLE_Step_2] sanz: i noted down from UW that stabbed wounds to zone 2 can be observed if pt stable...
02/11/05 20:53:43 [USMLE_Step_2] samantha: me too
02/11/05 20:53:45 [USMLE_Step_2] strug: yup sanz i asked abut lower zone
02/11/05 20:53:49 [USMLE_Step_2] lanny: ok sanz thx
02/11/05 20:53:50 [USMLE_Step_2] cyrus1345: in neck ,gunshout managment is differnt with stabb lanny
02/11/05 20:53:59 [USMLE_Step_2] sanz: GSW and stabbed wound Mx are diff
02/11/05 20:54:03 [USMLE_Step_2] dua_frank: *sounds the alarm* controversy time again, resolve and do let me know the conclusion please :P
02/11/05 20:54:08 [USMLE_Step_2] sanz: if GSW to zone 2, always explore
02/11/05 20:54:20 [USMLE_Step_2] samantha: one zone i think the lowest is imp vessels
02/11/05 20:54:50 [USMLE_Step_2] strug: there is no controversy what sanz is saying and i saying is same
02/11/05 20:54:58 [USMLE_Step_2] lanny: still confusing but thanks for your effoert will have to read it again
02/11/05 20:55:11 [USMLE_Step_2] sanz: yes.. strug :) we're on the same wavelength
02/11/05 20:55:11 [USMLE_Step_2] sanz: hehe
02/11/05 20:55:27 [USMLE_Step_2] strug: rd this trans dua and u will clear out
02/11/05 20:55:35 [USMLE_Step_2] cyrus1345: you know lanny in question look 2 things first is it gun or stabb 2.stable or unstable
02/11/05 20:55:46 [USMLE_Step_2] sanz: exactly nasi
02/11/05 20:55:50 [USMLE_Step_2] strug: yes nasi
02/11/05 20:55:59 [USMLE_Step_2] lanny: so diff in mgmt if gun or knife
02/11/05 20:56:01 [USMLE_Step_2] samantha: ok
02/11/05 20:56:04 [USMLE_Step_2] sanz: yup
02/11/05 20:56:06 [USMLE_Step_2] cyrus1345: ye slanny
02/11/05 20:56:06 [USMLE_Step_2] strug: yes lanny
02/11/05 20:56:08 [USMLE_Step_2] dua_frank: ok
02/11/05 20:56:19 [USMLE_Step_2] dua_frank: i guess i understand, GSW and stab wound
02/11/05 20:56:21 [USMLE_Step_2] lanny: oh never knew this thx guys
02/11/05 20:56:24 [USMLE_Step_2] megs: got it nasi thanx
02/11/05 20:56:32 [USMLE_Step_2] sanz: now you do lanny :)
02/11/05 20:56:37 [USMLE_Step_2] lanny: no
02/11/05 20:56:41 [USMLE_Step_2] samantha: for gun shot explore
02/11/05 20:57:19 [USMLE_Step_2] strug: pt with high speed collison, chest x ray s hows widened mediastinum, spiral ct unconclusive,,,,next step?
02/11/05 20:57:42 [USMLE_Step_2] sanz: USS?
02/11/05 20:57:52 [USMLE_Step_2] huli72: MRI?
02/11/05 20:57:53 [USMLE_Step_2] sanz: to rule out tamponade?
02/11/05 20:57:59 [USMLE_Step_2] iamzuhair: chest drain
02/11/05 20:58:09 [USMLE_Step_2] cyrus1345: aortogram
02/11/05 20:58:10 [USMLE_Step_2] huli72: surgery
02/11/05 20:58:12 [USMLE_Step_2] lanny: to rule out aortic rupture
02/11/05 20:58:16 [USMLE_Step_2] strug: yup nasi wonderful
02/11/05 20:58:28 [USMLE_Step_2] strug: high suspicion because high speed collison
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