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Asclepius1
02-18-2005, 02:26 PM
02/17/05 19:09:08 [USMLE_Step_2] strug: ok lets begin with most imp topic substance abuse
02/17/05 19:09:12 [USMLE_Step_2] sanz: hi guys :)
02/17/05 19:09:14 [USMLE_Step_2] strug: hi dua and sanz
02/17/05 19:09:18 [USMLE_Step_2] dua_frank: hey sanz and strug :)
02/17/05 19:09:22 [USMLE_Step_2] lanny: hi sanz
02/17/05 19:09:23 iamzuhair Logs in
02/17/05 19:09:27 iamzuhair Joins Subroom USMLE_Step_2
02/17/05 19:09:35 [USMLE_Step_2] iamzuhair: hi guys
02/17/05 19:09:39 [USMLE_Step_2] samantha: hi dua and sanz
02/17/05 19:09:42 [USMLE_Step_2] sanz: hey zu
02/17/05 19:09:51 [USMLE_Step_2] lanny: hi zu..
02/17/05 19:09:55 [USMLE_Step_2] iamzuhair: hey sanz and lanny
02/17/05 19:10:04 [USMLE_Step_2] iamzuhair: hey strug
02/17/05 19:10:10 [USMLE_Step_2] strug: pt with euphoria, anxiety, paranoid delusions, pupillary dilation, ...diagnosis?
02/17/05 19:10:13 [USMLE_Step_2] strug: hey zu
02/17/05 19:10:14 [USMLE_Step_2] iamzuhair: is dua active today
02/17/05 19:10:15 [USMLE_Step_2] lanny: ok strug think were all here shoot
02/17/05 19:10:27 [USMLE_Step_2] sanz: man came in with horizontal nystagmus, extremem agitation and hallucination... Dx?
02/17/05 19:10:31 [USMLE_Step_2] samantha: sub abuse
02/17/05 19:10:34 [USMLE_Step_2] sanz: cocaine strug?
02/17/05 19:10:37 [USMLE_Step_2] iamzuhair: pcp
02/17/05 19:10:44 [USMLE_Step_2] strug: nnnnoooooo
02/17/05 19:10:51 [USMLE_Step_2] lanny: amphetamine
02/17/05 19:10:57 [USMLE_Step_2] dua_frank: zuhair i'm alive thank you
02/17/05 19:10:58 [USMLE_Step_2] strug: its amphetamine right lanny
02/17/05 19:11:07 [USMLE_Step_2] iamzuhair: ans to sanlol
02/17/05 19:11:11 [USMLE_Step_2] iamzuhair: lol
02/17/05 19:11:12 [USMLE_Step_2] sanz: but cocaine does present that way too right?
02/17/05 19:11:20 [USMLE_Step_2] strug: one imp diff sanz
02/17/05 19:11:22 [USMLE_Step_2] iamzuhair: sanz q -- pcp
02/17/05 19:11:26 [USMLE_Step_2] sanz: except cocaine has HTN and tachy
02/17/05 19:11:38 [USMLE_Step_2] strug: paranoid delsusion with ampheramine mainly
02/17/05 19:11:39 [USMLE_Step_2] samantha: pcp
02/17/05 19:11:44 [USMLE_Step_2] lanny: i think key is paranoia
02/17/05 19:11:51 [USMLE_Step_2] strug: formication is with cocaine
02/17/05 19:11:53 doc Logs in
02/17/05 19:11:53 doc Joins Subroom USMLE_Step_2
02/17/05 19:12:05 [USMLE_Step_2] sanz: what is formication?
02/17/05 19:12:10 [USMLE_Step_2] strug: yes lanny key is paranoid
02/17/05 19:12:15 [USMLE_Step_2] sanz: zu you're right PCP
02/17/05 19:12:17 [USMLE_Step_2] lanny: feeling bugs crawling on body
02/17/05 19:12:18 [USMLE_Step_2] dua_frank: worms in pants
02/17/05 19:12:20 [USMLE_Step_2] strug: insects crawiling sanz
02/17/05 19:12:32 [USMLE_Step_2] sanz: oh yeah... i knew that... hehe
02/17/05 19:12:34 [USMLE_Step_2] samantha: ok strug
02/17/05 19:12:46 [USMLE_Step_2] iamzuhair: also seen in alcohol withdrawal strug ?
02/17/05 19:13:08 [USMLE_Step_2] strug: hhhmmm m not sure need to check out
02/17/05 19:13:12 [USMLE_Step_2] doc: hi everyone. hope everyone is enjoying the chats. we've been posting the transcripts for you when they are not posted, but its a bit time consuming for us to do it everyday. can one of you try to post them instead and we will get it if you ever miss it?
02/17/05 19:13:31 [USMLE_Step_2] strug: doc i tried couldnt do it
02/17/05 19:13:43 [USMLE_Step_2] strug: only half i was able to catch.....
02/17/05 19:13:46 [USMLE_Step_2] iamzuhair: yeah doc - how to do it
02/17/05 19:13:50 [USMLE_Step_2] doc: to post transcript, simply press the transcript button on the menu, the one with the 2 papers next to the speaker
02/17/05 19:13:51 [USMLE_Step_2] sanz: yes zu, formication is seen in alco DT
02/17/05 19:13:58 [USMLE_Step_2] dua_frank: we would be happy to do so if you could tell us how to
02/17/05 19:14:14 [USMLE_Step_2] iamzuhair: ok thanks sanz
02/17/05 19:14:21 [USMLE_Step_2] iamzuhair: just had a doubt
02/17/05 19:14:21 [USMLE_Step_2] doc: this will put up a sepate window that you can cut-n-paste the text into a post
02/17/05 19:14:41 [USMLE_Step_2] dua_frank: ah
02/17/05 19:14:52 [USMLE_Step_2] dua_frank: thanks, got it now
02/17/05 19:15:04 [USMLE_Step_2] iamzuhair: alcohol withdrawal also one distinguishing feature is vocal hallucinations i think if im not mixing it up
02/17/05 19:15:29 [USMLE_Step_2] doc: ok, if you have any trouble, feel free to send me a private message. also, if unable to do it ever, we'll take care of it. thanks for the help
02/17/05 19:15:42 [USMLE_Step_2] iamzuhair: thanks a lot doc
02/17/05 19:15:43 [USMLE_Step_2] strug: thanks doc
02/17/05 19:15:46 [USMLE_Step_2] iamzuhair: take care
02/17/05 19:15:54 [USMLE_Step_2] doc: no problem....enjoy your chat. bye
02/17/05 19:15:57 [USMLE_Step_2] lanny: thanks doc
02/17/05 19:16:02 doc Logs Out
02/17/05 19:16:04 [USMLE_Step_2] dua_frank: welcome and bye
02/17/05 19:16:44 [USMLE_Step_2] lanny: euphoria pupil constrict slurred speech what is this
02/17/05 19:16:54 [USMLE_Step_2] lanny: also agitation
02/17/05 19:17:17 [USMLE_Step_2] dua_frank: kicked myself out
02/17/05 19:17:27 [USMLE_Step_2] iamzuhair: tremlnous in 6 hrs , seizures in 12 to 24 hrs .............. in 72 hrs .... ? drug withdrawal
02/17/05 19:17:30 [USMLE_Step_2] samantha: heroin
02/17/05 19:17:37 [USMLE_Step_2] dua_frank: never press that button next to the ? mark icon
02/17/05 19:17:43 [USMLE_Step_2] dua_frank: NEVER
02/17/05 19:17:44 [USMLE_Step_2] strug: alcohol lanny
02/17/05 19:18:00 [USMLE_Step_2] lanny: opioid
02/17/05 19:18:06 [USMLE_Step_2] iamzuhair: opoid
02/17/05 19:18:11 doc Logs in
02/17/05 19:18:17 [USMLE_Step_2] sanz: zu, BBT
02/17/05 19:18:19 [USMLE_Step_2] dua_frank: barbs?
02/17/05 19:18:21 [USMLE_Step_2] lanny: pupil constrict is seen in opiod only
02/17/05 19:18:22 [USMLE_Step_2] strug: benzo zu
02/17/05 19:18:28 [USMLE_Step_2] lanny: strug
02/17/05 19:18:32 [USMLE_Step_2] sanz: lanny alcohol
02/17/05 19:18:46 [USMLE_Step_2] lanny: no sanz opioid intox
02/17/05 19:18:52 [USMLE_Step_2] iamzuhair: no
02/17/05 19:18:52 [USMLE_Step_2] strug: on lanny pupil constriction in alcohol withdrawal also
02/17/05 19:19:05 [USMLE_Step_2] strug: also with use of heroin and methadone lanny
02/17/05 19:19:22 [USMLE_Step_2] iamzuhair: the blank space is the answer to my q dude
02/17/05 19:19:23 [USMLE_Step_2] lanny: heroin and meth are opioids strug
02/17/05 19:19:30 [USMLE_Step_2] strug: yup
02/17/05 19:19:32 [USMLE_Step_2] sanz: but in alco withdrwal there wont be euphoria...
02/17/05 19:19:39 [USMLE_Step_2] lanny: not sure about alcohol but thx for telling
02/17/05 19:19:50 [USMLE_Step_2] iamzuhair: tremlnous in 6 hrs , seizures in 12 to 24 hrs .............. in 72 hrs .... ? drug withdrawal
02/17/05 19:19:55 [USMLE_Step_2] samantha: alcohol withdrawal no pupil constr
02/17/05 19:20:28 [USMLE_Step_2] strug: zu pl rephrame ur q cant get it....
02/17/05 19:21:26 [USMLE_Step_2] iamzuhair: what symptom is seen in 72 hours of withdrawal
02/17/05 19:21:44 [USMLE_Step_2] iamzuhair: tremlnous in 6 hrs , seizures in 12 to 24 hrs ...DT........ in 72 hrs .... ? drug withdrawal
02/17/05 19:21:46 [USMLE_Step_2] sanz: barbiturates?
02/17/05 19:21:51 [USMLE_Step_2] iamzuhair: now
02/17/05 19:21:52 [USMLE_Step_2] sanz: death
02/17/05 19:22:06 [USMLE_Step_2] strug: agree
02/17/05 19:22:22 [USMLE_Step_2] iamzuhair: tremlnous in 6 hrs , seizures in 12 to 24 hrs , DT in 72 hrs .... ? drug withdrawal
02/17/05 19:22:28 [USMLE_Step_2] sanz: alcohol
02/17/05 19:22:29 [USMLE_Step_2] iamzuhair: common guys
02/17/05 19:22:30 [USMLE_Step_2] iamzuhair: yes
02/17/05 19:22:41 [USMLE_Step_2] strug: thanks zu
02/17/05 19:23:02 [USMLE_Step_2] iamzuhair: u dont see DT straightaway on alcohol
02/17/05 19:23:18 [USMLE_Step_2] uniteus: hello everyone
02/17/05 19:23:28 [USMLE_Step_2] strug: hi uni
02/17/05 19:23:33 [USMLE_Step_2] lanny: hi uni
02/17/05 19:23:43 [USMLE_Step_2] iamzuhair: visual halucinations , geometric halucinations and flashes of light and after images ?
02/17/05 19:24:11 [USMLE_Step_2] strug: mariauhna
02/17/05 19:24:17 [USMLE_Step_2] iamzuhair: no
02/17/05 19:24:22 [USMLE_Step_2] lanny: LSD
02/17/05 19:24:25 [USMLE_Step_2] iamzuhair: yes
02/17/05 19:24:29 megs Logs in
02/17/05 19:24:31 [USMLE_Step_2] iamzuhair: all hallucinogens
02/17/05 19:24:32 megs Joins Subroom USMLE_Step_2
02/17/05 19:24:39 doc Logs Out
02/17/05 19:24:40 [USMLE_Step_2] lanny: key is visual halluc
02/17/05 19:25:10 [USMLE_Step_2] iamzuhair: mushroom and lsd and mescaline
02/17/05 19:26:04 [USMLE_Step_2] lanny: preg mum wants to detox after abusing heroin what do you do..?
02/17/05 19:26:17 [USMLE_Step_2] samantha: methadone

02/17/05 19:26:43 [USMLE_Step_2] lanny: right sam why dont you detox?
02/17/05 19:26:44 [USMLE_Step_2] strug: naloxone? lanny
02/17/05 19:26:52 [USMLE_Step_2] sanz: methadone
02/17/05 19:26:56 [USMLE_Step_2] lanny: no strug, methadone
02/17/05 19:26:56 [USMLE_Step_2] iamzuhair: disorientation , inc BP , inc HR, euphoria, calmness, self confidence, closeness to other people, inc apetite ?
02/17/05 19:27:24 [USMLE_Step_2] strug: amphetamines?
02/17/05 19:27:37 [USMLE_Step_2] uniteus: amp or coccaine

02/17/05 19:28:11 [USMLE_Step_2] lanny: marijuana
02/17/05 19:28:12 [USMLE_Step_2] iamzuhair: hint -strug is close
02/17/05 19:28:23 [USMLE_Step_2] iamzuhair: to the ans
02/17/05 19:29:00 [USMLE_Step_2] sanz: cocaine?
02/17/05 19:29:20 [USMLE_Step_2] sanz: but amp and cocaine wont cause calmness...
02/17/05 19:29:22 [USMLE_Step_2] lanny: cannabis??
02/17/05 19:30:00 [USMLE_Step_2] strug: alcohol?
02/17/05 19:30:07 [USMLE_Step_2] iamzuhair: XTC - methoxylated amphetamines , extacy -- designer drugs
02/17/05 19:30:17 [USMLE_Step_2] samantha: diazepam
02/17/05 19:30:21 [USMLE_Step_2] iamzuhair: very popular these days
02/17/05 19:30:53 [USMLE_Step_2] iamzuhair: ok same question with some changes
02/17/05 19:32:04 [USMLE_Step_2] iamzuhair: slowness in actions, miss judgement in targets and lengths , inc BP , inc HR, euphoria, calmness, self confidence, closeness to other people, inc apetite , hint -- CONJUNCTIVAL INJECTION --- main feature
02/17/05 19:32:19 [USMLE_Step_2] lanny: marijuana
02/17/05 19:32:22 [USMLE_Step_2] iamzuhair: yes
02/17/05 19:32:24 [USMLE_Step_2] uniteus: marijuana
02/17/05 19:32:27 [USMLE_Step_2] iamzuhair: right lany
02/17/05 19:32:35 [USMLE_Step_2] sanz: yeah cannbis
02/17/05 19:32:39 [USMLE_Step_2] iamzuhair: and uniteus
02/17/05 19:32:40 [USMLE_Step_2] strug: mariauhna
02/17/05 19:32:58 [USMLE_Step_2] lanny: easy to confuse with ecstacy but conj inject is the key
02/17/05 19:33:14 [USMLE_Step_2] iamzuhair: MC ABUSED OPOID ?
02/17/05 19:33:20 [USMLE_Step_2] sanz: heroine
02/17/05 19:33:23 [USMLE_Step_2] iamzuhair: YES
02/17/05 19:33:24 [USMLE_Step_2] strug: caeffeine
02/17/05 19:33:24 [USMLE_Step_2] lanny: heroin
02/17/05 19:33:30 [USMLE_Step_2] iamzuhair: HEROIN
02/17/05 19:33:36 [USMLE_Step_2] sanz: most abused substance is caffeine
02/17/05 19:33:39 [USMLE_Step_2] strug: sorry i though most commin subs of abuse
02/17/05 19:33:52 [USMLE_Step_2] iamzuhair: MC ABUSED SUBSTANCE
02/17/05 19:34:00 [USMLE_Step_2] sanz: caffeine
02/17/05 19:34:16 [USMLE_Step_2] uniteus: caffeine
02/17/05 19:34:25 [USMLE_Step_2] iamzuhair: NO -- NOT ACCORDING TO KAPLAN
02/17/05 19:34:31 [USMLE_Step_2] uniteus: alcohol
02/17/05 19:34:33 [USMLE_Step_2] iamzuhair: YES
02/17/05 19:34:40 [USMLE_Step_2] iamzuhair: ALCOHOL
02/17/05 19:35:27 [USMLE_Step_2] iamzuhair: WHAT TEST TO KNOW ABOUT PERSONS ABUSE STATUS
02/17/05 19:35:30 [USMLE_Step_2] iamzuhair: ?
02/17/05 19:35:31 [USMLE_Step_2] sanz: no, it's caffeine then nicotine then alcohol
02/17/05 19:35:50 [USMLE_Step_2] strug: breath test zu
02/17/05 19:35:59 [USMLE_Step_2] lanny: urine toxicology
02/17/05 19:36:02 [USMLE_Step_2] sanz: ask them CAGE questions
02/17/05 19:36:06 [USMLE_Step_2] iamzuhair: I MEAN ITS LIKE A STUDY DONE
02/17/05 19:36:09 [USMLE_Step_2] strug: to detect the level of alcohol in blood
02/17/05 19:36:13 [USMLE_Step_2] iamzuhair: YES CAGE QUESTIONS
02/17/05 19:36:18 [USMLE_Step_2] uniteus: urine tox?
02/17/05 19:36:25 [USMLE_Step_2] lanny: but cage is for alcohol abuse
02/17/05 19:36:33 [USMLE_Step_2] iamzuhair: YES IT IS LANNY
02/17/05 19:36:39 [USMLE_Step_2] lanny: not forall
02/17/05 19:36:46 [USMLE_Step_2] iamzuhair: MAST IS ALSO ONE OF IT
02/17/05 19:36:50 [USMLE_Step_2] strug: lanny he asked for alcohol
02/17/05 19:37:08 [USMLE_Step_2] lanny: no strug he did not say alcohol
02/17/05 19:37:11 [USMLE_Step_2] iamzuhair: BUT CAGE IS GENRALIZED FOR ABUSE
02/17/05 19:37:21 [USMLE_Step_2] uniteus: what is MAST?
02/17/05 19:37:23 [USMLE_Step_2] iamzuhair: NO I DIDNT SPECIFY ALCOHOL
02/17/05 19:37:38 [USMLE_Step_2] strug: really cage for all subs abuse?
02/17/05 19:37:40 [USMLE_Step_2] iamzuhair: FOR ALCOHOL SPECIFIC WOULD BE MAST
02/17/05 19:37:49 [USMLE_Step_2] uniteus: ok..thx iam
02/17/05 19:37:52 [USMLE_Step_2] lanny: dont think so cage is for alcohol
02/17/05 19:37:59 [USMLE_Step_2] strug: me too
02/17/05 19:38:06 [USMLE_Step_2] iamzuhair: CAGE IS FOR ALCOHOL , SMOKING etc
02/17/05 19:38:16 [USMLE_Step_2] lanny: also i think cage for narcotics
02/17/05 19:38:34 [USMLE_Step_2] iamzuhair: if you reed the last question for cage u guys would understand
02/17/05 19:39:07 [USMLE_Step_2] iamzuhair: even the second question gives a hint to alcohol
02/17/05 19:39:47 [USMLE_Step_2] lanny: agree zu cage is for alcohol not sure about the others
02/17/05 19:39:49 [USMLE_Step_2] iamzuhair: am i right strug .... ...?
02/17/05 19:40:00 [USMLE_Step_2] sanz: i think CAGE is purely for alcohol
02/17/05 19:40:17 [USMLE_Step_2] strug: zu i just checked at one site they say cage is for subs abuse and alcholo
02/17/05 19:40:17 [USMLE_Step_2] sanz: but the questions can be used to address subst dependence...
02/17/05 19:40:21 [USMLE_Step_2] samantha: yeah cage is for alcohol
02/17/05 19:40:44 [USMLE_Step_2] strug: but till now i thought cage is for alcohol alone and mainly used for alcohol
02/17/05 19:40:45 [USMLE_Step_2] iamzuhair: yes thats why its genralized -- u couldent say it for just alcohol
02/17/05 19:41:02 [USMLE_Step_2] strug: so maybe ur right
02/17/05 19:41:04 [USMLE_Step_2] iamzuhair: ok les moove on
02/17/05 19:41:25 [USMLE_Step_2] iamzuhair: have to do a lot portion today dude
02/17/05 19:41:27 [USMLE_Step_2] lanny: go zu
02/17/05 19:42:02 [USMLE_Step_2] iamzuhair: is genetic a risk for alcohol
02/17/05 19:42:06 [USMLE_Step_2] iamzuhair: abuse
02/17/05 19:42:09 [USMLE_Step_2] sanz: yes
02/17/05 19:42:10 [USMLE_Step_2] strug: yes
02/17/05 19:42:12 [USMLE_Step_2] iamzuhair: yes
02/17/05 19:42:13 [USMLE_Step_2] uniteus: yea
02/17/05 19:42:15 [USMLE_Step_2] iamzuhair: ur right
02/17/05 19:42:18 [USMLE_Step_2] lanny: yes
02/17/05 19:42:24 [USMLE_Step_2] strug: rapid metaboizers
02/17/05 19:42:53 [USMLE_Step_2] sanz: Rx of HTN in cocaine tox?
02/17/05 19:42:55 [USMLE_Step_2] iamzuhair: most effective rx for lcohol abuse
02/17/05 19:43:10 [USMLE_Step_2] strug: alcohol annonymous zu
02/17/05 19:43:11 [USMLE_Step_2] sanz: join a support group AA
02/17/05 19:43:13 [USMLE_Step_2] iamzuhair: yes
02/17/05 19:43:18 [USMLE_Step_2] iamzuhair: right
02/17/05 19:43:28 [USMLE_Step_2] lanny: yes aa
02/17/05 19:43:31 [USMLE_Step_2] sanz: what is AlAnon?
02/17/05 19:43:34 [USMLE_Step_2] strug: alpha blcokersor ccb sanz
02/17/05 19:43:42 [USMLE_Step_2] lanny: alcohol anonymoous
02/17/05 19:43:43 [USMLE_Step_2] strug: never b blcokers sanz
02/17/05 19:43:44 [USMLE_Step_2] iamzuhair: whats ans lany--- alpha blk
02/17/05 19:44:07 [USMLE_Step_2] sanz: strug, i thought it is b blockers...
02/17/05 19:44:11 [USMLE_Step_2] sanz: why not?
02/17/05 19:44:26 [USMLE_Step_2] iamzuhair: cause it centrally acting
02/17/05 19:44:35 [USMLE_Step_2] lanny: think its alpha
02/17/05 19:44:41 [USMLE_Step_2] iamzuhair: cocaine raises ur bp by acting on cns
02/17/05 19:44:53 [USMLE_Step_2] iamzuhair: im not sure ???
02/17/05 19:45:02 [USMLE_Step_2] sanz: really? i'll check...
02/17/05 19:45:22 [USMLE_Step_2] iamzuhair: post terminal receptors in adrenergic system
02/17/05 19:45:31 [USMLE_Step_2] iamzuhair: ????
02/17/05 19:45:38 [USMLE_Step_2] strug: no b blockers inc the cocaine mediated vasoconstricion
02/17/05 19:45:45 [USMLE_Step_2] strug: so never give b blocker
02/17/05 19:45:54 [USMLE_Step_2] strug: give alpha blockers or CCb
02/17/05 19:46:21 [USMLE_Step_2] lanny: yah strug its alpha block
02/17/05 19:46:40 [USMLE_Step_2] uniteus: cocaine prevents reuptake of Dopamine
02/17/05 19:47:16 [USMLE_Step_2] sanz: in emedicine and oxford it's b block... strange
02/17/05 19:47:42 [USMLE_Step_2] sanz: where did you guys learn that b blockers are C/I?
02/17/05 19:47:46 [USMLE_Step_2] sanz: i just like to read up...
02/17/05 19:47:50 [USMLE_Step_2] strug: really sanz? its there in UW
02/17/05 19:48:25 [USMLE_Step_2] sanz: oh, i didnt notice...
02/17/05 19:48:49 [USMLE_Step_2] sanz: but thnx for correcting me know guys...
02/17/05 19:48:57 [USMLE_Step_2] iamzuhair: ok guys have to pick up some one so will be back in 15 min -- sorry for the interuption>>>>>>. :(
02/17/05 19:48:59 [USMLE_Step_2] lanny: yea sanz paradoxical but i did read it somwhere about b block
02/17/05 19:50:09 [USMLE_Step_2] lanny: strug any more on substance
02/17/05 19:50:22 [USMLE_Step_2] lanny: questions
02/17/05 19:51:00 [USMLE_Step_2] lanny: how to trt LSD intox?
02/17/05 19:51:34 [USMLE_Step_2] uniteus: antipsychotics for the psychosis
02/17/05 19:52:38 [USMLE_Step_2] lanny: dont think there is psych in lsd uni
02/17/05 19:53:01 [USMLE_Step_2] uniteus: yeah..the visual hallucination,
02/17/05 19:53:13 [USMLE_Step_2] strug: hey sanz i checked in harrison they say b blockers should not be used and use alpha bloc or CCB
02/17/05 19:53:14 [USMLE_Step_2] lanny: LSD isprofuse sweat pupil dilate tach tremor palpit
02/17/05 19:53:30 [USMLE_Step_2] sanz: strug thnx
02/17/05 19:53:32 [USMLE_Step_2] lanny: strug youre right
02/17/05 19:53:52 [USMLE_Step_2] sanz: i checked anther article on emedicine and they also said b blcokers are best avoided
02/17/05 19:54:04 [USMLE_Step_2] lanny: yes sanz
02/17/05 19:54:06 [USMLE_Step_2] sanz: esmolol is the only one that has proven to be safe...
02/17/05 19:54:21 [USMLE_Step_2] lanny: oh thx sanz never knew!!
02/17/05 19:54:54 [USMLE_Step_2] sanz: ok ... no b block in cocaine tox
02/17/05 19:55:14 [USMLE_Step_2] strug: lanny u asked why u shouldnt detox in preg? for heroin addiction
02/17/05 19:55:20 [USMLE_Step_2] strug: whats the ans
02/17/05 19:55:36 samantha Joins Subroom USMLE_Step_2
02/17/05 19:55:36 [USMLE_Step_2] lanny: to avoid withdr in the babyt
02/17/05 19:55:48 [USMLE_Step_2] sanz: we should detox with methadone
02/17/05 19:56:13 [USMLE_Step_2] lanny: yes actually its maintain with methadone
02/17/05 19:56:31 [USMLE_Step_2] lanny: methadone is aopioid too but less adictive
02/17/05 19:57:27 [USMLE_Step_2] lanny: if baby is born with w drawal sms how do you trt?
02/17/05 19:57:27 [USMLE_Step_2] strug: which subs leads to pupil dilation?
02/17/05 19:58:29 [USMLE_Step_2] samantha: hi guys
02/17/05 19:58:42 [USMLE_Step_2] strug: wb sam
02/17/05 19:58:54 [USMLE_Step_2] samantha: thx strug
02/17/05 19:59:43 [USMLE_Step_2] strug: pupil dilatition with use of cocaine ampheramines and LSD and with withdraawal from heroin methadone and alcohol
02/17/05 20:00:41 [USMLE_Step_2] lanny: strug didnt you say pupil constrict in alco withd
02/17/05 20:01:23 [USMLE_Step_2] strug: oooopppp lanny i m so sorry.... my mistake
02/17/05 20:01:56 [USMLE_Step_2] lanny: ok cause pupil constrict is seen in only opioid tox.
02/17/05 20:02:07 [USMLE_Step_2] strug: yup lanny thannks
02/17/05 20:02:30 [USMLE_Step_2] lanny: not at all
02/17/05 20:03:22 [USMLE_Step_2] sanz: Rx of OCD?
02/17/05 20:03:23 [USMLE_Step_2] lanny: strug side note are we going to take psych q randomly or divide up into sections?
02/17/05 20:03:51 [USMLE_Step_2] strug: behaviousal sanz
02/17/05 20:04:05 [USMLE_Step_2] sanz: yes CBT
02/17/05 20:04:08 [USMLE_Step_2] strug: lanny i posted the topics on usmle.net and also on value md
02/17/05 20:04:11 [USMLE_Step_2] sanz: and if drug?
02/17/05 20:04:13 an_bo_al Joins Subroom USMLE_Step_1
02/17/05 20:04:17 [USMLE_Step_2] strug: paroxetine
02/17/05 20:04:19 [USMLE_Step_2] strug: i mean ssri
02/17/05 20:04:20 [USMLE_Step_2] lanny: oh ok will chk later
02/17/05 20:04:26 [USMLE_Step_2] sanz: yes
02/17/05 20:04:34 [USMLE_Step_2] lanny: clomipramine
02/17/05 20:04:43 [USMLE_Step_2] strug: ok so now we move to mood disorders
02/17/05 20:04:44 [USMLE_Step_2] lanny: sanz
02/17/05 20:05:42 [USMLE_Step_2] sanz: immediate relief for acute anxiety attack?
02/17/05 20:05:49 [USMLE_Step_2] lanny: benzo
02/17/05 20:05:50 [USMLE_Step_2] strug: benzo
02/17/05 20:06:09 [USMLE_Step_2] sanz: good... if the pt has GAD and is alcoholic... DOC?
02/17/05 20:06:23 [USMLE_Step_2] lanny: alprazolam
02/17/05 20:06:33 [USMLE_Step_2] strug: bupropion?
02/17/05 20:06:47 [USMLE_Step_2] strug: sorry its buspirone
02/17/05 20:06:56 [USMLE_Step_2] strug: i always get confused in the names
02/17/05 20:06:56 [USMLE_Step_2] sanz: yeah strug...
02/17/05 20:07:04 [USMLE_Step_2] sanz: i should rephrase my q
02/17/05 20:07:13 [USMLE_Step_2] sanz: good... if the pt has GAD and is alcoholic... DOC for long term Rx?
02/17/05 20:07:33 [USMLE_Step_2] lanny: buspirone
02/17/05 20:07:36 [USMLE_Step_2] strug: buspirone right
02/17/05 20:07:39 [USMLE_Step_2] sanz: yes lanny
02/17/05 20:08:47 [USMLE_Step_2] docak: hi guys!
02/17/05 20:09:12 [USMLE_Step_2] strug: hi docak
02/17/05 20:09:20 [USMLE_Step_2] docak: hi strug
02/17/05 20:09:26 [USMLE_Step_2] samantha: is buspirone pain med?
02/17/05 20:09:38 [USMLE_Step_2] docak: no
02/17/05 20:09:39 [USMLE_Step_2] sanz: what receptor does buspirone block?
02/17/05 20:09:48 [USMLE_Step_2] docak: its for GAD
02/17/05 20:10:02 [USMLE_Step_2] sanz: what receptor does buspirone act on?
02/17/05 20:10:23 [USMLE_Step_2] docak: it works on serotonin receptor
02/17/05 20:10:29 [USMLE_Step_2] sanz: good docak
02/17/05 20:10:36 [USMLE_Step_2] sanz: 5 HT1A
02/17/05 20:10:41 [USMLE_Step_2] docak: 5HT 1A partial agonist
02/17/05 20:10:58 [USMLE_Step_2] docak: thx sanz
02/17/05 20:11:08 [USMLE_Step_2] lanny: its used for anxiety
02/17/05 20:11:35 [USMLE_Step_2] sanz: it's anxiolytic and also antidepressant and also used in OCD
02/17/05 20:11:39 [USMLE_Step_2] lanny: alcohol has no effect on it
02/17/05 20:11:44 [USMLE_Step_2] docak: generalized anxiety disorder. i was given prescrip during my step 1 prep
02/17/05 20:11:54 [USMLE_Step_2] docak: thats how i remember
02/17/05 20:12:00 [USMLE_Step_2] docak: :)
02/17/05 20:12:11 [USMLE_Step_2] lanny: good
02/17/05 20:12:13 diabetes Logs in
02/17/05 20:12:22 [USMLE_Step_2] lanny: hope youre feeling relaxed now
02/17/05 20:12:28 diabetes Joins Subroom USMLE_Step_2
02/17/05 20:12:35 [USMLE_Step_2] samantha: ok doc
02/17/05 20:12:40 [USMLE_Step_2] docak: better thx lanz
02/17/05 20:12:56 stepchow Logs in
02/17/05 20:12:58 [USMLE_Step_2] strug: pt with bipolar disorder treated by you presents with tremores, nausea vomiting dearrhoea......next step?
02/17/05 20:13:09 [USMLE_Step_2] docak: stop drug
02/17/05 20:13:13 stepchow: hey y'all
02/17/05 20:13:13 [USMLE_Step_2] lanny: lithum
02/17/05 20:13:26 diabetes Joins Subroom Clinical_Skills
02/17/05 20:13:31 [USMLE_Step_2] strug: yup its litlhium toxivity
02/17/05 20:13:59 [USMLE_Step_2] sanz: also can cause hypothy
02/17/05 20:14:12 [USMLE_Step_2] lanny: yes sanz
02/17/05 20:14:31 [USMLE_Step_2] stepchow: hi lo
02/17/05 20:14:40 [USMLE_Step_2] sanz: hi step
02/17/05 20:14:48 diabetes Logs in
02/17/05 20:14:48 diabetes Joins Subroom USMLE_Step_2
02/17/05 20:14:58 [USMLE_Step_2] sanz: how is dysthymia different from MDD?
02/17/05 20:15:00 diabetes Joins Subroom USMLE_Step_2
02/17/05 20:15:05 [USMLE_Step_2] docak: hi stepcho
02/17/05 20:15:13 [USMLE_Step_2] lanny: > 2yrs of symptoms
02/17/05 20:15:17 [USMLE_Step_2] strug: > 2 years dec mood
02/17/05 20:15:17 [USMLE_Step_2] uniteus: dysthymia..is >2yr
02/17/05 20:15:19 [USMLE_Step_2] docak: whats MDD
02/17/05 20:15:24 [USMLE_Step_2] strug: also pt functional sanz
02/17/05 20:15:28 [USMLE_Step_2] sanz: maj depressive disorder
02/17/05 20:15:29 [USMLE_Step_2] uniteus: maj dep disorder
02/17/05 20:15:31 [USMLE_Step_2] lanny: major depress disord
02/17/05 20:15:39 [USMLE_Step_2] docak: thanx
02/17/05 20:15:49 [USMLE_Step_2] stepchow: don't mind me.....i'm just trying out this chat thing....first time :)
02/17/05 20:15:53 [USMLE_Step_2] sanz: yes strug and lanny... also their depressive episodes arent as severe
02/17/05 20:16:02 [USMLE_Step_2] lanny: yes sanz
02/17/05 20:16:04 [USMLE_Step_2] sanz: step sure...
02/17/05 20:16:05 [USMLE_Step_2] strug: yup
02/17/05 20:16:16 [USMLE_Step_2] sanz: define cyclothymic
02/17/05 20:16:36 [USMLE_Step_2] lanny: at least 2 yrs of hypo mania
02/17/05 20:16:38 [USMLE_Step_2] uniteus: mild depression n mild mania...like a cycle for 2y
02/17/05 20:16:39 [USMLE_Step_2] strug: major dep with hypomanica
02/17/05 20:16:46 [USMLE_Step_2] lanny: depressed mood
02/17/05 20:16:55 megs Disconnects
02/17/05 20:17:06 [USMLE_Step_2] sanz: yup depressive epidoes with hypomania lasting 2 yrs and more
02/17/05 20:17:13 [USMLE_Step_2] strug: sorry dyspthmia and hypominai
02/17/05 20:17:17 [USMLE_Step_2] lanny: strug its not major dep they have mild depress mood
02/17/05 20:17:29 [USMLE_Step_2] strug: lanny yes i corected myself
02/17/05 20:17:35 [USMLE_Step_2] lanny: saw it
02/17/05 20:17:40 [USMLE_Step_2] strug: feeling drowsy today
02/17/05 20:17:47 [USMLE_Step_2] sanz: what is the diff between bipolr 1 and 2?
02/17/05 20:17:49 [USMLE_Step_2] lanny: i have a headache
02/17/05 20:17:51 [USMLE_Step_2] strug: wanna get out of here as soon as possibl
02/17/05 20:17:56 [USMLE_Step_2] sanz: aawww strug
02/17/05 20:18:21 [USMLE_Step_2] docak: ru ok lanny?
02/17/05 20:18:28 [USMLE_Step_2] strug: major dep + mania is 1.....major dep + hypo is 2
02/17/05 20:18:41 [USMLE_Step_2] uniteus: drink coffee..strug..may help
02/17/05 20:18:44 [USMLE_Step_2] lanny: have a slight h ache had a long day thx im ok
02/17/05 20:18:48 [USMLE_Step_2] strug: thanks uni
02/17/05 20:19:03 [USMLE_Step_2] strug: Rx of akanthasia?
02/17/05 20:19:18 [USMLE_Step_2] sanz: Benztropine
02/17/05 20:19:29 [USMLE_Step_2] sanz: no benzo
02/17/05 20:19:30 [USMLE_Step_2] uniteus: antipsychotic
02/17/05 20:19:32 [USMLE_Step_2] docak: anticholinergics
02/17/05 20:19:41 [USMLE_Step_2] uniteus: or benzo
02/17/05 20:19:42 [USMLE_Step_2] lanny: akathisia? strug
02/17/05 20:19:59 [USMLE_Step_2] strug: main is beta blocekr ppnl..also can use antihistamins and benzos
02/17/05 20:20:09 [USMLE_Step_2] strug: yes lanny akathisia
02/17/05 20:20:15 [USMLE_Step_2] strug: sorry for the typo
02/17/05 20:20:19 [USMLE_Step_2] lanny: benztropine
02/17/05 20:20:24 [USMLE_Step_2] lanny: ok strug
02/17/05 20:21:14 [USMLE_Step_2] lanny: whats ppnl strug
02/17/05 20:21:20 [USMLE_Step_2] strug: pt on haloperidol with muscular rigidy hyperthermia autonomic insta and deliriun.....diagnosis/
02/17/05 20:21:23 [USMLE_Step_2] docak: 1.lower dose of derg
02/17/05 20:21:30 [USMLE_Step_2] uniteus: NMS
02/17/05 20:21:30 [USMLE_Step_2] strug: ppnl is propanolol
02/17/05 20:21:31 [USMLE_Step_2] docak: 2.change meds
02/17/05 20:21:36 [USMLE_Step_2] sanz: neuroleptic sundr
02/17/05 20:21:37 [USMLE_Step_2] lanny: malignant syndrome
02/17/05 20:21:41 [USMLE_Step_2] docak: 3.anticholinergics
02/17/05 20:21:43 [USMLE_Step_2] strug: yup doca
02/17/05 20:21:47 [USMLE_Step_2] docak: 4.beta blocker
02/17/05 20:21:51 [USMLE_Step_2] docak: 5.benzo
02/17/05 20:22:06 [USMLE_Step_2] strug: really doca? good
02/17/05 20:22:20 [USMLE_Step_2] docak: yeah from kaplan live
02/17/05 20:22:36 [USMLE_Step_2] strug: thanks doca
02/17/05 20:22:42 [USMLE_Step_2] docak: ur welcome
02/17/05 20:22:44 [USMLE_Step_2] uniteus: thx
02/17/05 20:22:55 [USMLE_Step_2] lanny: docak this is naswer to what
02/17/05 20:23:04 [USMLE_Step_2] docak: treatment of akathesia
02/17/05 20:23:10 [USMLE_Step_2] strug: Pt with NMS with haloperido dosent have symp under control.....which drug willu give now?
02/17/05 20:23:12 [USMLE_Step_2] lanny: thx
02/17/05 20:23:17 [USMLE_Step_2] uniteus: is it neuroleptic malinant syn strug?
02/17/05 20:23:22 [USMLE_Step_2] strug: yes
02/17/05 20:23:23 [USMLE_Step_2] sanz: clozapine
02/17/05 20:23:45 [USMLE_Step_2] uniteus: dantrolene
02/17/05 20:24:11 [USMLE_Step_2] sanz: oh you mean NMS?
02/17/05 20:24:17 [USMLE_Step_2] strug: uni after Rx of NMS dosent have psychotic symp under control....
02/17/05 20:24:24 [USMLE_Step_2] sanz: clozapine
02/17/05 20:24:26 [USMLE_Step_2] uniteus: oh..
02/17/05 20:24:29 [USMLE_Step_2] strug: sorry for not putting the q properly
02/17/05 20:24:48 [USMLE_Step_2] uniteus: risperidone
02/17/05 20:24:59 [USMLE_Step_2] lanny: agree clozarpine
02/17/05 20:25:01 [USMLE_Step_2] strug: u can put the pt again on haloperidol....no need to change drug
02/17/05 20:25:12 [USMLE_Step_2] strug: says kaplan video lectures
02/17/05 20:25:17 [USMLE_Step_2] sanz: oh ok
02/17/05 20:25:17 [USMLE_Step_2] lanny: oh and give a cholin
02/17/05 20:25:55 [USMLE_Step_2] docak: no cannot use haloperidol again
02/17/05 20:26:01 [USMLE_Step_2] uniteus: i thought u dont use the drug again?
02/17/05 20:26:13 [USMLE_Step_2] uniteus: cause of recurrent NMS
02/17/05 20:26:20 [USMLE_Step_2] docak: have to change drug once NMS develops
02/17/05 20:26:23 [USMLE_Step_2] strug: this is waht i was told inkaplan lectures
02/17/05 20:26:32 [USMLE_Step_2] strug: really docak?
02/17/05 20:26:39 [USMLE_Step_2] docak: strug was it live or vedio
02/17/05 20:26:43 [USMLE_Step_2] strug: video
02/17/05 20:26:56 [USMLE_Step_2] docak: caz i think the some vedios have old info
02/17/05 20:26:57 [USMLE_Step_2] strug: DR. Alena
02/17/05 20:27:06 [USMLE_Step_2] docak: i had her for live
02/17/05 20:27:11 [USMLE_Step_2] strug: ok so waht were u told?
02/17/05 20:27:19 [USMLE_Step_2] strug: we need to change?
02/17/05 20:27:23 [USMLE_Step_2] docak: cannot use drug again
02/17/05 20:27:31 [USMLE_Step_2] strug: thanks doc good to have u here
02/17/05 20:27:31 [USMLE_Step_2] docak: once pt develops NMS

02/17/05 20:27:54 [USMLE_Step_2] lanny: you can use a lower dose or use another drug
02/17/05 20:27:56 roxanita Logs Out
02/17/05 20:28:36 [USMLE_Step_2] lanny: agree with doc
02/17/05 20:28:37 [USMLE_Step_2] strug: pt with choreathetosis and involuntary movements...only during day .......diagnosis?
02/17/05 20:28:49 [USMLE_Step_2] strug: pt is on Rx with antipsychotics
02/17/05 20:28:58 ayesh Logs in
02/17/05 20:28:58 ayesh Joins Subroom USMLE_Step_2
02/17/05 20:29:09 [USMLE_Step_2] sanz: dystonia?
02/17/05 20:29:12 [USMLE_Step_2] strug: hey ayesh
02/17/05 20:29:16 [USMLE_Step_2] samantha: tardive dykinesia
02/17/05 20:29:17 [USMLE_Step_2] ayesh: hi guys
02/17/05 20:29:21 [USMLE_Step_2] sanz: hey ayesh
02/17/05 20:29:23 [USMLE_Step_2] strug: hi ayesh
02/17/05 20:29:28 [USMLE_Step_2] docak: hi ayesh
02/17/05 20:29:32 [USMLE_Step_2] uniteus: hi
02/17/05 20:29:35 [USMLE_Step_2] lanny: dystonia
02/17/05 20:29:37 [USMLE_Step_2] strug: yup its tardive dyskinesia
02/17/05 20:29:39 [USMLE_Step_2] ayesh: so what r u guys discussing
02/17/05 20:29:44 [USMLE_Step_2] strug: Rx?
02/17/05 20:29:59 [USMLE_Step_2] strug: is it reversible with Rx or not?
02/17/05 20:30:05 [USMLE_Step_2] lanny: no irrev
02/17/05 20:30:10 [USMLE_Step_2] strug: ayesh we r discussiong psychi
02/17/05 20:30:15 [USMLE_Step_2] sanz: not reversible
02/17/05 20:30:15 [USMLE_Step_2] ayesh: ok
02/17/05 20:30:17 [USMLE_Step_2] ayesh: thanks
02/17/05 20:30:26 [USMLE_Step_2] samantha: stop old med start new
02/17/05 20:30:30 [USMLE_Step_2] sanz: change to clozapine
02/17/05 20:30:41 [USMLE_Step_2] strug: swtich the pt to new antipsy yes correct
02/17/05 20:30:43 [USMLE_Step_2] lanny: yes but tardive dysk is irev
02/17/05 20:31:02 [USMLE_Step_2] strug: u dont want to worsen it....do u?
02/17/05 20:31:34 [USMLE_Step_2] lanny: yea but what if the pt is not doingwell on new drugs
02/17/05 20:31:53 [USMLE_Step_2] strug: first atleast start them
02/17/05 20:32:06 [USMLE_Step_2] docak: usually they respond better to newer drugs
02/17/05 20:32:10 [USMLE_Step_2] sanz: lanny we stop the neuroleptics once TD occurs and start them on atypicals antipsy
02/17/05 20:32:17 [USMLE_Step_2] strug: yup agree
02/17/05 20:32:18 [USMLE_Step_2] lanny: agree sanz
02/17/05 20:32:27 lenhoxung Logs Out
02/17/05 20:32:33 [USMLE_Step_2] uniteus: TD commonly occur in elderly also
02/17/05 20:32:45 [USMLE_Step_2] lanny: but the new drug will not trt it cause its irrev
02/17/05 20:32:50 [USMLE_Step_2] strug: S/E of olanza pine
02/17/05 20:32:52 [USMLE_Step_2] uniteus: so need least side effect drug after wards
02/17/05 20:32:53 [USMLE_Step_2] docak: TD usually seen in elderly women with underlying mood prob
02/17/05 20:32:58 [USMLE_Step_2] sanz: weight gain
02/17/05 20:33:03 [USMLE_Step_2] lanny: yes doc and uni
02/17/05 20:33:12 [USMLE_Step_2] ayesh: agree
02/17/05 20:33:21 [USMLE_Step_2] strug: right sanz weight gain
02/17/05 20:33:30 [USMLE_Step_2] lanny: wt gain correct
02/17/05 20:33:39 [USMLE_Step_2] sanz: side effects of lamotrigine?
02/17/05 20:33:39 [USMLE_Step_2] strug: S/E of ziprasidone
02/17/05 20:33:48 [USMLE_Step_2] strug: skin rash sanz
02/17/05 20:33:53 [USMLE_Step_2] sanz: good strug
02/17/05 20:34:00 [USMLE_Step_2] sanz: galactorrh
02/17/05 20:34:12 [USMLE_Step_2] docak: prolongation of QT interval
02/17/05 20:34:18 [USMLE_Step_2] strug: yes docak is right
02/17/05 20:34:37 [USMLE_Step_2] strug: ziprasidone causes prolon of QT interval
02/17/05 20:34:44 [USMLE_Step_2] sanz: risperidone is the one with galactorrhea...
02/17/05 20:34:50 [USMLE_Step_2] samantha: and also severe sedation for olanzapine
02/17/05 20:34:53 [USMLE_Step_2] sanz: sorry mis read the q
02/17/05 20:35:25 [USMLE_Step_2] strug: becareful in the exam........ :?
02/17/05 20:35:31 [USMLE_Step_2] sanz: i know :(
02/17/05 20:35:41 [USMLE_Step_2] sanz: these psy drugs all look the same
02/17/05 20:35:48 [USMLE_Step_2] uniteus: yeah scary
02/17/05 20:35:52 [USMLE_Step_2] strug: risperidone causes galactorrhea i didnt know that
02/17/05 20:35:52 [USMLE_Step_2] sanz: getting dyslexic... hehe
02/17/05 20:35:54 [USMLE_Step_2] docak: yeah
02/17/05 20:36:18 [USMLE_Step_2] sanz: yes risperidone block the tubofundibular tract particularly
02/17/05 20:36:29 [USMLE_Step_2] uniteus: which one cause gynecomastia?
02/17/05 20:36:45 [USMLE_Step_2] ayesh: cimentidine
02/17/05 20:36:54 [USMLE_Step_2] uniteus: i mean...psy drug
02/17/05 20:36:57 [USMLE_Step_2] ayesh: also that cause delusion and psychosis
02/17/05 20:37:02 [USMLE_Step_2] uniteus: sorry for incomplete q
02/17/05 20:37:24 [USMLE_Step_2] sanz: uni, i dont know of any psy drugs which would cause gynecomast
02/17/05 20:37:38 [USMLE_Step_2] ayesh: don't know
02/17/05 20:37:53 [USMLE_Step_2] strug: pt started with Rx of antidepressent comes with no improval of symp after 2 weeks .... wants to change med.....what will u give?
02/17/05 20:38:05 [USMLE_Step_2] sanz: what are 2nd line Drug for pt with bipolor?
02/17/05 20:38:07 [USMLE_Step_2] uniteus: chlopromazine
02/17/05 20:38:07 [USMLE_Step_2] ayesh: nothing
02/17/05 20:38:14 [USMLE_Step_2] ayesh: it stakes 4 to 6 weeks to work
02/17/05 20:38:16 [USMLE_Step_2] sanz: reassure and cont meds
02/17/05 20:38:33 [USMLE_Step_2] strug: TCA sanz
02/17/05 20:38:33 [USMLE_Step_2] docak: reassure pt and tell him it will take longer to see effects
02/17/05 20:38:34 [USMLE_Step_2] ayesh: valproste
02/17/05 20:38:40 [USMLE_Step_2] ayesh: valproate
02/17/05 20:38:50 [USMLE_Step_2] sanz: yes valproate and carbamezzapine
02/17/05 20:39:01 [USMLE_Step_2] strug: yup u guys right it takes 4 to 6 weeks for antideep to act
02/17/05 20:39:15 [USMLE_Step_2] docak: depacote
02/17/05 20:39:16 [USMLE_Step_2] sanz: what do you have to monitor if you put the pt on valproate?
02/17/05 20:39:22 [USMLE_Step_2] ayesh: lithum valproate and olanzapine
02/17/05 20:39:36 an_bo_al Logs Out
02/17/05 20:39:44 [USMLE_Step_2] docak: another name for valproate. this if the name given in Q
02/17/05 20:39:44 [USMLE_Step_2] strug: CBC sanz
02/17/05 20:39:55 [USMLE_Step_2] samantha: liver enzymes?
02/17/05 20:39:57 [USMLE_Step_2] sanz: CBC for clozapine...
02/17/05 20:40:01 [USMLE_Step_2] sanz: LFTs for valproate
02/17/05 20:40:03 [USMLE_Step_2] strug: liver enx
02/17/05 20:40:05 [USMLE_Step_2] ayesh: cbs ..can't thinki of anything
02/17/05 20:40:09 [USMLE_Step_2] lanny: agree sanz
02/17/05 20:40:09 [USMLE_Step_2] ayesh: ok
02/17/05 20:40:17 [USMLE_Step_2] docak: agree sanz
02/17/05 20:40:35 [USMLE_Step_2] lanny: side eff of carbamazepine?
02/17/05 20:40:48 [USMLE_Step_2] sanz: agranulocytosis
02/17/05 20:40:50 [USMLE_Step_2] samantha: agranulo
02/17/05 20:40:53 [USMLE_Step_2] strug: agranulo
02/17/05 20:41:00 [USMLE_Step_2] strug: folatedef also
02/17/05 20:41:09 [USMLE_Step_2] strug: caused NTD
02/17/05 20:41:14 [USMLE_Step_2] strug: neural tube defects
02/17/05 20:41:25 [USMLE_Step_2] samantha: side effect of clozapine?
02/17/05 20:41:29 [USMLE_Step_2] strug: agranulo
02/17/05 20:41:31 [USMLE_Step_2] sanz: agranulocytosis
02/17/05 20:41:35 [USMLE_Step_2] samantha: yes
02/17/05 20:41:36 [USMLE_Step_2] uniteus: agranu
02/17/05 20:41:47 [USMLE_Step_2] strug: S/E of thioridazone
02/17/05 20:41:49 [USMLE_Step_2] lanny: rash bone marrow suppress
02/17/05 20:41:59 [USMLE_Step_2] lanny: this is for carbama
02/17/05 20:42:01 [USMLE_Step_2] sanz: visual prob
02/17/05 20:42:11 [USMLE_Step_2] lanny: agree sanz
02/17/05 20:42:11 [USMLE_Step_2] docak: grey vision
02/17/05 20:42:17 [USMLE_Step_2] strug: cardiac conduction abnormalites and retinitis pigmentatosa
02/17/05 20:42:25 [USMLE_Step_2] strug: yup u guys r right
02/17/05 20:42:32 [USMLE_Step_2] uniteus: eye retinitis
02/17/05 20:43:00 [USMLE_Step_2] sanz: schizo pt with hypothermia... what drug is he taking?
02/17/05 20:43:17 [USMLE_Step_2] strug: pt on Rx of anxiety disorder complains of impotance....which drug?
02/17/05 20:43:32 [USMLE_Step_2] uniteus: SSRI strug
02/17/05 20:43:34 [USMLE_Step_2] sanz: strug, SSRI
02/17/05 20:43:46 [USMLE_Step_2] strug: good uni and sanz
02/17/05 20:43:57 [USMLE_Step_2] uniteus: fluoxetine sanz? not sure?
02/17/05 20:44:06 [USMLE_Step_2] lanny: yes zn SSRI
02/17/05 20:44:10 [USMLE_Step_2] sanz: fluphenazine uni
02/17/05 20:44:22 [USMLE_Step_2] sanz: the drugs all look the same!!
02/17/05 20:44:32 [USMLE_Step_2] uniteus: oh..i mixing dem up :(
02/17/05 20:44:48 [USMLE_Step_2] docak: its ok uni
02/17/05 20:44:52 [USMLE_Step_2] sanz: fluphenazine is a typical antipsy.. causes hypothermia by vasodilation
02/17/05 20:45:00 [USMLE_Step_2] docak: we'll learn
02/17/05 20:45:01 [USMLE_Step_2] sanz: uni, same here...
02/17/05 20:45:04 [USMLE_Step_2] uniteus: thx doc
02/17/05 20:45:08 [USMLE_Step_2] docak: urw
02/17/05 20:45:14 [USMLE_Step_2] sanz: i get them all mixed up too
02/17/05 20:45:28 [USMLE_Step_2] docak: i know its tough
02/17/05 20:45:43 [USMLE_Step_2] strug: which Tca used for chronic pain?
02/17/05 20:45:54 [USMLE_Step_2] samantha: yes antipsychotics cause hypothermia
02/17/05 20:45:57 [USMLE_Step_2] ayesh: amitriptyline
02/17/05 20:45:59 [USMLE_Step_2] sanz: amitrytyline?
02/17/05 20:46:06 [USMLE_Step_2] lanny: gabapentin
02/17/05 20:46:09 [USMLE_Step_2] strug: wow u guys rock ayesh and sanz
02/17/05 20:46:19 [USMLE_Step_2] ayesh: :-happy
02/17/05 20:46:26 [USMLE_Step_2] sanz: gabapentin is antiepileptic
02/17/05 20:46:32 [USMLE_Step_2] lanny: what is gabapentin
02/17/05 20:46:40 [USMLE_Step_2] sanz: strug, YOU rock!
02/17/05 20:46:43 [USMLE_Step_2] lanny: oh thx
02/17/05 20:46:50 [USMLE_Step_2] strug: thanks sanz
02/17/05 20:47:05 [USMLE_Step_2] ayesh: sorry for this ...i know it will keep rocking and take attention sorry guys
02/17/05 20:47:20 [USMLE_Step_2] uniteus: :)
02/17/05 20:47:27 [USMLE_Step_2] docak: :)
02/17/05 20:47:45 [USMLE_Step_2] sanz: 35 yr old woman with bipolar... b4 starting meds, what test do you have to do?
02/17/05 20:47:52 [USMLE_Step_2] ayesh: TSH
02/17/05 20:47:55 [USMLE_Step_2] strug: pt on Rx .... for depression develps a cold .... now presents with BP 180/100 diagnosis?
02/17/05 20:48:01 [USMLE_Step_2] uniteus: pregnancy sanz
02/17/05 20:48:04 [USMLE_Step_2] strug: TRH sanz
02/17/05 20:48:06 [USMLE_Step_2] sanz: good uni
02/17/05 20:48:13 [USMLE_Step_2] sanz: b hGC
02/17/05 20:48:13 [USMLE_Step_2] ayesh: yeah preg also
02/17/05 20:48:17 [USMLE_Step_2] samantha: lft's sanz
02/17/05 20:48:17 [USMLE_Step_2] strug: ok for ebstrin anom,alu
02/17/05 20:48:23 [USMLE_Step_2] ayesh: agree
02/17/05 20:48:27 [USMLE_Step_2] lanny: agree
02/17/05 20:48:28 [USMLE_Step_2] strug: we nneed to do alot of test i guess
02/17/05 20:48:44 [USMLE_Step_2] sanz: yes strug.... bhCG is more impt TSH....
02/17/05 20:48:49 [USMLE_Step_2] ayesh: yeah i agree
02/17/05 20:48:56 [USMLE_Step_2] ayesh: first test in young lady
02/17/05 20:49:03 [USMLE_Step_2] docak: whats the ans strug?
02/17/05 20:49:04 [USMLE_Step_2] lanny: preg
02/17/05 20:49:09 [USMLE_Step_2] sanz: wait strug
02/17/05 20:49:11 [USMLE_Step_2] sanz: thinking...
02/17/05 20:49:20 [USMLE_Step_2] docak: sorry sanz
02/17/05 20:49:28 [USMLE_Step_2] uniteus: hypertensive crisis MAOI
02/17/05 20:49:39 [USMLE_Step_2] sanz: it's ok docak...
02/17/05 20:49:45 [USMLE_Step_2] ayesh: cheese or any tyramine containg food
02/17/05 20:49:47 [USMLE_Step_2] lanny: TCA
02/17/05 20:49:59 [USMLE_Step_2] sanz: yeah hypertensive crisis
02/17/05 20:50:02 [USMLE_Step_2] strug: yup uni got it........very good
02/17/05 20:50:24 [USMLE_Step_2] uniteus: whew! finally the coffee is working
02/17/05 20:50:39 [USMLE_Step_2] sanz: caffeine has absolutely NO effect on me
02/17/05 20:50:42 [USMLE_Step_2] strug: also when pt on MAOI inhibi who takes amphetamins or antiasthamatic mediacaions
02/17/05 20:50:46 [USMLE_Step_2] lanny: thank god we are not exam writers
02/17/05 20:51:13 [USMLE_Step_2] strug: i m lanny :nah:
02/17/05 20:51:22 [USMLE_Step_2] uniteus: :)
02/17/05 20:51:38 [USMLE_Step_2] lanny: strug it was better if read pt is treated for flu like sms..
02/17/05 20:51:54 [USMLE_Step_2] sanz: venlafaxine inh what receptors?
02/17/05 20:51:56 [USMLE_Step_2] lanny: now i know you are not he he he lol
02/17/05 20:52:16 [USMLE_Step_2] strug: thats was to confuse u lanny and give u false satisfaction he he
02/17/05 20:52:37 [USMLE_Step_2] lanny: he he he helol
02/17/05 20:52:51 [USMLE_Step_2] lanny: i will catch you next
02/17/05 20:52:58 mmw Logs Out
02/17/05 20:53:29 [USMLE_Step_2] lanny: what antipsych good for smoke cessation
02/17/05 20:53:39 [USMLE_Step_2] strug: bupropion lanny
02/17/05 20:53:41 [USMLE_Step_2] docak: zyban
02/17/05 20:53:45 [USMLE_Step_2] uniteus: dunno..sanz
02/17/05 20:53:54 [USMLE_Step_2] samantha: ssri's
02/17/05 20:53:55 [USMLE_Step_2] lanny: what should you observe for
02/17/05 20:54:12 [USMLE_Step_2] lanny: correct strug
02/17/05 20:54:16 [USMLE_Step_2] docak: wellbutrin, forgot which class
02/17/05 20:54:21 [USMLE_Step_2] sanz: its action is inhbition of 5HT and NorEpi
02/17/05 20:54:27 [USMLE_Step_2] ayesh: hey sanz what is your ans'
02/17/05 20:54:32 [USMLE_Step_2] strug: seizures lanny
02/17/05 20:54:33 [USMLE_Step_2] sanz: its action is inhbition of 5HT and NorEpi reuptake
02/17/05 20:54:33 [USMLE_Step_2] ayesh: ok
02/17/05 20:54:44 [USMLE_Step_2] uniteus: thz sanz
02/17/05 20:54:53 [USMLE_Step_2] docak: bupropion is right agree
02/17/05 20:54:53 [USMLE_Step_2] lanny: no strug got it wrong again remember first day of chat
02/17/05 20:55:02 [USMLE_Step_2] samantha: that is venlafaxine
02/17/05 20:55:04 [USMLE_Step_2] lanny: i gave the correct answer
02/17/05 20:55:18 [USMLE_Step_2] sanz: bupropion is not an antipsy...
02/17/05 20:55:24 [USMLE_Step_2] lanny: yes doc bupropion
02/17/05 20:55:35 [USMLE_Step_2] sanz: it's an anti depressant to my knowledge...
02/17/05 20:55:38 [USMLE_Step_2] lanny: it is a heterocyclic
02/17/05 20:55:50 [USMLE_Step_2] lanny: yes sanz i made a mistake
02/17/05 20:56:06 [USMLE_Step_2] strug: i dunno what u want to convey lanny......but pl break the suspense now
02/17/05 20:56:12 [USMLE_Step_2] sanz: that's ok lanny... i was just making sure what i know is correct
02/17/05 20:56:12 [USMLE_Step_2] sanz: hehe
02/17/05 20:56:47 [USMLE_Step_2] strug: ur q was pt on bupropin what should u watch for right?
02/17/05 20:56:53 [USMLE_Step_2] lanny: ok if the pt has depress sms and hx of schizo he is stable and on buprop wat do you watch him for?
02/17/05 20:57:14 [USMLE_Step_2] strug: suicide idfeations
02/17/05 20:57:19 [USMLE_Step_2] sanz: aggravation of psychosis?
02/17/05 20:57:23 [USMLE_Step_2] lanny: i gave this ans on first chat
02/17/05 20:57:29 [USMLE_Step_2] uniteus: psychosis
02/17/05 20:57:29 [USMLE_Step_2] strug: lanny tell the ans
02/17/05 20:57:37 [USMLE_Step_2] lanny: yes sanz good!!!!!!
02/17/05 20:57:42 [USMLE_Step_2] strug: ok gotcha now
02/17/05 20:57:47 [USMLE_Step_2] strug: thanks lanny
02/17/05 20:57:47 [USMLE_Step_2] lanny: watch for aggrav of psychosis
02/17/05 20:58:02 [USMLE_Step_2] lanny: my attending in psych was slapped hard on the face
02/17/05 20:58:15 [USMLE_Step_2] lanny: whie i was an intern and ill remember that
02/17/05 20:58:23 [USMLE_Step_2] strug: which drug causes priapism?
02/17/05 20:58:31 [USMLE_Step_2] sanz: trazodone
02/17/05 20:58:32 [USMLE_Step_2] docak: trazodone
02/17/05 20:58:38 [USMLE_Step_2] lanny: trazondne
02/17/05 20:58:44 [USMLE_Step_2] strug: good keep it up guys
02/17/05 20:58:51 [USMLE_Step_2] docak: thx strug
02/17/05 20:58:59 [USMLE_Step_2] sanz: MDD pt on SSRI complians of impotence... which drug do you swtich to now?
02/17/05 20:59:16 [USMLE_Step_2] docak: trazodone
02/17/05 20:59:24 [USMLE_Step_2] strug: bupropiom sanz
02/17/05 20:59:31 [USMLE_Step_2] uniteus: fluoxetine
02/17/05 20:59:33 [USMLE_Step_2] sanz: good job strug
02/17/05 20:59:35 [USMLE_Step_2] docak: i just made a guess
02/17/05 20:59:37 [USMLE_Step_2] samantha: tri's
02/17/05 21:00:05 [USMLE_Step_2] uniteus: oops..didnt read the q correctly ..sorry
02/17/05 21:00:21 [USMLE_Step_2] strug: pt with depression has severe insomia..which drug u prefer?
02/17/05 21:00:31 [USMLE_Step_2] sanz: zolpidem
02/17/05 21:00:43 [USMLE_Step_2] ayesh: scizure
02/17/05 21:01:08 [USMLE_Step_2] ayesh: olanzapine
02/17/05 21:01:08 [USMLE_Step_2] uniteus: TCA
02/17/05 21:01:16 [USMLE_Step_2] ayesh: oh sorry
02/17/05 21:01:21 [USMLE_Step_2] strug: trazodone......becauseit is very sedative
02/17/05 21:01:22 [USMLE_Step_2] ayesh: i thought psychotic
02/17/05 21:01:41 [USMLE_Step_2] strug: used in pt with depsesison and insomia
02/17/05 21:01:50 [USMLE_Step_2] samantha: ok
02/17/05 21:02:08 [USMLE_Step_2] strug: pt with acute alcohol wihdrawal....agitated....what next?
02/17/05 21:02:09 [USMLE_Step_2] sanz: thnx strug...
02/17/05 21:02:13 [USMLE_Step_2] ayesh: BZ
02/17/05 21:02:14 [USMLE_Step_2] sanz: diazepam
02/17/05 21:02:20 [USMLE_Step_2] lanny: benszo
02/17/05 21:02:28 [USMLE_Step_2] uniteus: Benzodiazepine
02/17/05 21:02:33 [USMLE_Step_2] ayesh: chlordiazepoxide
02/17/05 21:02:41 [USMLE_Step_2] samantha: benzo
02/17/05 21:02:50 diabetes Logs Out
02/17/05 21:02:51 [USMLE_Step_2] strug: yup ayesh its chlordiax
02/17/05 21:03:00 [USMLE_Step_2] ayesh: thanks
02/17/05 21:03:20 [USMLE_Step_2] strug: but oxezepan and temezepam can also be given also lorezepam
02/17/05 21:03:27 [USMLE_Step_2] ayesh: yaeh
02/17/05 21:03:37 [USMLE_Step_2] samantha: +++++++++
02/17/05 21:03:38 [USMLE_Step_2] lanny: i think chlord takes faster to act?
02/17/05 21:03:57 [USMLE_Step_2] strug: because these dont go to the P450 syystem for metabolism
02/17/05 21:04:05 [USMLE_Step_2] samantha: ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++
02/17/05 21:04:14 diabetes Logs in
02/17/05 21:04:14 diabetes Joins Subroom USMLE_Step_2
02/17/05 21:04:17 [USMLE_Step_2] lanny: whats this sam?
02/17/05 21:04:31 [USMLE_Step_2] lanny: is your finger stuck..........................
02/17/05 21:04:35 [USMLE_Step_2] samantha: i am sorry i carried my comp
02/17/05 21:04:54 [USMLE_Step_2] samantha: upstairs
02/17/05 21:04:54 [USMLE_Step_2] lanny: ok dear
02/17/05 21:05:27 [USMLE_Step_2] lanny: strug are we done for today
02/17/05 21:05:38 [USMLE_Step_2] strug: there is alot more to do lanny
02/17/05 21:05:50 [USMLE_Step_2] lanny: i wanna peeeeeeeeeeeeeeeee...
02/17/05 21:05:53 [USMLE_Step_2] ayesh: what r the conditions u give ECT
02/17/05 21:06:03 [USMLE_Step_2] lanny: untreated MDD
02/17/05 21:06:05 [USMLE_Step_2] strug: u dont need my permission for that lanny..... he he
02/17/05 21:06:09 [USMLE_Step_2] sanz: in pregnancy
02/17/05 21:06:11 [USMLE_Step_2] strug: preg
02/17/05 21:06:15 [USMLE_Step_2] strug: emmergency
02/17/05 21:06:21 [USMLE_Step_2] sanz: lanny, honestly you dont need to share the info with us... hehe
02/17/05 21:06:21 [USMLE_Step_2] uniteus: high risk suicidal
02/17/05 21:06:23 [USMLE_Step_2] strug: refractory schizophrenia
02/17/05 21:06:35 [USMLE_Step_2] strug: yup suical
02/17/05 21:06:38 [USMLE_Step_2] uniteus: elderly wid MDD
02/17/05 21:06:46 [USMLE_Step_2] ayesh: what's MDD
02/17/05 21:06:56 [USMLE_Step_2] strug: major deprssive disorder
02/17/05 21:07:05 [USMLE_Step_2] lanny: is CT used in schizo strug
02/17/05 21:07:08 [USMLE_Step_2] uniteus: maj depressive disorder
02/17/05 21:07:15 [USMLE_Step_2] uniteus: sorry ayesh
02/17/05 21:07:58 [USMLE_Step_2] ayesh: refractory manis,severs dep, preg,NMS synd catatonic schz
02/17/05 21:08:16 [USMLE_Step_2] ayesh: its ok uniteus
02/17/05 21:08:20 [USMLE_Step_2] strug: i meant those which are not responsive to treatment
02/17/05 21:08:24 [USMLE_Step_2] lanny: strug is ECT used in schizo?
02/17/05 21:08:39 [USMLE_Step_2] lanny: oh i thought only inMDD
02/17/05 21:08:47 [USMLE_Step_2] sanz: lanny yes in acute psychosis
02/17/05 21:09:55 [USMLE_Step_2] sanz: contraindication for ECT?
02/17/05 21:10:07 [USMLE_Step_2] strug: none sanz
02/17/05 21:10:10 [USMLE_Step_2] lanny: seizures?
02/17/05 21:10:16 [USMLE_Step_2] uniteus: memory loss
02/17/05 21:10:17 [USMLE_Step_2] sanz: seizures and recent stroke
02/17/05 21:10:21 [USMLE_Step_2] ayesh: pt with depression and heart dz
02/17/05 21:10:24 [USMLE_Step_2] ayesh: which drug
02/17/05 21:10:36 [USMLE_Step_2] ayesh: sertraline .....sanz ans
02/17/05 21:10:37 [USMLE_Step_2] docak: increased intracranial pressur
02/17/05 21:10:44 [USMLE_Step_2] docak: is Ci for ECT
02/17/05 21:10:53 [USMLE_Step_2] sanz: yes.. MI is relative c/i and also brian tumour
02/17/05 21:11:00 [USMLE_Step_2] lanny: doc i think it can cause inc ICP
02/17/05 21:11:18 [USMLE_Step_2] docak: yes lanny any condition that increase ICP
02/17/05 21:11:28 [USMLE_Step_2] strug: guys i m trying to copy the transcropt i get only half the content
02/17/05 21:11:29 [USMLE_Step_2] docak: like tumor etc
02/17/05 21:11:33 [USMLE_Step_2] sanz: ayesh, i dont know what you mean...?
02/17/05 21:11:41 [USMLE_Step_2] ayesh: i gave your ans
02/17/05 21:11:57 [USMLE_Step_2] ayesh: its same as if pt has a heart dz...sertraline
02/17/05 21:12:36 [USMLE_Step_2] sanz: oh ok... i didnt know that... hehe
02/17/05 21:13:01 [USMLE_Step_2] sanz: strug what do you mean?
02/17/05 21:13:05 [USMLE_Step_2] ayesh: if a pt had tendency of suiside ...which drug u don't give
02/17/05 21:13:14 [USMLE_Step_2] sanz: SSRI
02/17/05 21:13:23 [USMLE_Step_2] ayesh: no
02/17/05 21:13:23 [USMLE_Step_2] docak: tca
02/17/05 21:13:25 [USMLE_Step_2] strug: TCA?
02/17/05 21:13:26 [USMLE_Step_2] ayesh: yap
02/17/05 21:13:28 [USMLE_Step_2] sanz: oh eyah TCA
02/17/05 21:13:29 [USMLE_Step_2] ayesh: tca
02/17/05 21:13:32 [USMLE_Step_2] ayesh: TCA
02/17/05 21:13:38 [USMLE_Step_2] docak: caz of narrow TI
02/17/05 21:13:54 [USMLE_Step_2] strug: sanz i m not able to post the transciopt i can copy only half the content starting from NMS
02/17/05 21:14:08 [USMLE_Step_2] strug: dua requested me to copy it but i cant.......
02/17/05 21:14:42 [USMLE_Step_2] sanz: ok let me try... which button do i click?
02/17/05 21:14:42 [USMLE_Step_2] strug: whats ur q docak?
02/17/05 21:15:01 [USMLE_Step_2] strug: the one nex t to the speaker which looks like two pages
02/17/05 21:15:08 [USMLE_Step_2] docak: i meant that TCA has narrrow therapeutic index
02/17/05 21:15:21 [USMLE_Step_2] strug: ok thanks doc
02/17/05 21:15:28 [USMLE_Step_2] docak: urw strug
02/17/05 21:15:40 [USMLE_Step_2] lanny: okguys think ill stop here
02/17/05 21:15:44 [USMLE_Step_2] sanz: mine is half the content too
02/17/05 21:16:01 [USMLE_Step_2] strug: leav it then sanz
02/17/05 21:16:10 [USMLE_Step_2] lanny: may join you later if you still here
02/17/05 21:16:10 [USMLE_Step_2] strug: ok shall we leave guys now?
02/17/05 21:16:17 [USMLE_Step_2] samantha: so what about narrow TI?
02/17/05 21:16:20 [USMLE_Step_2] sanz: ok
02/17/05 21:16:24 [USMLE_Step_2] lanny: will chk sched for tom
02/17/05 21:16:31 [USMLE_Step_2] strug: cognitive disorsders and sleep disorders tomorrow
02/17/05 21:16:39 [USMLE_Step_2] sanz: bye guys :)
02/17/05 21:16:40 [USMLE_Step_2] lanny: thanks a lot strug
02/17/05 21:16:40 [USMLE_Step_2] uniteus: ok
02/17/05 21:16:41 [USMLE_Step_2] strug: also the rest of th e stuff
02/17/05 21:16:43 [USMLE_Step_2] uniteus: bye
02/17/05 21:16:47 [USMLE_Step_2] lanny: goodnight all
02/17/05 21:16:48 [USMLE_Step_2] docak: TCA cannot be given in suicidal pt caz of narrow TI
02/17/05 21:16:50 [USMLE_Step_2] strug: bye guys have a good night
02/17/05 21:16:54 [USMLE_Step_2] sanz: u too
02/17/05 21:16:56 [USMLE_Step_2] lanny: you too
02/17/05 21:16:59 [USMLE_Step_2] uniteus: nite everyone
02/17/05 21:16:59 sanz Logs Out
02/17/05 21:17:06 [USMLE_Step_2] lanny: nite uni
02/17/05 21:17:08 [USMLE_Step_2] docak: bye guys, was great talking to u'll
02/17/05 21:17:12 [USMLE_Step_2] lanny: sanz nitey...
02/17/05 21:17:19 [USMLE_Step_2] docak: nitey nite
02/17/05 21:17:19 [USMLE_Step_2] strug: hoping to see u tom;or docak
02/17/05 21:17:30 [USMLE_Step_2] docak: sure stryg
02/17/05 21:17:37 [USMLE_Step_2] strug: bye all
02/17/05 21:17:39 strug Logs Out
02/17/05 21:17:47 uniteus Logs Out
02/17/05 21:17:48 [USMLE_Step_2] docak: don't let the bed bugs bite
02/17/05 21:17:54 [USMLE_Step_2] docak: :)
02/17/05 21:17:55 [USMLE_Step_2] ayesh: bye guys
02/17/05 21:17:59 [USMLE_Step_2] docak: bye

buller
02-21-2006, 02:34 PM
ich.sure aeine födin







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