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View Full Version : Psych Chat: day 2



Asclepius1
02-20-2005, 02:54 PM
02/18/05 19:18:14 [USMLE_Step_2] lanny: can we start by going yhru neuro transmitter and diff psych dz?
02/18/05 19:18:19 [USMLE_Step_2] sanz: ok
02/18/05 19:18:28 [USMLE_Step_2] lanny: schizo/
02/18/05 19:18:39 [USMLE_Step_2] sanz: dopamine
02/18/05 19:18:39 [USMLE_Step_2] lanny: what neuro implicated/
02/18/05 19:18:47 [USMLE_Step_2] lanny: yea xcess dopa
02/18/05 19:19:13 [USMLE_Step_2] sanz: depression?
02/18/05 19:19:23 [USMLE_Step_2] lanny: dec NE SER
02/18/05 19:19:29 [USMLE_Step_2] lanny: and dopa too
02/18/05 19:20:16 [USMLE_Step_2] sanz: successful suicide pt?
02/18/05 19:20:31 [USMLE_Step_2] lanny: dec dopa?
02/18/05 19:20:40 [USMLE_Step_2] sanz: i cant remember!
02/18/05 19:20:41 [USMLE_Step_2] sanz: hehe
02/18/05 19:21:04 [USMLE_Step_2] lanny: will chk later
02/18/05 19:21:09 [USMLE_Step_2] lanny: OCD?
02/18/05 19:21:22 [USMLE_Step_2] sanz: serotonin
02/18/05 19:21:36 [USMLE_Step_2] lanny: yes
02/18/05 19:21:51 docak Logs in
02/18/05 19:21:51 docak Joins Subroom USMLE_Step_2
02/18/05 19:21:57 [USMLE_Step_2] sanz: diff between malingering and factitious?
02/18/05 19:22:00 [USMLE_Step_2] lanny: bipolar disorder
02/18/05 19:22:16 [USMLE_Step_2] sanz: dop?
02/18/05 19:22:17 [USMLE_Step_2] lanny: malingering the pt seeks monetary or gain
02/18/05 19:22:22 strug Logs in
02/18/05 19:22:22 strug Joins Subroom USMLE_Step_2
02/18/05 19:22:35 [USMLE_Step_2] docak: hi guys
02/18/05 19:22:39 [USMLE_Step_2] lanny: bipol is inc NE SER DOPA
02/18/05 19:22:40 [USMLE_Step_2] sanz: hi docak
02/18/05 19:22:53 [USMLE_Step_2] docak: hi sanz
02/18/05 19:22:59 [USMLE_Step_2] lanny: sanz bipo is opp of MD
02/18/05 19:23:07 [USMLE_Step_2] sanz: ok thnx lanny
02/18/05 19:23:16 [USMLE_Step_2] sanz: hey strig :) how goes?
02/18/05 19:23:17 [USMLE_Step_2] strug: hey guys cant chat today........but i will peep in inbetween
02/18/05 19:23:21 [USMLE_Step_2] lanny: in terms of neuro transm levels
02/18/05 19:23:22 [USMLE_Step_2] strug: hi sanz
02/18/05 19:23:37 [USMLE_Step_2] lanny: ok strug
02/18/05 19:24:46 [USMLE_Step_2] lanny: factitious is to fake to get attention or to be loved
02/18/05 19:25:11 [USMLE_Step_2] lanny: malingering M is usually for Money
02/18/05 19:25:24 [USMLE_Step_2] docak: factitious - has primary gain but no seconday gain
02/18/05 19:25:38 [USMLE_Step_2] docak: malingering- has both primary and secondary gain
02/18/05 19:25:43 [USMLE_Step_2] lanny: can you explain this doc
02/18/05 19:26:15 [USMLE_Step_2] docak: yeas lanny. primary gain means the attention the pt gets
02/18/05 19:26:49 [USMLE_Step_2] docak: secondary gain is to ecape work, jail, prison, or for money, drugs etc
02/18/05 19:27:12 [USMLE_Step_2] lanny: yes sums it up good
02/18/05 19:29:10 [USMLE_Step_2] docak: factitious by proxy is munchausens
02/18/05 19:29:20 [USMLE_Step_2] lanny: yes
02/18/05 19:29:34 [USMLE_Step_2] lanny: which psych dz have genetic links
02/18/05 19:29:41 [USMLE_Step_2] docak: for eg: when mother produces sym in child and brings her to the hosp
02/18/05 19:29:49 [USMLE_Step_2] docak: bipolar
02/18/05 19:30:11 [USMLE_Step_2] lanny: what % of pop is affected
02/18/05 19:30:17 [USMLE_Step_2] lanny: in bipolar
02/18/05 19:30:32 [USMLE_Step_2] docak: schizophrenia to some extent but not as strong as bipolar
02/18/05 19:30:53 [USMLE_Step_2] lanny: both are the same
02/18/05 19:31:16 [USMLE_Step_2] lanny: 1 % for both in gen pop
02/18/05 19:32:22 [USMLE_Step_2] docak: bipolar is illness with greatest genetic linkage (says so in kaplan)
02/18/05 19:33:11 [USMLE_Step_2] lanny: ok but prevalence for both is 1 % is that right
02/18/05 19:33:39 [USMLE_Step_2] docak: agree with u lanny
02/18/05 19:34:01 [USMLE_Step_2] docak: prev is same
02/18/05 19:34:17 [USMLE_Step_2] lanny: yes
02/18/05 19:35:53 [USMLE_Step_2] docak: sanz is quiet today. r u okay sanz?
02/18/05 19:36:18 [USMLE_Step_2] lanny: ok trt of opiate dependence
02/18/05 19:36:34 [USMLE_Step_2] lanny: yea looks like strug took them all away
02/18/05 19:36:52 [USMLE_Step_2] docak: :)
02/18/05 19:37:07 [USMLE_Step_2] docak: methadone clinic?
02/18/05 19:37:15 [USMLE_Step_2] lanny: sanz megs dua where are you all
02/18/05 19:37:47 [USMLE_Step_2] lanny: its naloxone
02/18/05 19:37:51 [USMLE_Step_2] docak: ok
02/18/05 19:38:13 [USMLE_Step_2] lanny: but the withdrawal you give meth
02/18/05 19:38:19 [USMLE_Step_2] docak: i thought naloxone is for opiate overdose
02/18/05 19:38:40 [USMLE_Step_2] sanz: sorry guys...
02/18/05 19:38:52 [USMLE_Step_2] sanz: i'm back now... hehe
02/18/05 19:39:03 [USMLE_Step_2] docak: its ok sanz, just making sure u r fine
02/18/05 19:39:06 [USMLE_Step_2] lanny: naltrexone has a longer half life
02/18/05 19:39:15 [USMLE_Step_2] sanz: awww that's very nice of you docak
02/18/05 19:39:35 [USMLE_Step_2] docak: agree
02/18/05 19:39:48 dua_frank Logs in
02/18/05 19:39:49 dua_frank Joins Subroom USMLE_Step_2
02/18/05 19:39:57 [USMLE_Step_2] lanny: so we use naltrex for opioid dependence
02/18/05 19:40:06 [USMLE_Step_2] lanny: naloxone for o dose
02/18/05 19:40:16 [USMLE_Step_2] dua_frank: i got disconnected
02/18/05 19:40:17 [USMLE_Step_2] sanz: are u sure?
02/18/05 19:40:19 [USMLE_Step_2] sanz: wb dua
02/18/05 19:40:22 [USMLE_Step_2] dua_frank: thanks sanz
02/18/05 19:40:46 [USMLE_Step_2] sanz: to my knowledge, both naltrexone and naloone are for opioid od
02/18/05 19:41:33 [USMLE_Step_2] lanny: naloxone acts quickly so used for o dose
02/18/05 19:41:57 [USMLE_Step_2] lanny: this is how i remem them you can chk sanz
02/18/05 19:42:31 [USMLE_Step_2] lanny: smoking is a biggy guys lets discuss
02/18/05 19:42:46 [USMLE_Step_2] lanny: trt of nicotin dep?
02/18/05 19:42:56 [USMLE_Step_2] docak: patch?
02/18/05 19:43:07 [USMLE_Step_2] megs: bupropion
02/18/05 19:43:30 [USMLE_Step_2] sanz: yup bupropion
02/18/05 19:43:33 [USMLE_Step_2] lanny: good
02/18/05 19:43:46 [USMLE_Step_2] lanny: for reducing craving whats best/
02/18/05 19:44:08 [USMLE_Step_2] megs: how many trials for success
02/18/05 19:44:21 [USMLE_Step_2] sanz: as many times as needed?
02/18/05 19:44:24 [USMLE_Step_2] sanz: hehe
02/18/05 19:44:37 [USMLE_Step_2] lanny: sanz rught ill think
02/18/05 19:44:43 [USMLE_Step_2] megs: generally 5...to 6 trials r needed
02/18/05 19:44:57 [USMLE_Step_2] lanny: for rhe cravings which is best?
02/18/05 19:45:04 [USMLE_Step_2] lanny: to use
02/18/05 19:45:25 [USMLE_Step_2] megs: didnt get u r q lanny
02/18/05 19:45:35 [USMLE_Step_2] sanz: nicotine patch
02/18/05 19:45:43 [USMLE_Step_2] sanz: thnx megs, good to know that :)
02/18/05 19:45:46 ayesh Logs in
02/18/05 19:45:46 ayesh Joins Subroom USMLE_Step_2
02/18/05 19:45:47 [USMLE_Step_2] lanny: bupropion or the patch which is best to red the cravings
02/18/05 19:45:49 [USMLE_Step_2] megs: ok..got it now
02/18/05 19:45:52 [USMLE_Step_2] sanz: nicotine patch
02/18/05 19:45:56 [USMLE_Step_2] sanz: hey ayesh
02/18/05 19:45:56 [USMLE_Step_2] docak: ok
02/18/05 19:46:02 [USMLE_Step_2] megs: yup
02/18/05 19:46:04 [USMLE_Step_2] lanny: no snz
02/18/05 19:46:05 [USMLE_Step_2] ayesh: hi this is ayesha
02/18/05 19:46:10 [USMLE_Step_2] dua_frank: naltrexone
02/18/05 19:46:15 [USMLE_Step_2] docak: hi ayesha
02/18/05 19:46:23 [USMLE_Step_2] lanny: hi ayesh bupropion for the cravings
02/18/05 19:46:47 [USMLE_Step_2] docak: ok now i'm confused. which is for what
02/18/05 19:46:51 [USMLE_Step_2] lanny: pt on patch what should you always do as part of trt?
02/18/05 19:47:16 [USMLE_Step_2] ayesh: if pt on patch and also on bupropion
02/18/05 19:47:21 [USMLE_Step_2] ayesh: monitore BP
02/18/05 19:47:56 [USMLE_Step_2] uniteus: hi guys
02/18/05 19:47:59 [USMLE_Step_2] lanny: yes and also as part of trt always get pt on grroup psychothpy
02/18/05 19:48:05 [USMLE_Step_2] ayesh: ok
02/18/05 19:48:11 [USMLE_Step_2] docak: hi uni
02/18/05 19:48:15 [USMLE_Step_2] uniteus: sorry i am late
02/18/05 19:48:19 [USMLE_Step_2] lanny: docak buoropion is best for red the cravings
02/18/05 19:48:30 [USMLE_Step_2] docak: 0ok and the patch?
02/18/05 19:48:31 [USMLE_Step_2] megs: ok lanny
02/18/05 19:48:52 [USMLE_Step_2] lanny: what should you watch pt for on bupropion esp if he has a hx of schizo?
02/18/05 19:49:42 [USMLE_Step_2] megs: sucidal attemp lanny???
02/18/05 19:49:44 [USMLE_Step_2] uniteus: psychosis
02/18/05 19:49:58 [USMLE_Step_2] ayesh: sizures
02/18/05 19:50:11 [USMLE_Step_2] lanny: good uni aggravation of psycho
02/18/05 19:50:24 [USMLE_Step_2] uniteus: thanks lanny
02/18/05 19:50:30 [USMLE_Step_2] megs: good to know thanx
02/18/05 19:50:37 [USMLE_Step_2] lanny: always ask pt on bupro if hearing voices or seeing things
02/18/05 19:50:55 [USMLE_Step_2] lanny: esp if they have a psych hx
02/18/05 19:52:10 [USMLE_Step_2] lanny: diff bet anorexia nad bul
02/18/05 19:52:22 [USMLE_Step_2] lanny: and bulimiia?
02/18/05 19:52:53 megs Logs Out
02/18/05 19:53:08 megs Logs in
02/18/05 19:53:08 [USMLE_Step_2] docak: anorexia has body image prb, unlike bulimics
02/18/05 19:53:12 [USMLE_Step_2] uniteus: weight in anorexia is <15% of least normal BMI
02/18/05 19:53:12 megs Joins Subroom USMLE_Step_2
02/18/05 19:53:29 [USMLE_Step_2] ayesh: amenorrhea in anorexia
02/18/05 19:53:30 [USMLE_Step_2] docak: also wt in anorexia is low
02/18/05 19:53:47 [USMLE_Step_2] megs: bullemia...appetite good ..pt eat but tries too vomit it out
02/18/05 19:54:15 [USMLE_Step_2] uniteus: bulimea..exercise excessively but weight usually normal
02/18/05 19:54:35 [USMLE_Step_2] lanny: ok all right
02/18/05 19:55:01 [USMLE_Step_2] megs: what is treatment of bullemia
02/18/05 19:55:03 [USMLE_Step_2] lanny: do you trt anorexia as in or out pt?
02/18/05 19:55:19 [USMLE_Step_2] lanny: behavioral thpy
02/18/05 19:55:23 [USMLE_Step_2] uniteus: where's strug n sanz?
02/18/05 19:55:33 [USMLE_Step_2] lanny: sssri are used too
02/18/05 19:55:48 [USMLE_Step_2] megs: inpt lanny as they deny treatment
02/18/05 19:56:25 [USMLE_Step_2] lanny: and also to ensure safety of pt as they have electrolyte imbalances that coulld be fatal
02/18/05 19:56:43 [USMLE_Step_2] megs: for bullemia...imipramine ssri..and behav..all correct
02/18/05 19:57:06 [USMLE_Step_2] uniteus: yeah...nervosa prone to hypokalemia so prone to arrythmia then death if not treated early
02/18/05 19:57:14 [USMLE_Step_2] lanny: yep
02/18/05 19:57:24 [USMLE_Step_2] lanny: always admit to trt..
02/18/05 19:57:31 [USMLE_Step_2] docak: some pob i am not able to send messages
02/18/05 19:57:45 [USMLE_Step_2] uniteus: wat u mean doc?
02/18/05 19:58:01 [USMLE_Step_2] docak: it says rephrase most of the times
02/18/05 19:58:13 [USMLE_Step_2] lanny: maybe you haave a freeze
02/18/05 19:58:23 [USMLE_Step_2] docak: maybe
02/18/05 19:58:27 [USMLE_Step_2] lanny: oh you have an obscene word
02/18/05 19:58:36 [USMLE_Step_2] docak: well now seems to be fine let's see
02/18/05 19:58:37 [USMLE_Step_2] uniteus: :) lanny
02/18/05 19:58:44 [USMLE_Step_2] lanny: lut a space between
02/18/05 19:58:54 [USMLE_Step_2] docak: no :)
02/18/05 19:59:03 [USMLE_Step_2] docak: kleptomania
02/18/05 19:59:12 strug Logs Out
02/18/05 19:59:15 [USMLE_Step_2] docak: is seen in bulimics
02/18/05 19:59:18 [USMLE_Step_2] lanny: usually i do a s s for eg association
02/18/05 19:59:24 [USMLE_Step_2] docak: that is what i was trying to send
02/18/05 19:59:44 [USMLE_Step_2] docak: somehow when i put it in ine sentense it doesn't let me do it
02/18/05 19:59:48 [USMLE_Step_2] lanny: i know do it as a s s
02/18/05 19:59:57 [USMLE_Step_2] lanny: i had the prob too
02/18/05 20:00:22 [USMLE_Step_2] docak: thx lanny :)
02/18/05 20:00:40 [USMLE_Step_2] docak: was racking my head trying to think why
02/18/05 20:00:52 [USMLE_Step_2] uniteus: ok..what type of acid base imbalance will u find in nervosia or bulemics?
02/18/05 20:01:06 [USMLE_Step_2] lanny: oh yea they are very strict
02/18/05 20:01:07 [USMLE_Step_2] uniteus: due to vomiting
02/18/05 20:01:24 [USMLE_Step_2] docak: metabolic alkalosis and hypokalemia
02/18/05 20:01:30 [USMLE_Step_2] megs: alkolosis
02/18/05 20:01:32 [USMLE_Step_2] lanny: they vomit so metabolic acid
02/18/05 20:01:39 [USMLE_Step_2] uniteus: and ?
02/18/05 20:01:45 [USMLE_Step_2] lanny: sorry alkalosis
02/18/05 20:01:47 [USMLE_Step_2] uniteus: add something else doc
02/18/05 20:02:08 [USMLE_Step_2] lanny: compens resp acid
02/18/05 20:02:17 [USMLE_Step_2] uniteus: hypoCl
02/18/05 20:02:27 [USMLE_Step_2] lanny: yes
02/18/05 20:02:29 [USMLE_Step_2] docak: thnx lanny
02/18/05 20:02:29 [USMLE_Step_2] uniteus: all is right
02/18/05 20:02:31 [USMLE_Step_2] megs: k uni
02/18/05 20:02:36 [USMLE_Step_2] megs: ok uni
02/18/05 20:02:44 [USMLE_Step_2] uniteus: ok
02/18/05 20:03:04 [USMLE_Step_2] docak: but hypokalemia is dangerous, it may caz arrythmia
02/18/05 20:03:21 [USMLE_Step_2] lanny: yesthat why you keep them in hosp
02/18/05 20:03:22 [USMLE_Step_2] docak: its the common caz of death in these pts
02/18/05 20:03:25 [USMLE_Step_2] uniteus: yeah.
02/18/05 20:03:28 [USMLE_Step_2] lanny: yes
02/18/05 20:04:51 [USMLE_Step_2] uniteus: u guys did sleep disorder?
02/18/05 20:05:01 [USMLE_Step_2] lanny: not yet
02/18/05 20:05:11 [USMLE_Step_2] lanny: wanna lets do them ok uni
02/18/05 20:05:17 [USMLE_Step_2] lanny: i hate sleep
02/18/05 20:05:20 [USMLE_Step_2] uniteus: ok..but i hate it
02/18/05 20:05:27 [USMLE_Step_2] uniteus: lol
02/18/05 20:05:37 [USMLE_Step_2] docak: its ok guys. lets try and get it over with
02/18/05 20:05:38 [USMLE_Step_2] lanny: so whos an expert in sleep to guide us
02/18/05 20:05:48 [USMLE_Step_2] lanny: ok docak
02/18/05 20:06:11 [USMLE_Step_2] megs: what is tetrad of narcolepsy??/
02/18/05 20:06:53 [USMLE_Step_2] uniteus: cataplexy
02/18/05 20:07:07 [USMLE_Step_2] uniteus: sleep attack
02/18/05 20:07:15 [USMLE_Step_2] docak: cataplexy, sleep attack, sleep paralysis, hypnogogic and pompic hallucination
02/18/05 20:07:23 [USMLE_Step_2] megs: day time sleep,catalepsy,sleep paralysis and hypnogogic hallucinations..correct
02/18/05 20:07:37 [USMLE_Step_2] uniteus: thx meg n doc
02/18/05 20:07:45 [USMLE_Step_2] docak: urw uni
02/18/05 20:08:04 [USMLE_Step_2] megs: what is central sleep apnoea
02/18/05 20:08:13 [USMLE_Step_2] docak: they feel refreshed on waking
02/18/05 20:08:25 [USMLE_Step_2] uniteus: problem wid CNS respiratory
02/18/05 20:08:31 [USMLE_Step_2] uniteus: center..
02/18/05 20:08:32 [USMLE_Step_2] docak: thats a key point
02/18/05 20:08:44 [USMLE_Step_2] megs: its due to inadequete ventilatory drive correct..uni
02/18/05 20:09:01 [USMLE_Step_2] megs: what is reatment
02/18/05 20:09:01 [USMLE_Step_2] uniteus: :)
02/18/05 20:09:19 [USMLE_Step_2] docak: cpap
02/18/05 20:09:33 [USMLE_Step_2] lanny: is narcolepsy assoc with psych iatric illness and if so which one?
02/18/05 20:09:36 [USMLE_Step_2] megs: r u sure doc
02/18/05 20:09:52 [USMLE_Step_2] lanny: yes cpap also weight red
02/18/05 20:09:59 [USMLE_Step_2] docak: yes meg tratement of sleep apnea is cpap
02/18/05 20:10:13 [USMLE_Step_2] docak: yea lanny
02/18/05 20:10:25 [USMLE_Step_2] lanny: yes to my q?
02/18/05 20:10:28 [USMLE_Step_2] lanny: doc
02/18/05 20:10:29 [USMLE_Step_2] megs: that is for obstructive type doc
02/18/05 20:10:51 [USMLE_Step_2] megs: i asked for central type of sleep apnoea
02/18/05 20:11:00 [USMLE_Step_2] lanny: think for all three tpes u use CPAP
02/18/05 20:11:10 [USMLE_Step_2] docak: even central meg
02/18/05 20:11:15 [USMLE_Step_2] uniteus: dunno meg..
02/18/05 20:11:28 [USMLE_Step_2] docak: cpap and wt loss for osbst
02/18/05 20:11:30 [USMLE_Step_2] lanny: oxygen?
02/18/05 20:11:45 [USMLE_Step_2] megs: lanny correct
02/18/05 20:12:00 [USMLE_Step_2] megs: and acetazolamide and progesterone too
02/18/05 20:12:08 [USMLE_Step_2] lanny: yea cause they lack resp effort
02/18/05 20:12:10 [USMLE_Step_2] megs: but i dont know how they act
02/18/05 20:12:41 [USMLE_Step_2] docak: lanny is don't know the ans to ur q
02/18/05 20:12:51 [USMLE_Step_2] megs: how to diagnose sleep apnoea???
02/18/05 20:12:52 [USMLE_Step_2] lanny: ok
02/18/05 20:13:11 [USMLE_Step_2] docak: which illness is associ with narcolepsy?
02/18/05 20:13:12 [USMLE_Step_2] samantha: hi guys
02/18/05 20:13:17 [USMLE_Step_2] docak: hi sam
02/18/05 20:13:21 [USMLE_Step_2] lanny: hi sam
02/18/05 20:13:23 [USMLE_Step_2] uniteus: depression lanny
02/18/05 20:13:25 [USMLE_Step_2] uniteus: hi sam
02/18/05 20:13:37 [USMLE_Step_2] megs: hi samantha
02/18/05 20:13:45 [USMLE_Step_2] lanny: thought so correct uni
02/18/05 20:14:04 [USMLE_Step_2] uniteus: thx lanny
02/18/05 20:14:12 [USMLE_Step_2] lanny: narcol is usu seen in females sleep apn in males
02/18/05 20:15:54 [USMLE_Step_2] uniteus: sleep plethograpy megs?
02/18/05 20:15:56 [USMLE_Step_2] lanny: sleep stages anyone?
02/18/05 20:15:57 docak Joins Subroom USMLE_Step_2
02/18/05 20:16:22 [USMLE_Step_2] megs: polysomnography...uni
02/18/05 20:16:25 [USMLE_Step_2] samantha: sleep studies
02/18/05 20:16:34 [USMLE_Step_2] uniteus: oops..ok got cha...
02/18/05 20:16:37 [USMLE_Step_2] megs: is it same what u said?/
02/18/05 20:16:43 [USMLE_Step_2] docak: stage 1, 2 ,3 ,4
02/18/05 20:16:47 [USMLE_Step_2] samantha: 4 stages
02/18/05 20:17:00 [USMLE_Step_2] lanny: what is assoc with stages?
02/18/05 20:17:07 [USMLE_Step_2] lanny: correct 4
02/18/05 20:17:11 [USMLE_Step_2] uniteus: i was trying to remember the word n spelling megs..but somehow dat is the only one came up in my head
02/18/05 20:17:23 [USMLE_Step_2] megs: ok uni
02/18/05 20:17:50 [USMLE_Step_2] uniteus: plus REM stage lanny
02/18/05 20:17:53 jwls29 Logs Out
02/18/05 20:17:58 [USMLE_Step_2] lanny: yes uni
02/18/05 20:18:41 [USMLE_Step_2] megs: what is tratment of jetlag???
02/18/05 20:18:55 [USMLE_Step_2] docak: sunlight
02/18/05 20:19:02 [USMLE_Step_2] lanny: agree
02/18/05 20:19:05 [USMLE_Step_2] docak: melanin
02/18/05 20:19:23 [USMLE_Step_2] megs: :?
02/18/05 20:19:30 [USMLE_Step_2] docak: light on back of knees
02/18/05 20:19:46 [USMLE_Step_2] uniteus: melatonin
02/18/05 20:19:52 [USMLE_Step_2] docak: i heard this somewhere, can't remember where
02/18/05 20:20:04 [USMLE_Step_2] megs: never heard
02/18/05 20:20:10 [USMLE_Step_2] lanny: me too
02/18/05 20:20:11 [USMLE_Step_2] docak: sorry meant to say melatonin
02/18/05 20:20:17 [USMLE_Step_2] lanny: heard sunlight
02/18/05 20:20:22 [USMLE_Step_2] lanny: thx doc
02/18/05 20:20:48 [USMLE_Step_2] docak: promotes melatonin production
02/18/05 20:21:13 [USMLE_Step_2] lanny: what promotes
02/18/05 20:21:25 [USMLE_Step_2] docak: light on back of kness
02/18/05 20:21:31 [USMLE_Step_2] lanny: thx
02/18/05 20:21:32 [USMLE_Step_2] megs: i heard melatonin and sunliht..regarding depression of..winter season
02/18/05 20:21:48 [USMLE_Step_2] docak: urw
02/18/05 20:22:04 [USMLE_Step_2] lanny: whats urw
02/18/05 20:22:16 [USMLE_Step_2] docak: thats seasonal affective disorder meg
02/18/05 20:22:28 [USMLE_Step_2] megs: yup doc
02/18/05 20:22:46 [USMLE_Step_2] docak: u are welcome lanny :)
02/18/05 20:22:48 [USMLE_Step_2] megs: but never know that jetlag...u tx by sunlight
02/18/05 20:23:10 [USMLE_Step_2] lanny: whats urw doc
02/18/05 20:23:25 [USMLE_Step_2] docak: i said urw when u said thx
02/18/05 20:23:36 [USMLE_Step_2] lanny: youre welcomw?
02/18/05 20:23:42 [USMLE_Step_2] lanny: ok got it
02/18/05 20:23:44 [USMLE_Step_2] docak: yes lanny
02/18/05 20:23:44 kaash110zeh Disconnects
02/18/05 20:24:16 [USMLE_Step_2] uniteus: what neurotransmitter increase in NREM? n then REM ?
02/18/05 20:25:18 [USMLE_Step_2] docak: rem is Ach, nrem is NE
02/18/05 20:25:40 [USMLE_Step_2] lanny: increased?
02/18/05 20:25:45 [USMLE_Step_2] megs: rem...ach is incre
02/18/05 20:25:50 [USMLE_Step_2] uniteus: correct for rem doc..but NREM is not
02/18/05 20:25:58 [USMLE_Step_2] uniteus: yeah lanny
02/18/05 20:26:04 [USMLE_Step_2] lanny: thx
02/18/05 20:26:05 sargum Logs Out
02/18/05 20:26:09 [USMLE_Step_2] uniteus: right megs
02/18/05 20:26:30 [USMLE_Step_2] megs: tell us about NREM UNI
02/18/05 20:26:33 [USMLE_Step_2] docak: oh sorry
02/18/05 20:26:39 [USMLE_Step_2] uniteus: NREM is serotonin 5ht
02/18/05 20:26:48 [USMLE_Step_2] docak: nrem is decreased in rem
02/18/05 20:26:59 [USMLE_Step_2] docak: NE is decreased in rem
02/18/05 20:27:05 [USMLE_Step_2] uniteus: NE acutally decreased during sleep
02/18/05 20:27:19 [USMLE_Step_2] uniteus: yeah..i think dat is d link doc
02/18/05 20:27:39 [USMLE_Step_2] megs: ok...
02/18/05 20:27:49 [USMLE_Step_2] docak: SAND man
02/18/05 20:27:53 [USMLE_Step_2] uniteus: dude
02/18/05 20:28:29 [USMLE_Step_2] lanny: tell us doc sand man
02/18/05 20:28:46 [USMLE_Step_2] docak: serotonin initiates sleep and increases in sleep, Ach linked to REM,
02/18/05 20:29:01 [USMLE_Step_2] docak: NE decreased during sleep
02/18/05 20:29:13 [USMLE_Step_2] docak: Dopamine cazes wakefulness
02/18/05 20:29:28 [USMLE_Step_2] lanny: oh thats good will remember now
02/18/05 20:29:31 [USMLE_Step_2] lanny: thx
02/18/05 20:29:33 [USMLE_Step_2] megs: thanx doc
02/18/05 20:29:38 [USMLE_Step_2] uniteus: thx
02/18/05 20:29:45 [USMLE_Step_2] docak: urw guys
02/18/05 20:29:56 [USMLE_Step_2] docak: i meant u are welcome :)
02/18/05 20:30:05 [USMLE_Step_2] uniteus: Causes of shortened sleep latency?
02/18/05 20:30:35 [USMLE_Step_2] docak: benzo
02/18/05 20:30:42 [USMLE_Step_2] docak: alcohol
02/18/05 20:30:43 [USMLE_Step_2] uniteus: yeah..
02/18/05 20:30:47 an_bo_al Logs Out
02/18/05 20:30:56 [USMLE_Step_2] uniteus: more?
02/18/05 20:30:58 [USMLE_Step_2] lanny: uni i think tiredness
02/18/05 20:31:12 [USMLE_Step_2] uniteus: sleep deprivation yeah lanny
02/18/05 20:31:23 [USMLE_Step_2] uniteus: more...2 more
02/18/05 20:31:25 Roxanita Logs Out
02/18/05 20:31:27 [USMLE_Step_2] lanny: yea you fall asleep faster when tired
02/18/05 20:31:49 [USMLE_Step_2] uniteus: narcolepsy
02/18/05 20:31:50 [USMLE_Step_2] lanny: depression?
02/18/05 20:32:03 [USMLE_Step_2] uniteus: yeah
02/18/05 20:32:18 [USMLE_Step_2] lanny: depression corrrect uni?
02/18/05 20:32:36 [USMLE_Step_2] uniteus: ok the answers r drug induced ( benzo), alcohol, sleep deprive , narcolepsy n dep
02/18/05 20:32:48 [USMLE_Step_2] uniteus: all right!
02/18/05 20:32:53 [USMLE_Step_2] docak: thx uni
02/18/05 20:33:05 [USMLE_Step_2] uniteus: welcome doc
02/18/05 20:33:55 [USMLE_Step_2] megs: nightmares...in which stage???
02/18/05 20:34:12 [USMLE_Step_2] megs: nightterrors in which???
02/18/05 20:34:13 [USMLE_Step_2] lanny: REM ?
02/18/05 20:34:14 [USMLE_Step_2] docak: rem
02/18/05 20:34:27 [USMLE_Step_2] uniteus: REM nightmares
02/18/05 20:34:46 [USMLE_Step_2] docak: night terrors in delta
02/18/05 20:34:49 [USMLE_Step_2] megs: T=NREM,M=REM
02/18/05 20:34:57 [USMLE_Step_2] docak: stages 3 & 4
02/18/05 20:34:58 [USMLE_Step_2] lanny: delta is stage 4
02/18/05 20:35:33 [USMLE_Step_2] docak: ok
02/18/05 20:35:55 an_bo_al Logs in
02/18/05 20:35:59 an_bo_al Logs Out
02/18/05 20:37:03 [USMLE_Step_2] megs: MOST OF THE SLEEP RELATED DISORDERS OCCURS IN.STAGE 3,4=NIGHTTERRORS,SOMNABULISM,ENURESIS
02/18/05 20:37:33 [USMLE_Step_2] uniteus: thx megs
02/18/05 20:38:04 [USMLE_Step_2] lanny: what about longer sleep latency what causes
02/18/05 20:39:49 [USMLE_Step_2] megs: ALCHOL WITHDRAWEL????
02/18/05 20:39:51 dua_frank Logs Out
02/18/05 20:40:11 [USMLE_Step_2] lanny: not sure megs will chk
02/18/05 20:40:31 [USMLE_Step_2] uniteus: whats the ans lanny?
02/18/05 20:40:45 [USMLE_Step_2] docak: alcohol and benzo withdrawl,depression,insomnia
02/18/05 20:40:55 [USMLE_Step_2] lanny: dunno maybe lack of sleep insomnia?
02/18/05 20:41:18 [USMLE_Step_2] lanny: doc just put it thx doc
02/18/05 20:41:20 [USMLE_Step_2] uniteus: almost same as shortened doc?
02/18/05 20:41:30 dua_frank Logs in
02/18/05 20:41:32 dua_frank Joins Subroom USMLE_Step_2
02/18/05 20:41:42 [USMLE_Step_2] docak: shortened is caz of intoxication
02/18/05 20:41:57 [USMLE_Step_2] docak: prolonged is caz of withdrawl
02/18/05 20:42:05 [USMLE_Step_2] uniteus: cool got cha
02/18/05 20:42:22 [USMLE_Step_2] uniteus: thx
02/18/05 20:42:54 [USMLE_Step_2] docak: wecome guys
02/18/05 20:44:35 [USMLE_Step_2] lanny: can we do some somatoform
02/18/05 20:44:42 [USMLE_Step_2] lanny: disorders?
02/18/05 20:44:44 [USMLE_Step_2] megs: OK LANNY
02/18/05 20:44:47 [USMLE_Step_2] docak: yea lanny
02/18/05 20:45:01 [USMLE_Step_2] lanny: diag of somatization do
02/18/05 20:45:28 [USMLE_Step_2] docak: didn't get ur q lanny
02/18/05 20:45:43 [USMLE_Step_2] lanny: diagnosis of somatization disorder?
02/18/05 20:46:06 [USMLE_Step_2] docak: no physicsl findings on examination
02/18/05 20:46:18 [USMLE_Step_2] lanny: corrct
02/18/05 20:46:23 [USMLE_Step_2] docak: i meant physical
02/18/05 20:46:35 [USMLE_Step_2] uniteus: usually at least 4 pains symptoms: 2 GI, 1 sexual, 1 pseudoneurologic
02/18/05 20:46:42 [USMLE_Step_2] lanny: for establishing diag confirm what diag?
02/18/05 20:46:47 [USMLE_Step_2] uniteus: but normal phy exam
02/18/05 20:46:52 [USMLE_Step_2] lanny: ok uni just answered
02/18/05 20:46:56 [USMLE_Step_2] docak: yes uni
02/18/05 20:47:04 [USMLE_Step_2] lanny: rioght uni
02/18/05 20:47:15 [USMLE_Step_2] uniteus: :)
02/18/05 20:47:31 [USMLE_Step_2] lanny: what should the doc strive to do when encounter these pts?
02/18/05 20:48:39 [USMLE_Step_2] docak: regularly scheduled brief visits
02/18/05 20:48:43 [USMLE_Step_2] uniteus: regular follow up wid one doc
02/18/05 20:49:09 [USMLE_Step_2] lanny: YES NEVER REFER TO ANOTHER DOC
02/18/05 20:49:12 megs Logs Out
02/18/05 20:49:43 [USMLE_Step_2] lanny: if the pt comes to you at closing time with these vague same complaints do you stay to see them?
02/18/05 20:49:57 [USMLE_Step_2] docak: yes
02/18/05 20:50:10 [USMLE_Step_2] uniteus: yup
02/18/05 20:51:04 [USMLE_Step_2] lanny: no dont stay over to see her,, this is the reason visits have to be scheduled regular and stick to it dont just see her at any time
02/18/05 20:51:26 [USMLE_Step_2] docak: oh did'nt know that!
02/18/05 20:51:44 [USMLE_Step_2] lanny: tell her to go home and schedule an appt for another visit
02/18/05 20:51:55 [USMLE_Step_2] uniteus: oh
02/18/05 20:52:19 [USMLE_Step_2] uniteus: how u diagnose hypochondriasis?
02/18/05 20:52:28 [USMLE_Step_2] lanny: this is the key to trt regularly scheduled brief visits
02/18/05 20:52:42 [USMLE_Step_2] docak: thx lanny
02/18/05 20:53:26 [USMLE_Step_2] lanny: if she comes in unscheduled during your working hours do you squeeze her in cause you haave tims..?
02/18/05 20:53:38 [USMLE_Step_2] docak: pt believes that they have one specific disease, and have all the classic book sym
02/18/05 20:53:39 [USMLE_Step_2] lanny: have time
02/18/05 20:53:57 [USMLE_Step_2] docak: no for lanny's Q
02/18/05 20:54:12 [USMLE_Step_2] uniteus: no lanny
02/18/05 20:54:31 [USMLE_Step_2] lanny: good doc again visits have to be regular once a month say and scheduled
02/18/05 20:54:37 [USMLE_Step_2] lanny: good uni
02/18/05 20:55:01 [USMLE_Step_2] uniteus: n wat else doc
02/18/05 20:55:02 [USMLE_Step_2] docak: is me ans for hypochon right uni?
02/18/05 20:55:20 [USMLE_Step_2] docak: i meant my ans!
02/18/05 20:55:35 [USMLE_Step_2] uniteus: not complete doc
02/18/05 20:55:44 [USMLE_Step_2] lanny: they cant be convinced otherwise
02/18/05 20:55:54 [USMLE_Step_2] lanny: despite tests etc
02/18/05 20:55:58 [USMLE_Step_2] docak: ok pls fill me in on the rt ans
02/18/05 20:56:24 [USMLE_Step_2] docak: agree with lanny
02/18/05 20:56:35 [USMLE_Step_2] lanny: oh you should make sure its not delusion
02/18/05 20:56:50 [USMLE_Step_2] uniteus: patient believe one specific disease..n doc do all test ..which are normal..but he is still convince he is stil sick despite reassurance
02/18/05 20:56:58 [USMLE_Step_2] uniteus: right lanny
02/18/05 20:57:07 [USMLE_Step_2] docak: thx guys
02/18/05 20:57:57 [USMLE_Step_2] lanny: conversion disorder
02/18/05 20:58:12 [USMLE_Step_2] lanny: diagnosis guys help me with this one dont know it
02/18/05 20:59:08 [USMLE_Step_2] docak: some stressor precipitates sudden neurolog sym
02/18/05 20:59:36 [USMLE_Step_2] docak: and pt is not concerned "la belle indifferance"
02/18/05 20:59:46 [USMLE_Step_2] uniteus: pt has experience a neurological symptoms but cant explained by any medical or neuro disorder...usually has a stressor that cus it
02/18/05 21:00:36 [USMLE_Step_2] lanny: has it got to be a neuro sms.
02/18/05 21:00:44 [USMLE_Step_2] uniteus: yeah lanny
02/18/05 21:00:52 [USMLE_Step_2] lanny: ok thanks
02/18/05 21:01:11 [USMLE_Step_2] lanny: thx guys
02/18/05 21:01:29 [USMLE_Step_2] uniteus: welcome lan
02/18/05 21:01:38 [USMLE_Step_2] uniteus: guys ..i've got to go
02/18/05 21:01:38 [USMLE_Step_2] docak: welcome lanny
02/18/05 21:01:45 [USMLE_Step_2] lanny: whats best trt for body dysmoorphic
02/18/05 21:02:04 [USMLE_Step_2] uniteus: nite guys...
02/18/05 21:02:08 [USMLE_Step_2] docak: psycho therapy
02/18/05 21:02:14 [USMLE_Step_2] docak: nite uni
02/18/05 21:02:32 [USMLE_Step_2] lanny: nite uni
02/18/05 21:02:34 [USMLE_Step_2] docak: may also use ssri
02/18/05 21:02:40 uniteus Logs Out
02/18/05 21:02:42 [USMLE_Step_2] lanny: correct doc
02/18/05 21:03:00 [USMLE_Step_2] lanny: how do you diff pain do from somatoform do
02/18/05 21:03:09 [USMLE_Step_2] docak: i guess its just us lanny, what happened to sanz?
02/18/05 21:03:31 [USMLE_Step_2] lanny: dunno maybe she got held up
02/18/05 21:03:32 [USMLE_Step_2] docak: and others?
02/18/05 21:03:49 [USMLE_Step_2] lanny: its friday night maybe they took a break
02/18/05 21:04:18 [USMLE_Step_2] docak: pain disorder chief complaint is pain
02/18/05 21:04:20 [USMLE_Step_2] lanny: in pain do you dont have the 4 2 1 diff systems involved right?
02/18/05 21:04:39 [USMLE_Step_2] docak: yea lanny
02/18/05 21:04:59 [USMLE_Step_2] lanny: and can be anywhere?
02/18/05 21:05:22 [USMLE_Step_2] docak: pain in one or more anattomic sites
02/18/05 21:05:43 [USMLE_Step_2] docak: more than half pts have depression
02/18/05 21:06:21 [USMLE_Step_2] lanny: ok got it in somat it is not necessarily pain sms could be other problems in multiple systems.
02/18/05 21:06:34 [USMLE_Step_2] docak: yes
02/18/05 21:06:38 [USMLE_Step_2] lanny: 2 gi 1 sex 1 neuro
02/18/05 21:06:54 [USMLE_Step_2] docak: correct lanny
02/18/05 21:07:20 [USMLE_Step_2] lanny: ok thanksok thx dua well im leaving now got to eat before its too late
02/18/05 21:07:38 [USMLE_Step_2] docak: ok lanny
02/18/05 21:07:41 [USMLE_Step_2] lanny: we went thru sleep and somatoform
02/18/05 21:07:55 [USMLE_Step_2] lanny: also covered some statistics
02/18/05 21:08:28 [USMLE_Step_2] lanny: so we will continue tom
02/18/05 21:08:38 [USMLE_Step_2] docak: ok lanny see u tom
02/18/05 21:09:00 [USMLE_Step_2] lanny: goodnight
02/18/05 21:09:10 [USMLE_Step_2] docak: good nite lanny
02/18/05 21:09:18 [USMLE_Step_2] docak: good nite guys
02/18/05 21:09:23 [USMLE_Step_2] docak: see u all tom







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