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View Full Version : Peds Chat: Endocrine, Opthalmology (Friday)



Asclepius1
02-26-2005, 11:14 PM
02/25/05 19:13:17 [USMLE_Step_2] dua_frank: endo and ophthal today
02/25/05 19:13:48 [USMLE_Step_2] megs: ok so lets start
02/25/05 19:14:17 [USMLE_Step_2] megs: type 1 dm what is the no 1 rik factor???
02/25/05 19:14:29 [USMLE_Step_2] dua_frank: heriditary
02/25/05 19:14:37 [USMLE_Step_2] megs: TYPE2 DM WHAT IS NO 1 RISK FACTOR???
02/25/05 19:14:41 [USMLE_Step_2] megs: GOOD DUA
02/25/05 19:14:44 [USMLE_Step_2] dua_frank: obesity
02/25/05 19:14:58 [USMLE_Step_2] dua_frank: age maybe :P
02/25/05 19:15:00 [USMLE_Step_2] megs: YEAH ..
02/25/05 19:15:04 [USMLE_Step_2] dua_frank: ok obesity :P
02/25/05 19:15:11 [USMLE_Step_2] megs: OBESITY
02/25/05 19:15:45 [USMLE_Step_2] lanny: also autoimmune diseases
02/25/05 19:15:46 [USMLE_Step_2] sanz: i think hereditary factor is more in DM2...
02/25/05 19:15:47 [USMLE_Step_2] samantha: HLA Dr3 DR4
02/25/05 19:15:59 fero Logs in
02/25/05 19:15:59 fero Joins Subroom USMLE_Step_2
02/25/05 19:16:02 [USMLE_Step_2] megs: SANZ THAT IS FOR ADULTS
02/25/05 19:16:06 [USMLE_Step_2] fero: hi everyone
02/25/05 19:16:30 uniteus Logs in
02/25/05 19:16:30 uniteus Joins Subroom USMLE_Step_2
02/25/05 19:16:44 [USMLE_Step_2] uniteus: hi guys
02/25/05 19:16:44 [USMLE_Step_2] megs: we are talking about kids..you are right about adult typee2 DM and genetic corelation
02/25/05 19:16:50 shreya Logs in
02/25/05 19:16:50 [USMLE_Step_2] sanz: really megs, there's a difference between kids and adults for DM?
02/25/05 19:16:59 [USMLE_Step_2] dua_frank: first symptom prolonged neonatal jaundice and then feeding problems, lethargy and constipation, dx?
02/25/05 19:17:01 shreya Joins Subroom USMLE_Step_2
02/25/05 19:17:04 [USMLE_Step_2] dua_frank: hi fero and uni
02/25/05 19:17:14 [USMLE_Step_2] megs: for no.1 risk factor ..only sanz
02/25/05 19:17:24 [USMLE_Step_2] megs: otherwise no difference
02/25/05 19:17:43 [USMLE_Step_2] fero: hypo thr
02/25/05 19:17:51 [USMLE_Step_2] megs: because i was also under the same imp about genetics and type2 dm
02/25/05 19:17:59 [USMLE_Step_2] megs: as yours
02/25/05 19:18:03 [USMLE_Step_2] dua_frank: right fero
02/25/05 19:18:39 [USMLE_Step_2] megs: what is the comonest cause of juvenile hypothyroidism??
02/25/05 19:19:05 [USMLE_Step_2] lanny: irradiation
02/25/05 19:19:09 [USMLE_Step_2] uniteus: from mother hyperthyr
02/25/05 19:19:24 [USMLE_Step_2] dua_frank: maternal radioiodine treatment?
02/25/05 19:19:29 [USMLE_Step_2] dua_frank: developmental
02/25/05 19:19:30 [USMLE_Step_2] megs: its HASHIMOTHOS
02/25/05 19:19:32 [USMLE_Step_2] sanz: autoimm
02/25/05 19:19:32 [USMLE_Step_2] fero: dysgenisis
02/25/05 19:19:40 roxanita Logs Out
02/25/05 19:19:45 [USMLE_Step_2] dua_frank: hashimotos? are you sure?
02/25/05 19:20:10 [USMLE_Step_2] dua_frank: what kind of anemia in hypothyroidism?
02/25/05 19:20:17 [USMLE_Step_2] fero: iron?
02/25/05 19:20:34 [USMLE_Step_2] dua_frank: microcytic
02/25/05 19:21:00 [USMLE_Step_2] megs: aquired hypothyroidism during childhood is called juvenile hypothyroidism :)
02/25/05 19:21:14 [USMLE_Step_2] megs: now dua u have to agree
02/25/05 19:21:43 [USMLE_Step_2] megs: i didnt say congenital dua
02/25/05 19:21:49 [USMLE_Step_2] samantha: macro
02/25/05 19:21:53 [USMLE_Step_2] dua_frank: right, i agree
02/25/05 19:22:06 [USMLE_Step_2] dua_frank: nice q megs
02/25/05 19:22:11 [USMLE_Step_2] megs: if congenital hypo then ans is maternal radiiodine
02/25/05 19:22:35 [USMLE_Step_2] dua_frank: that wouldn't be congenital
02/25/05 19:22:40 [USMLE_Step_2] dua_frank: that would still be acquired
02/25/05 19:22:55 [USMLE_Step_2] dua_frank: congenital would be more in the lines of developmental thyroid defects
02/25/05 19:22:57 [USMLE_Step_2] samantha: or enzyme def
02/25/05 19:22:57 [USMLE_Step_2] shreya: congenital dysgenesis is common.
02/25/05 19:22:57 [USMLE_Step_2] fero: dysgeni is congenital
02/25/05 19:23:08 Jee Joins Subroom USMLE_Step_2
02/25/05 19:23:09 [USMLE_Step_2] megs: good point dua
02/25/05 19:23:22 [USMLE_Step_2] lanny: agree with you dua
02/25/05 19:23:27 [USMLE_Step_2] dua_frank: how early should hypothy be detected in a neonate?
02/25/05 19:23:30 [USMLE_Step_2] Jee: hi everybody
02/25/05 19:23:33 [USMLE_Step_2] samantha: peroxidase def
02/25/05 19:23:35 [USMLE_Step_2] dua_frank: and if its not then what could it lead to?
02/25/05 19:23:36 [USMLE_Step_2] dua_frank: hi jee
02/25/05 19:23:47 [USMLE_Step_2] sanz: as early as pos
02/25/05 19:23:51 [USMLE_Step_2] sanz: if not cretinism
02/25/05 19:23:53 [USMLE_Step_2] dua_frank: time sanz?
02/25/05 19:23:53 [USMLE_Step_2] lanny: after first year
02/25/05 19:23:55 [USMLE_Step_2] uniteus: asap
02/25/05 19:24:07 [USMLE_Step_2] fero: 3 to 6 months...becomes abvious
02/25/05 19:24:09 [USMLE_Step_2] dua_frank: within one month actually
02/25/05 19:24:13 [USMLE_Step_2] sanz: we usu do blood test at day 5 in the UK
02/25/05 19:24:26 [USMLE_Step_2] dua_frank: if its delayed beyond 3 months it leads to permanent neuro and growth impairments
02/25/05 19:24:31 [USMLE_Step_2] dua_frank: right sanz
02/25/05 19:24:36 [USMLE_Step_2] lanny: youre talking about cretin
02/25/05 19:24:48 [USMLE_Step_2] megs: agree sanz
02/25/05 19:24:56 [USMLE_Step_2] lanny: which is common in UK
02/25/05 19:25:00 [USMLE_Step_2] dua_frank: whats the difference lanny?
02/25/05 19:25:15 [USMLE_Step_2] fero: its the same lanny
02/25/05 19:25:28 [USMLE_Step_2] fero: cretins r , hypothyriod babies
02/25/05 19:25:36 [USMLE_Step_2] sanz: agree fero
02/25/05 19:25:48 [USMLE_Step_2] lanny: i know that but cretinism sms are earlier
02/25/05 19:25:54 [USMLE_Step_2] dua_frank: same thing lanny
02/25/05 19:26:11 [USMLE_Step_2] dua_frank: hypothyroid babies resemble cretins
02/25/05 19:26:13 [USMLE_Step_2] fero: wats sms?
02/25/05 19:26:19 [USMLE_Step_2] lanny: acquired hypothy can be seen after first year
02/25/05 19:26:20 [USMLE_Step_2] dua_frank: so its called as cretinism
02/25/05 19:26:46 [USMLE_Step_2] samantha: screened at birth
02/25/05 19:26:55 [USMLE_Step_2] megs: yeah
02/25/05 19:26:58 [USMLE_Step_2] samantha: for hypothyroidism
02/25/05 19:27:33 [USMLE_Step_2] shreya: if acquired brain damage wont occur i think
02/25/05 19:27:47 [USMLE_Step_2] dua_frank: shreya are you sure?
02/25/05 19:27:58 [USMLE_Step_2] lanny: if we talking about juven hypo then its acquired haashimoto common cause
02/25/05 19:28:01 [USMLE_Step_2] samantha: in utero mother's TSH is there
02/25/05 19:28:03 [USMLE_Step_2] dua_frank: i think any low thyroid state causes neuro damage
02/25/05 19:28:12 [USMLE_Step_2] shreya: not exactly brain damage - deaf mutism.
02/25/05 19:28:39 [USMLE_Step_2] megs: what is etiology of cretinism ///
02/25/05 19:28:46 [USMLE_Step_2] lanny: congenital hypo is cretinism and sms are earlier
02/25/05 19:28:49 [USMLE_Step_2] dua_frank: congenital megs
02/25/05 19:29:02 [USMLE_Step_2] megs: but what is that dua
02/25/05 19:29:16 [USMLE_Step_2] dua_frank: dysgenesis
02/25/05 19:29:24 [USMLE_Step_2] dua_frank: thyroid developmental defects
02/25/05 19:29:30 sanz Logs Out
02/25/05 19:29:30 [USMLE_Step_2] shreya: cretins are two types..neurological cretins & myxoedematous cretins.
02/25/05 19:29:47 malak1993 Logs in
02/25/05 19:29:51 malak1993 Joins Subroom USMLE_Step_1
02/25/05 19:29:53 [USMLE_Step_2] dua_frank: didn't know that shreya, thanks, tell us more please
02/25/05 19:30:26 sanz Logs in
02/25/05 19:30:27 sanz Joins Subroom USMLE_Step_2
02/25/05 19:30:31 [USMLE_Step_2] megs: isnt maternal consumtion of antithyroid drugs causes cretinism dua
02/25/05 19:30:44 [USMLE_Step_2] sanz: no megs
02/25/05 19:30:48 [USMLE_Step_2] shreya: in neurologic cretin u see- deaf mutism, m.r , spastic & rigid neuromotor disorders
02/25/05 19:31:07 [USMLE_Step_2] dua_frank: no megs
02/25/05 19:31:10 [USMLE_Step_2] fero: i find it strange too,,kaplan said about acquired hypo that school grades and work ,not effected
02/25/05 19:31:21 [USMLE_Step_2] lanny: megs that can cause transient hypothyroid
02/25/05 19:31:27 [USMLE_Step_2] megs: ok so it will cause just transient hypo
02/25/05 19:31:31 [USMLE_Step_2] megs: got it
02/25/05 19:31:49 [USMLE_Step_2] dua_frank: good points people
02/25/05 19:32:34 [USMLE_Step_2] dua_frank: low calcium, low phosphorus and high alkaline phosphatase, dx?
02/25/05 19:32:52 [USMLE_Step_2] fero: vit d def, sec hypo para
02/25/05 19:33:04 [USMLE_Step_2] dua_frank: rickets
02/25/05 19:33:09 [USMLE_Step_2] dua_frank: yes
02/25/05 19:33:15 [USMLE_Step_2] megs: agree
02/25/05 19:33:16 [USMLE_Step_2] uniteus: nutritional vit d def
02/25/05 19:33:20 [USMLE_Step_2] lanny: ricket
02/25/05 19:33:30 [USMLE_Step_2] shreya: myxoedematous cretin- retarded psychomotor dev, shortstature, coarse facial features, myxoedema without deaf mutism.
02/25/05 19:33:55 [USMLE_Step_2] dua_frank: thanks shreya
02/25/05 19:34:04 [USMLE_Step_2] shreya: welcome.
02/25/05 19:34:13 [USMLE_Step_2] lanny: thks shreyaz
02/25/05 19:34:35 [USMLE_Step_2] shreya: wlcm
02/25/05 19:35:16 [USMLE_Step_2] megs: nice shreya
02/25/05 19:35:40 [USMLE_Step_2] dua_frank: why low phos in rickets?
02/25/05 19:36:09 [USMLE_Step_2] megs: excretion by kidneys dua
02/25/05 19:36:10 [USMLE_Step_2] fero: vit d role is to absorb phos..so thats not working
02/25/05 19:36:28 [USMLE_Step_2] dua_frank: PTH elevation
02/25/05 19:36:42 [USMLE_Step_2] fero: how come dua?
02/25/05 19:36:51 [USMLE_Step_2] dua_frank: low calcium stimulates PTH
02/25/05 19:36:56 [USMLE_Step_2] dua_frank: PTH inturn causes low phos
02/25/05 19:37:06 [USMLE_Step_2] fero: if pth was elevated, ca would have been high
02/25/05 19:37:27 [USMLE_Step_2] dua_frank: vit d causes ca reabs mainly
02/25/05 19:37:35 [USMLE_Step_2] megs: there is secondery rise in pth fero
02/25/05 19:37:36 [USMLE_Step_2] dua_frank: no matter how high PTH is , ca will not be elevated
02/25/05 19:38:12 [USMLE_Step_2] samantha: yes you are right
02/25/05 19:38:22 [USMLE_Step_2] dua_frank: which is the enzyme missing?
02/25/05 19:38:22 [USMLE_Step_2] lanny: ccause vit d not working
02/25/05 19:38:29 [USMLE_Step_2] dua_frank: right lanny
02/25/05 19:39:23 [USMLE_Step_2] shreya: hydroxylase ?
02/25/05 19:39:32 [USMLE_Step_2] dua_frank: right shreya
02/25/05 19:39:36 [USMLE_Step_2] dua_frank: renal hydroxylase
02/25/05 19:39:55 [USMLE_Step_2] dua_frank: so in this case, is 25 oh2 d3 high or low?
02/25/05 19:40:05 [USMLE_Step_2] lanny: its 1 alpha if im not mistaken
02/25/05 19:40:06 [USMLE_Step_2] dua_frank: vit d dependent rickets that is...
02/25/05 19:40:30 [USMLE_Step_2] lanny: low
02/25/05 19:40:33 [USMLE_Step_2] uniteus: low 1,25oh2d3
02/25/05 19:40:44 [USMLE_Step_2] dua_frank: i asked 25 oh
02/25/05 19:40:46 [USMLE_Step_2] dua_frank: its high
02/25/05 19:40:50 [USMLE_Step_2] dua_frank: its 1, 25 thats low
02/25/05 19:40:55 [USMLE_Step_2] dua_frank: 25 is at liver level
02/25/05 19:41:05 [USMLE_Step_2] lanny: yea high no enzyme to conv it to 1 25
02/25/05 19:41:07 [USMLE_Step_2] samantha: high
02/25/05 19:41:12 [USMLE_Step_2] megs: agree dua
02/25/05 19:41:14 [USMLE_Step_2] dua_frank: so all renal diseases will have low 1,25 but high 25
02/25/05 19:41:29 [USMLE_Step_2] lanny: supposedly
02/25/05 19:41:34 [USMLE_Step_2] dua_frank: but all liver diseases causing rickets will have both low
02/25/05 19:41:55 [USMLE_Step_2] fero: rt,,,25 hydoxalation takes place in liver
02/25/05 19:42:02 [USMLE_Step_2] dua_frank: right
02/25/05 19:42:11 [USMLE_Step_2] lanny: dec intest abs of vit d in liver dz
02/25/05 19:42:21 [USMLE_Step_2] dua_frank: how about chronic anticonculsant therapy? 25 low or high?
02/25/05 19:42:26 [USMLE_Step_2] dua_frank: think think think
02/25/05 19:42:32 [USMLE_Step_2] lanny: or dec hydroxyl of vit d in liver
02/25/05 19:43:03 [USMLE_Step_2] Jee: low
02/25/05 19:43:12 [USMLE_Step_2] dua_frank: good jee
02/25/05 19:43:15 [USMLE_Step_2] shreya: low
02/25/05 19:43:19 [USMLE_Step_2] lanny: agree
02/25/05 19:43:22 [USMLE_Step_2] megs: how ///
02/25/05 19:43:39 [USMLE_Step_2] dua_frank: see phenobarbitol and phenytoid cause increased metabolism of 25ohd3
02/25/05 19:43:42 [USMLE_Step_2] dua_frank: so low 25
02/25/05 19:44:01 [USMLE_Step_2] dua_frank: in the liver ofcourse...
02/25/05 19:44:04 [USMLE_Step_2] lanny: these drugs inhib the metab of 25
02/25/05 19:44:13 [USMLE_Step_2] megs: ok
02/25/05 19:44:14 [USMLE_Step_2] dua_frank: inc metab lanny
02/25/05 19:44:17 [USMLE_Step_2] lanny: sorry thet inc
02/25/05 19:44:26 [USMLE_Step_2] lanny: yes just corrected thx
02/25/05 19:44:26 [USMLE_Step_2] fero: wow..dua where did u read this?book?
02/25/05 19:44:27 [USMLE_Step_2] dua_frank: oh wait
02/25/05 19:44:45 [USMLE_Step_2] dua_frank: not increased metab but dec synthesis
02/25/05 19:44:55 [USMLE_Step_2] dua_frank: these drugs prevent syn of 25oh in liever
02/25/05 19:44:56 dani252 Disconnects
02/25/05 19:44:57 [USMLE_Step_2] uniteus: decrease
02/25/05 19:45:11 [USMLE_Step_2] dua_frank: yes book fero
02/25/05 19:45:18 [USMLE_Step_2] dua_frank: i'm not that intelligent to come up with this on my own :P
02/25/05 19:45:19 [USMLE_Step_2] megs: what type1 and type 2 rickets??
02/25/05 19:45:20 [USMLE_Step_2] fero: which one?
02/25/05 19:45:25 [USMLE_Step_2] lanny: well if their metab is inc then their synthesis is low
02/25/05 19:45:35 [USMLE_Step_2] dua_frank: yes lanny, either ways low 25oh
02/25/05 19:45:39 [USMLE_Step_2] dua_frank: thats what matters
02/25/05 19:45:41 [USMLE_Step_2] lanny: agree
02/25/05 19:45:48 [USMLE_Step_2] fero: good point
02/25/05 19:45:56 [USMLE_Step_2] lanny: at least we understand what is generally happening
02/25/05 19:45:58 [USMLE_Step_2] dua_frank: sometimes they might confuse us by giving us these labs with inc and dec levels of 25 and 1,15
02/25/05 19:46:04 [USMLE_Step_2] dua_frank: and give us that its rickets already
02/25/05 19:46:10 [USMLE_Step_2] dua_frank: and ask us the etiology
02/25/05 19:46:21 [USMLE_Step_2] megs: yup dua good point u raised
02/25/05 19:46:24 [USMLE_Step_2] lanny: yes rickets is a confusing topic 3 or 4 causes
02/25/05 19:46:28 [USMLE_Step_2] dua_frank: yes
02/25/05 19:46:51 [USMLE_Step_2] fero: r u guys using kaplan for peds????
02/25/05 19:46:54 [USMLE_Step_2] lanny: a child with epilepsy...
02/25/05 19:47:10 [USMLE_Step_2] lanny: a child with chronic renal failure
02/25/05 19:47:19 [USMLE_Step_2] dua_frank: which other type of rickets would have dec syn of 1,25 oh along with phosphate wasting in kidneys
02/25/05 19:47:25 [USMLE_Step_2] lanny: a child with biliary atresia
02/25/05 19:47:26 [USMLE_Step_2] dua_frank: yes fero
02/25/05 19:47:32 [USMLE_Step_2] samantha: a doubt dua PTH inc ca by mobilizing bone?
02/25/05 19:47:35 [USMLE_Step_2] dua_frank: yeah lanny
02/25/05 19:48:13 [USMLE_Step_2] lanny: i think its a familial type?
02/25/05 19:48:30 [USMLE_Step_2] dua_frank: yes sammy but kids don't have that much calcium in their bones
02/25/05 19:48:40 [USMLE_Step_2] dua_frank: osteoid is still forming in them
02/25/05 19:48:48 [USMLE_Step_2] samantha: oh..
02/25/05 19:48:53 [USMLE_Step_2] megs: yeah samy aso increses ca absorbtion from kidney
02/25/05 19:49:13 [USMLE_Step_2] lanny: either hypophosphateemia or something of the sort?
02/25/05 19:49:28 [USMLE_Step_2] dua_frank: which is why bones in them are soft and metaphyses widened
02/25/05 19:49:52 [USMLE_Step_2] lanny: dua am i right
02/25/05 19:50:00 [USMLE_Step_2] dua_frank: lanny its x linked hypophosphatemia
02/25/05 19:50:19 [USMLE_Step_2] megs: u mean vit d resistant richets dua
02/25/05 19:50:29 [USMLE_Step_2] dua_frank: nope
02/25/05 19:50:34 [USMLE_Step_2] dua_frank: theres a difference
02/25/05 19:50:40 [USMLE_Step_2] samantha: thx dua and megs
02/25/05 19:50:47 [USMLE_Step_2] dua_frank: this comes under vit d resistant rickets
02/25/05 19:50:53 [USMLE_Step_2] dua_frank: oh yeah megs sorry same thing
02/25/05 19:51:03 [USMLE_Step_2] dua_frank: i thought you were talking about vit d dependent
02/25/05 19:51:05 [USMLE_Step_2] dua_frank: my mistake
02/25/05 19:51:09 [USMLE_Step_2] dua_frank: yes vit d resistant
02/25/05 19:51:19 [USMLE_Step_2] megs: ok dua no prb
02/25/05 19:51:29 [USMLE_Step_2] dua_frank: here you will find serum calcium normal
02/25/05 19:51:35 [USMLE_Step_2] dua_frank: PTH normal too
02/25/05 19:52:24 [USMLE_Step_2] dua_frank: so no point in giving vit d here as the renal tubules are resistant to vt d3
02/25/05 19:52:40 [USMLE_Step_2] megs: yup dua
02/25/05 19:52:51 [USMLE_Step_2] dua_frank: so how would you treat such a case megs?
02/25/05 19:52:54 [USMLE_Step_2] dua_frank: only calcium?
02/25/05 19:53:16 [USMLE_Step_2] megs: i think so dua but will chek
02/25/05 19:53:24 [USMLE_Step_2] dua_frank: but calcium levels are normal too
02/25/05 19:53:35 [USMLE_Step_2] dua_frank: maybe biphosphonates or something, not sure
02/25/05 19:53:50 [USMLE_Step_2] lanny: dua is vit d dep and vit d resist the same?
02/25/05 19:54:19 [USMLE_Step_2] dua_frank: no lanny
02/25/05 19:54:31 [USMLE_Step_2] dua_frank: vit d dependent rickets are the ones i talked about before
02/25/05 19:54:42 [USMLE_Step_2] lanny: what is the resist type?
02/25/05 19:54:59 [USMLE_Step_2] dua_frank: the renal diseases, liever diseases and vit d dependent rickets due to absence of enzyme renal hydrolase
02/25/05 19:55:04 [USMLE_Step_2] dua_frank: hydroxylase
02/25/05 19:55:34 [USMLE_Step_2] dua_frank: this one is where renal tubules are insensitive to vit d
02/25/05 19:55:52 [USMLE_Step_2] megs: dua organic phosphates is the treatment but it is diff to traet
02/25/05 19:55:52 [USMLE_Step_2] dua_frank: the labs will be normal here
02/25/05 19:56:08 [USMLE_Step_2] dua_frank: except for low phosphorus
02/25/05 19:56:20 [USMLE_Step_2] dua_frank: so ok give phos
02/25/05 19:56:23 [USMLE_Step_2] dua_frank: thats easy
02/25/05 19:56:28 [USMLE_Step_2] dua_frank: low phos, give phos :P
02/25/05 19:56:43 [USMLE_Step_2] megs: just now read ..treatment is organic phosphate
02/25/05 19:56:48 [USMLE_Step_2] dua_frank: thanks megs
02/25/05 19:56:58 [USMLE_Step_2] fero: goljan has div vit d dependant rickets in 2
02/25/05 19:57:02 [USMLE_Step_2] dua_frank: in all other cases, give calcium and vit d
02/25/05 19:57:11 [USMLE_Step_2] megs: yup
02/25/05 19:57:17 [USMLE_Step_2] dua_frank: clear then?
02/25/05 19:57:18 [USMLE_Step_2] fero: type 1 is > the one with dec 1 alpha hydox def
02/25/05 19:57:38 [USMLE_Step_2] megs: yeah fero
02/25/05 19:57:40 [USMLE_Step_2] fero: type 2> is with vit d rec absent
02/25/05 19:57:48 [USMLE_Step_2] megs: agree
02/25/05 19:58:35 [USMLE_Step_2] dua_frank: more than remembering it as types
02/25/05 19:58:39 [USMLE_Step_2] megs: what is diff between cushings syndrome and cushings diseas??
02/25/05 19:58:52 [USMLE_Step_2] dua_frank: its better we remember them as conditions causing vit d dependent and resistant rickets fero
02/25/05 19:59:06 [USMLE_Step_2] dua_frank: makes management part easier
02/25/05 19:59:14 [USMLE_Step_2] dua_frank: as well as easier to recognise from the labs
02/25/05 19:59:16 [USMLE_Step_2] fero: rt..but both r called vit d dependent....
02/25/05 19:59:16 [USMLE_Step_2] uniteus: cushing disease is pituitary while syndrome is elsewhere
02/25/05 19:59:21 [USMLE_Step_2] megs: good to know both fero and dua
02/25/05 19:59:28 [USMLE_Step_2] dua_frank: oh right yes
02/25/05 19:59:30 [USMLE_Step_2] megs: nope uni
02/25/05 19:59:52 [USMLE_Step_2] dua_frank: yeah megs ectopic focus causes syndrome
02/25/05 19:59:53 [USMLE_Step_2] lanny: cushing synd is adrenal gland dysfunction
02/25/05 20:00:02 [USMLE_Step_2] dua_frank: pituatary disease
02/25/05 20:00:04 [USMLE_Step_2] lanny: and ectopic
02/25/05 20:00:19 [USMLE_Step_2] dua_frank: anything that is not from pit is syndrome megs
02/25/05 20:00:24 [USMLE_Step_2] lanny: disease is pit gland involve
02/25/05 20:00:28 [USMLE_Step_2] fero: pit cushing> disease
02/25/05 20:00:32 [USMLE_Step_2] lanny: agree dua
02/25/05 20:00:38 [USMLE_Step_2] megs: are u sure dua
02/25/05 20:00:41 [USMLE_Step_2] uniteus: i mean the syndrome is not part of pituitary disease
02/25/05 20:00:45 [USMLE_Step_2] dua_frank: yes megs sure
02/25/05 20:01:05 [USMLE_Step_2] lanny: ectopic is a syndrome too
02/25/05 20:01:12 [USMLE_Step_2] megs: i think u are saying other way round
02/25/05 20:01:22 [USMLE_Step_2] dua_frank: no no
02/25/05 20:01:26 [USMLE_Step_2] uniteus: no meg
02/25/05 20:01:39 [USMLE_Step_2] samantha: cushings disease is pituitary
02/25/05 20:01:50 [USMLE_Step_2] uniteus: cushing disease = pituitary
02/25/05 20:01:53 [USMLE_Step_2] samantha: and everything else is syndrome
02/25/05 20:01:57 [USMLE_Step_2] megs: ok will ckeck guys
02/25/05 20:01:59 [USMLE_Step_2] lanny: agree sam
02/25/05 20:02:11 [USMLE_Step_2] fero: i checked,,pit > dis
02/25/05 20:02:36 [USMLE_Step_2] megs: agree u guys
02/25/05 20:02:38 [USMLE_Step_2] megs: thanx
02/25/05 20:02:42 [USMLE_Step_2] megs: sorry
02/25/05 20:02:45 [USMLE_Step_2] dua_frank: its also the basis of that one test
02/25/05 20:02:53 [USMLE_Step_2] dua_frank: to differentiate disease from syndrome
02/25/05 20:02:59 [USMLE_Step_2] dua_frank: checks ACTH levels right?
02/25/05 20:03:03 [USMLE_Step_2] dua_frank: whats that test?
02/25/05 20:03:04 [USMLE_Step_2] megs: dexa met supression
02/25/05 20:03:17 [USMLE_Step_2] lanny: DEXA high dose suppression test
02/25/05 20:03:19 [USMLE_Step_2] uniteus: dex meth suppression low first
02/25/05 20:03:22 [USMLE_Step_2] megs: i mean dexamethasone supression
02/25/05 20:03:24 [USMLE_Step_2] uniteus: then high
02/25/05 20:03:37 [USMLE_Step_2] dua_frank: explain how the picture is in both please
02/25/05 20:03:38 [USMLE_Step_2] dua_frank: after this test
02/25/05 20:04:19 [USMLE_Step_2] fero: test> cortisol is suppressed in pit cushing but not the other types
02/25/05 20:04:38 [USMLE_Step_2] samantha: 2mg and 8mg tests
02/25/05 20:05:06 [USMLE_Step_2] fero: i talked about the high dose dexa test
02/25/05 20:05:07 [USMLE_Step_2] megs: agree fero
02/25/05 20:05:19 [USMLE_Step_2] samantha: sorry 8mg
02/25/05 20:05:48 [USMLE_Step_2] dua_frank: ok
02/25/05 20:05:51 [USMLE_Step_2] dua_frank: thanks fero

02/25/05 20:07:39 [USMLE_Step_2] megs: what is low dose dexa test??
02/25/05 20:07:53 [USMLE_Step_2] dua_frank: no idea, explain please
02/25/05 20:08:02 [USMLE_Step_2] dua_frank: too volatile for me, keep forgetting this
02/25/05 20:08:20 [USMLE_Step_2] fero: same here
02/25/05 20:08:23 [USMLE_Step_2] samantha: in case of adrenal adenoma it is not suppressed
02/25/05 20:09:00 [USMLE_Step_2] megs: agree samy
02/25/05 20:09:02 [USMLE_Step_2] samantha: in case high dose dexa and then to ct
02/25/05 20:09:25 [USMLE_Step_2] dua_frank: say what? :P
02/25/05 20:09:34 [USMLE_Step_2] megs: i will explain low dose dexa test
02/25/05 20:09:59 [USMLE_Step_2] fero: low dose dexa cannot suppress, cortisol in pit/adrenal r actopic cush syn
02/25/05 20:10:12 [USMLE_Step_2] dua_frank: please consider me mentally retarted and come down to my level and explain please :P
02/25/05 20:10:30 [USMLE_Step_2] samantha: do CT scan to diagnose adrenal adenoma
02/25/05 20:10:31 [USMLE_Step_2] fero: high dose can supress , can only supress the pit dis
02/25/05 20:10:54 [USMLE_Step_2] uniteus: the first screening test is low dose dexa --> usually Abnormal no suppression
02/25/05 20:11:11 [USMLE_Step_2] uniteus: this means that there is cushing syndrome or disease
02/25/05 20:11:17 [USMLE_Step_2] dua_frank: ok
02/25/05 20:11:18 [USMLE_Step_2] uniteus: so u do high dose dexam
02/25/05 20:11:25 [USMLE_Step_2] uniteus: to differentiate them
02/25/05 20:11:42 [USMLE_Step_2] uniteus: n only cushing disease will suppress the high dose dexa
02/25/05 20:11:43 [USMLE_Step_2] fero: rt uni, u exp it better then me
02/25/05 20:11:56 [USMLE_Step_2] megs: if low dose dexa fails to supress pituitory and high dose does it ...it means
02/25/05 20:12:02 [USMLE_Step_2] dua_frank: uni :cl :-happy :lolup:
02/25/05 20:12:11 [USMLE_Step_2] uniteus: :congrats:
02/25/05 20:12:15 [USMLE_Step_2] dua_frank: lol
02/25/05 20:12:57 [USMLE_Step_2] uniteus: high dexamethasone will be suppressed ONLY in cushing's disease (pituitary) megs
02/25/05 20:13:06 [USMLE_Step_2] megs: ok uni
02/25/05 20:13:07 [USMLE_Step_2] fero: rt uni
02/25/05 20:13:10 [USMLE_Step_2] lanny: agree uni
02/25/05 20:13:11 [USMLE_Step_2] samantha: yes uni right
02/25/05 20:13:28 [USMLE_Step_2] megs: right
02/25/05 20:13:28 [USMLE_Step_2] lanny: dua i know youre confused
02/25/05 20:13:38 [USMLE_Step_2] lanny: but its not diff..
02/25/05 20:14:36 [USMLE_Step_2] fero: plasma ACTH? IN PIT CUSH? ADRENAL CUSH? and ectopic cush?
02/25/05 20:14:47 [USMLE_Step_2] dua_frank: i got it lanny
02/25/05 20:15:12 [USMLE_Step_2] dua_frank: low high low
02/25/05 20:15:25 [USMLE_Step_2] fero: try again
02/25/05 20:15:29 [USMLE_Step_2] dua_frank: low low low :P
02/25/05 20:15:35 [USMLE_Step_2] fero: lol
02/25/05 20:15:35 [USMLE_Step_2] lanny: high low low
02/25/05 20:15:39 [USMLE_Step_2] dua_frank: lol
02/25/05 20:16:01 [USMLE_Step_2] uniteus: low low high
02/25/05 20:16:08 [USMLE_Step_2] fero: rt uni
02/25/05 20:16:21 [USMLE_Step_2] fero: partly
02/25/05 20:16:22 [USMLE_Step_2] dua_frank: more like normal in ectopic right?
02/25/05 20:16:29 [USMLE_Step_2] lanny: dont agree uni
02/25/05 20:16:39 [USMLE_Step_2] fero: in actopic , ACTH will b markly elevated
02/25/05 20:16:44 [USMLE_Step_2] dua_frank: man
02/25/05 20:16:54 [USMLE_Step_2] fero: pit cush> normal to increased
02/25/05 20:17:00 [USMLE_Step_2] uniteus: where did i go wrong fero?
02/25/05 20:17:11 [USMLE_Step_2] uniteus: ok..got it
02/25/05 20:17:12 [USMLE_Step_2] megs: i agree with lanny
02/25/05 20:17:17 [USMLE_Step_2] fero: adrenal cush>low
02/25/05 20:17:24 [USMLE_Step_2] uniteus: thx
02/25/05 20:17:41 [USMLE_Step_2] dua_frank: ok so high/normal. high , higher
02/25/05 20:18:07 [USMLE_Step_2] fero: dua.............. high to normal/LOW/ HIGH
02/25/05 20:18:35 [USMLE_Step_2] dua_frank: why low in pit?
02/25/05 20:18:39 [USMLE_Step_2] megs: high low and highest in ectopic
02/25/05 20:18:49 [USMLE_Step_2] fero: WHO SAID
02/25/05 20:19:02 [USMLE_Step_2] dua_frank: ok why low in adrenal?
02/25/05 20:19:15 [USMLE_Step_2] fero: PIT> normal to high :(
02/25/05 20:19:25 [USMLE_Step_2] dua_frank: sorry i said :P
02/25/05 20:19:26 [USMLE_Step_2] megs: pituitory=high adrenal low and ectopic highest
02/25/05 20:19:36 [USMLE_Step_2] megs: am i correct fero
02/25/05 20:19:36 [USMLE_Step_2] dua_frank: why low in adrenal?
02/25/05 20:19:37 [USMLE_Step_2] fero: because thas a prim disorder
02/25/05 20:19:50 [USMLE_Step_2] fero: cortisol is low so ACTH has to b high
02/25/05 20:19:59 [USMLE_Step_2] dua_frank: ok
02/25/05 20:20:06 [USMLE_Step_2] fero: feed back mech..
02/25/05 20:20:10 [USMLE_Step_2] dua_frank: but in adrenal too you have low cortisol
02/25/05 20:20:15 [USMLE_Step_2] dua_frank: so why isn't ACTH high in that then?
02/25/05 20:20:31 [USMLE_Step_2] megs: thers is excess productin of cortisol by adrenals hense acth supressed dua
02/25/05 20:20:35 [USMLE_Step_2] fero: i talked abot adrenal dear
02/25/05 20:20:53 [USMLE_Step_2] uniteus: *)
02/25/05 20:21:07 [USMLE_Step_2] lanny: ACTH is low in adrenal
02/25/05 20:21:17 [USMLE_Step_2] megs: yup lanny
02/25/05 20:21:19 [USMLE_Step_2] fero: rt uni
02/25/05 20:21:23 [USMLE_Step_2] dua_frank: i'll have to read about this
02/25/05 20:21:37 [USMLE_Step_2] lanny: why not let someone chk it and avoid this
02/25/05 20:21:40 [USMLE_Step_2] fero: given niclyt in goljan dua
02/25/05 20:21:49 [USMLE_Step_2] megs: i checked guys
02/25/05 20:21:49 [USMLE_Step_2] fero: i dis chheck it
02/25/05 20:21:50 [USMLE_Step_2] dua_frank: thanks fero
02/25/05 20:21:55 [USMLE_Step_2] fero: did
02/25/05 20:22:47 [USMLE_Step_2] lanny: therthere is no feedback in ectopic right?
02/25/05 20:23:05 [USMLE_Step_2] fero: rt.. lanny
02/25/05 20:23:20 [USMLE_Step_2] megs: rt lanny hence acth is very high
02/25/05 20:23:31 [USMLE_Step_2] lanny: agree megs
02/25/05 20:24:27 [USMLE_Step_2] lanny: can we talk about growth?
02/25/05 20:24:31 [USMLE_Step_2] megs: ok what are the causes of short stature in a kid??
02/25/05 20:24:40 [USMLE_Step_2] lanny: familial
02/25/05 20:24:44 [USMLE_Step_2] fero: achondroplasia
02/25/05 20:24:44 [USMLE_Step_2] megs: lanny :)
02/25/05 20:24:52 [USMLE_Step_2] samantha: growth hormone def
02/25/05 20:25:09 [USMLE_Step_2] lanny: megs?
02/25/05 20:25:15 [USMLE_Step_2] samantha: hypothyroidism
02/25/05 20:25:41 [USMLE_Step_2] megs: nothing lanny same topic we wanted to raise growth
02/25/05 20:25:49 [USMLE_Step_2] megs: agre all
02/25/05 20:25:57 [USMLE_Step_2] megs: which one is commonest
02/25/05 20:25:59 [USMLE_Step_2] lanny: oh yea time to leave ACTH alone!! lol
02/25/05 20:26:15 [USMLE_Step_2] lanny: familila
02/25/05 20:26:40 [USMLE_Step_2] megs: familian and constitutional delay both
02/25/05 20:27:03 [USMLE_Step_2] megs: how to distinguish them???
02/25/05 20:27:38 [USMLE_Step_2] lanny: rule out thyroid dys and chronic dz?
02/25/05 20:27:52 [USMLE_Step_2] megs: by taking x ray and determining bone age...
02/25/05 20:28:02 [USMLE_Step_2] shreya: with help of growth charts megs??
02/25/05 20:28:11 [USMLE_Step_2] uniteus: and family history
02/25/05 20:28:34 [USMLE_Step_2] lanny: what will they show
02/25/05 20:28:37 [USMLE_Step_2] lanny: megs
02/25/05 20:29:08 [USMLE_Step_2] shreya: im not sure..
02/25/05 20:29:17 [USMLE_Step_2] megs: familial short stature will show bone age apropriate for that age
02/25/05 20:29:34 [USMLE_Step_2] lanny: oh ok thx megs
02/25/05 20:29:54 [USMLE_Step_2] megs: constitutional delay will be lagging bone parameters
02/25/05 20:30:03 [USMLE_Step_2] megs: lagging bone growth
02/25/05 20:30:36 [USMLE_Step_2] megs: what is treatment pog constitutional delay
02/25/05 20:30:49 [USMLE_Step_2] lanny: which one the child grows normal and then stops growing?
02/25/05 20:30:56 [USMLE_Step_2] megs: uni u too correct regarding history...family
02/25/05 20:31:22 [USMLE_Step_2] uniteus: ok
02/25/05 20:31:31 [USMLE_Step_2] megs: didnt get u r q lanny
02/25/05 20:32:01 [USMLE_Step_2] lanny: which one of the 2 does the child starts growing normal but then growth slows?
02/25/05 20:32:11 [USMLE_Step_2] dua_frank: constitutional delay?
02/25/05 20:32:42 [USMLE_Step_2] megs: agree dua
02/25/05 20:32:46 [USMLE_Step_2] lanny: right
02/25/05 20:32:47 [USMLE_Step_2] uniteus: constittional
02/25/05 20:32:52 [USMLE_Step_2] lanny: right uni
02/25/05 20:32:58 [USMLE_Step_2] dua_frank: delay= slow
02/25/05 20:33:01 [USMLE_Step_2] dua_frank: hint :P
02/25/05 20:33:18 [USMLE_Step_2] lanny: in familia theyare under the 5th percentile
02/25/05 20:35:04 [USMLE_Step_2] megs: which one is associated with delayed puberty??
02/25/05 20:35:27 [USMLE_Step_2] lanny: constit delay
02/25/05 20:35:35 [USMLE_Step_2] megs: constitutional..right
02/25/05 20:36:18 [USMLE_Step_2] megs: what about growth hormone deficiency??/
02/25/05 20:36:33 [USMLE_Step_2] megs: what is clinical presentation i mean
02/25/05 20:37:33 [USMLE_Step_2] megs: GH DEFICIENCY GROW AT SLW RATE LESS THAN 5 CM PER YEAR
02/25/05 20:37:47 [USMLE_Step_2] megs: HEY ALL WHERE ARE U ALL???
02/25/05 20:37:56 [USMLE_Step_2] samantha: early epiphysial closure?
02/25/05 20:37:59 [USMLE_Step_2] fero: here
02/25/05 20:38:05 [USMLE_Step_2] megs: OK
02/25/05 20:38:12 [USMLE_Step_2] fero: didnt come across this topic
02/25/05 20:38:22 [USMLE_Step_2] dua_frank: reading you megs
02/25/05 20:38:33 [USMLE_Step_2] lanny: GH def also has skeletal probs
02/25/05 20:38:36 [USMLE_Step_2] megs: :( I THOUGHT I AM BOARING U ALL
02/25/05 20:38:36 [USMLE_Step_2] fero: :(
02/25/05 20:38:43 ankh33 Logs in
02/25/05 20:39:00 [USMLE_Step_2] lanny: a pit tumor can cause GH def too
02/25/05 20:39:35 [USMLE_Step_2] megs: agree lanny
02/25/05 20:39:48 ankh33 Logs Out
02/25/05 20:40:01 [USMLE_Step_2] samantha: What about steroid use what is the path?
02/25/05 20:40:02 [USMLE_Step_2] fero: in hypo pit wat is the order of loss?in terms of ,TSH, ACTH, LH, FSH,
02/25/05 20:40:27 [USMLE_Step_2] lanny: ACTH then TSH then LH and FSH?
02/25/05 20:40:32 [USMLE_Step_2] shreya: no megs
02/25/05 20:40:47 [USMLE_Step_2] megs: WHAT SHREYA
02/25/05 20:40:48 [USMLE_Step_2] fero: ACTH is the last one to go
02/25/05 20:40:58 [USMLE_Step_2] dua_frank: no megs, please don't stop discussing
02/25/05 20:41:08 [USMLE_Step_2] shreya: u r not boring..
02/25/05 20:41:09 [USMLE_Step_2] dua_frank: these topics are not my strong points so i don't have much to add
02/25/05 20:41:12 [USMLE_Step_2] fero: FSH, LH GH.. first ones
02/25/05 20:41:25 [USMLE_Step_2] dua_frank: i appreciate your contributions to educating me more though :)
02/25/05 20:41:36 [USMLE_Step_2] uniteus: yeah megs
02/25/05 20:41:53 [USMLE_Step_2] shreya: i dont know much abot these topics. so following silently
02/25/05 20:42:02 [USMLE_Step_2] fero: MCC of hypopitu in kids?
02/25/05 20:42:09 [USMLE_Step_2] megs: OK ...GUYS NO PRB
02/25/05 20:42:37 [USMLE_Step_2] megs: SEPSIS FERO
02/25/05 20:42:53 [USMLE_Step_2] megs: or ischimia

02/25/05 20:43:02 [USMLE_Step_2] megs: not sure..
02/25/05 20:43:05 [USMLE_Step_2] fero: craniophrangioma in kids, pit adenoma in adults
02/25/05 20:43:53 [USMLE_Step_2] dua_frank: nice
02/25/05 20:43:58 [USMLE_Step_2] fero: wat visual field defact is associa with crainiopyragioma?
02/25/05 20:44:12 [USMLE_Step_2] lanny: bitemporal hemianopsia
02/25/05 20:44:14 [USMLE_Step_2] megs: bitemporal hemianopia fero
02/25/05 20:44:18 [USMLE_Step_2] shreya: agree
02/25/05 20:44:22 [USMLE_Step_2] fero: rt megs
02/25/05 20:44:24 [USMLE_Step_2] dua_frank: symptoms of salt wasting, inc serum 17- hydroxyprogesterone, dx?
02/25/05 20:44:36 [USMLE_Step_2] megs: CAH DUA
02/25/05 20:44:40 [USMLE_Step_2] uniteus: 21hydroxylase def CAH
02/25/05 20:44:43 [USMLE_Step_2] shreya: cah
02/25/05 20:44:45 [USMLE_Step_2] dua_frank: good uni
02/25/05 20:44:48 [USMLE_Step_2] lanny: agree uni
02/25/05 20:44:49 [USMLE_Step_2] megs: 21 HYDROXYLASE
02/25/05 20:44:56 [USMLE_Step_2] dua_frank: how is the ACTH level in this?
02/25/05 20:45:04 [USMLE_Step_2] lanny: inc
02/25/05 20:45:05 [USMLE_Step_2] uniteus: Increase
02/25/05 20:45:06 [USMLE_Step_2] dua_frank: right
02/25/05 20:45:12 [USMLE_Step_2] dua_frank: cortisone and aldo?
02/25/05 20:45:14 [USMLE_Step_2] megs: HIGH
02/25/05 20:45:21 [USMLE_Step_2] lanny: low
02/25/05 20:45:21 [USMLE_Step_2] megs: CORTISONE LOW
02/25/05 20:45:23 [USMLE_Step_2] uniteus: low cortisol low aldo
02/25/05 20:45:24 [USMLE_Step_2] dua_frank: right lanny
02/25/05 20:45:26 [USMLE_Step_2] dua_frank: renin?
02/25/05 20:45:28 [USMLE_Step_2] megs: LOW ALDO
02/25/05 20:45:31 [USMLE_Step_2] shreya: cortisone low in all
02/25/05 20:45:35 [USMLE_Step_2] lanny: inc renin
02/25/05 20:45:39 [USMLE_Step_2] dua_frank: right lanny
02/25/05 20:45:39 [USMLE_Step_2] uniteus: high renin
02/25/05 20:45:43 [USMLE_Step_2] fero: all i know is that they r salt losers
02/25/05 20:45:44 [USMLE_Step_2] megs: RENIN INCREASED
02/25/05 20:45:46 [USMLE_Step_2] dua_frank: affects females or males?
02/25/05 20:45:56 [USMLE_Step_2] uniteus: females more
02/25/05 20:46:01 [USMLE_Step_2] fero: females> ambig genti
02/25/05 20:46:08 [USMLE_Step_2] dua_frank: only females uni
02/25/05 20:46:14 [USMLE_Step_2] uniteus: ok..thx
02/25/05 20:46:14 [USMLE_Step_2] dua_frank: males are normal in appearance
02/25/05 20:46:17 [USMLE_Step_2] megs: NOPE DUA
02/25/05 20:46:24 [USMLE_Step_2] dua_frank: i meant physically
02/25/05 20:46:28 [USMLE_Step_2] shreya: short stature dua
02/25/05 20:46:30 [USMLE_Step_2] dua_frank: sorry should have been more clear
02/25/05 20:46:40 [USMLE_Step_2] megs: MALES ALSO GET AFFECTED BUT THEY DO NOT PRESNT WITH ABN GENITALIA
02/25/05 20:46:48 [USMLE_Step_2] shreya: rt
02/25/05 20:46:49 [USMLE_Step_2] dua_frank: right megs thats what i meant
02/25/05 20:46:51 kaash110zeh Logs Out
02/25/05 20:46:53 [USMLE_Step_2] megs: YUP
02/25/05 20:46:53 [USMLE_Step_2] uniteus: agree megs
02/25/05 20:47:17 [USMLE_Step_2] dua_frank: low aldo, htn and low potassium
02/25/05 20:47:19 [USMLE_Step_2] dua_frank: dx?
02/25/05 20:47:34 [USMLE_Step_2] megs: 11 HYDROXYLASE DEF PRESE
02/25/05 20:47:40 [USMLE_Step_2] dua_frank: right megs
02/25/05 20:47:43 [USMLE_Step_2] shreya: 11 b hydroxylase
02/25/05 20:47:46 [USMLE_Step_2] uniteus: 11hydroxylasedef CAH
02/25/05 20:47:52 [USMLE_Step_2] dua_frank: how will you differentiate this from 17 hydroxylase def?
02/25/05 20:48:15 [USMLE_Step_2] uniteus: increase aldo in 17
02/25/05 20:48:29 [USMLE_Step_2] lanny: HTN
02/25/05 20:48:33 [USMLE_Step_2] megs: NO INCRESE IN ANDROGNE IN 17
02/25/05 20:48:56 [USMLE_Step_2] dua_frank: right uni
02/25/05 20:49:03 [USMLE_Step_2] dua_frank: you guys are good
02/25/05 20:49:12 samantha Logs in
02/25/05 20:49:12 samantha Joins Subroom USMLE_Step_2
02/25/05 20:50:16 [USMLE_Step_2] uniteus: what you see in 17hydroxylase def in males?
02/25/05 20:50:44 [USMLE_Step_2] lanny: dec sex hormpnes
02/25/05 20:50:51 [USMLE_Step_2] lanny: hormones
02/25/05 20:50:53 [USMLE_Step_2] megs: YEAH LANNY
02/25/05 20:50:55 [USMLE_Step_2] uniteus: yeah..
02/25/05 20:51:01 [USMLE_Step_2] uniteus: but on physical exam?
02/25/05 20:51:12 [USMLE_Step_2] dua_frank: ambigous males
02/25/05 20:51:15 [USMLE_Step_2] fero: exter genitilia looks like female...since no testosterone
02/25/05 20:51:29 [USMLE_Step_2] uniteus: yeah dua..ambiguos genitalia
02/25/05 20:51:41 [USMLE_Step_2] samantha: hypokalemai and hypertension
02/25/05 20:51:54 [USMLE_Step_1] lenhoxung: you still there, mmw?
02/25/05 20:52:01 [USMLE_Step_2] megs: WHAT ARE THE CAUSES OF DIABETES INSIPIDUS???
02/25/05 20:52:16 [USMLE_Step_2] uniteus: either 11hydroxy or 17hydrox def samantha
02/25/05 20:53:11 [USMLE_Step_2] lanny: lack of ADH
02/25/05 20:53:21 [USMLE_Step_2] megs: TRAUMA ,BRAIN TUMOUR ,INFECTINS
02/25/05 20:53:24 [USMLE_Step_2] lanny: trauma
02/25/05 20:53:29 [USMLE_Step_2] megs: YUP
02/25/05 20:53:46 mmw Logs Out
02/25/05 20:53:54 [USMLE_Step_2] megs: ISOLATED DEF OF adh is very rare cause lkanny
02/25/05 20:54:24 [USMLE_Step_2] fero: wats waterhouse friderichsen syn?
02/25/05 20:54:27 [USMLE_Step_2] uniteus: drug too megs?
02/25/05 20:54:29 lenhoxung Logs Out
02/25/05 20:54:30 [USMLE_Step_2] lanny: agree
02/25/05 20:54:46 [USMLE_Step_2] dua_frank: meningococcus
02/25/05 20:54:52 [USMLE_Step_2] dua_frank: destroying adrenals
02/25/05 20:54:53 [USMLE_Step_2] megs: UNI WHICH DRUGS??/
02/25/05 20:55:00 [USMLE_Step_2] megs: AGREE DUA
02/25/05 20:55:09 [USMLE_Step_2] uniteus: Lithium and aminoglycoside
02/25/05 20:55:16 [USMLE_Step_2] fero: nesseria mengi,,,,with DIC rt dua
02/25/05 20:55:25 [USMLE_Step_2] megs: LITHIUM ONLY I KNOW
02/25/05 20:55:39 [USMLE_Step_2] dua_frank: destroys pit or adrenals fero?
02/25/05 20:55:45 [USMLE_Step_2] megs: DUNNO ABOUT AMINOGLYCOSIDE THANX UNI
02/25/05 20:55:46 [USMLE_Step_2] fero: adrenals
02/25/05 20:55:49 [USMLE_Step_2] dua_frank: ok
02/25/05 20:55:51 [USMLE_Step_2] dua_frank: thanks
02/25/05 20:56:00 [USMLE_Step_2] uniteus: the amino cause nephrogenic DI ..rare..just checked
02/25/05 20:56:06 [USMLE_Step_2] megs: OK
02/25/05 20:56:18 [USMLE_Step_2] dua_frank: demeclocycline too
02/25/05 20:56:26 [USMLE_Step_2] fero: colchichine and cyclophosphamise also
02/25/05 20:56:29 [USMLE_Step_2] dua_frank: oh
02/25/05 20:56:31 [USMLE_Step_2] dua_frank: yeah
02/25/05 20:56:36 [USMLE_Step_2] lanny: never knew fero
02/25/05 20:56:38 [USMLE_Step_2] uniteus: ok
02/25/05 20:56:44 [USMLE_Step_2] dua_frank: demeclo causes SIADH
02/25/05 20:56:45 [USMLE_Step_2] megs: thanx all
02/25/05 20:56:51 [USMLE_Step_2] dua_frank: also lithium i think
02/25/05 20:57:05 [USMLE_Step_2] megs: agree siadh,,,dua not di
02/25/05 20:57:06 [USMLE_Step_2] fero: rt lithium too
02/25/05 20:57:21 [USMLE_Step_2] lanny: lithium causes DI
02/25/05 20:57:28 [USMLE_Step_2] fero: lanny is rt
02/25/05 20:57:30 [USMLE_Step_2] lanny: not sure about SIA
02/25/05 20:57:33 [USMLE_Step_2] uniteus: wat typeDI lanny
02/25/05 20:57:34 [USMLE_Step_2] megs: yeah lanny
02/25/05 20:57:43 [USMLE_Step_2] fero: nephrogenic
02/25/05 20:57:45 [USMLE_Step_2] lanny: nephrog
02/25/05 20:57:53 [USMLE_Step_2] uniteus: rt lanny n fero
02/25/05 20:57:55 [USMLE_Step_2] megs: nephrogenic
02/25/05 20:58:03 [USMLE_Step_2] uniteus: yeah megs
02/25/05 20:58:29 [USMLE_Step_2] lanny: we trt SIa with lithium
02/25/05 20:58:34 [USMLE_Step_2] lanny: SIADH
02/25/05 20:58:45 [USMLE_Step_2] lanny: it does not cause SIADH
02/25/05 20:59:03 [USMLE_Step_2] lanny: NSAIDS cause SIAD
02/25/05 20:59:07 [USMLE_Step_2] dua_frank: and we trt DI with demeclo?
02/25/05 20:59:12 [USMLE_Step_2] megs: yup lanny
02/25/05 20:59:20 [USMLE_Step_2] dua_frank: ok so lets see
02/25/05 20:59:25 [USMLE_Step_2] megs: dunno dua :?
02/25/05 20:59:28 [USMLE_Step_2] lanny: no trt DI with desmopressin
02/25/05 20:59:36 [USMLE_Step_2] dua_frank: also demeclo if i remember
02/25/05 20:59:38 [USMLE_Step_2] lanny: ADH analog
02/25/05 20:59:40 [USMLE_Step_2] uniteus: no dua..
02/25/05 20:59:46 [USMLE_Step_2] fero: treatment of central DI?
02/25/05 20:59:49 [USMLE_Step_2] lanny: demeclo is for trt of SIAD
02/25/05 20:59:51 [USMLE_Step_2] dua_frank: demeclo causes either of those
02/25/05 20:59:55 [USMLE_Step_2] dua_frank: ah
02/25/05 20:59:55 [USMLE_Step_2] lanny: and lithium too
02/25/05 20:59:58 [USMLE_Step_2] dua_frank: ok
02/25/05 21:00:07 [USMLE_Step_2] lanny: yea easy to confuse
02/25/05 21:00:07 [USMLE_Step_2] dua_frank: so demeclo and lithium can cause DI
02/25/05 21:00:20 [USMLE_Step_2] megs: RX 'OF CENTRAL DI IS DDAVP
02/25/05 21:00:25 [USMLE_Step_2] lanny: no they are treatments dua
02/25/05 21:00:28 [USMLE_Step_2] dua_frank: and can be used for trt of SIADH
02/25/05 21:00:32 [USMLE_Step_2] dua_frank: lanny :(
02/25/05 21:01:28 [USMLE_Step_2] dua_frank: i just checked
02/25/05 21:01:32 [USMLE_Step_2] lanny: demeclo is an ADH antag so its used in SIADH
02/25/05 21:01:47 [USMLE_Step_2] dua_frank: lithium and demeclo can cause nephrogenic DI
02/25/05 21:01:49 [USMLE_Step_2] lanny: desmopressin is an ADH analog so used in DI
02/25/05 21:01:53 [USMLE_Step_2] shreya: nephrogenic - treatment is thiazides.
02/25/05 21:02:04 [USMLE_Step_2] uniteus: agree dua
02/25/05 21:02:21 [USMLE_Step_2] lanny: yes we said that already they cause
02/25/05 21:02:38 [USMLE_Step_2] megs: how thiazides act shreya???
02/25/05 21:02:47 [USMLE_Step_2] lanny: but the oposite with SIA remebere thety are both opposite dz
02/25/05 21:02:56 [USMLE_Step_2] uniteus: :? ok lanny
02/25/05 21:03:11 [USMLE_Step_2] shreya: im not sure its from kaplan..
02/25/05 21:03:38 [USMLE_Step_2] megs: i just wanted to know mech by which they help
02/25/05 21:03:41 [USMLE_Step_2] fero: VINCRISTINE also cause SIADH
02/25/05 21:03:47 [USMLE_Step_2] dua_frank: and SIADH by psychotrophs, chlorpropamide, cytotoxics and opiates
02/25/05 21:04:11 [USMLE_Step_2] lanny: right
02/25/05 21:04:18 [USMLE_Step_2] dua_frank: lanny think of it this way
02/25/05 21:04:19 [USMLE_Step_2] lanny: also NSAIDS
02/25/05 21:04:26 [USMLE_Step_2] dua_frank: all drugs that can trt SIADH can cause DI
02/25/05 21:04:31 [USMLE_Step_2] dua_frank: other end of the spectrum
02/25/05 21:04:31 [USMLE_Step_2] fero: GUYS, its overwheming..........all the endo+ pharma
02/25/05 21:04:47 [USMLE_Step_2] lanny: agree they are opposite dz so thats true
02/25/05 21:05:01 [USMLE_Step_2] lanny: what trt one causes the other
02/25/05 21:05:10 [USMLE_Step_2] dua_frank: yes
02/25/05 21:05:14 [USMLE_Step_2] lanny: basically speaking
02/25/05 21:05:36 [USMLE_Step_2] dua_frank: fero welcome to my world of pain and torture :( the USMLE :(
02/25/05 21:05:45 [USMLE_Step_2] lanny: yes fero plenty pharm in endo!!!!
02/25/05 21:05:55 [USMLE_Step_2] lanny: welcome to our world dua
02/25/05 21:05:56 [USMLE_Step_2] fero: :( :(
02/25/05 21:05:59 [USMLE_Step_2] dua_frank: right lanny
02/25/05 21:06:00 [USMLE_Step_2] lanny: youre not alone
02/25/05 21:06:12 [USMLE_Step_2] megs: i am too in a que
02/25/05 21:06:16 [USMLE_Step_2] uniteus: :(
02/25/05 21:06:16 [USMLE_Step_2] dua_frank: nice to know that lol
02/25/05 21:06:19 [USMLE_Step_2] megs: :(
02/25/05 21:06:21 [USMLE_Step_2] lanny: sometimes i wonder why i didnt go into computer or financial field
02/25/05 21:06:26 [USMLE_Step_2] dua_frank: lanny lol
02/25/05 21:06:29 [USMLE_Step_2] fero: i wishhhhhhhhh i did
02/25/05 21:06:49 [USMLE_Step_2] lanny: my friends are making are enjoying a friday night out and im stuck here
02/25/05 21:06:59 [USMLE_Step_2] dua_frank: i know
02/25/05 21:07:08 [USMLE_Step_2] dua_frank: they think we're losers you know
02/25/05 21:07:09 [USMLE_Step_2] megs: has anybody done ophtalm
02/25/05 21:07:09 [USMLE_Step_2] dua_frank: :(
02/25/05 21:07:14 [USMLE_Step_2] lanny: been stuck here for the last 5 mths on friday nights lol
02/25/05 21:07:18 [USMLE_Step_2] dua_frank: lol
02/25/05 21:07:25 [USMLE_Step_2] fero: stuck with us lanny
02/25/05 21:07:41 [USMLE_Step_2] lanny: hopefully all will be well for all of us
02/25/05 21:07:52 [USMLE_Step_2] dua_frank: hopefully
02/25/05 21:07:58 [USMLE_Step_2] lanny: and yet people dont know what it takes to have that title
02/25/05 21:08:03 [USMLE_Step_2] megs: hope and pray so
02/25/05 21:08:05 [USMLE_Step_2] dua_frank: lets always keep in touch, i think we form a great group of doctors
02/25/05 21:08:05 [USMLE_Step_2] lanny: of MD
02/25/05 21:08:25 [USMLE_Step_2] lanny: agree hopefully were all be here again for 3
02/25/05 21:08:35 [USMLE_Step_2] fero: INSHALLAH
02/25/05 21:08:39 [USMLE_Step_2] dua_frank: cs too for me
02/25/05 21:08:51 [USMLE_Step_2] fero: me too dua, when is yours?
02/25/05 21:09:00 [USMLE_Step_2] megs: ME TOO
02/25/05 21:09:04 [USMLE_Step_2] dua_frank: maybe after june
02/25/05 21:09:07 [USMLE_Step_2] shreya: me too
02/25/05 21:09:13 [USMLE_Step_2] lanny: oh dua its ok i did it a year ago youlle be ok
02/25/05 21:09:13 [USMLE_Step_2] dua_frank: great then, we're all in this together
02/25/05 21:09:23 [USMLE_Step_2] lanny: any tips will be glad to share
02/25/05 21:09:25 [USMLE_Step_2] dua_frank: thanks lanny, i hope so
02/25/05 21:09:39 [USMLE_Step_2] dua_frank: you have to come back after your step 2 to help us with cs lanny
02/25/05 21:09:53 [USMLE_Step_2] megs: YUP LANNY PL HELP US
02/25/05 21:09:55 [USMLE_Step_2] dua_frank: will send you a mail when we're about to start that prep
02/25/05 21:09:56 [USMLE_Step_2] fero: when is yours step 2 dua and all??
02/25/05 21:10:03 [USMLE_Step_2] dua_frank: fero mine in june
02/25/05 21:10:12 [USMLE_Step_2] dua_frank: how about the rest of you ?
02/25/05 21:10:12 [USMLE_Step_2] lanny: oh sure i did that one well cause i followed the med students while they were going for it first time last year
02/25/05 21:10:18 [USMLE_Step_2] fero: step 2 ck in june dua?
02/25/05 21:10:22 [USMLE_Step_2] dua_frank: yes fero
02/25/05 21:10:23 [USMLE_Step_2] shreya: im also planing in june.
02/25/05 21:10:28 [USMLE_Step_2] dua_frank: great shreya
02/25/05 21:10:32 [USMLE_Step_2] dua_frank: we're all around the same time then
02/25/05 21:10:34 [USMLE_Step_2] dua_frank: glad to know that
02/25/05 21:10:38 [USMLE_Step_2] lanny: im thinking of early april
02/25/05 21:10:47 [USMLE_Step_2] fero: u look in good shape dua, i though yours is soon
02/25/05 21:10:49 [USMLE_Step_2] megs: MAY...
02/25/05 21:11:06 [USMLE_Step_2] dua_frank: not really fero, surg and obgyn i know nothing about
02/25/05 21:11:15 [USMLE_Step_2] shreya: dua plz give me ur mail id..
02/25/05 21:11:16 [USMLE_Step_2] dua_frank: alien subjects
02/25/05 21:11:34 [USMLE_Step_2] dua_frank: [email protected]
02/25/05 21:11:46 [USMLE_Step_2] shreya: if i have doubts il mail u.
02/25/05 21:11:51 [USMLE_Step_2] shreya: thanks.
02/25/05 21:12:01 [USMLE_Step_2] dua_frank: mail me anyway shreya, i would like to keep in touch with all of you
02/25/05 21:12:16 [USMLE_Step_2] dua_frank: we have a long way to go before we get our residencies
02/25/05 21:12:20 [USMLE_Step_2] shreya: thanks.
02/25/05 21:12:30 [USMLE_Step_2] dua_frank: its good to keep in touch and advise each other
02/25/05 21:12:37 [USMLE_Step_2] megs: YEAH DUA
02/25/05 21:12:44 [USMLE_Step_2] fero: anyone done with step 1 here?
02/25/05 21:12:48 [USMLE_Step_2] dua_frank: me
02/25/05 21:12:57 [USMLE_Step_2] fero: good
02/25/05 21:12:59 [USMLE_Step_2] megs: hope each of us do that
02/25/05 21:13:00 [USMLE_Step_2] lanny: me too
02/25/05 21:13:14 [USMLE_Step_2] megs: me too
02/25/05 21:13:17 [USMLE_Step_2] dua_frank: i don't have your email addresses megs, shreya, fero
02/25/05 21:13:22 [USMLE_Step_2] shreya: me too
02/25/05 21:13:48 [USMLE_Step_2] shreya: [email protected]
02/25/05 21:13:49 [USMLE_Step_2] dua_frank: uni and samantha too
02/25/05 21:13:49 [USMLE_Step_2] fero: [email protected]
02/25/05 21:13:53 [USMLE_Step_2] megs: mine in [email protected]
02/25/05 21:13:59 [USMLE_Step_2] dua_frank: thanks
02/25/05 21:14:11 [USMLE_Step_2] dua_frank: i have megs
02/25/05 21:14:22 [USMLE_Step_2] megs: ok
02/25/05 21:14:37 [USMLE_Step_2] lanny: one advice guys lets stick with the basics screenings, figures risk factors common dz dont waste time about names youve not heard,they really ask the common stuff, like TB HTN know the cut off figures..etc
02/25/05 21:14:43 [USMLE_Step_2] lanny: well all do well
02/25/05 21:14:51 [USMLE_Step_2] dua_frank: right lanny
02/25/05 21:14:52 [USMLE_Step_2] lanny: [email protected]
02/25/05 21:15:29 [USMLE_Step_2] dua_frank: shall we do IM after peds?
02/25/05 21:15:43 [USMLE_Step_2] megs: perfect dua
02/25/05 21:15:49 [USMLE_Step_2] shreya: np for me.
02/25/05 21:15:52 [USMLE_Step_2] lanny: sure thats the biggy we can start it again
02/25/05 21:15:54 [USMLE_Step_2] dua_frank: ok then
02/25/05 21:16:03 [USMLE_Step_2] lanny: so whats tomorrow
02/25/05 21:16:05 [USMLE_Step_2] dua_frank: yes lanny, this time we can go into more details than before
02/25/05 21:16:09 [USMLE_Step_2] fero: plz IM AFTER PEDS
02/25/05 21:16:18 [USMLE_Step_2] lanny: yes and conc on the basics
02/25/05 21:16:21 [USMLE_Step_2] dua_frank: hemato and onco lanny
02/25/05 21:16:27 [USMLE_Step_2] dua_frank: fero yes
02/25/05 21:16:27 [USMLE_Step_2] megs: yup dua
02/25/05 21:16:35 [USMLE_Step_2] fero: HEMA is my wk point
02/25/05 21:16:39 [USMLE_Step_2] lanny: thanks dua
02/25/05 21:16:45 [USMLE_Step_2] megs: so see you all tomorrow
02/25/05 21:16:51 [USMLE_Step_2] dua_frank: ok guys thanks for today
02/25/05 21:16:56 [USMLE_Step_2] dua_frank: see you all tomorrow
02/25/05 21:16:57 [USMLE_Step_2] shreya: bye
02/25/05 21:16:58 [USMLE_Step_2] lanny: see you all tom
02/25/05 21:16:58 [USMLE_Step_2] dua_frank: bye
02/25/05 21:17:03 [USMLE_Step_2] megs: bye
02/25/05 21:17:06 shreya Logs Out
02/25/05 21:17:10 [USMLE_Step_2] fero: ok guys ,,happy studying,,,,i will b dreaming of ACTH tonight,,lol
02/25/05 21:17:16 [USMLE_Step_2] dua_frank: lol
02/25/05 21:17:20 megs Logs Out
02/25/05 21:17:23 dua_frank Logs Out
02/25/05 21:17:38 [USMLE_Step_2] fero: bye guys,,,bye lanny
02/25/05 21:17:48 [USMLE_Step_2] lanny: bye fero







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