osephmedman has joined the chat.
[breeze] hello?
[gurryaj] hi
[bond4urx] hey guys waz up?
[bond4urx] nobody can beat a dead room can they?
[bond4urx] speak up yaar.....
[bond4urx] hmmm
[bond4urx] looks like everyones gone with the wind!
[bond4urx] :gun
[bond4urx] *meow* *meow*
Now entering USMLE_Step_1 subroom.
josephmedman has joined subroom: USMLE_Step_1
[arezooman] yes, left Ant. Desc is the MC for atherosclerosis
[ppliutcm] anterior
[arezooman] Jibb>> right
[arezooman] Left circumflex is the most common for causing death
[josephmedman] hey guys
[arezooman] Hi
[Jibbsie] hey Joe
[georgere] Hi
[ppliutcm] hi
[josephmedman] where are we at?
[Jibbsie] mcc coronary artey for arthero, and for death
[josephmedman] ok cool..
[Jibbsie] lad for irst. , post circ for the next
[ppliutcm] do we finish card yet?
[josephmedman] no almost
[josephmedman] unless you guys want to move on
[josephmedman] its up to you
[ppliutcm] let's continue..
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[josephmedman] ok..what is the most common complication of AMI?
[arezooman] arrythmia?
[ppliutcm] lv
[josephmedman] yes..
[arezooman] IV?
[josephmedman] and waht is the most common cause of death?
[ppliutcm] left ventricle
[josephmedman] ventricular arryhthmia
[arezooman] VF
[josephmedman] same thing
[mistere] CHF
[josephmedman] arrythmia
[josephmedman] what artery
[josephmedman] part of the coronary
[josephmedman] do most ruptures occur with?
[seema_b2001] hi
[ppliutcm] rcd
[josephmedman] no
[josephmedman] anyone?
[josephmedman] most ruptures occur with LAD
[mistere] lad
[josephmedman] what does the right coronary artery supply?
[josephmedman] what part of the heart?
[arezooman] SA node
[ppliutcm] rh
[ppliutcm] av
[malak1993] rt vent
[Jibbsie] post 1/3 of interven. septum
[arezooman] SA and AV, inf of heart and 1/3 post
[seema_b2001] ra ,rv,sa node,av node
[josephmedman] RCA supplies the entire right ventricle and 2/3 posterior part of the septum..the posterior heart
[josephmedman] i dont know about RA?
[josephmedman] i knwo it supplies the RV
[josephmedman] anyone?
[alexander] are we still going by the schedule posted at http://usmle.valuemd.com/ftopic1885.html?
[arezooman] what was the q again?
[seema_b2001] kaplan says it supplies rt atrium
[josephmedman] what supplies the right atrium
[seema_b2001] rca
[josephmedman] we established that RCA supplies RV, 2/3 posterior part of septum and post heart
[josephmedman] ok cool..just making sure seema..thanks
[josephmedman] ok epigastric pain
[arezooman] so it is RCA for sure?
[josephmedman] is it left or righ coronary?
[josephmedman] i dont know arezooman
[arezooman] right
[josephmedman] good
[josephmedman] and what ist he symptom if left coronary?
[arezooman] dyspnea?
[josephmedman] pain radiating to the left arm
[josephmedman] we are off schedule
[josephmedman] like way behind
[seema_b2001] pain simulating angina
[josephmedman] we are finishing cardio now moving to resp today
[arezooman] pain can radiate from jaw to navel
[seema_b2001] ya
[alexander] thanks joe
[josephmedman] ok..i was just going by what goljan said..
[seema_b2001] sometimes it radiates to back also
[arezooman] yes, that one is more common, thanks
[josephmedman] yeah i guess you ahve to read into the question..because if you ar elookign at patient with epi pain radiating to back you are usualy thinking pancreatitis ..
[josephmedman] ok..
[josephmedman] dressler syndrome?
[josephmedman] what is it?
[arezooman] pericarditis immunologic 15 days
[arezooman] after mi
[Jibbsie] post mi pericarditis due to imm
[mistere] autoantibodies against heart
[josephmedman] umm..i think it is 6-8 weeks later
[malak1993] dessecting anuerysm radiat to back
[arezooman] oh, 6-8 weeks, let me check it
[josephmedman] what are soem systemic signs of dresslers?
[Jibbsie] friction rub
[josephmedman] what else..
[Jibbsie] chest pain
[josephmedman] what else..
[josephmedman] give me the main ones you see
[josephmedman] prototypical
[ppliutcm] friction rub
[josephmedman] fever, joint pains and friction rub..
[arezooman] Kaplnan says for Dressler several weeks later, u right Joe
[josephmedman] remember that it is autoimmune
[seema_b2001] ok
[arezooman] yes, it is
[josephmedman] what happens is when you had an infarct, you damaged the pericardial surface and formed autoantibodies against your pericardial tissue
[Jibbsie] I wonder why joint rather than chest pain
[perhaps] hi joe, good to have you back. we are at GI tomorrow 10am and hopefully renal 5:30pm. if it is ahead of your schedule, don't worry about it. Thanks for the Qs here!
[ppliutcm] auto-ab
[josephmedman] hey perhaps?..does GI coem after reps?
[josephmedman] what about auto-ab ppliutcm?
[arezooman] somthing like cross reaction you see in Sterp M protoin and heart
[josephmedman] resp*
[josephmedman] ?
[Jibbsie] ok
[josephmedman] here is a question..what is yoru chance of rupture of a ventricular aneurysm as a complication of MI?
[ppliutcm] i agree with arezooman
[arezooman] it seems joint are very prone to be affected in any rheumatiod dieases
[Jibbsie] slim
[josephmedman] what makes dresslers an rhemetoid disease though?
[josephmedman] dresslers is just a complication of MI right?
[arezooman] sorry, any autoimmune diase
[josephmedman] oh ok..gotcha..
[josephmedman] yeah i think you are right..
[josephmedman] i was going to say that
[josephmedman] but i was unsure..
[perhaps] yes, we did respiratory
[arezooman] dressler, I only heard it with MI
[perhaps] sorry...
[josephmedman] ok..well jibbs got it right..the reason ventriclar aneurysm as a complication of MI will not rupture
[josephmedman] is because the aneurysm is lined by scar tissue
[josephmedman] so it wont rupture
[josephmedman] heart failure is actualy the MC cause of death due to thsi..
[josephmedman] whatis the MC pathogen involved in rhematic fever?
[ppliutcm] step
[josephmedman] no..thats no problem..i have no problem with resp..
[Jibbsie] grp A
[josephmedman] i was just wondering if that was what came after resp on the schedule
[arezooman] Sterp. Pyogen
[josephmedman] because i dont have the schedule in front of me
[josephmedman] im donewith resp too
[arezooman] beta hemlitic group A
[josephmedman] what is the MC initial presentation?
[medicop45] Fever ,joint pain
[arezooman] fever? sore throat?
[perhaps] great. we are at the same yahoo messenger. lately it was just two of us so we didn't use the chat room. if we see you online, we will message you. don't worry if you are busy
[josephmedman] yes polyarthritis MC initial presentation
[medicop45] sore throat
[josephmedman] why are blood cultures negative?
[josephmedman] with this disease?
[ppliutcm] immunologic reac
[arezooman] becuase it is not because of bectermia
[Jibbsie] becos the infxn has cleared
[josephmedman] good jibs
[josephmedman] we are making antibodies against our own tissue becasuse there were similar antigensin that of the infected tissue
[josephmedman] in acture RF
[josephmedman] what type of valvular disorder do you get?
[arezooman] most common MS
[Jibbsie] regurg initaially
[josephmedman] oh ok..
[josephmedman] do i need to download yahoo messenger?
[Jibbsie] that is in acute dz
[josephmedman] no areezooman
[josephmedman] that is a board question too
[perhaps] yes. google"yahoo messenger" and it takes you right there
[josephmedman] it is mitral regurg not stenosis
[perhaps] a few clicks, should be within 10min
[arezooman] but as far as I know the MC cause of MS in developing countries is RF
[Jibbsie] that is in chronic Arez
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[Jibbsie] after healing by fibrosis
[josephmedman] not in acute RF though
[dremad75] i dont want to distract u ...but sorry i cant follow ... i dont have the paper yet ... can u pls try to send it on the e mail i gave to you before [email protected] .... i was asking for goljan 360 pages ... do u remember? ... good luck
[arezooman] but you didn't ask for acute or chronic
[josephmedman] i tried..you need a gmail account..teh file was too big
[josephmedman] but we are talkign about rhematic fever
[arezooman] oh sorry that was a sentence above
[dremad75] ohhh
[josephmedman] when you get carditis with rhematic fever
[josephmedman] it uis acute RF right?
[arezooman] yes
[josephmedman] remebmer that guys..its actually a huge point
[josephmedman] what titers are going to be elevated in rhematic disease?
[Jibbsie] ASO
[arezooman] ASO, ESR
[dremad75] ok ... send me mail telling me ur suggestion .... i will let u to follow ...sorry for bothering ... continue ur discussion sorry again
[medicop45] aso
[josephmedman] here is how the boards can ask it
[josephmedman] young person had an exudative tonsillitis a few weeks ago and now presents with joint pain and swelling and dyspnea. Hear rales in lung and pan systolic murmur. increased in intensity on expiration..
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[josephmedman] what is the MCC of chronic rhematic heart disease?
[ppliutcm] ms
[josephmedman] no problem..just open a gmail account and i can send it to you there
[josephmedman] good..
[Jibbsie] I don't get that
[arezooman] me neither
[Jibbsie] isn't the mcc repeated ARF
[arezooman] You meant most common cause of chronic rehem. heart diases?
[josephmedman] no
[josephmedman] most common cause of mitral stenosis
[josephmedman] is chronic rhematic heart disease
[Jibbsie] ok. And not the other way round
[josephmedman] umm..
[arezooman] and MCC of MR?
[josephmedman] MVP
[arezooman] I am not sure, is it MI?
[josephmedman] is MCC of mitral regurg
[arezooman] Oh, MVP,u r right
[josephmedman] hold up lets think about this for a second
[medicop45] What is MVP?
[josephmedman] i think it is aroudn teh line of what jibs was saying earlier
[mistere] mitral valve prolapse
[arezooman] mitral valve prolpase
[josephmedman] after heling by fibrosis
[medicop45] ok ok
[josephmedman] it is MS
[medicop45] thanks
[josephmedman] thats why MR is ***. with acute and MS with chronic?
[Jibbsie] yep
[josephmedman] ok..good one jibs..
[mistere] sounds good
[josephmedman] is mitral stenosis a problem in systole or diastole?
[mistere] diastole
[josephmedman] good..why
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[Jibbsie] diastole i whn blood goes in to ventricle
[arezooman] problem of blood entering to LV
[josephmedman] what are some clinical signs and symptoms of MS?
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[mistere] RVH
[arezooman] facial plethra (MS face), dyspnea
[mistere] pulm. HTN
[seema_b2001] LAH. pul. htn
[arezooman] openning snap
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[josephmedman] ok here are the big board ones..
[seema_b2001] pul. oedema
[josephmedman] dyspnea and hemoptysis
[seema_b2001] ya
[josephmedman] a fib secondary to left atrial dilationand hypertrophy
[josephmedman] dysphagia for solids
[malak1993] AF
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[josephmedman] what happens is the la is the most posterior chamober and compresses the esophagus
[arezooman] MCC of AF due to valvulopathy is MS but it is most commonly seen with MR
[malak1993] embolism
[Jibbsie] what is a fib secondary to ....
[josephmedman] what is the most common valvular disease in the young population
[arezooman] MVP
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[malak1993] MVP
[josephmedman] a fib secondary to left atrial hypertrophy
[Jibbsie] joe? ..a fib ..
[josephmedman] and left atrial dilation
[arezooman] after that bicuspid of aorta 2%
[josephmedman] got it jibs?
[Jibbsie] what is a fib
[arezooman] fibrillation?
[Jibbsie] ohh
[malak1993] atrial fibrilation
[arezooman] atrial fib
[nemesis1] what does left atrial hypertrophy look like on ekg?
[josephmedman] waht genetic disease is mitral valve prolapse associated with?
[sillyglue] marfan
[nemesis1] marfan
[sillyglue] cystic medial necrosis
[Jibbsie] marfans
[josephmedman] ok i will email you if i have problems
[arezooman] Marfan
[josephmedman] wont be able to make it to the morning
[josephmedman] but will try to make it late afternoon
[josephmedman] what else
[mistere] ehlers
[josephmedman] what kind of genetic diseases have late manifestations in life?
[josephmedman] AD
[josephmedman] or AR?
[Jibbsie] ad
[perhaps] thanks, don't want to mess up your schedule. You are doing a great job here!
[mistere] ad
[josephmedman] good..
[arezooman] AD
[josephmedman] hereis one..
[josephmedman] what is the most common cause of sudden death in a marfans patient?
[nemesis1] aortic dissection
[mistere] dissecting aortic aneurysm
[josephmedman] you would have gotten that question wrong on the boards..
[josephmedman] trick question
[arezooman] AD in basketball players
[seema_b2001] aortic aneurysm
[josephmedman] the answer is MVP
[Jibbsie] mital valve
[josephmedman] aortic dissection isnt sudden
[mistere] true
[josephmedman] arezooman, what did you say about basketball players?
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[arezooman] it is said it the most common killer in basketball players
[arezooman] marfan complications I mean
[Jibbsie] isn't that hypertrophic cardiac dz
[arezooman] that's overall
[josephmedman] bball players wwith marfans you mean?
[arezooman] no, all Basketball players
[arezooman] for all players it is IHSS, but in Basketball it is Marfan's complicatoins
[mistere] IHSS?
[josephmedman] IHSS?
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[arezooman] which I thought was Aortic dissec
[arezooman] Idopathic hypertrophic aortic stenosis
[seema_b2001] what is IHSS?
[josephmedman] yeah..you have to read the question..MCC of death is aortic dissection
[arezooman] subaortic
[malak1993] arrythmia
[alexander] MV prolapse
[josephmedman] SUDDEN death is MVP
[josephmedman] what is IHSS?
[arezooman] Hpertrohic CMP
[Jibbsie] more confusing abbreviations
[josephmedman] oh ok..
[arezooman] idiopathic hypertrophic subaortic stenosis
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[josephmedman] here is the mech o Aortic diss..
[Jibbsie] ok
[arezooman] CMP = cardiomypathy
[Jibbsie] ok
[josephmedman] cystic medial necrosis can lead to aortic diation with anerysm of p. aorta dissecting anerysm of aorta..loss of connective tissue leads to MVP
[josephmedman] what is the MCC of cacified congenital bicuspid valve
[arezooman] more stress on the two valves?
[alexander] here is something on IHSS with pics (but must be logged in to see pics) http://www.valuemd.com/ftopic10338.html
[malak1993] What IS MCC OF DEATH IN MVP
[georgere] why MVP cause sudden death? decreased blood flow to aorta?
[josephmedman] from vtach
[arezooman] you mean MVP cuase VF? any reason for that?
[josephmedman] aortic stenosis is the MCC of cacified congential bicuspid valve
[josephmedman] no the sudden cardiac death is from vtach in marfans syndrome
[georgere] Thanks
[medicop45] what is vtach?
[georgere] ventricular tachycardia?
[josephmedman] ventricular tach
[medicop45] ohh thanks
[sillyglue] i thought vtach was just a fast HR and vfib is what kills you
[mistere] doesn't bicuspid valve CAUSE aoritc stenosis?
[sillyglue] yeah, mistere, i think so
[josephmedman] ok well aortic stenosis is the MCC of cacified congential bicuspid valve
[arezooman] bicuspid valve is the MCC of AS
[arezooman] that's what I remember
[josephmedman] yes
[josephmedman] it is also the most common valvular caause of syncope and angina with excersise
[arezooman] you mean AS?
[josephmedman] thanks perhaps..some stuff came up and i got caught off scedule..regardless of whether or not i am able to make ti to your goljan chats i would LOVE to join you for other subjects afterwards..
[mistere] yes AS
[arezooman] becasue AS commes with syncope and angina
[josephmedman] bicuspid valve
[arezooman] so both of them r associated, thanks
[josephmedman] yup
[Jibbsie] yeah becos the coronary takes origin from there
[josephmedman] what do you mean jibs?
[josephmedman] can you explain?
[josephmedman] no prob
[Jibbsie] the origin of coronary artey is from the aortic sinus which just lies after the valves
[arezooman] coronary orfice is near aorta and is the first artery of aorta?
[arezooman] so could be easily affected
[arezooman] either with AS or bicuspid aortic valve
[josephmedman] gotcha..
[perhaps] thank you, sounds great! I will keep you updated after Goljan. now we are pretty much at a morning 10am and a 5:30 = 6am ish schedule. if you see either of us online with yahoo messenger, feel free to contact us]
[josephmedman] here is a reduction in the valve orifice area
[Jibbsie] so if u don't have enough blood coming out of aorta --angina
[josephmedman] so you ahve an increase in resistence to ejection of blood during systole
[Jibbsie] and syncope
[josephmedman] therefore decreased stroke volume
[josephmedman] and decrease CO
[josephmedman] got it..
[josephmedman] ok..here are some facts to know
[Jibbsie] u got it right
[josephmedman] aortic stenosis is the most common valvular lesion assoicated with angina
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[josephmedman] it is the most common valvular lesion associated with syncope and excersise
[josephmedman] and is the MC cause of macroangiopathic hemolytic anemia with schistocytes
[josephmedman] ok guys..what is the MCC of aortic regurg?
[josephmedman] hold up..brb..gotta go tape HOUSE on fox..ha
[arezooman] pul HTN?
[arezooman] :-)
[josephmedman] long standing essential HTN
[Jibbsie] how?
[arezooman] HTN is the MCC of AR?
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[josephmedman] what is the mc valve involved in IV drug abusers?
[josephmedman] long standing essential htn
[Jibbsie] tricus
[josephmedman] yes
[alexander] tricuspid
[arezooman] tricuspid
[georgere] tv
[josephmedman] umm..here it says AV
[malak1993] TC
[arezooman] I didn't get that one, I mean the MCC of AR?
[arezooman] aortic valve is the second as I rember
[josephmedman] ok..the most common cause of aortic regurgitation is long standing essential hypertensionj
[josephmedman] there are other causes like infective endocarditis and chronic rhematic heart disase
[josephmedman] but that is MC
[mistere] the increased pressure in the aorta is too much for the valve to handle and regurges?
[perhaps] i mean 5:30 or 6pm
[alexander] for the valves infected, in non IV drug users its MV followed by AV. But in IV drug users, its tricuspid followed by aortic
[josephmedman] thans alexander
[arezooman] what is your source for HTN and AR? Goljan?
[josephmedman] yeah
[josephmedman] pg 127
[arezooman] thanks
[josephmedman] what type of murmur in aortic regurg?
[mistere] diastolic
[arezooman] diastolic
[josephmedman] what does it sound like
[alexander] high pitched blowing
[mistere] blowing
[josephmedman] good
[josephmedman] what is MCC of infective endocarditis?
[alexander] strep viridans
[sillyglue] s. aureus
[arezooman] sterp. viridans
[Jibbsie] staph
[Jibbsie] staph for acute
[arezooman] for acute it is Staph
[arezooman] for suacute = Strep. Viridans
[alexander] in IV drug abusers its staph aureus, but in non-IV drug users its strep viridans
[josephmedman] MCC overall is strep viridans
[alexander] and overall strep viridans followed by staph
[josephmedman] second staph aureus
[josephmedman] here is a question
[arezooman] Is it S.Saprophiticus for prosthetic surgery?
[josephmedman] patient with colon cancer presents with endocarditis?
[josephmedman] what is organism involved
[arezooman] S. Bovis?
[malak1993] murantic
[alexander] strep bovis
[josephmedman] good
[josephmedman] tell me about carcinoid heart disease
[arezooman] Murantic for dental abscess?
[josephmedman] and how it turns into carcinoid syndrome
[sillyglue] affects the right heart
[arezooman] PS and TS
[malak1993] mutans
[arezooman] yes, Mutans for dental, isn't it?
[josephmedman] anyone?
[malak1993] yes
[arezooman] by met to liver
[alexander] mets of carcinoid tumor from liver and serotonin gets into blood
[josephmedman] ok..well in order to have carcinoid syndrome you have to have mets to the live
[josephmedman] here is the mech.
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[josephmedman] serotonin gets into the hepatic vein tributaries and then gets into the venous blood, serotnin produces a fibrous tissue response of the valves
[josephmedman] TIPS
[josephmedman] tricuspid insufficiency and pulmonic stenosis
[arezooman] so it is not PS?
[josephmedman] in mets carcinoid tumor in the liver
[josephmedman] where is the primary?
[josephmedman] what so you mean arezooman?
[arezooman] most common is appendix?
[josephmedman] it is PS and TI
[alexander] terminal ileum
[malak1993] ileum
[arezooman] I mean it is only PS and TI but not TS?
[josephmedman] actually primary cancer is in the terminal ilieum
[josephmedman] and that is board impt..
[josephmedman] yes
[josephmedman] only those two arezooman
[arezooman] thanks for the TIPS
[josephmedman] just remember TIPS with carcinoid
[josephmedman] no doubt..
[georgere] Thanks
[ppliutcm] good tips
[josephmedman] what type of hypersensitivity is associated with infective endocarditis?
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[josephmedman] type III
[josephmedman] here is a clinical scenario
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[josephmedman] you have a murmur of tricuspid regurg in an IV drug abuser:infective endocarditis
[josephmedman] what virus is the most common cause of myocarditis and pericarditis?
[sillyglue] coxsachieB
[josephmedman] here is a ttip goljan gave
[josephmedman] if you ever get an infection question on the boards
[josephmedman] and you dont know what the answer is
[josephmedman] and coksackie is there
[alexander] coxsackie
[josephmedman] pick it..
[josephmedman] here is a question
[josephmedman] woman 6 weeks post partum and she is having dyspnea. CXR shows a generalized cardiomegaly and effusion of both lung bases..what is it?
[sillyglue] dilated cardiomyopathy?
[alexander] congestive cariomyopathy
[josephmedman] yes..dilated congestive cardiomyopathy
[josephmedman] think post partum
[Ammu] congestive
[josephmedman] good chance of congestive cardiomyopathy
[arezooman] due to?
[alexander] coxsackie
[josephmedman] what is the MCC of sudden death in young people and athletes?
[arezooman] is it more common postpartum?
[sillyglue] hypertrophic cardiomyopathy
[Ammu] Hypert
[arezooman] IHSS
[josephmedman] well post partum is just a cause
[josephmedman] coxsackie is a separate vause
[josephmedman] good
[josephmedman] AD
[sillyglue] hypertrophic cardiomyopathy cuases conduction defects
[josephmedman] you develop vtach and die
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[josephmedman] what is the most common reason for a child needing a heart transplant?
[Jibbsie] has it ended. My computer..
[josephmedman] ill post it again jibbs
[josephmedman] on both sites
[Jibbsie] thanks
[arezooman] CF?
[josephmedman] the answer is endocardial fibroelastosis
[josephmedman] whats CF?
[josephmedman] cystic fibrosis?
[arezooman] cystic fibrosis mMC for heart and pul transplant
[josephmedman] here it says..the most common reason for a child needing a heart transplant is endocardial fibroelastosis: thick endocardial tissue
[Jibbsie] can u describe the dz
[josephmedman] what is the MNC primary adult heart tumor?
[Jibbsie] fibroma
[arezooman] myxoma?
[sillyglue] myxoma
[fakehugs] atrail myoma
[josephmedman] all i knwo is its a restrictive cardiomyopathy
[Jibbsie] atral myxoma, sorry
[josephmedman] is a cardiac myxoma malignant?
[Jibbsie] no
[fakehugs] no
[Ammu] no
[malak1993] no
[josephmedman] what is the MC primary heart tumor in children?
[sillyglue] rhabdomyoma
[fakehugs] rhabydo
[arezooman] rhabdomyoma?
[Ammu] rhabdo
[Jibbsie] yep
[josephmedman] ok..here is a question
[josephmedman] they are describing a tumor in the heart of a kid associated with an ad DISEASE
[josephmedman] WHAT IS IT?
[sillyglue] tuberous sclerosis?
[josephmedman] tuberous sclerosis
[Ammu] Tuberous sclerosis
[josephmedman] what is the MC cardiac disease in SLE?
[sillyglue] pericarditis?
[josephmedman] what is the most common worldwide cause of constrictive pericarditis?
[Jibbsie] lebmans
[sillyglue] TB
[Ammu] TB
[malak1993] TB
[josephmedman] tb
[josephmedman] in sle its pericardial effusion
[josephmedman] followed by libmans sacks
[fakehugs] okay when are we going to do resp?
[josephmedman] any young woman
[josephmedman] who has unexplained pericardial effusion or pleural effusion
[sillyglue] SLE
[josephmedman] it is SLE
[josephmedman] until proven otherwise..
[josephmedman] what is becks triad?
[Ammu] jvp,hypot
[sillyglue] acute cardiac tamponade and something else
[josephmedman] kusmauls pulsus paradoxus and muffled Heart sounds
[josephmedman] what is pulsus paradoxus?
[josephmedman] it is a drop in BP on inspiration right?
[arezooman] more than 10mmhg with insp
[josephmedman] ok..
[josephmedman] ok guys im out of here..
[josephmedman] ill see you all tomorrow
[georgere] Thanks
[Jibbsie] to go watch House on Fox?
[josephmedman] haha to go eat..then have to watch house which is being taped right now..
[perhaps] thanks Joe
[josephmedman] great motivator..
[josephmedman] try greys anatomy too
[josephmedman] gret show..ha
[josephmedman] going to be us very soon..
[josephmedman] no prob perhaps..
[fakehugs] okay what is on the schedule for tommorrow
[Jibbsie] thanks Joe, and everyone. Goodnite
[josephmedman] tomm. we start resp. we are doen cardio
[josephmedman] resp is short
[josephmedman] shoudl be quick
[josephmedman] cardio needed much attention
[fakehugs] gi and live on thurs
[josephmedman] very HY
[fakehugs] cards is impt
[josephmedman] yes
[Jibbsie] is House like Grey's. I have seen Greys
[josephmedman] house is a little like grey's but less dramatic and a little funnier
[josephmedman] but its awesome when you know what they are talkign about
[Jibbsie] Na-nite
[josephmedman] shows liek these are great motivators
[josephmedman] and we can relate to them
[arezooman] what about ER?
[josephmedman] ER is ok
[josephmedman] used to be better long time ago
[josephmedman] getting mundane
[josephmedman] ok guys..see you tomorrow..
[georgere] I know
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[georgere] See you
[josephmedman] transcript will be on both websites..
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[arezooman] thanks and bye
[Ammu] bye
[ppliutcm] thanks
[perhaps] bye
[ppliutcm] bye
[josephmedman] will do jen.take care..
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