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  1. #1
    dua_frank is offline Junior Member
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    Peds chat: Respiratory system, Rheumatology, Cardiovascular

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    Welcome
    dua_frank has joined the chat.
    [elisa] hi
    [elisa] anyone
    [elisa] ??
    [elisa] is there anybody there?
    [dr_gpsbambra] elisa lets chat
    [dranvita]
    [Patrick_Wei] ??
    [Patrick_Wei] any one here?
    [romdoc] I hope i am in the right chat room. Question? What is SABA's attrition rate?
    [chandra] hello
    Now entering USMLE_Step_2 subroom.
    dua_frank has joined subroom: USMLE_Step_2
    [samantha] yeah
    [dua_frank] hi all
    [dua_frank] sorry i'm late
    [dua_frank] be right with you
    [samantha] i have to do that
    [ash] hi dua
    [ash] and i guess the nbme form 1 and 2 would be good too
    [samantha] yes
    [samantha] havn't done that yet
    [ash] hey dua what are the peds topics for todays discussion?
    [samantha] hi dua
    [samantha] ok
    [ash] for step 1 i had solved nbme form 1 and it gave the exact percentile of my usmle score
    [sanz] hi dua
    [sanz] sorry was away on the phone sam...
    [sanz] sammy, the last 2 weeks, i;d say go thru the NMBE
    [sanz] and then First Aid Step 2
    [sanz] that was what i did and it worked
    [ash] thanks sanz
    [samantha] should i read medicine or paeds sanz?
    [sanz] dont leave the NMBE too late... go thru the qs with someone
    [sanz] medicine is the majority sam... but i had a lot of peds and ObGyn as well
    [samantha] but i don't have the q ?
    [samantha] can we write them down?
    chandra has left the chat.
    [ash] is dua back yet?
    samantha has left the chat.
    [ash] hello anybody here????
    [dua_frank] back
    [dua_frank] i was putting up the schedule, forgot to do that yesterday
    [sanz] hey dua
    [dua_frank] hey sanz!
    [dua_frank] nice to see you here today
    [sanz] how is it goin buddy!! *hugs*
    [dua_frank] *hugs*, going good. how about with you
    [sanz] i have been so lazy and such a bum.. so i thought i'll come in here and disturb you!
    [ash] dua what do we discuss today?
    [dua_frank] oh please do anytime
    samantha has left the chat.
    [sanz] peds, according to sam
    [dua_frank] 12th Apr Respiratory system, Rheumatology, Cardiovascular system, Nutrition
    [ash] ok thanks
    [dua_frank] welcome
    [dua_frank] sanz your cds are still in the printing process, i hope you don't mind the delay
    [dua_frank] i don't have a dvd writer
    [dua_frank] getting one of my friends to do that for me
    [ash] should we start?
    [sanz] dua, take your time... i'm just reading novels at themo
    [dua_frank] lol ok then good
    [dua_frank] yes ash
    [dua_frank] whats the mc fatal inherited disease of the whites?
    [ash] cystic fibrosis?
    [dua_frank] yes
    [dua_frank] what is its initial manifestation?
    [ash] meconium ileus
    [dua_frank] right
    [dua_frank] tell me the other systems it can affect and the manifestations
    [ash] respiratory tract
    [ash] pseudomonas
    [ash] bronchiactesis
    [ash] pancreas
    [dua_frank] bronchiatasis, malabsoption, prolapse of rectum
    [ash] malabsorption
    [dua_frank] resp and gi system
    [ash] diabetes
    [dua_frank] right
    [sanz] what organism is common in CF pt?
    [sanz] in CF pt lungs...
    [dua_frank] staph aureus
    [ash] pseudomonas
    [sanz] yup pseudo is killer
    [dua_frank] mc is staph aureus in initial infection ash
    [ash] fruity odour
    [sanz] what Ab'ics?
    [dua_frank] pseudo in later stage and yes its fatal
    [ash] ok thanks dua
    [dua_frank] also h influenza in initial and aspergillus in later stages
    [dua_frank] welcome
    [sanz] great dua
    [sanz] need to know the Ab'ics for pseudo
    [dua_frank] what is the metabolic abnormality produced?
    [dua_frank] bactrim?
    [ash] diabetes
    [dua_frank] right
    [sanz] pipercillin
    [dua_frank] the electrolyte abnormality?
    [ash] ceftriaxone
    [dua_frank] uh oh
    [dua_frank] antibiotics
    [ash] third generation cephalosporins
    [dua_frank] yeah
    [ash] newer penicillins+clavulinic acid
    [dua_frank] most gram negative activity by third generation cephs
    [dua_frank] most gram positive by first generation cephs
    [ash] remember henpeck
    [dua_frank] anerobes by fourth, cefipine
    [dua_frank] whats henpeck?
    [sanz] or pipercillin and tobramycin for pseudomonas... also ceftazidime and cefepime
    [dua_frank] thanks
    [sanz] that's high yield ...
    [dua_frank] hypochlorimic met alkalosis
    [ash] h influ,enterobacter,neisseria,proteus,e coli,klebsiella
    [dua_frank] whats henpeck for ash?
    [ash] dua see the first letters of the above list of each organism,peck is second generation cefalosporins
    [ash] and henpeck is for third generation cephalosporins
    [dua_frank] oh ok thanks
    [dua_frank] any for the first?
    [ash] oh
    [ash] sorry
    [ash] peck is for first generation
    [ash] and henpeck is for second
    [dua_frank] ok
    [dua_frank] third?
    [dua_frank] pseudomonas i guess
    [samantha] what do they stand for?
    [ash] third for gram negative
    [samantha] means hen and peck
    [ash] and fourth for both gram positive and negative
    [dua_frank] rx of aspirin induced asthma?
    [ash] misoprostol
    [sanz] the infectious disease chapter in Kap IM notes are more than enuf... they explain the Ab'ics well
    [dua_frank] yes as well as leukotriene inhibitors
    [dua_frank] zifirlukast
    [ash] or montelukast
    [ash] thanks sanz
    [dua_frank] rx of exercise induced asthma?
    [ash] i was really worried about the infectious diseases
    [ash] too many in reality
    [sanz] also know what to give the neutropenic pt
    [ash] salmeterol
    [ash] salbutamol
    [dua_frank] albuterol for acute attacks and cromolyn sodium in between
    [samantha] yup
    [dua_frank] salmetrol is not for acute attacks ash
    [ash] well albuterol belongs to the same class as salbutamol
    [ash] and salmeterol
    [ash] yes
    [dua_frank] whats the mc cause of cerebral palsy?
    [ash] salmeterol is long acting
    [dua_frank] yes it does, but induction time is longer
    [samantha] for neutropenic pts what do u give sanz?
    [ash] so not for acute attacks
    [dua_frank] plus yes it does stay for a longer time too
    [samantha] drugs dua
    [samantha] ?
    [dua_frank] what drugs for neutropenic patients?
    [ash] dua ischemia during intrauterine life
    [dua_frank] depends on the kind of infections they are predisposed to getting
    [sanz] it depends on the case sam...
    [samantha] no cc of cerebral palsy
    [dua_frank] yes ash, cerebral anoxias
    [dua_frank] oh
    [sanz] ok.. let me give you cases.. and you ans
    [ash] ok sanz
    [dua_frank] no not drugs, anoxia
    [samantha] ok dua
    [samantha] ok sanz
    [sanz] first define febrile neutropenic pt
    [sanz] temp >38.8C
    [sanz] and wbc <500
    [dua_frank] ok
    [samantha] yes
    [sanz] so let's say they said this pt had undergone some sort of chemo recently
    [ash] ok
    [sanz] and now temp 39 and wbc 300
    [ash] ok
    [ash] myelosuppression
    [dua_frank] right
    [sanz] then you ned to decide if he's very ill or hemodynamically unstable
    [ash] ok
    [dua_frank] ok
    [sanz] if his BP is reasonable, like 130/80... then mono therapy
    [sanz] if not, you need
    [sanz] vanc
    [sanz] brb
    [sanz] phone
    [ash] huh?
    [dua_frank] lol
    [samantha] what is brb?
    [dua_frank] be right back
    [ash] barbiturates?
    [dua_frank] lol
    [ash] vancomicin and phenobarbitone?
    [dua_frank] if the patient is unstable, give vanco
    [samantha] lol i think sanz is ans phone
    [dua_frank] no ash, brb means be right back
    [dua_frank] yes
    [dua_frank] forget the brb)
    [dua_frank] lol
    [ash]
    [ash] *)
    [dua_frank] what kind of gait do you see in cerebral palsy patients?
    [ash]
    [samantha] lol lol
    [ash] spastic
    [ash] mostly
    [samantha] apraxia of gait
    [dua_frank] scissoring and yes due to spasticity of the adductors
    [dua_frank] how will you rx this?
    [ash] release surgery?
    [dua_frank] diazepam or dantrolene
    [samantha] what is apraxia of gait?
    [ash] oh yes!!!duh!!spastic
    [ash] so give a relaxant right
    [dua_frank] apraxia of gait is when the person's cerebrum is messed up
    [dua_frank] they cannot tell position
    [ash] cerebellum
    [dua_frank] so they have gait disturbances
    [ash] not cerebrum
    [samantha] thanx dua
    [dua_frank] i thought it was one of the symptoms of the parietal lobe ash
    [dua_frank] gait apraxias
    [ash] i am doing it all wrong!so sorrt!i was talking about ataxia
    [sanz] ok... sorry guys... i'm back
    [ash] sorry dua
    [ash]
    [ash] just not my day
    [sanz] anyway, if the pt just meeds monotherapy - give ceftazidime or cefepime
    [sanz] if not improving or not stable... add gentamicin
    [dua_frank] Apraxia is a syndrome reflecting motor system dysfunction at the cortical level, exclusive of primary motor cortex.
    [sanz] if hemodynamically unstable or pt has long lines, add vanc
    [dua_frank] ok sanz
    [sanz] that's it
    [ash] thanks sanz
    [dua_frank] start cephs, then gentamicin
    [dua_frank] then vanco
    [dua_frank] ok
    [dua_frank] thanks sanz
    [sanz] FA has a good diagram and UW had a q like this
    [dua_frank] please go inject hard to store information like this into our brains
    [dua_frank] we need your help on this
    [ash] ok i have to go now.good night all
    ash has left the chat.
    [sanz] dua you'r doing fine!
    [dua_frank] spike and wave pattern on the EKG
    [dua_frank] dx?
    [samantha] absence epilepsy?
    [dua_frank] yes
    [samantha] temporal lobe
    [samantha] dua is good sanz
    [sanz] i know she is sam
    [dua_frank] no i'm not
    [dua_frank] i never get more than 35 on tests
    [dua_frank] no matter how much i try
    [samantha] with out knowing a lot u cannot prepare q's
    [dua_frank] thats my problem sammy, ive never been good at tests
    [sanz] 35/test on kap qbank?
    [sanz] that's good
    [dua_frank] i learn just for the heck of knowing things, not for exams ever
    [dua_frank] and what i don't like, never gets into my head, like cephalosporins
    [dua_frank] yeah q bank sanz
    [sanz] dua that's even better way of learning... for life... not for just one stupid exams
    [dua_frank] i have a mental block to a lot of things in medicine
    [sanz] dua, everyone has... dont worry... think positive
    [samantha] that's the way to do it dua after the exam u are on your own to managage pts
    [sanz] you're fine *hugs*
    [dua_frank] yeah but need to clear these exams to get till there sammy
    [dua_frank] these exams are a real pain, can't wait to get over with them
    [samantha] that u will do very well dua
    [sanz] soon guys soon
    [dua_frank] i hope we both do well sammy
    [samantha] i am really scared i want just to pass
    [sanz] yeah i'll be praying for you all
    [dua_frank] nah, you're well prepared too sammy
    [dua_frank] thanks sanz
    [samantha] thanx sanz
    [sanz] if i could do it anyone could
    [sanz] dont worry... just work consistently
    [dua_frank] no way, you're a genius
    [samantha] i am not sure dua i have been studying reasonably well
    [dua_frank] i have never known anybody to get a 99 with only 2 months prep
    [samantha] but not that good
    [sanz] 3 mths dua
    [dua_frank] 3 months is less too sanz
    [sanz] hehe... maybe 3 is my lucky number
    [sanz] i did step 1 in 3 mths too
    [sanz] anyway, back to the discussion...
    [samantha] sanz u must have been a very bright student
    [dua_frank] she sure is
    [sanz] what are the cyanotic heart conditions?
    [dua_frank] i'm not deluding myself by comparing myself to her
    [dua_frank] i'll take my 6-7 months prep all
    [dua_frank] all the Ts
    [dua_frank] tricuspid atresia, TGA, TOF
    [dua_frank] Eisenmengers
    [samantha] agree
    [dua_frank] seizures right after going to sleep?
    [sanz] good
    [sanz] Rx for acute TOF?
    [samantha] forgot dua
    [david100] hi doctors
    [sanz] hi *****
    [dua_frank] propranolol
    [dua_frank] hello *****
    [dua_frank] morphine oxygen
    [david100] can i know which topic are you dicussing?
    [samantha] hi *****
    [dua_frank] sodium bicarb
    [sanz] good dua! See you know stuff! propranolol, knee chest position and fluids
    [dua_frank] benign rolandic epilepsy
    [dua_frank] i got to know those sanz, i worked in CT remember *)
    [david100] all of you preparing for step2?
    [dua_frank] ask me antibiotics besides vancomycin, i'd say, say what? lol
    [samantha] i am getting demented
    [sanz] not me *****.... i'm just disturbing them... hehe
    [samantha] lol
    [dua_frank] clox and gentamicin and vanco is all that we used
    [david100] by the way doctors i have the latest qbank if any need them tell me
    [dua_frank] whats infantile spasms?
    [sanz] baby seize with posture like Monro reflex... only in succession
    [dua_frank] right, there is MR associated with this
    [dua_frank] rx?
    [sanz] gaba?
    [sanz] dont rememebr
    [sanz] or ACTH?
    [dua_frank] no idea sanz, was hoping you would know
    [samantha] diazepam?
    [dua_frank] anticonvulsants for benign rolandic epilepsy
    [sanz] wait... i'll go find out for ya
    [dua_frank] but dunno for infantile spasms
    [dua_frank] ok
    [sanz] ACTH and pred
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    [lanny] hi guys sorry im late
    [dua_frank] baby 5 months high fever having seizues, rx?
    [sanz] ACTH works for a reason...
    [dua_frank] thanks sanz
    [dua_frank] how does it work?
    [sanz] cuz infantile spasm is thought to be due to overstimulation of CRH
    [dua_frank] ohhhhhhhhhh
    [dua_frank] that explains that
    [sanz] actually it was strug who told us this... now i remember
    [samantha] febril seizures
    [dua_frank] thanks sanz
    [samantha] hi lanny
    [sanz] hi lanny
    [dua_frank] yes sammy rx underlying cause
    [dua_frank] hi lanny
    [lanny] hi sammy
    [lanny] hi sanz
    [lanny] hey dua
    [sanz] i'm messing around in here... hehe.. how have you been lanny?
    [lanny] so we have a sched now
    [lanny] been good getting thru kap q bank in a few days
    [samantha] paeds lanny
    [lanny] ok sammy thanks
    [dua_frank] sanz your qs are valuable
    [lanny] then will take NBME
    [dua_frank] please do continue asking them
    [sanz] dua i will... i have forgotten so much
    [lanny] i was geting 72 cummulative now im down to 70 instead of going up dissapointed
    [samantha] yes sanz please be around
    [dua_frank] time to re read your notes lanny
    [sanz] lanny it's alright... just go thru yr wrong qs... which i didnt have time for...
    [lanny] yes sanz i make sure i read the explanations
    [sanz] read thru the ones you got right too... and the other options
    [lanny] ok thanks
    [dua_frank] ataxia of gait, hypotonia, optic atrophy, intellectual deterioration, absent reflexes, upgoing toes, raised csf protein and dec motor nerve conduction velocity, dx?
    [lanny] did your NBME score correlate with you real score sanz??
    [dua_frank] age 1-2 yrs
    [sanz] lanny yes
    [samantha] GB synd
    [lanny] thanks
    [dua_frank] GB has absent babinski
    [samantha] guillian barre?
    [dua_frank] nope
    [lanny] but any explanations in NBME?
    [dua_frank] hint AR disorder
    [sanz] no lanny... discuss it with someone
    [lanny] ok
    [samantha] MS?
    [dua_frank] MS does not happen in children
    [sanz] ataxix telan dua?
    [samantha] oops...
    [dua_frank] but you're close
    [sanz] or fredriech ataxia?
    [dua_frank] think of an MS variant in infants
    [lanny] myotonic dyst
    [dua_frank] freidrichs no hypotonia
    [dua_frank] right?
    [dua_frank] its the dorsal column disease
    [sanz] dua yeah you're right
    [dua_frank] metachromatic leukodystrophy
    [dua_frank] can you believe that they asked this *)
    [sanz] oh man yeah
    [dua_frank] AML like symtoms in newborn, whats the disease?
    [lanny] oh this is lorenzos oil
    [samantha] oh...
    [lanny] did you watch that movie
    [dua_frank] whats lorenzos oil?
    [sanz] no lanny
    [samantha] werdnig hoffman
    [dua_frank] good sammy
    [dua_frank] the infant born is floppy here, no tone in muscles
    [lanny] ok a classic movie came out a few yrs ago
    [dua_frank] same clinical picture as metachromatic leukodystrophy but with hyperacusis and seizures and happening at 6 months age, dx?
    [dua_frank] again an AR disease
    [lanny] the actor was a boy with metachrom leukodystrophy
    [samantha] it is congenital rt?
    [dua_frank] does he have all those symptoms lanny?
    [lanny] yep
    [dua_frank] i like such pictures of rare disorders
    Please rephrase your last message.
    [lanny] ALS
    [dua_frank] no other way can i remember the da mn names :an
    [dua_frank] krabbes
    [dua_frank] MLD and krabbes are both to do with myelin
    [dua_frank] lipidosis
    [dua_frank] so is MS in a way
    [dua_frank] right?
    [dua_frank] so there will be a mixed pictuer of sensory and motor symptoms
    [dua_frank] go by the age
    [dua_frank] old man, MS
    [dua_frank] 6 months Krabbes
    [dua_frank] 1-2 yrs MLD
    [sanz] wow, that's good dua
    [sanz] i could never get my head around white matter disease
    [samantha] def of enzyme cerebroside sulfatase,causing metachromatic lipids to accumulate in white matter
    [dua_frank] sammy my head is already overload with names
    [samantha] peripheral nerves kidney spleen and others
    [dua_frank] i don't know if those enzymes will stay now
    [sanz] enz are more of step 1 anyway.. just know how to dx and rx
    [dua_frank] thanks sanz, they are a pain
    [samantha] progessive paralysis dementia before 2 yr fatal by age 10
    [dua_frank] yeah i'd rather not learn the enzyme, i doubt they will give the enzyme in step 2
    [dua_frank] not even as a hint, i;m sure
    [dua_frank] thats a dead give away
    [dua_frank] they are not that nice!
    [sanz] hehe
    [dua_frank] mottled lungs dx?
    [sanz] ?
    [samantha] yes dua no need for enzyme just to know it is enzyme def
    [dua_frank] mottled lungs with Mental retardation, bloated up abdominal organs
    [dua_frank] blind, deaf too
    [dua_frank] dx?
    [sanz] dont know!
    [dua_frank] ok ok i throw in cherry red macula :P
    [samantha] dunno
    [dua_frank] coz i'm nice :P
    [dua_frank] niemann pick
    [samantha] tay sach?
    [sanz] tay sach
    [dua_frank] tay sachs only affects brain
    [dua_frank] not abdominal organs
    [dua_frank] neiman picks goes everywhere
    [sanz] ooooooh
    [dua_frank] both have cherry red macula
    [sanz] yeah
    [dua_frank] both in jews
    [samantha] wow...
    [dua_frank] both die befor 3 years
    [sanz] dua is a knowledge pot
    [dua_frank] gauchers is the nice one
    [dua_frank] only affects liever so babies can still survive
    [dua_frank] with enzyme replacement with glucocerebrosidase
    [dua_frank] comparison is the only way to rememebr the da mn things sanz
    [samantha] yes sanz
    [dua_frank] but it does make things easier doesn't it?
    [samantha] sure dua...
    [sanz] dua yeah... but i'll not remember in a day or 2
    [dua_frank] lol i don't think i will either
    [dua_frank] lets just remember that the two resembling MS are... :
    [dua_frank] ?
    [sanz] krabbe
    [dua_frank] and?
    [sanz] and MLD
    [dua_frank] right
    [sanz] Krabbe is young 6 mth
    [sanz] MLD older kids
    [samantha] gr8
    [dua_frank] the two with jews and cherry red macula, one with brain signs and other with brain plus abdomen signs and both die are?
    [dua_frank] MLD like in 1-2 yrs yes
    [sanz] tay sach and nieman
    [dua_frank] tay is the brainy one
    [dua_frank] which is the nice one affecting only liver and spleen and is treatable?
    [sanz] gaucher
    [lanny] nieman pick
    [dua_frank] right
    [sanz] i think it affects bone
    [sanz] bone as well i mean
    [dua_frank] guachers?
    [sanz] gaucher.. i remmeber the classic sign is a flask shape of the femur head
    [dua_frank] really?
    [lanny] crmpled paper calls???
    [lanny] crumpled
    [lanny] cells is patho for gaucher
    [dua_frank] It then accumulates, mostly in the liver, spleen, and bone marrow. Gaucher disease can result in pain, fatigue, jaundice, bone damage, anemia, and even death.
    [sanz] lanny yeah rumpled paper cells too
    [dua_frank] yes you're right, it does accumulate in the bone marrow to
    [dua_frank] ok there are two variants, fabrys which affects the heart and charcot marie tooth which affects the peroneal muscle
    [sanz] http://www.amershamhealth.com/medcyc...LASK_DEFORMITY
    [sanz] there you go
    [dua_frank] thanks
    [lanny] ok ive heard this deform sanz
    [sanz] dua can you clink on the links now?
    [sanz] i know you had problems before...
    [samantha] thanx sanz
    [dua_frank] no
    [sanz] oh
    [sanz] type erlenmeyer flask gaucher in google images
    [sanz] you'll get this link
    [dua_frank] i did that
    [sanz]
    [samantha] stork deformity is in which?
    [dua_frank] psoriasis?
    [sanz] dont know sam
    [samantha] charcot marie tooth
    [sanz] oh yeah of cuz clever girl u!
    [samantha] or peroneal muscle atropy
    [dua_frank] is that whats called pes cavus?
    [dua_frank] hehe i got the mental picture
    [samantha] i think so dua
    [sanz] pes cavus is fredriech atax i think
    [dua_frank] its also mentioned in charcot marie tooth sanz
    [sanz] maybe they both have it
    [dua_frank] how can one differentiate between galactosemis?
    [sanz] reducing sugar test
    [dua_frank] explain please
    [sanz] hhmm... i dont know how to explain... i just know we did it where i worked before...
    [sanz] bad huh?
    [dua_frank] thats okay, i don't know why the heck we do so many tests either
    [dua_frank] i'm trusting the 4 years of residency to figure out those mysteries
    [sanz] i doubt it dua
    [sanz] but i hope we will figure out some tho
    [dua_frank] sammy and lanny, any inputs?
    [samantha] there are 2 types rt?
    [dua_frank] i think maybe galactokinase def does not have hypoglycemia
    [dua_frank] yes
    [dua_frank] one is galactokinase def and the other galactose 1 phosphate uridyl transferase
    [sanz] maybe they are looking for acc of galactase which is a reducing sugar
    [dua_frank] the second one has a lot of symptoms with cataracts and MR
    [sanz] one has cataract but the other doesnt have
    [dua_frank] the other one has it too sanz
    [sanz] both has cataracts?
    [dua_frank] both occur after nursery that is after they start breast feeding
    [dua_frank] yes
    [dua_frank] at birth cataracts would point to rubella
    [sanz] ok, i just went to check out my step 1 notes...
    [sanz] GU
    [sanz] sorry
    [samantha] the accumulation of galactitol in the lens causes cataracts
    [dua_frank] also please help differentiat hunters from hurlers sanz
    [samantha] hunters is x linded
    [sanz] GL1PUT def cause liver prob and hyperbili
    [sanz] the other type of galactosemia doesnt have hyperbili
    [sanz] both have cataract
    [samantha] hurlers less serious and auto reccessive
    [dua_frank] oh ok so the liever is imp here
    [sanz] hurlers has cataract
    [sanz] hunters dont
    [dua_frank] one baby with hypoglycemia and reducing sugars in urine
    [sanz] dua yes to differentiate the 2 types of galactosemia
    [dua_frank] has hepatomeglay
    [dua_frank] one without
    [dua_frank] thanks sanz
    [dua_frank] thanks sammy
    [dua_frank] hunters is x linked
    [samantha] thanx sanz and dua
    [dua_frank] somethign to do with brain too in hunters
    [dua_frank] MR
    [sanz] well guys... gtg... see ya around and good luck with yr prep!
    [dua_frank] thanks sanz
    [dua_frank] bye
    [sanz] bye bye
    sanz has left the chat.
    [dua_frank] hypercalcemia, preductal AS and peculiar elephant facies, dx?
    [dua_frank] i hope we remember what we learnt today sammy, today's differentiating points will help us in diagnosing those confusing and odd ped diseases
    [samantha] rt dua all this helps
    [samantha] to understand it does not stay
    [dua_frank] yeah
    [lanny] back guys sorry had to go make dinner
    [dua_frank] lets keep the three words in our mind, MS like, AML like, Jews association
    [samantha] if we go back and read it
    [dua_frank] we have at least 6 diseases figured out right there
    [samantha] rt dua
    [dua_frank] then we have galactosemias with and withotu liver
    [samantha] galactose 1 po4 uridyl
    [samantha] is more serious?
    [lanny] dua is A ML ALS you mean
    [samantha] galactokinase def is one
    [dua_frank] yes sorry
    [lanny] what is AM
    [lanny] L guys?
    [dua_frank] yes sammy
    [samantha] went back and read it dau
    [dua_frank] leu geikes
    [samantha] dua
    [samantha] Amytrophic lateral sclerosis lanny
    [lanny] right but is it seen in kids this young??
    [samantha] yeah it is called leu gericg's dis
    [dua_frank] hunters and hurlers have same presentation
    [lanny] lou gerighs dz
    [dua_frank] except hurlers is fast progressing and worse
    [samantha] yes lanny
    [samantha] dua the ans to your q is hurlers rt?
    [samantha] the elephant facies
    [dua_frank] ALS like in newborns is werdnig hoffman lanny
    [dua_frank] no thats williams syndrome
    [samantha] oh...
    [dua_frank] hypercalcemia, preductal AS and elephant facies
    [lanny] rught i was gonna say that in kids it is called werdnig hoff
    [lanny] hallmark is hypotonia
    [samantha] rt lanny
    [dua_frank] we were just zeroing in our points for today
    [dua_frank] MS and ALS association
    [dua_frank] jews
    [lanny] oh ok i see
    [dua_frank] galactose
    [lanny] sorry i missed it
    [dua_frank] fabrys for heart
    [samantha] there is a condition of mucopolysaccaridosis do u know which one?
    [dua_frank] charcot marie for peroneal ms
    [dua_frank] those are hunters and hurlers sammy
    [samantha] they have gross facies also
    [dua_frank] MPS 1 is hurlers
    [dua_frank] MPS II is hunters
    [dua_frank] yeah i think thats hurlers
    [samantha] thanx dua
    [dua_frank] welcoe
    [lanny] right dua
    [dua_frank] i sure hope we rememebr these
    [lanny] hunter is mild mental retard
    [lanny] cornea no affected
    [lanny] in hurler cornea is cloudy
    [dua_frank] thanks lanny
    [lanny] and retard is severe
    [lanny] hunter is a mans name so hes gotta be able to see to hunt
    [lanny] and be clever to hunt too
    [lanny] so he needs his brain
    [dua_frank] in which resp condition would you see a patent ductus arteriosus?
    [lanny] mild mental retard)
    [samantha] nice lanny
    [dua_frank] nice
    [dua_frank] man blind and dumb
    [dua_frank] x linked
    [samantha] lol
    [lanny] right
    [dua_frank] are you sure we're not talking about all men in general here? :P
    [dua_frank] kidding ... lol
    [samantha] just joking
    [lanny] hunter is a man ..............x chromrecessive
    [lanny] hurler is aut dom
    [dua_frank] i thougth hurlers AR
    [lanny] sorry recess
    [dua_frank] RDS
    [samantha] u hunt on the X mark so x linked
    [lanny] what s with RDS?
    [dua_frank] resp disorder in kids with PDA
    [lanny] oh ok
    [dua_frank] sammy cool
    [dua_frank] which CVS condition would you use PGE1?
    [samantha] yeah dua lanny
    [lanny] no time for dancing for me im depressed
    [lanny] in transposition
    [dua_frank] lanny, ive been having bad days at tests too, my scores came down too by 5 points
    [dua_frank] maybe we are just getting tougher questions
    [samantha] decided not to get worked up
    [dua_frank] yes TGA
    [dua_frank] time to keep your cool and tell yourself all the q you are getting wrong are new information qs
    [samantha] will do what ever i can
    [lanny] well what can i say will know where i stand from my NBME
    [dua_frank] rx of tet spells?
    [lanny] oxygen
    [dua_frank] lanny you can take this exam down
    [dua_frank] you got to
    [lanny] oh boy may your wish come true
    [dua_frank] yes o2, morphine, nahco3
    [dua_frank] most importantly
    [dua_frank] IV propranolol
    [lanny] oh yes that q is in UW
    [dua_frank] MC of CHF in first week of life?
    [lanny] so how does a child with tet spells prst?
    [dua_frank] blue tachypnea
    [lanny] AS
    [dua_frank] agitated
    [dua_frank] right lanny
    [dua_frank] 2nd week?
    [samantha] which resp condition there is PDA dua
    [lanny] ARDS sam
    [dua_frank] RDS sammy
    [dua_frank] not adult
    [lanny] yes
    [samantha] thanx
    [dua_frank] 2nd can be either VSD or PDA
    [dua_frank] 2nd week
    [lanny] yes
    [dua_frank] septum primum ASD with what syndrome?
    [lanny] fetal alcohol
    [dua_frank] downs
    [lanny] downs is endocard cushion dua
    [dua_frank] yes and ASD primum is partial endocard cushion defect lanny
    [dua_frank] complete would be AV canal defects which are mc in downs yes
    [samantha] yes rt
    [lanny] ok du
    [lanny] right
    [dua_frank] hypoxias and pulmonary htn keeps pda open
    [samantha] shall we leave for today?
    [lanny] ok dua
    [samantha] see u tom guys
    [dua_frank] ok
    [dua_frank] see you tomorrow bye and good night
    samantha has left the chat.

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    my mother has a heart attack now.any one cane help

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    i gave here clexane ampouls but she still snooing and the bluesh colour in extremitis and legis appea........i gave here one tab dinitrate sublingual but she still snooring coold

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    can anyone explain to me the interrelationship between the cardivascular and the respiratory systems?

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    can u explain the interrelationship between the cardiovascular and the respiratory systems

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