s******t
发帖数: 579 | 1 (The patient was admitted because of MDD secondary to her debilitating LLE weakness, numbness and tightness. I'd like to focus on her neurological symptoms.)
CC:
A 72 y/o white F complains of LLE weakness, numbness and tightness.
HPI:
Pt was diagnosed lumbar spondylosis, lumbar spinal stenosis, low back pain and lumbar radiculopathy 2 yrs ago. Had a lumbar fusion 1 yr ago. Started to recover at the beginning, but had worsening of weakness and eventually required a hardware removal 6 months ago. ... 阅读全帖 |
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f*****g
发帖数: 37 | 2 2nd page:
AAO 34mm AO sinus 32mm LA end systole 23mm
LA end diastole 37mm LVEF 60% IVS end diastole 6mm
LVPW end diastole 6mm AO root 14mm Left PA 3.5mm
Right PA 6mm RA end systole 38mm RV end systole 28mm
Forwarding flow 2.2m/s at RVOT. Echo shows:
RA, RV are enlarged. RV wall becomes thickened, 6mm. Left heart wnl. Wall
motion wnl.
Loss of Echogenicity at infundibulum septum.
Overriding AO, degree 55%. ROVT has m... 阅读全帖 |
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h***y
发帖数: 834 | 3 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
h***y
发帖数: 834 | 4 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
b**o
发帖数: 5769 | 5 考试题不能贴啦。
给一个我们的作业好了。
O.D. is a 18 YO F who presented to your hospital 5 days ago following an
intentional ingestion of Seroquel® after a verbal disagreement with her
mother. O.D. admitted to taking 20—300 mg extended release Seroquel®
tabs. Several hours later, O.D. collapsed and her eyes rolled back in her
head. The paramedics noted seizure activity, and O.D. was transferred to
the hospital for further care. She was noted to have a tonic-clonic seizure
lasting 30 minutes and was int... 阅读全帖 |
|
s********o
发帖数: 3319 | 6 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
|
s********o
发帖数: 3319 | 7 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
|
l*h
发帖数: 4124 | 8 wnl - within normal limits |
|
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m*********e
发帖数: 40 | 10 wnl within normal limits. 都正常
看不懂这个新生儿筛查的单子，项目名称完全不知道是什么。这个value的缩写是什么
意思也不知道。版上有没有懂的好心人帮忙翻译一下，谢谢各位好心人先。 |
|
I*********t
发帖数: 5258 | 11 Mac的sort虽然也是gnu sort，但是比较老。你可以用其它方法实现随机分选，比如
$ cat SortedFile.txt | perl -wnl -e '@f=<>; END{ foreach $i (reverse 0 .. $#
f) { $r=int rand ($i+1); @f[$i, $r]=@f[$r,$i] unless ($i==$r); } chomp @f;
foreach $line (@f){ print $line; }}'
这个应该是跨平台的 |
|
D*a
发帖数: 6830 | 12 PMID:
19015485
Neurology. 2008 Nov 18;71(21):1702-8. doi: 10.1212/01.wnl.0000335163.88054.
e7.
Growth hormone secretagogue MK-677: no clinical effect on AD progression in
a randomized trial.
Sevigny JJ, Ryan JM, van Dyck CH, Peng Y, Lines CR, Nessly ML; MK-677
Protocol 30 Study Group.
PMID:
23401344 |
|
r*******e
发帖数: 123 | 13 PMID: 16924025
DOI: 10.1212/01.wnl.0000230145.73496.a2
Neurology. 2006 Aug 22;67(4):687-90.
A novel GABRG2 mutation associated with febrile seizures.
Audenaert D1, Schwartz E, Claeys KG, Claes L, Deprez L, Suls A, Van Dyck T,
Lagae L, Van Broeckhoven C, Macdonald RL, De Jonghe P.
Please e-mail to my gmail account: [email protected]
thank you very much. |
|
N****e
发帖数: 31 | 14 38yr, female, present with diarrhea for 4 days, initially loose watery
diarrhea, 3-4 times/days, now every hour, and blood mixed with the stool,
medium volume, non-foul smelling, with mild crampy abd pain. Had a course of
antibiotics (Keflex) 2 weeks ago
Labs:
LFTs/Amylase/Lipase: WNL
Chemo: Na 137 K 3.4 Cl 108 CO2 23 BUN 6 Cr 0.6 Glu
127
CBC: WBC 13.6 Hgb 12.4 HCT 37.9 Plt 264
Coag: PT 12.2 INR 1.1 PTT 29
Hospital Course:
1. IVF, po hydration
2. St... 阅读全帖 |
|
N****e
发帖数: 31 | 15 38yr, female, present to PAH on 4/4/10 with diarrhea for 4 days, initially
loose watery diarrhea, 3-4 times/days, now worse and loose watery stool
every hour, and blood mixed with the stool, medium volume, non-foul smelling
, with mild crampy abd pain. Have had 5 BMs since yesterday, and the last
one almost all blood. (+) subjective fever, no chills, no cough/SOB. Had a
course of antibiotics (Keflex) 2 weeks ago (3/9/10- 3/14/10).
PMHx: Kidney stones, Seizure disorders, Vit D deficiency
PSHx: S... 阅读全帖 |
|
k********n
发帖数: 756 | 16 Male, 40s, no PMH, sub-acute onset, VS WNL
hearing loss
encephalopathy
blurry vision
MRI: multi-focal contrast enhancing/demyelinating changes, corpus callosum involved.
Hint: not MS |
|
e****0
发帖数: 678 | 17 mid age man follow up visit. pt has been healthy and exercise regularly up
until his cardiac event. He clapsed on Golf course with Vfib cardiac arrest.
Intubated and CPR on field, transferred to CCU and subsequently had hypoxia
encephalopathy.
Pt recovered completely. EF normal, heart function normal. Implanted ICD
before discharge. ICD wire caused SVC stenosis and clotted off. Pt presents
with SVC syndrome.
Come in office for the medication adjustment and SVC syndrome follow up
PE: no acute dis... 阅读全帖 |
|
d******0
发帖数: 296 | 18 Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake hands. Is everything in the room
alright for you? Let me cover you with this to make you a little m... 阅读全帖 |
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m******r
发帖数: 1904 | 19 1.没用过。不懂。
2.Common abbreviations for SP note
BP Blood pressure
P pulse
R respiatory rate
T temperature
yo year-old
m male
f female
b black
w white
L left
R right
hx history
h/o history of
c/o complaining of
NL normal limits
WNL within normal limits
Ø without or no
+ positive
- negative
Abd abdomen
AIDS acquired immune deficiency... 阅读全帖 |
|
n***j
发帖数: 184 | 20 考试的时候，enter是占格的。但是全一起写又太难看了，我是分成下面的几个块写的
，下面有空行的地方考试的我没有空行。最后PN是*，希望能有帮助。 good luck
CC: A 45 yo M c/o bloody vomiting.
HPI: 2 episodes, 2 hours ago and 30 mins ago, w/o known causes. Feels dizzy.
A cupful each time, bright red, no clots, smelly. Epigastric pain at the
same time,dull, buring, 6-8/10, radiating to the back, intermittent,
aggravated with drinking fluids, no alleviating factors. Heartburn for a
long time. No previous episode of bloody vomiting/ nausea/ fever/ chest pain
/ cough/ bla... 阅读全帖 |
|
d****y
发帖数: 2180 | 21 ☆─────────────────────────────────────☆
Jane27 (小简) 于 (Sun Nov 25 23:53:22 2012, 美东) 提到:
在USMLE官方网站上面练习PN的链接， 如果每次点enter的话就会take up 很多的space
,结果是我的PN上面的history taking 部分总是不够space。听人说在真正的考试的时
候，这个问题是不存在的，只要你字数不超就可以，你可以按enter来分行。
因为我写PN用的是bulletin的格式，需要分行很多，所以这个问题大大困扰了我。 有
考过的同学可以进来说说吗？
谢谢！
☆─────────────────────────────────────☆
largebird (largebird) 于 (Mon Nov 26 00:04:46 2012, 美东) 提到:
不能分行，要不写不下。一气呵成吧。没办法
☆─────────────────────────────────────☆
Jane27 (小简) 于 (Mon Nov 26 10:51:23 2... 阅读全帖 |
|
m******r
发帖数: 1904 | 22 ☆─────────────────────────────────────☆
dora2010 (dora) 于 (Wed Feb 29 16:55:46 2012, 美东) 提到:
Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake ha... 阅读全帖 |
|
m******r
发帖数: 1904 | 23 ☆─────────────────────────────────────☆
oldclock (oldclock) 于 (Wed Apr 18 10:59:11 2012, 美东) 提到:
1。step2 CS的UW video要单买还是在CS的UW题库里都包括了？
2。patient note可以写ABBREVIATIONS吗？除了FA上的ABBREVIATIONS，还有其他哪些
地方的ABBREVIATIONS可以用呢？
3。此外，看到麦地里有提到过patient note用子弹体方式书写，什莫是子弹体啊？哪
里可以找到范文呢？ 给扫扫盲吧。
多谢各位了！
☆─────────────────────────────────────☆
medwater (小麦) 于 (Wed Apr 18 11:08:03 2012, 美东) 提到:
1.没用过。不懂。
2.Common abbreviations for SP note
BP Blood pressure
P pulse
R respiatory rat... 阅读全帖 |
|
b**********r
发帖数: 60 | 24 多谢高手们支招，kaplan老师也说最好不要全大写，不过有人这么干也过了。我觉得第
一句话尽可能囊括越多的内容是很牛的，我会多加练习的。谢谢大家。
就是有一点疑问。ROM本身不是任何描述，因为如果是正常的我们也要写XXjoint ROM
WNL b/l . 所以阳性的话是不是应该写成
+change in ROM
or
+impaired ROM |
|
d*********n
发帖数: 18 | 25 Confusion case: O CFDP P ADL, IADL, TIA/stroke, depression, DM, thyroid,
normal pressure hydrocephalus, PAMHUGSFOSS
insulin induced hypoglycemia
Electrolyte abnormalities
Vitamin B12 deficiency
Medications
TIA
Multi-infarct dementia
Chronic subdural hematoma
Alzheimer’s dementia
Normal pressure hydrocephalus
Intracranial tumor
Neurosyphilis
Depression
Hypyothyriodism
DDx Confusion
DEMENTIA
D-Diabetes /Dementia/ Drugs
E-Epilepsy
M-Migraine/Mult Infarct Dementia
E-Ethanol (withdrawl / Toxicity)
N... 阅读全帖 |
|
t******a
发帖数: 408 | 26 1. where do these questions come from? can you please tell us the source? I
am really curious.
2. I will choose D.
pt is a young healthy F, has HTN.
Suspect secondary HTN.
Because (1)"healthy" pt = Board's code word for ASX(asymptomatic) and (2)
urinalysis are within normal limits ---> unlikely to be
glomerulonephritis (nephritic synd.)
Then suspect: RAS --- renal artery stenosis
In Young female: ---> consider fibromuscular dysplasia
Old male: ---> consider atherosclerosis
[This is a very... 阅读全帖 |
|
F********1
发帖数: 151 | 27 今天和skype上两位学友谈到CS准备，我翻出自己以前写的CS总结，在这里贴一下仅供
参考。Hope it helps. 另外，我觉得面对面练习非常重要。希望大家一定要找同城考
友面对面练习。
1) Encounter may begin.
开始阅读doorway信息。last name, 性别，主诉，快速瞄一眼要不要求体检。然后快速
写下OCDFPPAAAGUWASFT PFHAMOSS, 女性把o改为OB/GYN。在AAA旁边写上2-3个鉴别诊断
名词，同时写上体检项目（心、肺、腹、神、头、甲）。同时，这些也是需要询问的大
系统。这一步40-50秒，争取不要超过1分钟。
2) 走到病人面前，微笑，建立眼神接触之后再说话，伸出手准备握手。Hi, Mr. Smith
, I am Dr. X, I am a physician in this hospital. I will be taking care of
you today. Very nice to meet you!
SP: Nice to meet you too.
Before we start, let me cove... 阅读全帖 |
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w*******7
发帖数: 412 | 28 哎,你们越说我越害怕了. 我不喝酒,连bubble tea都不喝.本来天天点外卖的人才怀孕
后开始自己买菜做饭.感觉除了上班其余时间都用来吃饭睡觉了
尤其周末花好多时间在吃上.
我第一次发现macrocytic anemia的时候就要求IM injection了,OB不同意连口服都不给
开,我只好自己去pharmacy买oral supplement. 没想到吃了2个月查了3次还是
macrocytic anemia,还是不同的lab查的.但是我半年前的一次CBC确实是WNL的.
我除了morning sickness which comes with pregnancy外没有其他GI symptoms, 没有hypothyroidism symptoms, Live function normal, no past medical history,no family history, not on any other meds except prenatal vitamin(contain 1mg folic acid per tablet) and oral V12. 想不出wh... 阅读全帖 |
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b*****l
发帖数: 8603 | 29 我现在贴的这些感兴趣的同学可以学习学习，如果回答的话点击本贴回复就好，要不就
不知道那个是那个了
Pediatric~~
15m old boy without significant medical history presented to the ED for
pallor and fatigue. Mother said he had a cold a few weeks ago. He has one
year well child visit at his pediatrician's office and at the time the CBC
was reported normal. Tachycardia, HR 150, afebrile, other VSS. Exam: Pale,
playful and active. No jaundice, No HSM, No LAD, the rest exam WNL. No
dismorphic feature. CBC showed WBC 11.7, normal diff, Hb 5.1, MCV 86, PL... 阅读全帖 |
|
A*******s
发帖数: 9638 | 30 A 67 years old female with only history of DM presented with one day history
of involuntary movement in her left arm. She could not control her left
hand due to intermittent jerking. There were no other symptoms associated
with the jerking. Her PCP called me so she was brought in right away for
assessment.
PMH: DM only, last glucose a week ago was 120.
SH: No smoking/ETOH/drugs
FMH: DM
ROS: unremarkable.
PE: VSS normal.
Except left hand myoclonus, and mild ataxia, all others were wnl.
Labs/imag... 阅读全帖 |
|
A*******s
发帖数: 9638 | 31 A 67 years old female with only history of DM presented with one day history
of involuntary movement in her left arm. She could not control her left
hand due to intermittent jerking. There were no other symptoms associated
with the jerking. Her PCP called me so she was brought in right away for
assessment.
PMH: DM only, last glucose a week ago was 120.
SH: No smoking/ETOH/drugs
FMH: DM
ROS: unremarkable.
PE: VSS normal.
Except left hand myoclonus, and mild ataxia, all others were wnl.
Labs/imag... 阅读全帖 |
|
B******f
发帖数: 2489 | 32 见到这个case很久了，一直想post上来分享，觉得A＋＋和小粉可能会喜欢，嘿嘿
20+ yo F
HPI: multiple episodes of altered mental status (AMS), shortness of breath,
slowed speech since 8 months ago. An episode can last days, and she returns
to base line function between episodes. During the periods of AMS, patient
was unable to care for herself, and the mother had to dress and feed her.
PMH: she had multiple hospital admissions to outside Hospital for similar
complaint, however, work up has been negative
Head CT: Normal
Brain MRI: No... 阅读全帖 |
|
B******f
发帖数: 2489 | 33 不清楚在outside hospital怎么treat STD的，应该就是常规抗生素吧
另外，repeat lab：
Immunology: PRP-, HIV1/2 Ab -, HTLV I/II Ab-, serum IgG WNL, cocci CSF IgG/
IgM -, Lyme Ab-, Mono Heterophile Ab-
Micro: CMV PCR-, EBV PCR-, HSV PCR- |
|
m*******e
发帖数: 1886 | 34 our case is morphology less than 3% but all other measures are WNL. Since we
never had issue with conception but recurrent early pregnancy loss. Our RE
thought IUI or IVF is not indicated at this time. |
|
