Tuesday, January 24, 2012

Day at court

 M44
bipolar, Dr made the case that he is uncapable of compliance w meds, appts
harm to his well being
pressured speech, required ETO several times
disorganized thought process, rambling
recommending 3 more weeks, then to ALF
Zyprexa
Claims the Dr is trying to kill him by feeding him NaCl pills

M18
Touching females inappropriately in the ER had to be Baker acted
not taking meds and not eating
very psychotic hearing voices and god, paranoid
suicidal, anxious, screaming, verbally abusive
1. schizophrenic paranoid type
2. MR
3. GERD, history of seizures
Not capable, poor impulse control, hits walls, hits staff
providing alternatives to release frustrations
Admitted to hearing commanding voices -- case over



Monday, October 31, 2011

How much potassium is in a banana?

http://www.healthalternatives2000.com/fruit-nutrition-chart.html

422mg

Most addicting substances

http://addictionrecoverybasics.com/am-i-stupid-or-is-this-list-of-the-18-most-addictive-drugs-all-mixed-up/
According to the panel of health experts consulted by Health magazine, here is their list:

1. Nicotine
2. Ice, Glass (Methamphetamine, smoked)
3. Crack
4. Crystal Meth (Methamphetamine, injected)
5. Valium (Diazepam)
6. Quaalude (Methaqualone)
7. Seconal (Secrobarbital)
8. Alcohol
9. Heroin
10. Crank (Amphetamine oral)
11. Cocaine
12. Caffeine
13. PCP
14. Marijuana
15. Ecstasy
16. Psilocybine Mushrooms
17. LSD
18. Mescaline

Pannus

We had a Pt that was over 400 lbs and had a "Pannus" which the attending described as a hardening of the tissue and skin of the flab of fat that was hanging down beyond her knees. After a quick wikipedia, I see that Pannus is incorrectly used in place of a Panniculus.

A Panniculus is a medical term describing a dense layer of fatty tissue growth, consisting of subcutaneous fat in the lower abdominal area.[1] It can be a result of obesity and can be mistaken for a tumor or hernia. Abdominal panniculus can be removed during abdominal panniculectomy, a type of abdominoplasty. A panniculus can also be the result of loose tissues after pregnancy or massive weight loss.[2]

[edit] Grading of abdominal panniculiGrade 1
Panniculus barely covers the hairline and mons pubis but not the genitalia.
Grade 2
Extends to cover the genitalia.
Grade 3
Extends to cover the upper thigh
Grade 4
Extends to cover the mid thigh.
Grade 5
Extends to cover the knees or beyond.

Wednesday, September 28, 2011

Tips from a friend in clinical rotations

me: cud u email me tips for starting internal medicine
i want to be smmmurt
D: lol
7:14 PM i just started internal medicine
me: how is it
D: its good
A.) Work Hard
if a patient says they were seen at another hospital for something related to their current hospitalization
call up the other hospital and get that info
7:15 PM me: nice
D: B.) follow up on info
if you know a patient is getting a culture or xray, call up xray etc and follow up
key is to be proactive
go after information
don't wait for it to come to you
7:16 PM me: werd
D: if you get assigned a patient
and they have something
look up papers on that
and maybe discuss it when talking about the patient the next day
it shows that you are interested and care
7:17 PM things like that stick out
read Step up to Medicine
know your antibiotics
just put forth a strong effort
7:18 PM me: k sweet
thx
too clutch bra
D: you mean brah
me: lulz
7:19 PM Dib: when you do things like thism the residents like you
cause you are doing stuff they don't have to do anymore and they can free up more time to teach you
it sounds silly, you are making their life easier and your better
7:20 PM me: makes sense
D: when you do stuff like that, they'll also enjoy teaching you more
and be less dickish to you
7:22 PM me: i like less dickish

Wednesday, July 27, 2011

some lists today

Drugs that can cause Leukopenia (<4000)/suppress the bone marrow
1. Chloremphenicol
2. Vinblastine
3. AZT
4. Benzene

Viral causes:
1. Parvovirus B19
2. Hep C
3. Hep E

7 Drugs that can cause Neutropenia and cause agranulocytosis*
1. Carbamazapine*
2. Colchicine
3. Clozapine*
4. Propylthiouracil
5. Methimazole
6. Dapsone
7. Ticlopidine*

The Herpes viruses
HHV1 oral
HHV2 genital
HHV3 varicella
HHV4 EBV
HHV5 CMV
HHV6 Roseola
HHV7 Pityriasis
HHV8 Kaposi