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Old 06-12-2011
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Help Few questions after finishing my physiology class

hey guys i have some questions. i know i may google or wiki them but i wana share here..

1) what is HOLTER MONITOR AND WHATS ITS USE (esp its imp in step1)

2)waht is ankle/brachial index and its uses

3)in case of aortic regurgitation pain radiates to lower left sternal border?

4)a pt is in E/R with massive hemorrhage what is best initial therapy?

a)PEEP b)C.PAP c)controlled mode d)AC

btw what are these can some explain all..
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Old 06-12-2011
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i wonder why u bother abt these things right now. Most r clear-cut step 2 concepts and never gonna be tested in step 1.

1. Holter monitor is 24-hour ECG monitor to detect unknown cardiac arrhythmias that may be causing syncope or some other cardiac problem.

2. Ankle/brachial index is best initial way to detect peripheral vascular disease due to atherosclerosis. Normal due to gravity, pressure is higher in ankle than brachial, so ankle to brachial ratio is 1 or above. in peripheral vascular disease, pressure in ankle decreases so ratio goes below 1.

3. talking abt pain or murmur? murmur radiates to lower left sternal border, because this s the direction of blood flow. If u want to understand every congenital or acquired heart disease and their murmurs, watch step 1 anatomy kap videos. u will never forget. that teacher is a bit slow, but blows mind out.

4. With a massive bleeding, first thing we have to do is to support vascular system, lest it should not collapse. So get IV lines, get blood for typing and cross match, and run IV fluids wide-open.

5. Various modes of ventilatory suppport for a patient who can not breath on his own. Worry abt these mostly in step 3. i never saw a q abt these modes in either step 1 or step 2 qbanks.

Last edited by drahmednawaz; 06-13-2011 at 01:20 AM.
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Old 06-12-2011
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thats y i m worying bout it cuz i never saw it till today whn conrad fischer asked these things
any way thanks for sharing
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Old 06-12-2011
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I know he must be talking abt most accurate test, best initial test, or best initial therapy, things like these. These r very high-yield concepts for step 2 and frequently tested. For example, holter moniter is the most accurate way to detect arrhythmias, but it doesn't mean we should and need to do it routinely. Take example of gastero-esophageal reflux disease (GERD). 24-hour PH monitoring is the most accurate, but do we do it routinely? No, it is just a clinical diagnosis. Someone comes with symptoms of GERD, we give him proton-pump inhibitors, symptoms go way and we have diagnosis. we do 24-monitoring in extreme cases. A patient comes with nocturnal cough. we suspect that GERD may be causing cough. we give proton-pump inhibitors. No relief. we give methacholine test to diagnose cough-variant asthma. test -ve. now we go for 24 hour ph monitoring. only in extreme cases.
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