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  #1  
Old 06-08-2011
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Angry Treatment of Elderly agitation

Here is another UW set of questions that makes me crazy:

in one question, they ask about an agitated elderly, and the answer as a next step is haloperidol (preferred superior over BZ in elderly for obvious reasons)


this is all fine and dandy, but then you get a question about an agitated elderly (who obviously has a UTI from the labs) and the next step IS ANTIBIOTICS although they have haloperidol on the options ....

this is so unfair: i chose haloperidol, said to myself, i will treat the old man's agitation and make him calmer, THEN give antibiotics ... thats the best course of action that i thought, and thus chose halo as a next step

guess what, the twisted question writers said its Abs and not halo because the cause of agitation is know as UTI ....WHAT? ABS NEED AT LEAST A DAY TO WORK and the guy is agitated ...


Please tell me whats wrong in my reasoning ...i am about to crack as my exam is near (as you all know by now)
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Old 06-08-2011
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When have a patient with a disease you treat the disease (if treatable) and then the symptoms of that disease will go away.

That UTI patient did not have agitation as a major issue, it the UTI that you need to treat. Just like in real practice. Doctors will give antibiotics for an agitated UTI patient not sedatives.

You think of sedatives when agitation is the core issue such as a psychiatric or disturbed patients.

Hope that helps
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Old 06-08-2011
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Originally Posted by Chessmatic View Post
When have a patient with a disease you treat the disease (if treatable) and then the symptoms of that disease will go away.

That UTI patient did not have agitation as a major issue, it the UTI that you need to treat. Just like in real practice. Doctors will give antibiotics for an agitated UTI patient not sedatives.

You think of sedatives when agitation is the core issue such as a psychiatric or disturbed patients.

Hope that helps
I agree with chesmatic on this one
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Old 06-08-2011
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unfortunately, this is more philosophical than objective!!!

a guy comes with pain beacuse of an etiology, we control the pain dont we???

imagine an agitated guy all over the place, why is that less of (ameliorating life quality) than pain control?


I sincerely disagree ... you see, its not a medical knowledge issue, you have a patient confused, agitated, you need to make him calm down, and then treat ... thats the human part of medicine ....


in Pulmonary edema we we give Morphine to calm the person down ...
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unfortunately, this is more philosophical than objective!!!

a guy comes with pain beacuse of an etiology, we control the pain dont we???

imagine an agitated guy all over the place, why is that less of (ameliorating life quality) than pain control?


I sincerely disagree ... you see, its not a medical knowledge issue, you have a patient confused, agitated, you need to make him calm down, and then treat ... thats the human part of medicine ....


in Pulmonary edema we we give Morphine to calm the person down ...
Its not philosophy... Its being objective.. you must weigh in the options... Look at the big picture... If it was a pure neuro/psych or a case with indeterminate etio then yes.. halo is the correct answer.... When in a question you are able to make a diagnosis then you should treat it accordingly... Thats the answer the boards expect... once u are board certified you can do whatever you want

Btw... Morphine is given in pulm edema not only to calm down the person but there is another reason.... Check it out
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morphine has an effect on vasculature as well, granted, but its also given to decrease the panic of drowning sensation

----

they break our (cojones) with next step tricks and whatnot ... i thought its one of those address concerns things ...


gawddarnit
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what would happen if we calm the guy down then give the forsaken antibiotics ....


its more human .... anyway, i hope i wont screw on the real thing, because its a shame ... studied like i should
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Originally Posted by docoftheworld View Post
morphine has an effect on vasculature as well, granted, but its also given to decrease the panic of drowning sensation

----

they break our (cojones) with next step tricks and whatnot ... i thought its one of those address concerns things ...


gawddarnit
LOL... Just a tip to handle questions mate... dont look at all the nitty gritty of the entire q stem... See the options... Which ds seems to be having more features... Answer that.. For ex... like in your previous q abt pheochromo and menigioma, though an intial mention was made about the leg weakness, the rest of the stem dealt only with pheo... So dont be rigid... Let your answers also be flexible like the question
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i did well on step 1 .... but now, i find my performance mediocre ... oh well, i guess i am a pathologist project as i am planning

Step 1 was much more straightforward, mechanisms, diseases, sigh, it was much less complicated ....


Thank you so much for your support bud!
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Old 06-08-2011
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Default Its not quite this complicated

Start the ABX immediately to start treating the UTI. Maybe use soft restraints while you set up the IV. They probably ask for what one would do, or do initially in management. After you admin Abx, give 5 mg Haldol q 6-8 hrs prn. That is real world.
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  #11  
Old 06-14-2011
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it is good discussion
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Infectious-Diseases, Internal-Medicine-, Psychiatry-

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