tolito
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hi guys, i want to start this thread where we write old 'debunked' ideas and write what is currently applied today.
this is particularly important for me as an old img. so much has changed!!! and even more importantly, i need to recognise that options that were rational for me in my third world country are NOT acceptable in the super worlds!!!
please feel free to add your contributions.
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| tolito
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i will start:
whenever there is CT, MRI or USS in the investigation, remember to choose that over excison biopsy or needle aspiration when you have no clue about the answer.
x-rays are not used in the diagnosis of CDH ( cong displasia of hip). uss is used instead. we used to do xrays and calculate angles!!!
Edited by tolito on 08/17/06 - 07:07 PM
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| tolito
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spiral CT to diagnose pulm embolism in the post op patient not V/Q lung scans cos latter are usu abn in post op pt.
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| tolito
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if you suspect pus in wound infection, do USS dont stick a needle in first!!
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| tolito
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exceptions to the CT/MRI/USS before you stick a needlie
1. GI series in which first endoscopy, then biopsy then CT
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| tolito
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first step in invest urol patient is plain abd x ray followed by USS. it used to be followed by IVP
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| Shaina
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hi tolito ,good work ,thanks
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| tolito
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TURP rarely done these days for BPH. instead, give alpha blocker or 5 alpha OHase blocker.
( this is interesting. in my country of origin, we still perform OPEN prostatectomy...will send e-mail to my gen surg friends)
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| tolito
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no blanket exclusions for transplant donors anymore.
hepatitis person is donor for hepatitis patient.
metastatic patient can donate cornea
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| study_ing
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hello tolito..great job. ive been really slow over the past week. will pick up pace and hopefully add something useful...
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| tolito
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in achalasia, first line is pneumatic dilatation, second is botulinium tox. botox may be first line in those who dont want pneumatic dilatation.
myotomy is done when pneum dilat and botox fail.
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| tolito
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tobacco, alcohol and steroid do not directly cause ulcers.
tobacco and alcohol reduce healing rate.
alcohol causes gastritis
who knows mech for steroids?? i always thought they act thro reduction in PG production ( like NSAID'S)
Edited by tolito on 08/22/06 - 04:16 AM
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| tolito
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vagotomy and gastric resection no longer gold standard rx for PUD. now give PPI + clarithromycin + amoxycillin.
Hey, this tiple regimen is different from the one we learnt in step 1 ala lippincott this is supposed to be second line after bismuth + tetra + amoxy
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| tolito
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sulphasalazine is no longer used for infl bowel dis.
now we use mesalamine derivatives.
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| tolito
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vancomycin no longer first line drug in treatment of cl difficile. now it is metronidazole.
metro can be given iv in a patient taht is vomitting but vanco iv does not have effect on bowel
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| tolito
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saline or cold water irrigation via ng tube is of no benefit in upper gi bleeding.
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| tolito
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ct scan is better for prognosis of pancreatitis than ranson criteria which was developed before there was ct scaning
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| tolito
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in liver cirrhosis, vit k is usually given but it is of no effect cos liver cannot synth clotting factors.
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| tolito
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steroids are no longer used in managing head injury.
mannitol remains useful before surgery.
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| tolito
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dont break blisters in burns
back in the day, we broke blisters >1cm
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| tolito
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hey study-ing, just noticed your post. yeah feel free to post something here. i enjoyed our discussions in step 1 forum
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| tolito
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whole blood tx rarely given but components are given depending on disease.
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| tolito
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staging laparotomy and lymphangiog no longer ROUTINELY done in hodgkin. INDICATION would be when to definitely exclued disease whe localised radiorx is planned...eg splenecomy
ct is sufficient
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| tolito
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steroids of no proven use in mx of stevens johnson syn
( i got this from Co-T on 2 occasions, the third time, i confirmed it was drug reaction and i stopped after just first dose. i used steroids too on all three ocasions...this was in 1984)
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| tolito
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tomograms and lordotic films are no longer used. have been replaced by CT. always a wrong choice
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