indidoc1
Forum Guru
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Sorry fr that but this is getting funny... no one's agreeing wth anyone.
i dunno about researchers but i get GERD whenever i have too much coffee.. will try eating a jar full of salt today.. then we shall analyse the results
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| keepgoing
Forum Guru
Topics: 62
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1st of all do u all guys think its a case of GERD ??no reflex here, pat has epigastric pain not retrosternal or anything like heartburn but peptic ulcer  coffee do exaggearte but more thn 3 cups a day and smoke is too risk factor so better if u councel abt quittin smokin agree with me00 ..... so either coffee or smoke quittin' shold be the appropriate ans.
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| Luckyall
Forum Guru
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 agree , like i said is a typical CS case, but you still 1st remind about the importance of quitting smoking, dont you ?
Indidoc1, do let us know how it goes after eating a jar full of salt
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| babydoc4usmle
Forum Guru
Topics: 18
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keepgoing wrote:1st of all do u all guys think its a case of GERD ??no reflex here, pat has epigastric pain not retrosternal or anything like heartburn but peptic ulcer coffee do exaggearte but more thn 3 cups a day and smoke is too risk factor so better if u councel abt quittin smokin agree with me00 ..... so either coffee or smoke quittin' shold be the appropriate ans.
according to Kaplan notes in PUD smoking is NOT a risk factor, neither alcohol, it sure will SLOW recovery, but it wil not MAKE or AFFECT PUD appearance
but coffee is still there
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| keepgoing
Forum Guru
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where in kaplan?step 2 books?well ok let it be thn s/s doesnt lead us to gerd its APD (acute peptic dis/pud))--->eigastric pain thn QUIT COFFEE ....but im sure smoke is also one of cause PUD so either quit smokin or coffee ......................if u say shall i google n provide any link??
ok i got one its from bmj..
http://jech.bmj.com/cgi/content/full/58/1/80
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| keepgoing
Forum Guru
Topics: 62
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oh wonderful i got this link hope my point got cleared...
http://jrnlappliedresearch.com/articles/Vol3Iss1/...
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| babydoc4usmle
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Topics: 18
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now i am confused, because Kaplan clearly states that alcohol and tobacco THEMSELVES do not cause PUD, but do interfere/delay healing.
H.pylory and NSAIDs remain the strongest risk factors for PUD.
Merck mannual does list smoking as a risk factor for development and complications of PUD...
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| keepgoing
Forum Guru
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dont get confused buddy u agree kaplan is not 100%rt we needed to consult others books for some corrections but trust it is a one of impt factor....its in CMDT also if im not wrong...
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| keepgoing
Forum Guru
Topics: 62
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ok if u want to think kaplan is rt even thn u can think if it states smokin and etoh do interfere/delay healing thn should we recommend it to our pat who is experiencing acute symptoms or having an ulcer....even thn we will councel to quit smokin cos it will delay healing....
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| babydoc4usmle
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that's is absolutely right, but if we get back to a question setting - Pt does not want to quit smoking. period. and in this kind of situation doctor should not make him do otherwise. but it is also true that doctor should continue raising this question every time he sees this Pt. in the meantime - coffee should be excluded.
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| babydoc4usmle
Forum Guru
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is there a correct answer?
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| keepgoing
Forum Guru
Topics: 62
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think so since no ans is given acc to ancyclostoma, stuck between a n b... a we can exclude thinking pat refuses but here i agree with what me007 said,so for the ans even im confused...but considering evidences we can say quit smoking wud be the best advice n that wat we hv been asked for, if coffee is reduced but smoking not even thn no healing so i will stick to A unless provided other proof...
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| epica
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The similar Q was in Kaplan Qs
Smoooooking is Ans. It's BS Q, not Patho
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| Ancylostoma
Forum Guru
Topics: 42
Posts: 642
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 got to love the arguments... Well everyone pick the one they want, no one is going to agree
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| new_n_lost
Politically InCorrect
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LoL We cna have Representations for Questions n Still no one will agree
Well atleast we all know wht shud we answer in face of such a question
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| epica
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please post the ans
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| keepgoing
Forum Guru
Topics: 62
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hey plz post ur comments ancyclostoma n nnl i wonder if u still think other ans to be the rt one plz now very much curious n of course....epica---what block(kqnank) this question is from?
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| epica
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Sorry, I don't remember which block, but I saw this Q (somewhere)
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| keepgoing
Forum Guru
Topics: 62
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ok no probs thanks epica..
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| Ancylostoma
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Topics: 42
Posts: 642
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I think its salt intake. the new study show that salt intake had a major effect, second it also shows that having one cup of coffee causes problems but then having 7 cups decreases relux 40% . No such thing occurs with salt intake. the more salt the more reflux so I must think that slalt has greater value interms of effect. People disagree with me and like I said its just up to you to shoose one line of reasoning and go with it. Second, it is not smoking, when a patient absolutely says that he wont stop that doesnt mean because you say so he will. We have to find a solution to the problem that he will do. Coffe or salt depending on what you prefer after reading.
This same study is said to prove that alcohol and tea do not cause reflux as they were once thought to, while coffe is a little undecided. What they did prove is that salt has a definate effect. Look at the two articles that I pasted.
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| keepgoing
Forum Guru
Topics: 62
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 where is question now?after editing, question disappeard plz check...anyway still wonder if usmle wants us to know all these new reserches as well?but never heard in med schools neither in any txtbook well thanks for the links ...!one question to u ancyclostoma what block is this from?can u plzz tell...teh reason tea is helpful might be cozof flavnoids i guess...
thanks
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| new_n_lost
Politically InCorrect
Topics: 650
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look u will find different reasonings for every point ITS STILL UPTO U TO DECIDE WHTEVER THE LINE OF REASONING U CHOSE.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| indidoc1
Forum Guru
Topics: 50
Posts: 978
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Luckyall wrote:Indidoc1, do let us know how it goes after eating a jar full of salt
Actually the salt experiment didn't turn out to be too good.
Took a jar full n then downed 5 cups of coffee to make it stay down.. Got a BIIIIIG attack of GERD but what ll u attribute it to??
And please don't ask me to volunteer again 
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"Whether you think you can or whether you think you can't, you're right!" ~ Henry Ford
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| new_n_lost
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lol Good dont worry we wont ask u again
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| Ancylostoma
Forum Guru
Topics: 42
Posts: 642
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lol next experiment, tablespoons of arsenic. Let me know what your breath smells like ok!!
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