PPD for nephrotic $ patient

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE STEP 3 Forum » USMLE Step 3 CCS Forum

PPD for nephrotic $ patient

Author

10 Posts

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 07:32 PM

for a patient wid nephrotic syndrome...to obtain a Tb screen before starting steroids...how do we do it? place a PPD? do we consider nephrotc syndrome patients as immunocompromised?? They lose IgG in urine and hence humoral immunity might be affected...does this affect the interpretation of PPD?

CCS driving me crazy!!!!

robin082006
Forum Hero
avatar

Topics: 471
Posts: 5,125

07/28/07 - 07:43 PM

Type PPD

Analyzing result as normal people I think

___________________
The Key to Succeed is Patience.

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 07:43 PM

also when we give albumin and lasix therapy..when do we stop? after edema resolves or after S. albumin increases to some desired level..and if so,what level?

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 07:44 PM

thx robin, can u answer my second q plz?

GOGETA
I'm Dr. GOGETA
avatar

Topics: 321
Posts: 2,710

07/28/07 - 07:53 PM

hey for that lasix sandwich you have to be sure that the patient is not in a bad Cardiac output.

___________________
As a general rule, the better it felt when you said it, the more trouble it's going to get you into.

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 07:58 PM

u mean we check CO before stopping? and if it is good, we stop the sandwich? and we chart the CO using ECHO right?

or are u saying that we dont start sandwich if patient has a poor CO?

i am confused!

{CO= cardiac output}

GOGETA wrote:
hey for that lasix sandwich you have to be sure that the patient is not in a bad Cardiac output.

robin082006
Forum Hero
avatar

Topics: 471
Posts: 5,125

07/28/07 - 08:00 PM

misty wrote:
also when we give albumin and lasix therapy..when do we stop? after edema resolves or after S. albumin increases to some desired level..and if so,what level?

Do not try albumin unless the patient is refractory to other therapy.

Try lasix first--> if not--> paracentesis.

ALbumin may worsen the problem, be careful, and in the exam no need to order it.

___________________
The Key to Succeed is Patience.

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 08:13 PM

gonna flunk stpe 3 it seems!!!

robin082006
Forum Hero
avatar

Topics: 471
Posts: 5,125

07/28/07 - 08:30 PM

haha I am worried too

many people failed step 3. So Be careful.......

Visit www.usmleforum.com, you will see lots of recent flunkers

___________________
The Key to Succeed is Patience.

misty
Forum Elite

Topics: 58
Posts: 284

07/28/07 - 08:42 PM

#10

oh No!!!! Lord save us!

You don't have permission to post.