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misty
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07/28/07 - 05:32 PM       #1

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
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07/28/07 - 05:43 PM       #2

Type PPD

Analyzing result as normal people I think


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misty
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07/28/07 - 05:43 PM       #3

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
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07/28/07 - 05:44 PM       #4

thx robin, can u answer my second q plz?


GOGETA
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07/28/07 - 05:53 PM       #5

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


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misty
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07/28/07 - 05:58 PM       #6

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
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07/28/07 - 06:00 PM       #7

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.


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misty
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07/28/07 - 06:13 PM       #8

gonna flunk stpe 3 it seems!!!


robin082006
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07/28/07 - 06:30 PM       #9

haha I am worried too

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

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


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misty
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07/28/07 - 06:42 PM       #10

oh No!!!! Lord save us!










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