tamerbashir
Forum Elite
Topics: 20
Posts: 284
|
EXPLAIN PLZ
1-Pat. in chronic pain. Too much pain meds causes resp. depression.
Pat. asks to be given lethal dose of pain meds.
Increasing narcotics needed to control pain. What do you do?
1. reduce dosage to not impair respiration
2. give nec. amt pain meds despite resp. impairment
3. give dose nec. to control pain and add centrally acting stimulant
4. appeal to faily to convince pat. to tolerate a bit more pain
EXPLAIN PLZ
2-
19 yo woman 39 weeks gestation in labor.
contraction every 2-3 min. 4cm dilated 80% effaced.
requests epidural for pain. Ten min. after epidural pat.
becomes nauseated, diaphretic and vomits. BP 60/palpable.
Fetal heart shows sustained fetal deceleration.
Cervix is now 8cm dilated. Next best step?
1. ephedrine,
2. mag. phos,
3. nifedipine,
4. oxytocin,
5. terbutaline
3- 55year old man visits his primary health care physician with a
complaint of urinary infrequency. Examination finds a 1cm - nodule on
his prostrate gald. The physician orders a prostrate specific antigen
(PSA) serum test. By common standards a PSA level greater than 4ng/ml
is considered abnormal. Using this standard the test has a sensitivity
of 80% and specificity of 90%. A recently published epidemiological
article found that in a cross-sectionl study showed that
10% of the men of this age have prostrate cancer.
The result on the patients PSA is 7ng/ml.
what what is your best estimate of the likelihood
that this man actually has prostrate cancer.
a) 13%
b) 25%
c) 36%
d) 47%
e) 58%
f) 69%
g) 72%
h) 81%
PLZ NEED UR EXPLAIN THANKS FOR ALL
|
| me007
Forum Guru
Topics: 72
Posts: 803
|
1. Q is incomplete (chronic pain due to what? Does pt has DNR?)
and actually this situation was discussed and choice 3 looks good.
Not 1 and not 4 for sure.
2. ans 1.
complication of epidural - hypotension, jeopardy for fetus (hypoxia),
Rx - ephedrine + saline solution.
|
| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,240
|
1 - answer is 2 if patient is terminal. Your primary goal is to make patient comfortable during the end of life, if prognosis is closed, even if the drugs speeds the process. But I agree the question is incomplete, "chronic pain" is present in many different situations.
2 - answer is 1 - use of vasopressor and intravenous ressuscitation (saline, Ringer lactate)
3 - No idea!
___________________
When men make the rules, God decides the exceptions.
|
| ing
Forum Guru
Topics: 45
Posts: 435
|
10% has the disease: so there are 100 people w/ disease and 900 w/o disease in 1000 people. Use this information plus specificity and sensitivity to fill up the 2x2 table.
.............disease+............disease-
psa+.......80(sensitivity)......90
psa-........20......................810(specificity)
------------------------------------------------------
total.......100.....................900
The question is asking positive predict value: 80/(80+90)=47%
Edited by ing on 12/09/07 - 05:56 PM
___________________
Never give up!!
|
| Gourdon
Topics: 14
Posts: 87
|
agree with me007
|
| cool doctor
Forum Junior
Topics: 1
Posts: 226
|
agree with arlete
1-b
2-a
|
| drduck
Forum Guru
Topics: 82
Posts: 529
|
its B for sure..........for Q number 1,
no idea about rest all, need a reading.
|
| cool doctor
Forum Junior
Topics: 1
Posts: 226
|
Thanks ing for the stat answer
|
|
| |
| | | | | | | | |
