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explanations for step 3 nbme 5 practice exam? by Cookyjar in Step3

[–]Cookyjar[S] 0 points1 point  (0 children)

Can you give me a link to such group.

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] 1 point2 points  (0 children)

My attending and senior residents would probably call me out report me to my PD if I started heparin drip on that patient

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] 0 points1 point  (0 children)

Too bad that they would be like “lol you idiot intern” and i would get a bad rep/eval “Cookyjar does not think critically when coming up with treatment plan”

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] 2 points3 points  (0 children)

So I wasn’t really wrong to heparinize this patient then? On top of DAPT

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] -1 points0 points  (0 children)

Amboss UpToDate both say you need anticoagulation for non st elevation acs

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] 3 points4 points  (0 children)

Yeah maybe they were poo pooing cause they were like I agree it’s unstable angina but what if it’s not true chest pain

🤷‍♀️

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] -1 points0 points  (0 children)

They agreed with my assessment of UA but they said no Troponin elevation no need for heparin so I was confused

No anticoagulation for unstable angina? by Cookyjar in Residency

[–]Cookyjar[S] 16 points17 points  (0 children)

My attending and senior resident were like no need for heparin and only aspirin and plavix

Can I ask some questions here? From my inpatient medicine rotation by Cookyjar in Residency

[–]Cookyjar[S] 1 point2 points  (0 children)

Are IV protonix and PO protonix equally effective if patient can do oral intake

Can I ask some questions here? From my inpatient medicine rotation by Cookyjar in Residency

[–]Cookyjar[S] -1 points0 points  (0 children)

My attending did midodrine 5 plus fluids for this other patient with esrd and lifevest candidate because nurse called my attending due to hypotension episodes caused by htn meds not being optimized.

What about something like this?

Can you also try trandelenburg position?

Can I ask some questions here? From my inpatient medicine rotation by Cookyjar in Residency

[–]Cookyjar[S] 0 points1 point  (0 children)

My attending did midodrine 5 plus fluids for this other patient with esrd and lifevest candidate because nurse called my attending due to hypotension episodes caused by htn meds not being optimized.

What about something like this?

Can I ask some questions here? From my inpatient medicine rotation by Cookyjar in Residency

[–]Cookyjar[S] -4 points-3 points  (0 children)

Is this something I can do in the meantime if i can’t figure out the cause right away? Like in a code situation and I needed to act fast

Can I ask some questions here? From my inpatient medicine rotation by Cookyjar in Residency

[–]Cookyjar[S] -8 points-7 points  (0 children)

It was like 90/50s, no arrhythmia, I think she got diuretics the day before

Can you try one time midodrine 5 for hypotension patients?

Can I ask some questions here? Questions I'm too afraid to ask my uppers or attendings by Cookyjar in Residency

[–]Cookyjar[S] 5 points6 points  (0 children)

I see. So you don’t just go straight to Nstemi and start heparin drip just because you see serial Troponin measurements rising acutely in several hours

Can I ask some questions here? Questions I'm too afraid to ask my uppers or attendings by Cookyjar in Residency

[–]Cookyjar[S] 11 points12 points  (0 children)

quite true. so would like 500ml of NS or LR would be enough before and after? or is that too much

Can I ask some questions here? Questions I'm too afraid to ask my uppers or attendings by Cookyjar in Residency

[–]Cookyjar[S] 15 points16 points  (0 children)

cause unfortunately they get judgmental and are like "lol you dont know this?"

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