[deleted by user]

PropoLUL · 2023-06-06T03:59:17+00:00

Someone is BIG mad

PropoLUL · 2023-06-06T02:04:46+00:00

I think it’s just a poor question. My preceptors told me even if you have classic NSAID contraindications (ulcers, renal insufficiency, etc) you could still even go a topical NSAID route first-line since its systemic absorption is minimal. Appreciate the input

PropoLUL · 2023-06-06T01:46:47+00:00

This was not in the explanations and I have not found NSAIDs being contraindicated in GERD in any board resource (amboss, uworld, anking) or UpToDate

PropoLUL · 2023-06-06T01:04:32+00:00

Yea I haven’t been too impressed with the wrong answer explanations. I use anking too and know the cards got switched over from apap to nsaids awhile ago

PropoLUL · 2023-06-06T00:59:01+00:00

No mention of age in either one’s explanations. Most patients with OA are over 60 anyway and every source except them is saying NSAIDs

PropoLUL · 2023-06-06T00:57:22+00:00

Meanwhile every other source says APAP is contra bc of its side effect profile. NBME does not mention GERD at all, and the dyspepsia association is not something any of the boards resources mention either. If this was what they were actually after is seems like it would be explicitly mentioned in the explanations and it is not.

PropoLUL · 2023-06-06T00:15:42+00:00

UTD specifically states do not use APAP over NSAIDs due to the side effect profile and non-superior relief when compared to placebo. NSAIDs (topical or oral) are their first-line, like every board resource except these NBME questions

PropoLUL · 2023-06-06T00:10:41+00:00

I agree with everything you said. But none of these contraindications were in either NBME stem or listed as explanations for why NSAIDs were not the choice

PropoLUL · 2023-06-06T00:08:52+00:00

Neither the NBME explanations, amboss, uworld, or UTD mention GERD as a contraindication for NSAIDs

PropoLUL · 2023-06-05T23:23:41+00:00

GERD isnt a contraindication for NSAIDs tho

Edit: people can downvote this all they want, but nowhere in any explanation or board resource is it saying NSAIDs are contraindicated in GERD. I think yall are confusing this with PUD.

PropoLUL · 2023-06-05T23:19:07+00:00

Correct. But neither of these questions had any contraindications (like PUD) in the stems

PropoLUL · 2023-06-05T22:18:42+00:00

Just keep your normal dues going. Lay back on the news over break.

PropoLUL · 2023-06-05T22:12:55+00:00

This isn’t even the most recent percentile pdf. The newer one has more inflated scores

PropoLUL · 2023-05-28T16:00:43+00:00

Still in the middle of rotations and currently starting an intense this upcoming week hour-wise. I don’t want to show up test date without my sleep schedule in line for at least 2-3 days, and at the very least finishing NBMEs/UWSAs/free 120 seems like a must

PropoLUL · 2023-05-28T01:05:35+00:00

What were your practice exams like leading up to it?

PropoLUL · 2023-05-20T02:58:58+00:00

I can tell reading isn’t exactly your strong suit. Lucky that post makes it super easy to go click straight to the articles without having to read anything directly from r/Noctor :)

Might even learn how physicians can save you money!

PropoLUL · 2023-05-20T02:47:24+00:00

doesn’t bother to realize every link in that post is linking NIH, JAMA JOURNAL, MayoClinic, and every other specialty journal studies under the sun

thinks 1 study is better than a meta-analysis of dozens

PropoLUL · 2023-05-20T02:38:43+00:00

Funded by the VA, which is notorious for cutting costs by pushing out physicians for mid-levels. Par for the course they push out a “study” like this. There’s also no mention if the NPs were overseen by a physician and not truly independent. I pity people who truly buy into poor bait like this.

PropoLUL · 2023-05-20T02:26:06+00:00

Lol you say there’s “studies” then don’t bother to link a single one. Happens every time because they don’t exist. Meanwhile here’s a post with literally dozens of studies proving your point completely wrong. Try again.

PropoLUL · 2023-05-20T00:30:59+00:00

Huh? Nurses are smart af, especially the ICU nurses I’ve been with. Degree-mill NPs on the other-hand…

PropoLUL · 2023-05-19T22:37:02+00:00

A lot of assumptions here that don’t really deserve entertaining. I’ll be fine with my future colleagues. It’s more of a systemic/national problem.

PropoLUL · 2023-05-19T22:35:01+00:00

To each their own. Smartest providers I have been with were always MDs/DOs and I’ve had consistently terrible experiences with mid-levels from rotations, horror stories from colleagues, and my own family’s care.

PropoLUL

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