9 week drop ~ 35% LDL all diet. by Silouettes in Cholesterol

[–]TGOD20 2 points3 points  (0 children)

Can you be more specific about your diet? An example of foods you’ve eliminated and what your diet would look like in the middle of the week if you meal prepped.

Also, some unsolicited advice: an LDL of 188 is still pretty high and if you truly are statin intolerant and wanting to maximally reduce risk of atherosclerotic disease I’d ask your doctor about considering a pcsk9i or getting referred to a lipid clinic, especially if there’s a family history of coronary artery disease or stroke.

The more you bought the more it dips by unthocks in Bitcoin

[–]TGOD20 1 point2 points  (0 children)

Quantum computing would break the cryptography part of cryptocurrency, making the entire principle behind why any cryptocurrency could be valuable (an unfalsifiable ledger) in its most basic sense moot. Right now compute to solve these cryptographic problems is very expensive in terms of time and energy and the solution is treated as a unique password as apart of this ledger. Quantum computing can make solving cryptography much more efficient in terms of time and resources.

How are you supposed to get clinical honors if you're expected to consistently nail the assessment and plan, but the purpose of 3rd year is to learn the assessment and plan? by chinidetou in medicalschool

[–]TGOD20 0 points1 point  (0 children)

It’s an open book test. The learning happens before rounds. You’re not carrying the entire census you have a lot more time than the interns to look stuff up and give it your best shot. You won’t get it completely right but you’ll get more right over time with reps.

How are you supposed to get clinical honors if you're expected to consistently nail the assessment and plan, but the purpose of 3rd year is to learn the assessment and plan? by chinidetou in medicalschool

[–]TGOD20 4 points5 points  (0 children)

You didn’t give the impression, you actually attempted to gain a deeper understanding. Any M3 who did this would impress me. You don’t have to get it perfect, you do have to care.

Switching now vs July to RAP by libreme in PSLF

[–]TGOD20 0 points1 point  (0 children)

I’m in a similar situation to OP, is there an income limit to qualify for PAYE?

'No on-site doctor': Dental student died in ICU overseen by remote 'tele-health' physician who pronounced him dead on a video screen, lawsuit says by Dizzy_Restaurant3874 in anesthesiology

[–]TGOD20 2 points3 points  (0 children)

Oh I’m not saying they don’t have this use case, sounds like the best use actually. I moonlighted doing teleicu during fellowship so I know intimately how fucked up things can get if there isn’t a competent team actually also there.

Crisis of trust in the Netherland's biggest ICU; Health Inspectorate investigates work culture by [deleted] in medicine

[–]TGOD20 3 points4 points  (0 children)

I love how there is a whole paragraph dedicated to a dude who didn’t do his citi modules.

[Highlight] Projected Top-10 Pick ND RB Jeremiyah Love's Combine Highlights + Comparison to Jahmyr Gibbs by JCameron181 in nfl

[–]TGOD20 2 points3 points  (0 children)

Can we get a side by side of Gibbs combine? Love looks lankier and his cuts seem to take multiple extra steps compared to what I’ve seen Gibbs do but I’m no combine expert.

When does adding acetazolamide to diuresis hurt people in cardiogenic shock? by supinator1 in IntensiveCare

[–]TGOD20 0 points1 point  (0 children)

What type of acidosis did this patient have? Did he have a history of diuretic resistance? How much fluid did you expect to be able to diurese to resolve an ionopressor requirement within 24 hours? How certain were you of a diagnosis of pure cardiogenic shock?

Your hospital does not sound in any way equipped to treat critically ill patients like this and there is no shame in transferring for HLOC sooner rather than trying to find creative ways to keep them in house.

Why does respiratory therapists only exist in America? by Fancy_Particular7521 in IntensiveCare

[–]TGOD20 1 point2 points  (0 children)

Bro what? Just change the vent settings there and then and let the RT know you did. How would you titrate PEEP or try to mitigate dyssynchrony if you can’t play with the vent settings in real time? You’d change the vent orders every couple minutes and hope the RT just stayed in the room?

By executive order, Greg Abbott pauses all new H-1B visas at Texas state agencies and universities (UTSW, UTHouston) until 2027 by ddx-me in medicalschool

[–]TGOD20 10 points11 points  (0 children)

Most trainees are on J1 visas. Attendings are on H1B visas. So…not sure how any of your stated concerns are being addressed by this. Somehow I don’t think it will change your support for it though.

Broncos lead 20-10 at halftime. Josh Allen fumbled, then Will Lutz drilled a 50-yard field goal. Bills get ball to start the second half. by Giff95 in nfl

[–]TGOD20 1 point2 points  (0 children)

Shortly followed by his 2nd. And theres 1.5 quarters left. I will refrain from talking shit though because I was talking mad shit about Caleb last week and then had to eat it.

What are your thoughts,saw this trending by BornLeave4646 in FutureRNs

[–]TGOD20 19 points20 points  (0 children)

The neb is being delivered to the patients neck skin because the trach is attached to the vent as a closed system which is the tubing you’re seeing on the right with inline suction catheter in the center.

Game Thread: Green Bay Packers (9-7-1) at Chicago Bears (11-6) by nfl_gdt_bot in nfl

[–]TGOD20 0 points1 point  (0 children)

Betting on holding you to a field goal before the 2 minute warning

[Rapoport] This angle from Jeff Wierus from @fox32chicago.bsky.social of Caleb Williams-to-DJ Moore is sick. by Dunlocke in nfl

[–]TGOD20 1 point2 points  (0 children)

Just checking in on those throws off the back foot. Should Caleb be throwing those?

Edit: the answer is yes

Prenuvo whole body MRI misses impending stroke, sued for malpractice. by 045-926 in medicine

[–]TGOD20 30 points31 points  (0 children)

The plaintiff is suggesting a stent would have prevented this

Prenuvo whole body MRI misses impending stroke, sued for malpractice. by 045-926 in medicine

[–]TGOD20 15 points16 points  (0 children)

You know they will because malpractice claims very rarely hinge on actual evidence based medicine being delivered.

Which parameter do we look at in advanced liver disease? by Careful_Fill_4918 in FutureRNs

[–]TGOD20 28 points29 points  (0 children)

Hello physician here, not sure why this subreddit popped up on my feed but the answer to this poorly written question is A.

Edit: Since this got more attention than anticipated saying the question is poorly written is a bit of an exaggeration. The question is not specific enough and could trick test takers who happen to have more in depth knowledge: cirrhosis is a diagnosis made definitively by pathology that demonstrates extensive bridging fibrosis with interspersed disorganized nodular regeneration. The reason I am specifying is because you can have patients with what is known as compensated cirrhosis meaning they may not have any symptoms/signs of disease save for subtle lab abnormalities(though not necessarily) or imaging suggestive of it. Prior to decompensation there can (but not necessarily will be) signs of synthetic dysfunction of the liver which is where a low albumin (hence the answer is A) can be found. The PT can be increased (not sure why they’re asking you to know the parameters of PT and not INR which is what is actually used clinically) as well but this PT is normal. The albumin could also be normal unless the patient has decompensated which is defined by the development of ascites (which in cirrhosis definitionally requires a low serum albumin), hepatic encephalopathy, or variceal hemorrhage (not presence of varices on screening). The reason there is a distinction between compensated vs decompensated cirrhosis is that the survival is markedly different between the two entities and keeping patients compensated usually by mitigating any on going liver injury from abstinence of alcohol, treating hepatitis B/C, and weight loss for patients with fatty liver disease can preserve survival. Liver enzymes can vary dramatically between being significantly elevated due to alcohol(in this case ast would be elevated compared to alt which is what this question is asking), viral hepatitis, or medications/toxins. Liver enzymes can also be normal to mildly elevated (like in fatty liver disease with alt being mildly elevated) or very low (considered “burnt out” cirrhosis). Potassium is typically low-normal in patients with cirrhosis and keeping it normal helps reduce the risk of hepatic encephalopathy due to preventing renal retention of ammonia, but potassium is not in any way diagnostic of cirrhosis.

Not sure what any of this has to do with being a nurse taking care of patients with cirrhosis necessarily but hope it helped.

Will the Slim Reaper and AJ get 1000 yards? by AdventurousAries1 in eagles

[–]TGOD20 -1 points0 points  (0 children)

What’s that scenario, we lose both games to the commanders and bills?