GT Doctos or Medical Students thread 2

[quolet]

wow antagal ko nang di nakapost dito. super busy! goodluck sa mga incoming first years!

[ettevyvi]

doctors, ano pong tawag kaya dun sa yellow discharge sa ilalalim ng mata pasyente ko? para syang muta pero pag ginalaw mo parang part sya ng aqueous humor.. diagnosis nya ay dm type 2, ckd, s/p albumin transfusion.. thanks and sana magets nyo yung tanong ko po..

[isha17]

hi sisses, ask ko lang whats the best book po for Board exam review? i want to give it as a gift for my guy.. =) thanks!

[veeyaa006]

wuhoo! i just passed! so far feeling unemployed pa din pero it's been 2 days pa lang naman, hehe

[lianneg]

hi mga doctors.. will i have a hard time adjusting from computer science field to medical field?

i want to be an OB sana, and I haven't discussed these things to my parents yet. it's a big shift kasi right after i graduate.

will that be ok?

[bleudskymd]

hi sisses, ask ko lang whats the best book po for Board exam review? i want to give it as a gift for my guy.. =) thanks!

First Aid USMLE Step 1 Reviewer 2010 edition. kung mayroon ng 2011 edition, that's better. 

[bleudskymd]

wuhoo! i just passed! so far feeling unemployed pa din pero it's been 2 days pa lang naman, hehe

congratulations! and welcome to the real world.

[bleudskymd]

hi mga doctors.. will i have a hard time adjusting from computer science field to medical field?

i want to be an OB sana, and I haven't discussed these things to my parents yet. it's a big shift kasi right after i graduate.

will that be ok?

honestly, ikaw lang ang makakasagot niyan. it will be entirely up to you kung paano ka makakapag-adjust from com sci to med. it's either you "fight" the pressure, or "flight" and quit. actually, hindi lang naman ikaw ang magkakaroon ng adjustment issues - pati mga magiging classmates mo (na nag-take ng pre-med courses) kasi ibang-iba ang environment, schedule kapag nasa medical school ka na. good luck to you!

[bleudskymd]

Up ko lang ito..

[au_chic]

Makeup duty mode ako for 1 month 

Pero ang sarap turuan ang new clerks. Ganda pakinggan na "outgoing clerk" na ko. 

mukhang pgh na nga ako mag-iintern. Walk in na lang haha. Ang tagal pa ng results ng 2nd matching.

[bleudskymd]

^ hey sis. good luck to your up & coming internship. marami ka naman matututunan sa PGH plus marami kayong interns na manggagaling sa ibang schools. enjoy!

[neshyy_0014]

hello po.. Inquire lang ako mga sis,.. planning to take up medicine. Tourism po ako before, i wonder paano yung set up non? magtetake na ba ako agad ng NMAT? huhu... And what are the best schools for medicine? thanks...

[FOURever]

^sis baka you need to take some subjects pa sa science? If you'll take NMAT agad, what i know is may expiration yun. So kung sa tingin mo magtatagal ka pa sa pag take ng subjects at mag eexpire NMAT mo, mag take ka na lang pag mga 1 year to 10 months to go bago ka mag apply sa medschool.

May minimum number of units kasi yata for science subjects like chemistry, etc bago pwede makapag apply sa medschool. Not sure, though.

[bleudskymd]

hello po.. Inquire lang ako mga sis,.. planning to take up medicine. Tourism po ako before, i wonder paano yung set up non? magtetake na ba ako agad ng NMAT? huhu... And what are the best schools for medicine? thanks...

If your college degree is a non-pre-med course, then you have to take additional subjects/units as prerequisites for Medicine. Taking up those additional subjects will take you around 1-2 years. NMAT score is only valid for 2 years. Plan your schedule well.

Listed are the pre-req units for Medicine (I got from another website). Check if you've reached the units from your Tourism course. Otherwise, you have to enroll.   
15 units of Biology
10 units of Chemistry
9 units of Math
5 units of Physics
When I took my NMAT almost 10 yrs ago, meron pang 5 units of Social Sciences. I don't know kung kailan at bakit nila tinanggal.

Best school? Lahat sila. It's up to you how you'll do good.

Good luck to you!

[pretinnes]

hello po.. Inquire lang ako mga sis,.. planning to take up medicine. Tourism po ako before, i wonder paano yung set up non? magtetake na ba ako agad ng NMAT? huhu... And what are the best schools for medicine? thanks...

The NMAT
result has no validity period but medical schools have their own admission
guidelines.

Some medical schools do not require or do not have prerequisite units in order to proceed to Med School. what school are you eyeing?

[ettevyvi]

[textspeak!] am drs, tanong ko lang... may patient kami, gunshot wound, inexplore lap sya. then sobrang restless, move ng move, nagturn pa sa side.. kapag ba explore lap, flat on bed lang talaga siya at hindi pwedeng igalaw in any other way? na expire sya, sobrang nagulat kami kasi unexpected. bigla na lang syang nagvomit ng coffee ground vomitus tapos deretso code na. ano kayang nangyari sa kanya? affected talaga ako kasi kakilala ko un relatives nung patient.

[bleudskymd]

[textspeak!] am drs, tanong ko lang... may patient kami, gunshot wound, inexplore lap sya. then sobrang restless, move ng move, nagturn pa sa side.. kapag ba explore lap, flat on bed lang talaga siya at hindi pwedeng igalaw in any other way? na expire sya, sobrang nagulat kami kasi unexpected. bigla na lang syang nagvomit ng coffee ground vomitus tapos deretso code na. ano kayang nangyari sa kanya? affected talaga ako kasi kakilala ko un relatives nung patient.

Yes, in explore lap, the patient should be under sedation, flat on bed (supine). If he has to be mobilized, the bed will be moved sideways, hindi yung patient. I'm guessing your patient died due to hypovolemic shock due to massive blood loss. You didn't mention anything about his vital signs upon entry into the ER. Was blood transfused habang ino-operahan siya? Do you have an idea what were the operative findings? Were there other identified sites of bleeding?

I encountered a similar case before. I also assisted during the operation (explore lap), and our patient eventually survived.   

[ettevyvi]

sis, nasa ward na sya nung nangyari nagcardiac arrest sya, after nya magmove. v/s upon er is stable naman. operative finding states multiple gun shot wound with colon injury. actually, sobrang nagbi-bleed pa sya sa loob.. kasi coffee ground pa rin yung drainage per NGT.:/

[bleudskymd]

^ I could arrive at this hypothesis, based on what you've said (though I still have many questions kasi my kulang pa sa narration mo):

Since he had signs of massive internal GI bleeding (coffee ground material by NGT), he has decreased circulating blood volume in his body. Then when he exerted effort during his "movement" (whatever that is), his heart didn't receive enough blood supply to his heart thus he could have had acute myocardial infarction leading to fatal ventricular arrhythmia and then to his demise.


My questions are:
1. What were his vital signs at the wards post-OR, including his sensorium? Were input/output closely monitored? What were his medications on-board?
2. Any other intervention/s done to investigate the other source/s of bleeding? Were other measures done to stop the bleeding?
3. Were there other signs of bleeding identified (i.e. melena, raccoon sign)?
4. What were done when you sounded the "code blue"? (i.e. ECG, Hgt, doses of epinephrine, NaHCO3) How long was the code before you declared the patient "expired"?

[ettevyvi]

stable ang v/s nya post op.120/80, hr - 70s-80s. his sensorium changed day 2 post op. bigla na lang syang naging restless at iritable, pinipilit nyang tanggalin yung mga contraptions. strictly monitored and i&o nya. medications were antibiotic and pain reliever. no other signs of bleeding were identified. wala ding melena. before coding, may pulse pa sya. although he was very diaphoretic simula nung naging restless sya. i have informed the residents pero they didn't check him.

2 amps of epi were given, after that ecg(asystole) pero wala na din. nag dnr na din ang relatives.mga 30 mins simula ng nagarrest before he was declared.

actually, hindi naman right after mamove. mga 30 mins din ang nakakaraan after sya magcode. nagpahinga sya ng konti tapos sinuction pa sya pero after nun kasi nga ang daming secretions. all of a sudden, he vomitted. dun na nagsimula.