crotchitymedic1986 Posted January 2, 2009 Share Posted January 2, 2009 You asked for it, you got it. This is above my head (just an old medic), so I apologize if the kick-off questions is too dumb, I have faith that you guys can challenge each other: Which medication (and dosage) is used to treat acute respiratory distress in the sarcoidosis patient ? Lets say bilateral wheezing, tachypnea, and a pulse ox in the 80s. Remember to leave a new challenge question please. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted January 2, 2009 Author Share Posted January 2, 2009 Guess that one was too hard. Has anyone heard of "Sweets Syndrome" ? Buddy of mine just transported a patient with that diagnosis the other day, sounded pretty gnarley. Link to comment Share on other sites More sharing options...
AZCEP Posted January 3, 2009 Share Posted January 3, 2009 Which medication (and dosage) is used to treat acute respiratory distress in the sarcoidosis patient ? Lets say bilateral wheezing, tachypnea, and a pulse ox in the 80s. Treatment is going to depend on how far the disease, and specifically the inflammation has progressed. Corticosteroids are the common first step, but if they fail to control the inflammatory process, there are a number of possibilities that can be tried geared toward slowing down the inflammation in the respiratory system. Has anyone heard of "Sweets Syndrome" ? AKA Acute Febrile Neutrophilic Dermatosis, more common in middle aged women and associated with a number of medications and other diseases. Presents with a fever, and acute onset of erythematous plaques, nodules, and occasionally pustules, assymetrically distributed over the face, neck, and extremities. No, I had never heard of it before. What is the Barr body, and why is it important? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 3, 2009 Share Posted January 3, 2009 The human abnormalities called Kleinefelter's syndrome and Turner's syndrome both result from an unnatural presence or absence of a Barr body. In the case of the former, the male possesses a Barr body that it would normally not have, and in the latter case the Barr body is absent If the female did not have an inactivated X chromosome there would be much more genetic material than men and that would be a problem especially with reproduction. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted January 3, 2009 Author Share Posted January 3, 2009 nice, I learned something today. Ruff, please leave a new question. Thank You. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 4, 2009 Share Posted January 4, 2009 Call i ran a week or so ago - think hard on this, one treatment will kill him. chest pain call, you have a 67 year old man who has short runs of V-tach which cause him to lose consciousness and no pulse with them. The v-tach spontaneously converts with perfusing pulse. 30 seconds later this happens again. You have given lidocaine for this with no response. The patient goes into v-tach again for 6 seconds with no pulse and it converts again spontaneously. What are your treatments and what order? Link to comment Share on other sites More sharing options...
mobey Posted January 4, 2009 Share Posted January 4, 2009 I am not supposed to answer in this thread, but I want to stab at this as a medic student. 150mg amiodarone Transcutanious pacing Link to comment Share on other sites More sharing options...
AZCEP Posted January 4, 2009 Share Posted January 4, 2009 That's a pretty good stab mobey, but the onset of Amiodarone is so long that the VT will continue until it takes effect. Recurrent/refractory VT. Treatment nuances will depend on historical factors. I'd consider some magnesium since the lidocaine is ineffective, but I need more information before deciding. Link to comment Share on other sites More sharing options...
Camulos Posted January 4, 2009 Share Posted January 4, 2009 Is the VT monomorphic or polymorphic? Past medical history would also be useful. Stay safe, Curse :evil: Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted January 4, 2009 Share Posted January 4, 2009 monomorphic, patient is semi conscious when his heart is beating at a rate of 80-90 sinus rate but he keeps going in and out of these 4-8 second runs of v-tach with complete loc and loss of pulse when this happens. He lives about 35 minutes away from the closest ER and an hour or so away from a cardiac center via air ambulance but the birds weren't flying due to snow coming down. Link to comment Share on other sites More sharing options...
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