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Welcome to thajoker’s page.
Contributor score: 11


Comments ...

 +0  (step2ck_form8#31)

Wtf, Wells Criteria for DVT says always do confirmation thru US/D-Dimer before treating...

jd1  @thajoker It's not a DVT (vein), it's an arterial embolus which needs Heparin EM, (DVT would not have absent pulses or be cold b/c the blood is stuck inside vs with an artery the blood can't get in (also AFIB makes you think arterial anyway) @kingfriday management of an acute episode is different from chronic arterial embolus where assessment would start with an ABI and management would start with exercise. In an acute episode, patient needs EM heparin and likely thrombectomy after +4
thajoker  lol brain fart, thank you for this +2

 +0  (step2ck_form7#33)

lung cancer loves to present with digital clubbing


 +1  (step2ck_form7#21)

Severe, acute illness: e.g., infection with fever > 38.5°C (> 101.3°F) is a contraindication for immunizations. Although this pt has a mild illness, her temp remains at 100F

seagull  Yes, I will also add clear allergy to a vaccination (anaphylaxsis). However, seizures are not a contraindication. +1

 +5  (step2ck_form7#35)

Nystagmus is almost always pathological unless congenital. Especially gaze evoked nystagmus is almost always pathological.

BPPV btw is head movement induced nystagmus, which isn't the same as gaze evoked. Gaze just means moving eyes whereas bppv usually the nystagmus comes from moving the entire head.

The rest are normal findings for age, except e, which could be normal pupil size for any age.


 +1  (step2ck_form7#33)

Vesicovaginal fistula presents with constant urinary incontinence, not only after voiding.


 +1  (step2ck_form7#35)

Nurse maids elbow. X-ray not necessary initially as reduction is therapeutic and diagnostic


 +0  (step2ck_form7#15)

Kidney stone, not pyelo. Antibiotics not indicated and hydration among first line tx


 +1  (step2ck_form7#14)

s/p CABG, decreased CO and hypotension, CXR shows widened mediastinum --> mediastinal hemorrhage





Subcomments ...

submitted by thajoker(11),

Wtf, Wells Criteria for DVT says always do confirmation thru US/D-Dimer before treating...

jd1  @thajoker It's not a DVT (vein), it's an arterial embolus which needs Heparin EM, (DVT would not have absent pulses or be cold b/c the blood is stuck inside vs with an artery the blood can't get in (also AFIB makes you think arterial anyway) @kingfriday management of an acute episode is different from chronic arterial embolus where assessment would start with an ABI and management would start with exercise. In an acute episode, patient needs EM heparin and likely thrombectomy after +4  
thajoker  lol brain fart, thank you for this +2  


submitted by step_prep2(18),
  • Key idea: Risk factors for asthma include (1) Family history of atopy (2) Environmental exposures (second-hand smoke, pollution, etc.)

https://step-prep.org/tutoring/

thajoker  So to be clear, Family history is the number one risk factor, all the other exposures are secondary risk factors? +