Thoracic Outlet Syndrome

[21p]

No not really. Any physician with a decent training will be able to answer all of those questions on the spot. Those are very straightforward questions, save the last one. The last one an ER physician would know 100%, which is why I wrote it for you.

If you can't you're fake end of story.

 

[Dr JIM]

Yea well than answer mine Mr "doctor".
bc those are NOT refutable as are YOURS

 

[21p]

that's easy as fuck lol.
kidney failure
a 'scratchy' ekg with pericardial friction rubs, machine like murmur on auscultation fyi
STEMI is the first sign of an acute MI.

A tech would know this shit.

 

[Dr JIM]

Your not having to look anything up ARE YOU "DOCTOR"!

 

[CensoredBoardsSuck]

This only works if the questions are multiple choice bc otherwise it become an test if "what am I thinking"

21 could only formulate a multiple choice question if HE knew what multiple choice answers to use. Since he does not, he won't play.

 

[CensoredBoardsSuck]

STEMI is the first sign of an acute MI.

Not if it's a NSTEMI

A tech SHOULD know that shit!

 

[21p]

^Jesus, seriously? Answer the question big boy! You can't because I didn't write them in a way you could look up on google and get a quick factoid. If you had even a rudimentary understanding of clinical neurology, the first question would have been a knee-jerk.

lol, dude ANY ER doc would know the answers to those questions. I smell bullsheot! If you were a doctor, this shit would be hammered into your soul because you would have been asked 192939124 times during your internship and residency, especially in the ER!!!

FAKE FAKE FAKE
YOU ARE NOT A DOCTOR!!!!

Why would I waste my night off busting a fake ass? Because it's dangerous and it takes away from people like me who spent 150k getting an education + 6 years of no sleep and minimal pussy... AHHHHH!

 

[Dr JIM]

that's easy as fuck lol.
kidney failure
a 'scratchy' ekg with pericardial friction rubs, machine like murmur on auscultation fyi
STEMI is the first sign of an acute MI.

A tech would know this shit.

Really how interesting bc YOU MISSED EVERY ONE DOCTOR!

FIRST the EKG changes of acute pericarditis WAS the QUESTION and NOT the CLINICAL FEATURES
DOCTOR!

SECOND
UREMIA results in an ANION GAP METABOLIC ACIDOSIS
(The primary causes are Renal tubular acidosis and an Entero-Enteric fistula) DOCTOR!

THIRD
HYPERACUTE T WAVE CHANGES are the initial EKG findings of an AMI which is followed by ST SEGMENT ELEVATION.
DOCTOR!

Haste makes waste
DOCTOR, LMAO!!

 

[21p]

I will haunt every word of your posts until everyone knows you for the fake you are. Hahaha I thought I'd never catch someone pretending to be a doctor but somehow neglected to remember the internet is full of idiots! Hahahaha

 

[CensoredBoardsSuck]

I will haunt every word of your posts until everyone knows you for the fake you are. Hahaha I thought I'd never catch someone pretending to be a doctor but somehow neglected to remember the internet is full of idiots! Hahahaha

And THAT^^^ ladies and gentlemen, is game, set, match!

Another google cowboy that can (barely) talk the talk but definitely can't walk the walk. LMFAO!

 

[21p]

You're right, I'll forget about this loser by Sunday. I am still in awe that only a few people question his thoughts lol. Jeez

DRJIM is a fake pretending to be a doctor.

 

[Dr JIM]

Alright, mr. ER doctor. I stumbled on a few other threads of people questioning your credentials. Apparently I'm not the only one who thinks you're a fraud, DRJIM. I'm going to give you a few questions, let's see what you know.

What is the number one way rule out metabolic coma?

If a patient comes in to your ER with a fever, elevated opening pressure, and double vision, what test would you order to determine the root cause? What would be your three ddx?

If you suspect a hemothorax, what angle of approach will you take when doing this common procedure? How can you tell hemo from pneumo without an x-ray?

If a burn patient has 27% of his body covered in 3rd degree burns, how would you determine the fluid resuscitation? What would you follow your ringer's with and how much would you give in relative proportion to the initial drip?

Well ok the first is most CW meningitis BUT double vision esp if is associated with diplopia is more cw a brain stem tumor.
Depending upon what tests have already been performed this patient needs a CT SCAN, an antigen antibody panel and culture.

Hemp vs Pneumothorax
Shifting dullness in hemothorax would be expected while hyper resonance is expected w a SIMPLE pneumothorax.

I assume your referring to the Chest tube angle of insertion, that matters not and their is no evidence to the contrary

Finally did you forget to include the patients weight bc it's needed to calculate the total volume infused in the first 8 hours

But if your referring to the Parkland Formula" the amount infused is the % of body burned x patients weight x FOUR with 1/2 being infused in the first 8 hours.

There is NO EVIDENCE that swapping out LR for NS achieves improved outcomes in burn patients

NEXT DOCTOR!

 

[CensoredBoardsSuck]

Well ok the first is most CW meningitis BUT double vision esp if is associated with diplopia is more cw a brain stem tumor.
Depending upon what tests have already been performed this patient needs a CT SCAN, an antigen antibody panel and culture.

Hemp vs Pneumothorax
Shifting dullness in hemothorax would be expected while hyper resonance is expected w a SIMPLE pneumothorax.

I assume your referring to the Chest tube angle of insertion, that matters not and their is no evidence to the contrary

Finally did you forget to include the patients weight bc it's needed to calculate the total volume infused in the first 8 hours

You're wasting your time. It's like trying to intelligently discuss general relativity with Einstein's janitor - just because he's heard about gravitational time dilation doesn't mean he comprehends it. 21's last post just removed any doubt - the boy is all hat and no cattle.

 

[Dr JIM]

Not if it's a NSTEMI

A tech SHOULD know that shit!

Sorry the FIRST EKG sign of an acute MI is the development of "hyper-acute T waves". MF rest assure most techs don't know that INCLUDING YOU, LOL!

However they are evanescence and are often missed unless the ECG is performed soon after the development of symptoms!

 

[21p]

holy shit, you don't even understand the acronyms.
Ddx = differential diagnoses.

#1: CSF culture. done.

Metabolic coma = pupils equal and responsive to light
non-metabolic coma = pupils not equal or responsive to light
^this is day 1 shit my friend. There's no way you work in an ER and don't know the answers to these questions. You went back and edited in your answers after this conversation, too. FAAAKKKKEEE DOOOCCTTTOORRR ONNN THEEE INNTTTERRRNNEETTT!!!! HAHAHA fake fucker!

Not only are you wrong on #1, you can't even recognize the parkland formula in #3. That's what ANY practicing doctor would tell you, he wouldn't even have to work in the ER. If you would have given me that, I'd be willing to consider you might be telling the truth.

#2 is more or less correct, kudos.

You are a fake, DRJIM. Change your name and stop giving people medical advice as if you were a doctor. It's not right and it will eventually land your ass in a heaping shit ton of trouble.

 

[Dr JIM]

Of course it was not recognizable bc you didn't include the WEIGHT CLOWN!

You only asked for three presumptive diagnoses within the differential.

The only fake here is YOU! Shit NONE of your answers were correct, NONE, WHAT A JOKE!

 

[Dr JIM]

Pupillary exam was NOT mentioned BOZO! Where did you locate this garbage.

Metabolic coma WTF that's NOT a part of a DDX, but a large category of causes that may cause "COMA"! Such as infections, toxins, DKA, uremia, hepatic encephalopathy, etc

Now why do you think the questions I asked from the outset were relevant?

What is the DAMN GCS CLOWN! (Another question I asked BUT you failed to answer bc your no dam doctor)

No doubt YOUR A FAKE, so please do stick around bc as CBS mentioned it can be entertaining busting pretenders like yourself!

 

[21p]

The sad part is how many posts you've accumulated in your quest to prove yourself as real. I have maybe this weekend to post or read. No doctor, unless he is disabled for some reason, has your free time to answer posts on a board with this frequency. I go back to work monday, but judging your count, you don't. I can spot liars a mile away in real life and on the web. 7 years ago you would've fooled me too, you loser. You'll get yours, even if no one else on this board figures your cheap game out.

You are a fake. You will be found out one day. Don't kid yourself. Epic rant over.

 

[CensoredBoardsSuck]

FAKE FAKE FAKE
YOU ARE NOT A DOCTOR!!!!

I will haunt every word of your posts until everyone knows you for the fake you are.

DRJIM is a fake pretending to be a doctor.

There's no way you work in an ER and don't know the answers to these questions.

FAAAKKKKEEE DOOOCCTTTOORRR ONNN THEEE INNTTTERRRNNEETTT!!!! HAHAHA fake fucker!

You are a fake, DRJIM. Change your name and stop giving people medical advice as if you were a doctor. It's not right and it will eventually land your ass in a heaping shit ton of trouble.

You're trying too hard. Flogging that point so many times exposed your agenda. One thing is clear - you're not just some run-of-the-mill troll. You're either a disgruntled former member or the friend of one. Why don't you tell us who you really are or who sent you?

 

[Dr JIM]

Dude how can you as a "doctor" account for the fact you missed ALL THREE of the questions I posed?

Remember even you admitted they were "so easy a tech could answer them"!

Does this mean your one of the more "stupid techs", LMAO!

Hey I know perhaps you will fare better at a "Spelling B" contest!