urgent plz xam tommorow - connect2nasir

[ArchivalUser]

guys i ve been practcing uw ccs ...nbme software case 5 guy with HTN and chest pain ... MI is huge in D.D but cxr shows mediastinal widening ... i started patient early on aspirin and heparin after fobt is -ve as suspicion so high ,,..ekg is non specfic ... UA is huge possibility .. thn cxr return with medistinum widen... however in guide nbme say aspirin and heparin are unnecessary discomfort in this case plz reply what is this

[ArchivalUser]

urgent plz atleast some body can have his comments regarding this ... what i thnik nme pays HUGE attention to presentation ...and neglects d.d ... asks u to manage presentation 1st

[ArchivalUser]

n body likes to do nbme

[ArchivalUser]

any chest pain first rule out AAA before giving heparin.

chest pain radiating to the back, high BP at presentation-------do CXR stat.....if it shows mediastinal widening...go for TEE.

no heparin, in suspected AAA.

[ArchivalUser]

pray ---------------Good luck -------------this is thing you need now
all the best

[ArchivalUser]

Don't ever give heparin if you don't have a diagnosis if I remember only time you give heparin in ccs DVT prophylaxis, embolism (clot), NSTEMI,
Nitroglycerin always make sure your BP can take it
rule number 1 don't give no drugs if you don't have a diagnosis name it aspirin, nitrogly.., heparin, morphine
Good luck. Think positive Say I have to pass ... I have to pass mind is powerful you did not your part already meaning study, a lot your sacrifice ... you forget about christmas... forget about ...... you will pass trust me you will. sign off the forum forget about all the doubt... go to movie, or do something fun exam is tomorrow go to bed early, relax deep breath again mind is powerful

[ArchivalUser]

this patient was high suspect of MI with BP 190/115 no bp dif b/w arms ... but rule is pay closer look to individual presetation...inshALLAH i ll pass .... see u guys soon ...

[ArchivalUser]

i agree with u connect 2 nasir.i too thought it was mi..gave aspirin n sl nitates before examining the pt..
on exam u get decresendo diastolic murmur-aortic regurg..
antwats they say u lose point 4 giving aspirin....but what if it was mi..?