Pimp Questions

[mycrofft]

Pyridium.

Was getting ready to spin a urine spec thatb looked like Tang breakfast drink from pyridium, turned it on, left the room and heard a "crack" noise. Plastic tube had failed, pyridium urine had done spin art all over the room.

 

[Brandon O]

Micro is currently a weak area for me Just got in my copy of Medical Microbiology yesterday, though! So ask me again in a month

Some good answers, but I really had in mind C. Diff and the norovirus. Both really need either a good soap and water washing, or bleach in order to decontaminate. Alcohol-based and other antiseptics are ineffective.

 

[Farmer2DO]

How does the typical reptile heart differ from the heart of the human?

And how does this relate to disorders in human hearts?

 

[mycrofft]

How does the typical reptile heart differ from the heart of the human?

And how does this relate to disorders in human hearts?

Offhand, crocodilian hearts have no coronary artery system as we know it, they just use whatever's being pumped. Experiments were done where instead of grafting a vein to replace an artery, pits similar to the reptiles' were one to the human hearts. I don't think it worked very well...

Or I'm missing your point entirely.

 

[Farmer2DO]

Offhand, crocodilian hearts have no coronary artery system as we know it, they just use whatever's being pumped. Experiments were done where instead of grafting a vein to replace an artery, pits similar to the reptiles' were one to the human hearts. I don't think it worked very well...

Or I'm missing your point entirely.

That's a valid point. I'll grill my next newbie with that.

What I was referring to, however, is that most reptiles have a "3 chambered heart", with blood from the ventricles mixing, and the correlation to a ventricular septal defect in humans, and the pathophysiology that would go along with it.

 

[mycrofft]

My brain has a habit of looking for an opening and making for it when questioned.

EDIT: That's not a question.

 

[VFlutter]

What is tetralogy of fallot? Ah peds

 

[NomadicMedic]

What is tetralogy of fallot? Ah peds

Blue baby syndrome! A sepal wall shunt, RVH, aortic displacement and pulmonary arterial stenosis.

 

[VFlutter]

Blue baby syndrome! A sepal wall shunt, RVH, aortic displacement and pulmonary arterial stenosis.

"Tet Spells"

What is a simple position that may help with tet spells? And why?

 

[Dwindlin]

What is a simple position that may help with tet spells? And why?

Squatting. Increases SVR which will decrease right-to-left shunting.

 

[NomadicMedic]

I would have guessed left lateral...

 

[systemet]

Seconded on vasopressin. Not leaning towards phenyl, though.

Can confirm that phenylephrine works via the alpha adrenoceptor like levo --- it just has minimal affinity for the beta receptor, so it increases SVR without the added inotropic support of levo.

 

[TheLocalMedic]

I recall having a Tetralogy of Fallot question for national registry. Also got to see a tet spell because I know a woman whose child had Tetralogy of Fallot. Very interesting...

 

[Thricenotrice]

Never heard of that.... Glad that wasn't on my registry. Got some reading to do.

 

[NomadicMedic]

It was a registry question for me, as well. Also, my next door neighbor was a tet baby. I didn't know what was wrong with him until years later.

 

[Dwindlin]

This may be a gimme based on the questions answered thus far, but since people seem interested in Tetrology, please explain how increased SVR decreases shunting.

 

[VFlutter]

This may be a gimme based on the questions answered thus far, but since people seem interested in Tetrology, please explain how increased SVR decreases shunting.

TOF has a R-L shunt. Squatting decreases venous blood return and increases SVR which creates a pressure gradient that temporarily reverses the R-L shunt creating a L-R flow.

 

[CANDawg]

Describe the method of how sodium bicarb acts as a treatment for TCA overdose.

 

[VA Transport EMT]

it acts as an antidote...probably due to the polarity and salt stuff.

 

[VFlutter]

Describe the method of how sodium bicarb acts as a treatment for TCA overdose.

^ could you be more specific? :blink:

I will take a stab...

The more alkaline the blood pH is there is a greater affinity for TCA to bind to protein therefore reducing serum levels. Also the increase in pH causes unbinding of TCA from Sodium Chanel Receptors (which is what is causing most of the problems). There may be a few other mechanisms I can't think remember.

Compare and contrast the mechanisms that cause hypotension in Septic, Neurgoenic, and Cardiogenic Shock.