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    (Original post by visesh)
    I've got a case scenario I've partially worked through:

    A 68 year old man with a Hx of PVD and type 2 DM (with a proximal to distal femoral bypass on one leg 2/12 ago and a below knee amputation in the other) is 12 hours post-op after his BKA. Urine output in the last 2 hours is 15-20ml, and he is hypotensive (90/40). He is being pain managed with an epidural, and has a brown cannula in. You are called to the ward. What do you do. (the obvious...)

    Next:
    After administration of 250ml Gelofusine, his vitals are now: HR 104, RR 16, BP 96/56. His foot is warm but his hands are cool, and he has poor capillary refill in his fingers. His stump is dry and 'he can only feel the cold of the ice from his costal margin upwards and he can't move either leg at all'.

    What's going on? :confused: I find the last bit particularly hard to understand.
    For the last part think complications of epidural - not wanting to give it away entirely.
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    (Original post by Ataloss)
    For the last part think complications of epidural - not wanting to give it away entirely.
    Ta.
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    (Original post by kate0904)
    i am so annoyed with myself and upset right now - i spent hours working on my pbl for the week - had it all nicely written up and properly referenced, have since had my laptop reset and i copied the wrong version to my external hard drive and only have 1 day to redo it all
    6 hrs later, finally got it finished and can go to bed... probably not quite as good as the first time i did it but i no longer care!
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    (Original post by visesh)
    I've got a case scenario I've partially worked through:

    A 68 year old man with a Hx of PVD and type 2 DM (with a proximal to distal femoral bypass on one leg 2/12 ago and a below knee amputation in the other) is 12 hours post-op after his BKA. Urine output in the last 2 hours is 15-20ml, and he is hypotensive (90/40). He is being pain managed with an epidural, and has a brown cannula in. You are called to the ward. What do you do. (the obvious...)

    Next:
    After administration of 250ml Gelofusine, his vitals are now: HR 104, RR 16, BP 96/56. His foot is warm but his hands are cool, and he has poor capillary refill in his fingers. His stump is dry and 'he can only feel the cold of the ice from his costal margin upwards and he can't move either leg at all'.

    What's going on? :confused: I find the last bit particularly hard to understand.
    Do you have an INR on him? Was the epidural site examined/imaged?
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    (Original post by Ataloss)
    For the last part think complications of epidural - not wanting to give it away entirely.
    Damn!!!
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    http://www.nda.ox.ac.uk/wfsa/html/u13/u1311_04.htm#comp

    :yy:

    Thanks again Ataloss. That sort of thing isn't really covered in my surgery textbook or in my tiny anaesthesia book.
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    Does anyone fancy setting up a(nother) case scenario thread for us current medics?
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    (Original post by visesh)
    Does anyone fancy setting up a(nother) case scenario thread for us current medics?
    I think that it sounds like a good idea but I have going to bed so will do it in the morning if no ones else has :p:
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    (Original post by *tink*)
    oh and in terms of revision they jsut allocate you to two panels, and then get allocated to one question in the exam
    What? Just panels? That's not particularly helpful
    I suppose it is close to the end of year exams though :sigh:
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    Phew, been working on my elbow, arm and shoulder anatomy all afternoon and a lot of the evening... it's tough going! But interesting too, I guess.

    Time for some rest :ninja:.
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    (Original post by Demon_AS)
    Phew, been working on my elbow, arm and shoulder anatomy all afternoon and a lot of the evening... it's tough going! But interesting too, I guess.

    Time for some rest :ninja:.
    Missed the wrong lecture today....bugger, first day and already behind. I also need to somehow preserve all the anatomy I learnt today before it slips away.

    Our notes also say something along the lines of 'you need to get and stay ahead of the course'. Is anyone ever ahead of a medicine course?
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    (Original post by Wangers)
    Missed the wrong lecture today....bugger, first day and already behind. I also need to somehow preserve all the anatomy I learnt today before it slips away.

    Our notes also say something along the lines of 'you need to get and stay ahead of the course'. Is anyone ever ahead of a medicine course?
    You can get ahead?

    For me, just trying to keep up is hard lol. I'm not even sure I'm managing that, either. Just gotta do what you can, mate.
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    (Original post by randdom)
    I think that it sounds like a good idea but I have going to bed so will do it in the morning if no ones else has :p:
    Done http://www.thestudentroom.co.uk/showthread.php?t=780803
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    http://news.bbc.co.uk/1/hi/uk/7823707.stm
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    (Original post by Wangers)
    Missed the wrong lecture today....bugger, first day and already behind. I also need to somehow preserve all the anatomy I learnt today before it slips away.

    Our notes also say something along the lines of 'you need to get and stay ahead of the course'. Is anyone ever ahead of a medicine course?
    Keeping up is enough work for me! It took me a while to realise I couldn't know everything we are taught straight away. :rolleyes:
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    considering he's a doctor, my GP tutor is a complete **** - he hasn't seemed to cotton on to the fact that a wheelchair won't go upstairs, and if someone's in a wheelchair they probably can't get upstairs on their own...
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    (Original post by visesh)
    The DR makes me incredibly hungry. It's good fun, but not on a Monday morning, and defo not on Fridays after a heavy night out.
    I agree about the DR making me hungry... It's very very odd.
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    DR = Dissecting Room?
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    (Original post by Demon_AS)
    DR = Dissecting Room?
    :yes:



    And everyone I've spoken to agrees that DR = hunger!
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    (Original post by Ribbons)
    :yes:



    And everyone I've spoken to agrees that DR = hunger!
    I agree with that! I always crave chicken...
 
 
 
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