MikeLigalig.com

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Quote from: Lorenzo on March 25, 2011, 09:42:31 AM

Professionalism aside, I can sympathize with why you guys didn't give up, at the request of the patient's family. How old was the patient diay? And what was the cause of death? Hypertrophic cardiomyopathy or acute MI?

patients less than 50-60 years old, usually of patients with MI.

Doc, keep those cases coming... and thank you.

Quote from: Lorenzo on March 25, 2011, 10:05:38 AM
A 69 year old man is hospitalized for an exacerbation of asthma. He is placed on albuterol and an inhaled corticosteroid , but due to low oxygen saturation, he is intubated. After 3 days in the hospital, he has a temperature of 39.4 degs C, a blood pressure of 104/ 63 mm Hg, a pulse of 108/ min, and a respiratory rate of 35/ min. On physical examination, the patient is found to have coarse rhonchi at the base of the lung fields bilaterally. The patient is producing purulent , foul-smelling sputum that shows Pseudomonas aeruginosa on culture analysis. Which of the following agents could be used to treat Pseudomonas aeruginosa infection?

A. Cefoperazone
B. Cefotaxime
C. Cefotetan
D. Ceftriaxone
E. Cefuroxime

4th generation cephalosporins has the highest bactericidal effect on Psuedomonas, but 3rd generation are also useful for serious gram neg infections, however, among the 3rd generation ceftazidime and cefoperazone are the ones most active against psedomonas aeroginosa so answer is A

A. Cefoperazone- 3rd gen

B. Cefotaxime-3rd gen
C. Cefotetan-2nd gen
D. Ceftriaxone- 3rd gen
E. Cefuroxime-2nd gen

This was a hospital in Cebu. as in Ramiro however, I don't really know if they do use or not because I have never worked there but I know they make use of everything that they have. The patient's family just go home with a lot of bills to pay. In the setting in internship/clerkship cguro, hospitals like CDUH and the like make most of their many interns or PGI's in a code. Also the lasck of knowledge with the use of a defibrillator also comes to mind as well.

Quote from: Lorenzo on March 24, 2011, 08:53:31 PM
24 epinephrines ? Ka grabeh pood sa Pilipinas. Dili diay sila kahibalo that after 2 high doses of epi, mag saturate ang receptors sa pericardium?


Dra, I will nonetheless give you a standing ovation for that dedicated 2 hours of physical cardioeversion when all seemed lost. Daghan ko kaayo respect para nimo!!

we manually resuscitate especially at the ER and wards (and its not only me sad nagpump oi, puli puli mi sa mga co-interns) but i noticed we only used the defibrillator when the patient had insurance or good financial background (thats the sad part) and these are the family of patients who asks the doctors to not stop resuscitating... we usually alternate sa defibrillator then manual. with regards to the epi, thanks, new learning for me. Its not always all the time sad that we give more than 3 epis... most really is three epi's and we give 15mins for response if wla na, we appraise the family but like i said some family's in their verge of emotional insatbility cguro moask man ipadayun sa doc, especially if the patient is young so ambot nganu tagaan man sad epi nasad sa amo resident.

this is so true. unfortunately, esp in the phils. if dli ipaundang sa family sa patient, dli sad paundangun sa doctor. i remember as an intern, we resuscitated a patient for two hours before declared dead. he had 24 epinephrines given na cguro with no response. kapoi intawn cge og pump.

hi kerstin.

LA is good. just busy with stuff....

anyway, update on UCLA girl, She is reported to be quiting school because she has been recieving death threats....

so sweet... God Bless

hahaha... maybe.

lisod kaayo asthmatic pajud. ang pagkahypertensive ani cguro wlay check-up check-up. taas cguro cholesterol sad ani bataa.

sure mo asthma to basin nagcongestive heart failure sya. wla pajud dialysis, basin ni.inom daghan fluids mao na nagdyspnea. mao pud na ka-paet kay non-compliant mga patients also because mahal sad tambal.

Quote from: Lorenzo on March 18, 2011, 03:45:51 PM
I'd like to add something that i saw today (and was saddened by):


21 year old african american female comes in to the ER after failing to meet her dialysis appointment. Patient's history indicates that she has CHF (chronic heart failure), CRF (chronic renal failure) , both of which are secondary to her untreated hypertension. The patient came in because she was suffering from asthma. What drug would she be given if she suffered an acute asthma attack?


A: Albuterol



OT: I was really saddened today to see such a young person who has yet to live life already dying. Only 21 years old and already CHF and CRF.   

this is really unfortunate. how did she get CHF? tambok ni sya? african americans have the highest risk of cardiovascular problem and hardest to treat depending on their inherited genes. ambot lng sad pero so far mao ako nabantayan. have to update myself more with US statistics.

WebMD (3/11, Warne) reported, "Broccoli may help fight cancer by blocking a defective gene associated with tumor growth," according to new research in the Journal of Medicinal Chemistry. Studies have shown that "compounds in broccoli and other cruciferous vegetables called isothiocyanates (ITCs) appear to target and block mutant p53 genes associated with cancer growth." When researchers "analyzed the effects of ITCs on gene p53 in a variety of human cancer cells, including lung, breast, and colon cancer, in the lab," they found that ITCs were "capable of removing the defective p53 gene while leaving healthy versions of the gene alone." The study authors noted that further studies to confirm these findings could potentially lead to new cancer therapies.

Quote from: Lorenzo on March 18, 2011, 03:29:49 PM
dra, what do we call waiter's tip ?

they have the same nerve involvement sa ape hand. so as with claw hand, also known as pope hand

Quote from: Lorenzo on March 18, 2011, 03:26:55 PM
Warning: This is sexual, but highly useful and well remembered by many, many male medics. bwahahaha


THE 12 CRANIAL NERVES

the ever famous.


Mnemonic : Oh Oh Oh To Touch And Feel Virgin Girl's Vagina Ah Heaven!



O = Ocular
O = Optic
O = Oculomotor
T = Trochlear
T = Trigeminal
A = Abducens
F = Facial
V = Vestibulococchlear
G = Glossopharyngeal
A = Accessory
H = Hypoglossal

buing... nice man ireview nga naay mkarelate gud... lahi sad ako remembering tool sa brachial plexus... Radial.n---wRist drop (R=R),  Ulnar n.--Claw hand (itakilid ang u= c) median n.---ape hand or waiters tip (balihon ang M=W)

put some more. nalingaw ko. hehehe

thanks for these, doc... nice ireview

The Orlando Sentinel (3/12, Shrieves) reported, "Men who take statins -- one type of cholesterol-lowering drugs -- may be 60 percent less likely to be diagnosed with high-grade prostate cancer, according to a" study of "patient files from the Veteran Affairs New England Healthcare System." Investigators identified 55,875 patients using either a statin or a blood pressure drug. Investigators found that "men taking statins were 30 percent less likely to be diagnosed with prostate cancer than those on anti-hypertensive medication" and that "statin users also were 60 percent less likely to be diagnosed with high-grade prostate cancer."

murag maswallow man ang lake sa baje...scary..

hormones... when we have more estrogen we go for the more masculine type. and at our time of ovulation, women also tend to be more attractive in the eyes of men rather than the other days of our cycle. it also changes the quality of our voice, etc. we are just not aware of this changes.

OMG! are you kidding me? thus answers the famous line... Love is blind.

hahaha! @finally part, i saw that episode in discover channel about womens choices when they are ovulating.... so true though.

Quote from: Lorenzo on March 18, 2011, 02:09:03 PM
There is no harm in prayer. the benefits are endless.. 

Amen to that

this flooding problem has always been a problem sa philippines. I don't know why we have never recovered from this. and its really sad how still a lot of Filipinos are not educated enough about preventive measures. naa man gud sa ato batasan na kung mkaya pa, kakayanin (is that even a word?)

so pasabot ani ang diploma is the apple of eden?

unfortunate.

people believe what they choose to believe. what i believe? nature is just taking its course. remember what we were taught in history class how everything started as big land mass and it slowly broke down later creating land bridges until different islands form? and thats how humans changed their colors, culture, adapting to the places they live, etc... well, thats probably whats happening. i don't know. am not a scientist, i believe what i choose to believe.

Quote from: islander on March 17, 2011, 01:44:14 PM
i'd rather believe that it's more of cleansing than punishment.  i cannot imagine a just god who's been guiding us on the road to salvation since the beginning of time to be so cruel as to punish his own creation with destruction.  it is easier to believe that we are punishing ourselves by not heeding his warnings.

ya, and you can't help connect why things happen... like what happened before in japan, the live human experiments and dolphin slaughter... so sad.

:-)

yes, in some sense, alien to the other cells but also not quite, because in turn, cells would not survive without them except if you are an RBC or a non-eukaryotic cell because, remember, they are afterall the power house of the cell. Cells function because of them.

alien (plural aliens)

--A person, animal, plant, or other thing which is from outside the family, group, organization, or territory under consideration.... YES
--A foreigner residing in a country... YES  
--Any life form of extraterrestrial (extraterrestrial (plural extraterrestrials)---A being originating from outside of the Earth's atmosphere, from space, or from another planet)origin...DOUBTFUL

                       

asus, basin lain imo nabantayan, tight spandex she's wearing you say? hehehehe...whats she doing out on a snow storm anyway? geezz...

Saudi Prince Alwaleed Bin Talal Alsaud






mao ba? unsa kha ingalan niya sa iya resort?

mkalilong man sad tingali ni oi.

dli uroy sila tugnawon... brrrrr

ya, very historic mga butang sa sulod. sija ni jose rizal, mga butang ni rizal pagadto nija germany, etc... upload ko pic sa likod..

Dugay mkamata, dli na mkaprepare, diretso na work. mangape lng mao na mokutaw ang tijan kay stimulant baja kape unja ana ra mkahinumdom ig alas gis, mao na mahulog na og brunch.

front view sa peacock garden, Baclayon

Quote from: hubag bohol on March 15, 2011, 08:38:09 PM
Bodies talk...

action speak louder than words

salamat vist. Dli sad tanan cguro. naa man uban sitwasyon nga sakit jud kaayo sa kasing-kasing (naks!) mao na dli matabang sa mga luha na mugawas man jud.

abtik lage kayo ka doc enzo motubag dayun. hahaha... isn't it late na dha chicago?

ajaw sad isaba oi, maulaw sad ta. asa naman si meikylla?

you should see what other people are saying. ok raman magpost og rant sa youtube but naa sad limitation oi. ambot na unsa na kaha ni sija.

No. she was just not thinking before doing. a lot of people of all races are making a parody about this already. she just embarrassed UCLA by doing this.

unsay hinagiban?.. sorry ha, lawum na jamo na para nako

Re-Post: Asians in the Library - UCLA Girl going wild on Asians

hahaha.. o oi, first man nako. hehehe.. and lami imo recipe.. :-)

yes, you can always text not say anything but share what you feel through letters... hehehe. there's a video am trying to look sa youtube about this.
It started where the girl was sitting under a tree reading and was on earphones apparently listening to something then a guy sat next to her and not wanting to disturb her, wrote in a post it for her to read, "can i listen to what your listening on your earphones?" the girl simply replied no on the piece of paper. so he stopped bothering her. the next day, the guy wrote two more notes and she replied but they never talked. soon they knew a lot of things about each other just through writing notes until the girl decided i guess its ok if he listens to her earphones, they she gave it to him. When he held it to his ear, there was no music. :-)

true happiness is contentment and appreciating what there is

mao diay ni star fruit. ako gihunahuna sad kay star apple. lami ni sya, wla mana dri LA oi. last time i had one was in highschool.

I dunno na.

I'm just so proud to mention a few esp that i know these people by heart. kamo, ipost sad dri ang inyong nailhan.

Philippine Dentistry 2004 - Gail Anthony Bitancor (4th place)
CPA oct 2003- Majesty Eve Jala (14th place) 
Physicians Board exam feb 2007- Edilfavia Mae S. Uy (1st place)
Bar exam 2008- Majesty Eve Jala (4th place)
Phil Dentistry 2010- Joanna Bless Yap (6th place)

wla sad ko kabalo. wla naman si mam caberte. i think it was her that made the school great bisan istricta, she had objectives for the school.

ang the very popular ptb. hahaha

yup, part sa amo clerkship. Rural setting. sa CIM, its in paknaan, handled by family med residents as their facilitators. I think two months rotation sa CIM.

Am not from CIM but my husband is.

from what I have observed, CIM people are really smart, no doubt but lack in skills/labor/ hard work. they are very good in theory. they have been consistently 100% sa board exams sa phils the past years. but in work, lets just say i know a couple of people from CIM na niquit og residency kay either they cant take the pressure or load of work. but this is just also recently mga bago na batches. some med students man sad gud sa pinas, maCIM ba or whatever school, some kay napugos ra btaw sa ila parents, i guess mao na wla sa ila passion motrabaho. kapoyan na ba. ambot lng

sa ilaha batch rana. the previous batches were ok. CIM is very good with theory, no doubt smart sila but honestly, lack in skills/ labor. ask them questions and then can answer. they learn their skills/ hardwork through clerkship and internship.. i know a lot of CIM na nagresidency then quit lng kalit kay gkapoi or something.

that would be so cool! thanks doc enzo!

Enzo, ok sad. maajo... moral support. weeeee!!

Quote from: Mike Ortega Ligalig on March 15, 2011, 07:32:55 AM
Hello Everyone,

Here's the posting on why TubagBohol was inaccessible yesterday: http://tubagbohol.mikeligalig.com/forumhelp/tubag-bohol-outage-march-14-2011-and-images-not-showing-up/

I'm still thinking how we can further polish our site's face.

For now, bye-bye to the "somber" skin of TB.

thanks Mike!

how do i upload a pic here again? thanks

Enzo, step 1 pa intawn.

makalimtan? ahehe

what i've heard, wla pa ka human paper works mga lake. mao na. strict bya kayo CIM.

so that's what happened yesterday. I thought gi-ban ko. toinks!

i dont know but dli lage ko nahan kaon ani. baho-an ko ba.

ako lng nikaon, 1/4 the prep raman ako g.gama. 3 ra ka shakoy. unsaon pagupload? nahan ko ibutang. in fairness, lami imo imo recipe. salamat hubs

:-) good for you. you are the only one who knows best what to do in the end

nicely said... :-)

so you studied med dri sa US diay?

hmmmm... lalake jud ka. i dont think it would make you weak. and why are you crying about her? in love japon ka nija diay? ayay... past is past. its how you became you now. besides, whats more harder than life sa medicine? kinabuhi bya imo gtackle. honestly, she will appreciate it that you called. just a call. :-)

wow! idol! daghan jamo pinoy dha chicago.

sa girls point of view akoa, but i think for a guy, impotrant na they have to provide. its in your ego that has the persona that you have to provide. uban lake kay dli man showy/ affectionate, but sa ila know how kay ipakita sa giving gifts/ how they provide. sakto ba?

Payag ghapon ko pero pwede sad sa buzz cafe in ICM.

another a bit farther from tagbilaran sa albur, peacock garden, lami sad unja sa panglao sa asia tika

Bahalag saging basta labing

Dia ko LA, magtake exam sa USMLE... oist na OT nata! hahaha

i could hardly open the tubagbohol page yesterday. anyway, i feel for your ex. Gibuwagan man sad ko sa ako ex boyfriend pagmedicine kay mao daw kaso nahagbong sija. Ikaw rajud mkabalance imo relationship and study and manage how it affects you. kadto uyab pami, inspired kayo ko. I finished my studies on time so I could see my ex. I even was in the top ten of the whole year level and I got offered a scholarship pero ako gturned down kay i knew ma.affected ko sa break-up and dont like to be pressured. after that, average student nlng ko. so na ex na sija nako pero cge ghapon ko tawag, nangamusta unja pareha man mi freinds so magkita ghapon me... mao to mga sakit na panahon. hangtud i tried not contacting him at all for at least 3 months ... i slowly healed in time, met another guy, now my husband and happy ever since. we are facebook friends with my ex. small world ra bya ang medicine, kaila sad sila sa ako bana.

unsa ka dugay naman diay mo wlay contact? if over a year, you should try to at least make friends. if she's still available, you never know, but if dli... accept na mao man to imo na decision. be happy for her. mao na nagdamgo ka kay wla pakay closure if ok ra ba sija or dli.

nahurot na. i had problems loading the page the whole day yesterday dri.

taga city of friendship, tagbilaran city...

ay, hubag... nahan jud ko luto-luto especially kung bored ko (teehee) and right now, i am. toinks. gpatubo na nako ang shakoy sa bowl.

hala oi, once a boholano, always a boholano... o di va? wla bya kabayo sa ato. kabajo ra. ahahaha

amen

hahaha... 1998 grad ko. lahi naman sad wisdom oi na wla na sila mrs. caberte.

actually, wla may kaso if mingawon ka nija. normal raman na kay tao ra bya ta but naa jud limitasyon. ya, i still call particular exes but only the ones i know the wives/ gfs kay as a girl, kbaw nka mukutaw bya ang utok basta mkadungog nitawag ang ex. you have to respect the girls point of view sad. and i am glad i have good relations with all my exes.

salamat, hubag sa recipe, ako ni himuon karon. hehehe

miss deepwater ko. hehehe. thanks.. maajo kay naa ni.

pwede sad oi but at night? its kinda weird. i guess it also depends unsay reason sa call.

what year diay ka graduate sa wisdom?

My aunt is in Japan. So thankful her family is safe.

Hi mga Boholanos! i am still trying to get used to this. want to keep in touch with the place i grew up.

Happy Birthday!

this is my favorite snack pastime when i was kid with matching ice candy

the same way i love.... very much

mrs. tebio cguro pasabot nimo.

yes, i still remember my first love. i dont think anyone would forget it, their first love..