Medical Jokes

Anaesthesia practical examination in some college in north India
(Based on real facts will little masala)

Scene 1
Examiner – How will you manage a case of elderly primi with eclampsia in labour?

Candidate 1- sir, I will cancel the case, I will ask them to refer the patient to medicine for the management of hypertension

Examiner – good, you are passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 2
Examiner – A patient is referred from casualty with OP poisoning, how will you manage

Candidate 2 – sir, I will tell the referring doctor that the ventilator is not working and I will refuse to take up the case as without it we can’t manage the case

Examiner – very good. U r passed

šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 3

Examiner- How will u manage a case of appendicitis with fever

Candidate 3 – sir, I will cancel the case as the patient is having fever

Examiner – good. You are passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 4

Examiner – how will u manage a case of compound fracture femur when patient is in shock

Candidate 4 – sir as such cases are managed conservatively with debridement and slab application, I will ask the ortho doc to do the same

Examiner – good, u r passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 5

Examiner – how will you manage a case of cholelithiasis with no complication
posted for elective cholecystectomy

Candidate 5 – sir, I will cancel the case

Examiner – very good, u r passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 6

Examiner – how will u manage a case of non functioning right kidney posted for nephrectomy with all normal parameters

Candidate 6- sir, I will cancel the case

Examiner- good, u r also passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 7

Examiner – how will u counsel a patient with uncontrolled hypertension posted for hysterectomy about the risks involved in surgery? How will u explain her that u can’t give anaesthesia for her?

Candidate 7- sir I will write “posted provisionally” on her case paper, I will give all the required drug list, I will make her buy all the medicine, I will make her mentally, physically and economically prepare for the surgery. And on the day of surgery I will let their consultant explain her that the surgery is cancelled šŸ˜ˆ

Examiner- excellent, u are also passed
šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘

Scene 8

Examiner- how will u….
Candidate 8 – (even before completing the question) sir, I will
Cancel the case

Examiner- excellent!! U r the topper šŸ˜‚
šŸ‘šŸ‘šŸ˜‚šŸ˜‚šŸ‘šŸ‘šŸ˜‚

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Sleep Hygiene

The promotion of regular sleep is known as sleep hygiene. The following is a list of sleep hygiene tips which can be used to improve sleep.

1. Go to bed at the same time each night and rise at the same time each morning.

2. Make sure your bedroom is a quiet, dark, and relaxing environment, which is neither too hot or too cold.

3. Make sure your bed is comfortable and use it only for sleeping and not for other activities, such as reading, watching TV, or listening to music.

4. Remove all TVs, computers, and other “gadgets” from the bedroom.
Avoid large meals before bedtime.

Reader’s Digest Slides

Tips from Harvard

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Antibiotic lock therapy : Summary

Antibiotic lock therapy (ALT) involves instillation of a concentrated antibiotic solution into the catheter lumen with the intention of achieving a drug level high enough to kill sessile bacteria within the biofilm of the catheter. Anticoagulants are often included in the solution and are thought to facilitate antibiotic penetration into microbial biofilm.

For clinically stable children and adults with infections of long-term tunneled central venous catheters and ports due to coagulase-negative staphylococci, gram-negative rods, and vancomycin -sensitive enterococci in whom a decision is made to salvage the catheter, we suggest ALT in conjunction with systemic antibiotics rather than systemic antibiotics alone ( Grade 2B ).

Catheter management options for catheter-related bloodstream infections (CRBSI) include removal, salvage, and exchange over a guidewire. Catheter salvage should not be attempted in the following circuminfections

-Complicated CRBSI
-Severe sepsis or hemodynamic instability
-Persistent bacteremia despite 72 hours of appropriate antibiotic therapy
-Infections caused by S. aureus, P. aeruginosa, fungi, mycobacteria, Bacillus species, Micrococcus species, or Propionibacteria
-Tunnel infections, port abscesses, or exit site infections

Cefazolin , vancomycin , ceftazidime , and gentamicin are commonly used in ALT and are stable in solution with heparin over a prolonged period of time ( see table ). Specific antibiotic selection for ALT should be guided by culture and susceptibility results when available. We favor a dose in which the final antibiotic concentration exceeds the minimum inhibitory concentration (MIC) of the organism by at least 10administered

image

For patients receiving ALT, we typically include heparin in the antibiotic lock solution unless there is a contraindication to heparin (eg, heparin-induced thrombocytopenia). For patients with contraindications to heparin, only antibiotics that have been shown be stable and effective when used alone should be administered

Fungal superinfection, systemic toxicities of antibiotics or anticoagulants included in lock solutions, and emergence of antibiotic resistance with failure are potential but not frequently reported adverse effects.

Antibiotic lock solutions should be administered in an amount sufficient to fill and dwell in the catheter lumen when the catheter is not in use. Depending on the need for access, dwell times can range from four to six hours to three days, after which the solution should be withdrawn and discarded.

Infected catheters should be removed in patients who remain febrile 48 to 72 hours after initiating ALT, who have persistently positive blood cultures 72 hours after initiating ALT, or who have signs of sepsis, hemodynamic instability, or metastatic infection.

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