« 1/23(火) セミナー参加 | メイン | 1/25(木) »

1/24(水) セミナー参加

◆今日の気持ち
(外科 4ヶ月目)
・今日はカンファ前に余裕があった。新患が少なかったのはあるが、よかった。
・問診、やっぱりまだ歯車が合いきらない。聞き忘れがある。何がいかんのか? 疾患が気になるため感度の高い質問をついしてしまう。特異度の高い質問ではずしていかないと、だめ。鑑別もあらためて丁寧にあげてみよう。
・最近救急をみていない。けれど不満はあまりない。やっぱり、逃げたかったのだろう。回復。
・循環器の薬は苦手…。資料は買ったけれど読む暇がない…。
・感染症。サンフォードと培養に頼ってしまい、微生物を治療前に推定しておく、という基本を最近やっていなかったことを認識。
・免疫不全のセミナー、とても勉強になった。しかし、あててもらったのだがまともに答えられず。悔しさをかみしめる。軽快の見込みある免疫不全患者は診ていないのはあるけれど、基本をおさえていれば、思考はできたはずで。
・治療は第一線の専門家に任せるしかないが、入り口、の診断は完全でありたい。

●目指す医師像
まずは、医者

●今の目標
・外科を味わいきる
・「マクギーの身体診断学」を読み終える

●今日の新患・診断

●今日の病院滞在時間
5時〜20時半

●今日行ったこと・見たこと・知ったこと
・外科カンファ
・CVポート設置  外まわり
・開腹胃廊設置  麻酔、タキった…
・セミナー 免疫不全時の感染症

・イレウス
腹水あるとき注意。絞扼性かtumorの可能性あり。多ければ、抜いて調べる。
・縫合
メスで切った創は閉じやすい。少し間をあけてもくっつく
・感染症の基本
host, focus, organism。鑑別あげて、確率を事前に推定して整理し培養してから、治療と観察。サンフォードはお手軽にやるための、そしてわからないとき安全を確保するための、ツール。診断は、その先。

トラックバック

このエントリーのトラックバックURL:
http://dream-hosp.net/cgi/mt/mt-tb.cgi/2404

コメント

What a lovely day for a 3664643! SCK was here

What a lovely day for a 4388846! SCK was here

What a lovely day for a 2522934! SCK was here

What a lovely day for a 979870! SCK was here

store the result in

Get CAR INSURANCE? New, FREE service compares quotes to get you the best and cheapest coverage. Want Car Insurance

Hey, I think your very on point with this, I won't say I totally agree , but its not really that big of a issue.

I have read a few of the articles on your website now, and I really like your style of blogging. I added it to my favorites blog site list and will be checking back soon. Please check out my site as well and let me know what you think.

Hrmm that was weird, my comment got eaten. Anyway I wanted to say that it's nice to know that someone else also mentioned this as I had trouble finding the same info elsewhere. This was the first place that told me the answer. Thanks.

What a lovely day for a 1905889! SCK was here

I was very delighted to discover this site on yahoo.I wanted to say thank you to you with regard to this excellent read!! I definitelyappreciated every little bit of it and I've you bookmarked to look into new stuff you post.

Strange this post is totaly unrelated to what I was searching google for, but it was listed on the first page. I guess your doing something right if Yahoo likes you enough to put you on the first page of a non related search. :)

When do you think this Real Estate market will go back up? Or is it still too early to tell? We are seeing a lot of housing foreclosures in Longwood Florida. What about you? We would love to get your feedback on this.

Hello - I must say, Iテ「竄ャ邃「m impressed with your site. I had no trouble navigating through all the tabs and information was very easy to access. I found what I wanted in no time at all. Pretty awesome. Would appreciate it if you add forums or something, it would be a perfect way for your clients to interact. Great job

I love quotations because it is a joy to find thoughts one might have, beautifully expressed with much authority by someone recognized wiser than oneself.

What a lovely day for a 4286563! SCK was here

You are a very smart individual!

I'm usually to blogging and i actually recognize your content. The article has really peaks my interest. I am going to bookmark your site and hold checking for brand new information.

A lot of what you articulate happens to be supprisingly precise and it makes me ponder the reason why I had not looked at this in this light before. This particular article truly did turn the light on for me personally as far as this particular subject goes. But at this time there is just one factor I am not really too comfortable with and while I make an effort to reconcile that with the central theme of the position, allow me see exactly what all the rest of the readers have to point out.Nicely done.

*The following time I learn a blog, I hope that it doesnt disappoint me as a lot as this one. I mean, I do know it was my choice to learn, however I truly thought youd have one thing attention-grabbing to say. All I hear is a bunch of whining about something that you could repair in the event you werent too busy searching for attention.

Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point. You clearly know what youre talking about, why throw away your intelligence on just posting videos to your blog when you could be giving us something enlightening to read?

Hmm it appears like your blog ate my first comment (it was super long) so I guess I'll just sum it up what I submitted and say, I'm thoroughly enjoying your blog. I too am an aspiring blog blogger but I'm still new to the whole thing. Do you have any tips and hints for newbie blog writers? I'd really appreciate it.

For those who enjoyed th is post, ensure you subscribe to my RSS feed!

I窶冦 impressed, I must say. Really not often do I encounter a weblog that窶冱 both educative and entertaining, and let me tell you, you could have hit the nail on the head. Your idea is outstanding; the problem is something that not sufficient individuals are talking intelligently about. I am very comfortable that I stumbled throughout this in my search for something referring to this.

Amazing post. I was checking constantly this blog and I am quite impressed! Extremely helpful information particularly the last part. I care for such info a lot. I was seeking this particular info for a long time. Thank you and best of luck.

great blog post, i absolutely love this site, keep on it

I would like to get across my gratitude for your kind-heartedness in support of folks who absolutely need help on your field. Your personal commitment to getting the message along turned out to be exceptionally practical and has usually permitted associates like me to arrive at their dreams. Your invaluable advice denotes a great deal a person like me and further more to my mates. Thanks a lot; from each one of us.

If you necessary to litigate, you undergo to spell to city, he attention deficit hyperactivity disorder, have in mind to the circle office in the USA.

Over and over, I read observations such as the one earlier mentioned. Though that perspective isn't just my cup of joe, a number of first rate factors are pointed out.

Excellent. I like it!

Hey! This is my 1st comment here so I just wanted to give a quick shout out and tell you I truly enjoy reading your posts. Can you recommend any other blogs/websites/forums that deal with the same topics? Thank you so much!

Hello there, just became aware of your blog through Google, and found that it is really informative. I窶冦 gonna watch out for brussels. I窶冤l be grateful if you continue this in future. A lot of people will be benefited from your writing. Cheers!

This really is a really amazing powerful resource that you窶决e offering and you just provide it away cost-free!! I quite like discovering websites which often see the particular worth of giving you a excellent learning resource for zero cost. We truly dearly loved examining these pages. Regards!

Im no professional, but I suppose you just crafted the best point. You naturally fully understand what youre speaking about, and I can definitely get behind that. Thanks for staying so upfront and so sincere.

There are many fascinating time limits in this posting however I don窶冲 determine if they all center to heart. You can find some validity however I'll take hold opinion until I look into it further. Good article , thanks and then we want extra! Added to FeedBurner as properly

Beach front homes are truly well-liked in the vicinity, so even despite the fact that the folks earlier mentioned are usually not conclusively agreeing with just what I presume, they still do deliver about reasonably beneficial points relating to real estate at this point.

in a very foolhardy way without the need of using that in large that whenever some people get an important last plastic card in L6, 000, that they surely have three cards now by means of stabilizes totalling 1, 000.

Can I simply say what a relief to search out somebody who actually is aware of what theyre speaking about on the internet.

An impressive share, I just given this onto a colleague who was doing a little analysis on this. And he in fact bought me breakfast because I found it for him.. smile. So let me reword that: Thnx for the treat! But yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading more on this topic. If possible, as you become expertise, would you mind updating your blog with more details? It is highly helpful for me. Big thumb up for this blog post!

Your IRS . GOV will in addition show you generally if the return can be retarded so it has problems with your overtax bring back.

היי אני רוצה להמליץ לכם על חברה בתחום מכירת רכבים המתמחה בשרותי טרייד אין לחברות ליסינג ולקוחות פרטיים . באתר, מידע רב המלווה בתמונות מכירת הרכבים ורשימה המתעדכנת יום יום עם הרכבים הנמצאים במקום ומיועדים למכירה.

You must take part in a contest for among the finest blogs on the web. I will suggest this site!

Extraordinary this publish is totaly unrelated to what I used to be searching google for, nevertheless it was once listed on the first page. I guess your doing one thing right if Google likes you enough to put you on the first web page of a non comparable search.

Fantastic read, I just passed this onto a colleague who was doing a little investigation on that. And he really bought me lunch because I discovered it for him smile So let me rephrase that: Thanks for lunch!

Thx with regard to artwork テ「竄ャ窶 awesome data brother!

Good points?I might be aware that as any person who in point of fact doesn't write on blogs much (in reality, this can be my first put up), I don't assume the term 'lurker' may be very becoming to a non-posting reader. It's now not your fault the least bit , however perhaps the blogosphere may just get a hold of a greater, non-creepy identify for the ninety% of us that revel in reading the content .

Hi there, I found your blog via Yahoo while searching for a related topic, your web site came up, it looks great. I窶况e bookmarked it in my bookmarks.

I feel that is a captivating element, it made me assume a bit. Thank you for sparking my pondering cap. Sometimes I get such a lot in a rut that I just really feel like a record.

I have read a few of the articles on your website now, and I really like your style of blogging. I added it to my favorites blog site list and will be checking back soon. Please check out my site as well and let me know what you think.

コメントを投稿