Wonder Me!
Sprains, Strains and Other So-Tissue Injuries
The most common soft tissues injured are muscles, tendons, and ligaments. These injuries often occur during sports and exercise activities, but sometimes simple everyday activities can cause an injury.
Sprains, strains, and contusions, as well as tendinitis and bursitis, are common soft-tissue injuries. Even with appropriate treatment, these injuries may require a prolonged amount of time to heal.
Cause
Soft-tissue injuries fall into two basic categories: acute injuries and overuse injuries.
Acute injuries are caused by a sudden trauma, such as a fall, twist, or blow to the body. Examples of an acute injury include sprains, strains, and contusions.
Overuse injuries occur gradually over time, when an athletic or other activity is repeated so often, areas of the body do not have enough time to heal between occurrences. Tendinitis and bursitis are common soft-tissue overuse injuries.

Common Acute So-Tissue Injuries
Acute soft-tissue injuries vary in type and severity. When an acute injury occurs, initial treatment with the RICE protocol is usually very effective. RICE stands for Rest, Ice, Compression, and Elevation.
Rest. Take a break from the activity that caused the injury. Your doctor may recommend that you use crutches to avoid putting weight on your leg.
Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin. Compression. To prevent additional swelling and blood loss, wear an elastic compression bandage.
Elevation. To reduce swelling, elevate the injury higher than your heart while resting. Sprains
A sprain is a stretch and/or tear of a ligament, a strong band of connective tissue that connect the end of one bone with another. Ligaments stabilize and support the body's joints. For example, ligaments in the knee connect the thighbone with the shinbone, enabling people to walk and run.
https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/ 1/5
12/22/2017 Sprains, Strains and Other Soft-Tissue Injuries - OrthoInfo - AAOS
The areas of your body that are most vulnerable to sprains are your ankles, knees, and wrists. A sprained ankle can occur when your foot turns inward, placing extreme tension on the ligaments of your outer ankle. A sprained knee can be the result of a sudden twist, and a wrist sprain can occur when falling on an outstretched hand.
A twisting force to the lower leg or foot is a common cause of ankle sprains.
Reproduced from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.
Sprains are classified by severity:
Grade 1 sprain (mild): Slight stretching and some damage to the fibers (fibrils) of the ligament.
Grade 2 sprain (moderate): Partial tearing of the ligament. There is abnormal looseness (laxity) in the joint when it is moved in certain ways.
Grade 3 sprain (severe): Complete tear of the ligament. This causes significant instability and makes the joint nonfunctional.
While the intensity varies, pain, bruising, swelling, and inflammation are common to all three categories of sprains. Treatment for mild sprains includes RICE and sometimes physical therapy exercises. Moderate sprains often require a period of bracing. The most severe sprains may require surgery to repair torn ligaments.
Strains
A strain is an injury to a muscle and/or tendons. Tendons are fibrous cords of tissue that attach muscles to the bone. Strains often occur in your foot, leg (typically the hamstring) or back.
https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/ 2/5
12/22/2017 Sprains, Strains and Other Soft-Tissue Injuries - OrthoInfo - AAOS
A severe hamstring injury where the tendon has been torn from the bone.
Similar to sprains, a strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination. Typical symptoms of a strain include pain, muscle spasm, muscle weakness, swelling, inflammation, and cramping.
Soccer, football, hockey, boxing, wrestling and other contact sports put athletes at risk for strains, as do sports that feature quick starts, such as hurdling, long jump, and running races. Gymnastics, tennis, rowing, golf and other sports that require extensive gripping, have a high incidence of hand sprains. Elbow strains frequently occur in racquet, throwing, and contact sports.
The recommended treatment for a strain is the same as for a sprain: rest, ice, compression and elevation. This should be followed by simple exercises to relieve pain and restore mobility. Surgery may be required for a more serious tear.
Contusions (Bruises)
https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/ 3/5
12/22/2017 Sprains, Strains and Other Soft-Tissue Injuries - OrthoInfo - AAOS
A contusion is a bruise caused by a direct blow or repeated blows, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface. The discoloration of the skin is caused by blood pooling around the injury.
Most contusions are mild and respond well with the RICE protocol. If symptoms persist, medical care should be sought to prevent permanent damage to the soft tissues.
Common Overuse So-Tissue Injuries Tendinitis
Tendinitis is an inflammation or irritation of a tendon or the covering of a tendon (called a sheath). It is caused by a series of small stresses that repeatedly aggravate the tendon. Symptoms typically include swelling and pain that worsens with activity.
Tiny tears in the Achilles tendon cause it to swell and thicken.
https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/ 4/5

12/22/2017 Sprains, Strains and Other Soft-Tissue Injuries - OrthoInfo - AAOS
Professional baseball players, swimmers, tennis players, and golfers are susceptible to tendinitis in their shoulder and arms. Soccer and basketball players, runners, and aerobic dancers are prone to tendon inflammation in their legs and feet.
Tendinitis may be treated by rest to eliminate stress, anti-inflammatory medication, steroid injections, splinting, and exercises to correct muscle imbalance and improve flexibility. Persistent inflammation may cause significant damage to the tendon, which may require surgery.
Bursitis
Bursae, are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.
Bursitis is inflammation of a bursa. Repeated small stresses and overuse can cause the bursa in the shoulder, elbow, hip, knee or ankle to swell. Many people experience bursitis in association with tendinitis.
Bursitis can usually be relieved by changes in activity and possibly with anti-inflammatory medication, such as ibuprofen. If swelling and pain do not respond to these measures, your doctor may recommend removing fluid from the bursa and injecting a corticosteroid medication into the bursa. The steroid medication is an anti-inflammatory drug that is stronger than the medication that can be taken by mouth. Corticosteroid injections usually work well to relieve pain and swelling.
Swelling associated with elbow bursitis.
Although surgery is rarely necessary for bursitis, if the bursa becomes infected, an operation to drain the fluid from the bursa may be necessary. In addition, if the bursa remains infected or the bursitis returns after all nonsurgical treatments have been tried, your doctor may recommend removal of the bursa.
https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/ 
Wonder Me!
Donepezil (Aricept) - acetyl-cholinesterase inhibitor
takes 6-12 months to know if effective

SSRI (Paroxetine)
Takes 8-12 weeks to take effects

-pril ACE-I


Check K level in 1 week
Takes 6-8 weeks to produce anti-protein-uric effects

HIV
IF initial OR CHANGING , CD4 every 2-8 weeks
IF STABLE, CD4 Every 3-6 months

Thyroid

TSH slightly high in medicated pt
Repeat the TSH in 2-3 weeks (could be transient or missed dosage)
 TSH monthly in pregnant women w/ hypo/hyperthyroidism

Diabetes type 2:
If BS is not in control, increase 2-3 units at a time w/ BS check 3 days in a row. 
If not at goal, increase another 2-3 units, repeat..


Half-life:
Steady state: 3-5 half-life to reach steady state (when given continuously)
Elimination: 4-5 half-life to be totally eliminated from the body when a drug is dc



Labels: 0 comments | | edit post
Wonder Me!
A good distracter should be inferior to the correct answer but should also be plausible to a non-competent candidate. All options should be true and contain facts that are acceptable to varying degrees. The examiner would ask for the most appropriate, most common, least harmful or any other feature which is at the uppermost or lowermost point in a range. It needs to be expressed clearly that only one answer is correct. A candidate's response is considered correct if his/her selection matches the examiner's key.
When creating a distracter, it helps to predict how an inexperienced examinee might react to the clinical case described in the stem.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410060/ 
Wonder Me!



Wonder Me!

THE ART OF EFFECTIVE TEST TAKING
Test-taking ability can be divided into three categories:  mastery of basic knowledge and information; awareness of test-taking techniques and strategies; and, finally, freedom from anxiety that, if present at a high level, will interfere will application of both of the other categories.
Understanding the Question
The question is called the stem, and the answer choices are called distractors.  The purpose of distractors is to distract you from identifying and choosing the correct answer.  Thus, in the process of taking a multiple-choice test, all of your knowledge, expertise, and judgment are utilized.
In effective test construction, the stem is direct and to the point.  This means that the question is asking for one particular response and that you should notread other information into the question.  Often, you will find questions that are asking for "common sense" answers.  Reading into these questions or searching for subtle hidden meanings is not advised.  Principle:  Do not read extra meaning into the question; assume it is direct and to the point.  Your first action then, upon being presented with the question, is to ask yourself " What is this question asking?"  Look for key words or phrases to help you understand.  It is important to have the central point clearly in your mind before going on to consider the distractors.
Make very sure you read the stem correctly.  Notice particularly the way the question is phrased.  Is it asking for the right or wrong response?  One of the most important principles in test taking is understanding what the question is asking.  Principle:  Understand exactly what the stem is asking before considering the distractors.
Another technique for assessing the stem and interpreting the question correctly is to rephrase the question so that it is very clear in your own mind.  For example, consider the following statement:  "The one treatment that is not required in cardiogenic shock is..."  Rephrase it to read:  "They are asking me to identify a treatment that is not required in cardiogenic shock, but may be required in other shock conditions."  Rephrasing in your own language can assist you to read the question correctly and, in turn, choose the appropriate response.  This is particularly important when you are faced with a difficult and/or confusing question.  Principle:  Rephrase the question in your own words so that it is clear in your mind.  If possible, think of the correct answer before considering the distractors.  If you do not know the answer, the following cues to working with distractors may prove helpful.
Distractors are various alternatives chosen to be as close as possible to the right answer.  In good test construction, all distractors should be feasible and reasonable and should apply directly to the stem.  There should be a commonality in all of the distractors.  If one distractor is off base and not plausible, then you can safely assume the person writing the test question ran out of reasonable distractors.  Principle:  When analyzing the distractors, isolate what is important in the answer alternatives from what is not important, relative to the question.  In other words, all distractors may be correct but not the right choice for the specific question that is asked.  One method of helping you choose the correct answer is to ask yourself whether each possible alternative is true or false in relation to the stem.  Asking yourself which distractor is true or false is a shortcut method of answering the question.  It forces you to keep looking at the stem.  Otherwise, you are trying to judge all of the choices at once.  After you have completed the true-false process, remember to go back to the stem and ask yourself if your choice is, in fact, answering the question.
An answer alternative may be correct as it stands by itself, but wrong in terms of what the question is asking.  Many, many students fail to recheck the answer with the stem, and they answer the question incorrectly.  An effective strategy in assessing test questions is to judge all four alternative choices against the stem, not against each other.  Read the stem, then check Alternative A against the stem, then check Alternative B against the stem, and so on.  This process will eliminate choosing an alternative that does not fit the question.  Principle:  After choosing the correct answer alternative and separating it form the distractors, go back to the stem and make sure your choice does, in fact, answer the question.
If you are answering a test question in which one distractor is considerably different from the others, it is probably not the correct choice.  Often, students tend to pick this alternative just because it is different.  Principle:  Look for similarities in two or three of the choices remembering that the purpose of distractors is to divert you from the one right answer.
The multiple-variable question is one in which each possible answer to the question includes several variables.  An effective technique for handling multiple variables is to use the process of elimination.  First, study the question and ask yourself what variable fits with this condition, or, after examining the distractors, underline the variable that you know is correct.  Now ask yourself what variable is not present with this condition.  Again, examine the distractors and cross out those variables which are incorrect.  By this process, you probably will have eliminated at least two distractors even without taking the time to consider the other two.  Principle:  When a question contains multiple variables as alternative choices, use the elimination-of-variable technique.

Source: http://www.fireprep.com/the_art_of_effective_test_taki.html
Wonder Me!
12/12/2017 4 ways to outsmart any multiple-choice test - Business Insider
4 ways to outsmart any multiple-choice test
EMMIE MARTIN
JUN. 26, 2015, 2:16 PM
Ideally, multiple-choice exams would be random, without patterns of right or wrong answers. However, all tests are written by humans, and human nature makes it impossible for any test to be truly random.
Because of this fundamental flaw, William Poundstone, author of "Rock Breaks Scissors: A Practical Guide to Outguessing and Outwitting Almost Everybody," claims to have found several common patterns in multiple- choice tests, including computer- randomized exams like the SATs.
After examining 100 tests — 2,456
questions in total — from varied sources,
including middle school, high school,
college, and professional school exams;
driver's tests; licensing exams for
firefighters and radio operators; and
even newspaper quizzes, Poundstone says he found statistical patterns across all sources.

From this data, he determined several strategies to up your chances of guessing correctly on any exam, whether you're stumbling through a chemistry final or retaking your driver's test.
While Poundstone emphasizes that knowledge of the subject matter is always the best test-taking strategy and that "a guessing strategy is useful to the extent that it beats random guessing," he suggests you always guess when you're unsure. And guessing smartly will only improve your chances of being correct.
Here are a few of Poundstone's tactics for outsmarting any multiple-choice test:
1. Ignore conventional wisdom.
You've probably been given test-taking advice along the lines of "always guess the middle answer if you don't know" or "avoid any answer that uses the words 'never,' 'always,' 'all,' or 'none'" at some point in your life. However, according to Poundstone, this conventional wisdom doesn't hold up against statistics. In fact, he found
A few simple tips can give you an edge on multiple-choice tests.
U.S. Navy/Flickr
http://www.businessinsider.com/4-ways-to-outsmart-any-multiple-choice-test-2015-6 1/4
12/12/2017 4 ways to outsmart any multiple-choice test - Business Insider
that the answers "none of the above" or "all of the above" were correct 52% of the time. Choosing one of these answers gives you a 90% improvement over random guessing, he says.
2. Look at the surrounding answers.
Poundstone found correct answer choices hardly repeated consecutively, so looking at the answers of the questions you do know will help you figure out the ones you're stuck on. For example, if you're stuck on question No. 2, but know that the answer to No. 1 is A and the answer to No. 3 is D, those choices can probably be eliminated for No. 2. Of course, "knowledge trumps outguessing," Poundstone reminds us. Cross out answers you know are wrong based on facts first.
Alberto G./Flickr
3. Choose the longest answer.
Poundstone also noticed that the longest answer on multiple-choice tests was usually correct. "Test makers have to make sure that right answers are indisputably right," he says. "Often this demands some qualifying language. They may not try so hard with wrong answers." If one choice is noticeably longer than its counterparts, he says it's likely the correct answer.
4. Eliminate the outliers.
Some exams, like the SATs, are randomized using computers, negating any patterns usually found in the order of the answers. However, no matter their order, answer choices that are incongruent with the rest are usually wrong, according to Poundstone. He gives the following sample answers from an SAT practice test, without including the question:
A. haphazard...radical
B. inherent...controversial

http://www.businessinsider.com/4-ways-to-outsmart-any-multiple-choice-test-2015-6 2/4
12/12/2017 4 ways to outsmart any multiple-choice test - Business Insider
C. improvised...startling
D. methodical...revolutionary E. derivative...gradual

Because the meaning of "gradual" stands out from the other words in the right column, choice E can be eliminated. Poundstone then points out that "haphazard" and "improvised" have almost identical meanings. Because these choices are so close in meaning, A and C can also be eliminated, allowing you to narrow down over half the answers without even reading the question.
"It's hard to see how one could be unambiguously correct and the other unambiguously wrong," he says. For the record, the correct answer is D.
http://www.businessinsider.com/4-ways-to-outsmart-any-multiple-choice-test-2015-6 3/4

12/12/2017 4 ways to outsmart any multiple-choice test - Business Insider
http://www.businessinsider.com/4-ways-to-outsmart-any-multiple-choice-test-2015-6 4/4 
Wonder Me!
Wonder Me!
The clinician should remember this axiom in dermatology: “There are more errors made by not looking than by not knowing.”
Labels: 0 comments | | edit post
Wonder Me!
Wonder Me!

Key minerals to help control blood pressure

It's usually best to get calcium, magnesium, and potassium from food. Are you getting enough?
A healthy, balanced diet plays a major role in blood pressure control. And you should consume some specific minerals on a regular basis for good blood pressure management: calcium, magnesium, and potassium. But do most of us get enough of these? "If you're eating a healthy diet, you probably have nothing to worry about. But people eating a diet of processed and canned foods might need to be concerned, as well as people taking certain medications," says Dr. Randall Zusman, director of the Division of Hypertension at the Massachusetts General Hospital Heart Center.


Images: Thinkstock
1/2 cup canned white
beans:
595 milligrams (mg)
of potassium, 67 mg of magnesium,
and 96 mg calcium.

3 ounces of cooked
halibut:
490 mg of
potassium, and 91 mg of
magnesium.


1/2 cup cooked spinach:
419 mg potassium,
78 mg of magnesium, and
146 mg of calcium.

1 Potassium
Normal body levels of potassium are important for muscle function, including relaxing the walls of the blood vessels. This lowers blood pressure and protects against muscle cramping. Normal potassium levels also are important for the conduction of electrical signals in the nervous system and in the heart. This protects against an irregular heartbeat.
Potassium is found naturally in many foods, such as prunes, apricots, sweet potatoes, and lima beans. But food may not be enough to keep up your potassium levels if you take a diuretic for high blood pressure such as hydrochlorothiazide (Esidrix, HydroDiuril). These drugs cause potassium to leave your body in the urine, thereby lowering your body's potassium levels. "I'd say at least a third of patients on diuretics for heart failure or high blood pressure or edema don't get enough potassium from their diets. In those cases, we do use supplements," says Dr. Zusman. Don't try a supplement on your own. Too much potassium, like too little, can lead to dangerous irregular heart rhythms.
The Recommended Dietary Allowance (RDA) of potassium is 4.7 grams per day for both men and women ages 51 and older.

2 Magnesium

Magnesium helps regulate hundreds of body systems, including blood pressure, blood sugar, and muscle and nerve function. We need magnesium to help blood vessels relax, and for energy production, bone development, and transporting calcium and potassium. Just like potassium, too much magnesium can be lost in urine due to diuretic use, leading to low magnesium levels.
The National Institutes of Health (NIH) reports that most older adults in the U.S. don't get the proper amount of magnesium in their diets, although extreme magnesium deficiency is very rare. It's best to get the mineral from food, especially dark, leafy green vegetables, unrefined grains, and legumes. The RDA of magnesium is 420 milligrams (mg) per day for men ages 50 and older; 320 mg/day for women ages 50 and older.
Too much magnesium from a supplement or from magnesium-containing drugs such as laxatives may cause diarrhea. There are no known adverse affects of magnesium intake from food.

3 Calcium

Calcium is important for healthy blood pressure because it helps blood vessels tighten and relax when they need to. It's also crucial for healthy bones and the release of hormones and enzymes we need for most body functions. We consume it naturally in dairy products, fish with bones (such as canned salmon and sardines), and dark, leafy greens.
The RDA of calcium for men ages 51 and older is between 1,000 and 1,200 mg per day. For women ages 51 and older it's 1,200 mg per day. Unfortunately, most people get about 700 mg of calcium in their daily diet. So should you take a supplement to make up the difference?
That's tricky business. As we reported in June 2013, some evidence shows calcium supplements increase the risk of death from heart disease. "It's been controversial, so most of us advise our patients to get their calcium from food rather than from supplement pills," says Dr. Zusman. If it's not possible to get enough calcium from food, you can use a low-dose calcium supplement to reach your daily RDA. 
Labels: 0 comments | | edit post
Wonder Me!
 
 

Wonder Me!
http://www.rhymezone.com/

Mnemonics in part is created by similar sounds. I found this website http://www.rhymezone.com/ helpful for creating similar sounds such as Thyer-Martin = Thigh-er Martyr mnemonics that I've made.

~by Qt