Rebecca Taylor Tillery

The next pages of this document show how one #DailyCDM question addresses the highlighted parts in the #MCCQE1 objective below. #meded #mccqe #mcc #nac

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Of 375 #Gout pts D/C pegloticase after a median of 8 infusions (taken 112days (max 1,240d). Only 73% had SUA < 6 during pegloticase. After D/C 84% went on ULT (63% allopurinol; 34% febuxostat; after mean 92d); after ≥ 30 days), 51% achieved SUA < 6

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So here we go with terminology again. What can we and what can't we do. Is it just black and white of can we use this so called critical thinking that we are said to use? #stirthatpot #spd #cpd #cssd #mdr #sterileprocessing

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To my cardiac sonographer friends (part 12) Interventricular septum seperates the LV and RV,a ventricular septal defect is a communication within this septum. The membranous septum is a very small area in high of the Interventricular septum,If it is defected , called a membranous VSD ,because the membranous (on the right septum side) is located between the anterior and septal leaflets of the Tricuspid Valve, the Gerbode defect results in a LV-to-RA shunt,whenever this shunt is detected,the VSD is called Gerbode defect Note that the membranous septum is higher than the cardiac conduction system (figure B),so the pure defect has no effect on the cardiac conduction. If you pay attention to the figure C,you see the membranous septum(on the left septum side)is adjacent to the non coronary cusp and right coronary cusp of aortic valve,so the defect could be associated with the these cusps prolapses and aortic valve regurgitation. The another important issue : Septal TV leaflet tissue can completely or partially close the membranous defect. #cardilogy #echocardiography

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Empowering Medical Imaging Professionals: A Recruiter's Mission for Better Pay and Benefits As a medical imaging recruiter, I've seen firsthand the dedication and expertise that radiologic technologists, sonographers, and other imaging professionals bring to their work every day. But I've also seen the burnout and frustration that can come with inadequate compensation and benefits. That's why I'm committed to fighting for better pay and PTO for the medical imaging professionals I work with. I believe that these talented individuals deserve more than just a paycheck - they deserve a career that supports their well-being, their families, and their futures. The reality is that the medical imaging field faces significant challenges, from staffing shortages to evolving technology and regulations. But I believe that by working together, we can create a more sustainable and supportive work environment that benefits everyone. As a recruiter, my goal is to connect medical imaging professionals with opportunities that align with their values, skills, and goals. But I also want to inspire candidates to work with me because they know I'm committed to fighting for their rights and interests. Here's what I'm fighting for: - Better pay: Medical imaging professionals deserve compensation that reflects their expertise, experience, and dedication. - More PTO: Time off is essential for rest, relaxation, and rejuvenation - and I believe that everyone deserves a generous PTO package. - Work-life balance: I want to help create schedules and work environments that support a healthy balance between work and personal life. - Professional development: I'm committed to helping medical imaging professionals grow and develop in their careers, with opportunities for training, mentorship, and advancement. [email protected] 7272163360

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Fluids Or No Fluids? That is the question. When you have a hypotensive patient, the question that you have to ask is this patient in front of me going to respond to fluids or is this fluid just going to build up in the extra vascular space? This is one of those clinical questions that we still have not been able to accurately assess despite all the technology we have available. If you've ever watched my videos, you'll know that I'm very opposed to just giving fluids and seeing what'll happen. You need a way to know whether or not your patient's going to respond to fluids. There's one test that has been shown to have the most reliability of all the tests we have available to us. It's called the passive leg raise. The passive leg raise has a patient sitting with their head of bed elevated 45 degrees and we assess what their stroke volume is. You need an ultrasound, a swan-ganz catheter, or another noninvasive monitor. And Then you lay the head of the bed down and put their legs up 45 degrees wait about a minute and a half. The blood that's in the capacitance veins of the lower extremity and the pelvis now get into the central circulation between 200 and 400 cc's of the patient's endogenous blood gets back into the central circulation and you need to assess the stroke volume again. If the stroke volume improves by 10-15% this person's likely volume responsive. Go ahead and give them crystalloids. The biggest pitfall I see when people are doing a passive leg raise is they put the legs up there and they look at the blood pressure. Blood pressure is not a measurement of your stroke volume. It may be a reflection of your stroke volume but it is not in itself a reflection of the stroke volume. If you're going to use the passive leg raise you need a way to assess whether or not there's a change in stroke volume, not blood pressure. So whenever you manage a patient who's hypotensive, always ask the question: will they respond to fluids? #PassiveLegRaise #FluidResponsiveness #Hypotension #CriticalCare #StrokeVolume #shock #emergencymedicine

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In a SLEEP STUDY, what is the ODI or Oxygen Desaturation Index? In the context of sleep studies, the Oxygen Desaturation Index (ODI) is a measure of the frequency and severity of oxygen desaturation events during sleep. It is a common parameter used to assess the severity of sleep-related breathing disorders, such as obstructive sleep apnea (OSA). The ODI is calculated by dividing the total number of oxygen desaturation events by the total sleep time. An oxygen desaturation event is defined as a decrease in oxygen saturation (SpO2) of 3% or more from a previous reading, which is typically measured using pulse oximetry. The ODI is usually expressed as events per hour of sleep. For example, an ODI of 10 indicates that there were 10 oxygen desaturation events per hour of sleep. A higher ODI indicates a higher frequency and severity of oxygen desaturation events. In general, an ODI of: 0-5 events/hour is considered normal. 5-10 events/hour is considered mild. 10-20 events/hour is considered moderate. 20 events/hour or more is considered severe. The ODI is an important parameter in diagnosing and monitoring sleep-related breathing disorders, as it can help identify patients who are at risk for hypoxemia (low oxygen levels) and related complications.

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Great opportunities

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How many types of contrast use and side-effects so completely explained in this slice

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As a MFM/OB sonographer, I hear this question at least 10 times a day, Is it a boy🧢 or girl 🎀? Also I’m noticing a trend where patients are opting to purchase gender tests from Amazon early on rather than waiting for the traditional 2nd trimester ultrasound to reveal the baby's gender. Some even decline more comprehensive NIPT tests after receiving these results. I must admit, I have mixed feelings about this. While I understand the excitement and anticipation that comes with knowing the gender early on in pregnancy, I can't help but question if it truly impacts health outcomes or prenatal care decisions. Of course, there are certain genetic conditions that may be specific to certain genders, and early detection is crucial in those cases. And I empathize with parents who have experienced unnecessary stress and anxiety due to false positives in NIPT tests. Why is knowing the gender within the 1st trimester becoming such a priority for some individuals, especially if it's not related to genetic disorders or abnormalities? Are we placing too much emphasis on something that ultimately does not affect the overall health of the baby or mother? I would love to hear your thoughts on this matter. Do you believe knowing the gender early on has any significant impact on prenatal care or outcomes? Let's start a conversation and explore different perspectives on this evolving trend. #prenatalcare #genderreveal #healthoutcomes #pregnancydecisions

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LAST CALL!!! New introductory lecture online this coming Sunday ( live) and Monday (recorded but I will come in live to answer any questions). Labs follow and see flyer. This particular FES is different from all other pediatric electrical stimulation courses that are available. Children ASK FOR IT, and motor learning occurs so the children can progress. It is not doing it TO the child-it is facilitating movement that the child wants perform , but has difficulty with initiatjng or sustaining the movement. It is a real gamechanger, and I will explain how and why it works in children with neuromotor impairment, explained through application of evidence based research. It even works in adults with neurologivcal injury. Come and join us for a different approach that induces change you can see from the first treatment session ( we no longer need to wait months /years)! https://lnkd.in/g45gcqZR

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Metanalysis of 40 papers, 486,465 RA pts & 3,928 incident ILD outcomes shows no signif risk of ILD w/ DMARD use; no ILD risk w/ TOFA or TNFi (Oral Surveillance n=2,911; OR 0.94). MTX use yielded a Lower ILD risk (OR 0.49; 0.32 to 0.76) vs no MTX use. https://buff.ly/404woHw

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Today marks one year of working as a sonographer! Here are a few things I have learned in that time: • You never stop learning in this field. It has been a year since I graduated, but I have grown so much in my scanning abilities through experience and practice. • Conversation and interpersonal skills can be practiced and developed, rather than being something a person is inherently "good" or "bad" at. As someone who hasn't always been great at small talk, I never considered that I could improve these skills. However, I recently started focusing on improving my communication with patients, allowing me to create a stronger patient-healthcare professional relationship. • Every mistake is a learning opportunity. For example, if the images do not send from the ultrasound machine to the computer, it is a good idea to simply check the internet cord before making phone calls in the middle of the night (yes, I am speaking from experience here). One year down, many more to go!

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Tomorrows episode I (Marcelene Forbus) sit down to explain the purpose for writing this post and the value our profession already has. No one ever gets rich while they are busy talking about how poor they are; why would professional recognition be any different. Let's change our narrative together! #professionalrecognition #ourfoundation #RADtopics #yougetoutwhatyouputin #speakingofrespect #yourforthetaking #wealreadyhaveitmade #radiology #multiplemodality #medicalimaging #wearerespected #diagnosticimaging #radiationprotection #RADeducation #beRAD #BeSeen #radiologytechologist #xraytech #radtech #ct #cttech #mri #mritech #nuclearmedicine #nucmedteach #NMAA #RRA #RPA #APRT #advancement #educationiskey #mammography #mammographer #dosimetry #dosimetrist #physicist #radiationtherapy #radiationtherapist #ultrasound #ultrasoundtech #sonography #sonographer #cathlabtech #interventionaltech #IRtech #PACS #RadAdmin #management #patientcare #alreadythere #stopandlook #recognizetogether #unity #RADunity #wherewemeet #whatwespeak #wordshaveimpacts #speakrespectgainrespect

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There are four major considerations when prescribing DTI-EPI: • The phase-encode direction should always be anterior/posterior rather than the more typical left/right for non-EPI scans. • Magnetic field inhomogeneities can cause significant artifacts for any EPI based imaging. • Lipid/fat suppression is necessary because of the large chemical shift of lipids with EPI. • Eddy currents become significant with clinical DTI-EPI diffusion gradients and may require Double Spine Echo (DSE) or post-processing compensation. #magneticresonance #DTI #medicalimaging #imageprocessing #radiologist #Medicalphysicists #mrtechnologist #diffusionmri

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While I utilize topography a lot in Orthok, evaluating fluorescein patterns is also very helpful in Orthok troubleshooting. Checking for centration, proper reverse curve depth/width, 360° alignment in the mid periphery, and adequate edge lift are all key components to look for

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The THREE Tips YOU need to do Wire Work as an Endovascular beginner... If I was creating an IR BOOT CAMP where you were going to learn basic skills in a 1 to 2 day course, this is what I would start with. The most basic skill you need to do endovascular cases, after sterile technique, is how to handle the wires. Before you begin handling wires, you have to understand their properties. Metal Wires: 💠 They are not slippery, so they are easier to use.   💠 But they don’t have any directionality to them.  💠 They can be super stiff to soft. 💠 They can have floppy or J Tips. Black (Hydrophilic) Wires 💠 Coated with a material that makes the wire slippery when it gets wet. 💠 Angled tips allow for turning the wire for the catheter to follow. 💠 Stiff versions can help with exchanges and crossing. 💠 Will dry out if they are not kept wet. Pinning the Wire 💠 This is keeping the wire in one place, while the catheter is adjusted or a drain or sheath is being placed. 💠 It is important to provide a “rail” for the device to move over.   💠 Hold the wire properly by not letting it move in your fingers. This can be challenging with a glide wire. The trick is to pinch it with your fingertips or bend the wire over your fingers, so you can feel it move. 💠 The wire must be anchored. You will not feel your hand move if you are holding it away from your body. Pin it to the table or patient, so you know that you are not moving. Push Pull 💠 This is the process of changing a catheter over a wire. 💠 One hand must be pinning the wire, 💠 And, the other one slowly brings the catheter to it. 💠 This must be done in small increments in order to prevent the wire from buckling or kinking. Looping the wire 💠 This is a way to manage long wires by coiling them up. 💠 First, grip the wire at two points, a reasonable distance apart. 💠 Bring your two points together, one behind the other until they meet. 💠 Hold the new loop in the hand closest to the end of the wire. 💠 Repeat these steps until the wire is completely coiled in one hand. 💠 Place in a bowl or put away on your back table. Learning these skills will allow you to do almost any endovascular case. I use these skills everyday I work. What other basic wire skills would you teach someone learning endovascular work? Society of Interventional Radiology Society for Vascular Surgery OEIS Society Chas Sanders

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