Medical Funnies :D

Have fun!

Hannah

Chart Farts

1. Brachycardia

2. Order - "DC home when strong"

3. The patient was given a banana bath

4. The patient is actually a fairly reliable historian.

5. Hyperglycemia toe

6. Admitted to our unit after getting report from
ICU nurse via wheelchair.

Enjoy!

Hannah M. Loveland

Cardiac Arrythmias

Cardiac arrhythmia

A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. Several forms of cardiac arrhythmia are life-threatening and considered medical emergencies.

In order to diagnose the type of arrhythmia present an electrocardiogram (abbreviated ECG or EKG) should be ordered.
Types of arrhythmias
Premature complexes

Premature complexes. Such complexes represent the most common interruption of normal sinus rhythm, most frequently arising from the ventricles and less often from the atria and the AV node.

* Premature atrial complexes (PACs)
* Premature junctional complexes (PJCs)
* Premature ventricular complexes (PVCs)

Bradycardia (brady-arrhythmias)

In bradycardia the heart beat is less than 60 beats/min. Brady-arrhythmias usually do not pose a diagnostic dilemma and there are relatively few treatment options (atropine, pacing).

* Sinus bradycardia
* Heart block

Tachycardia (tachy-arrhythmias)

In tachycardia the heart beat is more than 100 beats/min. Tachy-arrhythmias are usually not life threatening if short in duration.

Though the underlying mechanism of the tachycardia critically determines both prognosis and therapy, initial investigation may allow only for characterization of the tachycardia as either narrow complex (QRS duration <120 ms) or wide complex (QRS duration >120 ms) as read in the EKG.
I. Narrow complex tachycardia (QRS < 120 ms)

Narrow complex tachy-arrhythmias originate from impulses in the atrium and thus do not affect the width of the QRS wave, hence the name narrow (QRS < 120 ms by EKG). It can be further classified according to its rhythm as either regular or irregular.

a. Regular narrow complex tachycardia

* Sinus tachycardia

* Paroxysmal supraventricular tachycardia: These are paroxysmal; i.e., characterized by an abrupt onset and abrupt termination. They are caused by an accessory pathway in the conduction system between atria and ventricles. This maybe dual AV node (AVNRT) which is present in many people or an accessory pathway (AVRT e.g. Wolf-Parkinson-White syndrome).

o AV nodal re-entrant tachycardia (AVNRT): This is initiated by an ectopic atrial impulse that travels down a dual AV node pathway.
o Atrio-ventricular reciprocating tachycardia (AVRT): Here the ectopic impulse bypasses the AV node into the ventricle via an accessory pathway. These may be orthodromic, which are retrograde and present with a paroxysmal "narrow complex" tachycardia. Or they may be antidromic, which are antegrade and present as a "wide complex" tachycardia). Wolf-Parkinson-White syndrome is an example of AVRT.

* Atrial tachycardia: P wave rate < 250/min. Other characteristics include a long RP interval.

* Atrial flutter: Characterized by very rapid P waves known as flutter waves. In the most common form the P waves are twice as fast as the ventricular rate (i.e. only half the impulses from the atrium are being conducted to the ventricle, also known as a 2:1 conduction

b. Irregular narrow complex tachycardia

* Atrial fibrillation (AF)
* Multifocal atrial tachycardia (MAT)
* Atrial flutter with variable heart block
* Frequent premature atrial complexes (PACs)

II. Wide complex tachycardia (QRS > 120 ms)

Wide complex tachy-arrhythmias originate from impulses in the ventricles and hence affect the width of the QRS wave, hence the name wide (QRS > 120 ms by EKG). It can be further classified according to its rhythm as either regular or irregular.

a. Regular wide complex tachycardia

* Ventricular tachycardia (VTAC)

b. Irregular wide complex tachycardia

* Ventricular fibrillation

Later,
Hannah

Medical Funnies!

* A man goes to his doctor and says, "I don't think my wife's hearing isn't as good as it used to be. What should I do?" The doctor replies, "Try this test to find out for sure.

When your wife is in the kitchen doing dishes, stand fifteen feet behind her and ask her a question, if she doesn't respond keep moving closer asking the question until she hears you."

The man goes home and sees his wife preparing dinner. He stands fifteen feet behind her and says, "What's for dinner, honey?" He gets no response, so he moves to ten feet behind her and asks again. Still no response, so he moves to five feet. still no answer. Finally he stands directly behind her and says, "Honey, what's for dinner?" She replies, "For the fourth time, I SAID CHICKEN!"


* "Doctors at a hospital in Brooklyn, New York have gone on strike. Hospital officials say they will find out what the Doctors' demands are as soon as they can get a pharmacist over there to read the picket signs!"



* The difference between a neurotic and a psychotic is that, while a psychotic thinks that 2 + 2 = 5, a neurotic knows the answer is 4, but it worries him.



* Doctor: I have some bad news and some very bad news.
Patient: Well, might as well give me the bad news first.
Doctor: The lab called with your test results. They said you have 24 hours to live.
Patient: 24 HOURS! That's terrible!! WHAT could be WORSE? What's the very bad news?
Doctor: I've been trying to reach you since yesterday.



* A man speaks frantically into the phone, "My wife is pregnant, and her contractions are only two minutes apart!"
"Is this her first child?" the doctor queries.
"No, you idiot!" the man shouts. "This is her husband!"


Later,
Hannah

Even More Chart Farts

Sorry It took so long to post again. I get chart farts about every 2 weeks.

1. Chronic acid infection

2. Lumpnoma

3. "They took a 50-cent piece out of my colon"
(hemicolectomy)

4. Father died at 97. Mother is alive at 56.

5. LAD ostium with 110% occlusion

6. NH orders - "Force PO fluids"

Later,
Hannah Marie
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN, MBChB"

Chart Farts!

I'm back with more Chart Farts!

Here they are!

1. Blood cx - "suspicious x2 bottles"

2. Neutrition

3. Her CHF got much better with diaphoresis

4. Allergies - "PCU"

5. She did not lose control of her rectum


6. Plan - "gently dehydrate"

They come about every 2 weeks by Email. I'll try to post them as soon as I get them.

Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN, MBChB"

-ectomy

-ectomy
Lots of it going on!
Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN, MBChB"

Follow Me On Twitter

http://twitter.com/FutureSurgeon

It's fun.

Mainly blabbing about how much I wish I was in Nursing/Med School

Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"

Chart Farts!

1. Could be secondary to pulmonary process vs. other causes
(Thank you for your expert opinion)

2. I have a home nipplizer

3. I see a beautician for my pressure
(Therein lies the problem)

4. Ortho consult - "Can you preop this guy?
His ejection fracture is 30%"

5. Colonosophy

6. In the past, I perpetrated my colon

Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"

More Coming Soon

Medical Funnies 2

The Ranks of a Hospital

Surgeon:
Leaps tall buildings in a single bound
Is more productive than a train
Is faster than a speeding bullet
Walks on water
Talks with God

Internist:
Leaps short buildings in a single bound
Is more powerful than a switch engine
Is faster than a speeding BB
Walks on water if the sea is calm
Talks with God if special request is approved

General Practitioner:
Leaps short buildings with a running start and favorable winds
Is almost as powerful as a switch engine

Nurse Practitioner:
Can fire a speeding bullet
Walks on water in an indoor swimming pool
Is occasionally addressed by God

Resident:
Barely clears a picket fence
Loses tug-of-war with a train
Can sometimes handle a gun without inflicting self-injury
Swims well
Talks with animals

Intern:
Makes high skid marks on a wall when trying to leap buildings
Is run over by a train
Is not issued ammunition
Dog paddles
Talks to walls

Medical Student:
Runs into buildings
Recognizes a train 2 out of 3 times
Wets himself with a water pistol
Cannot stay afloat without a life preserver
Mumbles to himself

Nurse:
Lifts buildings and walks under them
Kicks trains off the track
Catches speeding bullets with her teeth and eats them
Freezes water with a single glance
The Nurse IS God!!!!

Medical Funnies

The following quotes were taken from actual medical records dictated by physicians.

• By the time he was admitted, his rapid heart had stopped, and he was feeling better.
  
• Patient has chest pain if she lies on her left side for over a year.
  
• On the second day the knee was better and on the third day it had completely disappeared.
  
• She has had no rigors or shaking chills, but her husband states she was very hot in bed last night.
  
• The patient has been depressed ever since she began seeing me in 1983
  
• Patient was released to outpatient department without dressing.
  
• I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.
  
• The patient is tearful and crying constantly. She also appears to be depressed.
  
• Discharge status: Alive but without permission.
  
• The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.
  
• Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.
  
• The patient refused an autopsy.
  
• The patient has no past history of suicides.
  
• The patient expired on the floor uneventfully.
  
• Patient has left his white blood cells at another hospital.
  
• The patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.
  
• She slipped on the ice and apparently her legs went in separate directions in early December.
  
• The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary edema at home while having sex which gradually deteriorated in the emergency room.
  
• The patient had waffles for breakfast and anorexia for lunch.
  
• Between you and me, we ought to be able to get this lady pregnant.
  
• The patient was in his usual state of good health until his airplane ran out of gas and crashed.
  
• Since she can't get pregnant with her husband, I thought you would like to work her up.
  
• She is numb from her toes down.
  
• While in the ER, she was examined, X-rated and sent home.
  
• The skin was moist and dry.
  
• Occasional, constant, infrequent headaches.
  
• Coming from Detroit, this man has no children.
  
• Patient was alert and unresponsive.
  
• When she fainted, her eyes rolled around the room.
  
• MD during a physical exam, stated, in my ears, "I am unable to arouse this woman", personally, I really don't think he should have bragged about it.
  
  

---

True Doctor Stories

At the beginning of my shift I placed a stethoscope on an elderly and slightly deaf female patient's anterior chest wall. "Big breaths," I instructed. "Yes, they used to be," remorsed the patient.

---

One day I had to be the bearer of bad news when I told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, I heard her reporting to the rest of the family that he had died of a "massive internal fart,"

*

I was performing a complete physical, including the visual acuity test. I placed the patient twenty feet from the chart and began, "Cover your right eye with your hand." He read the 20/20 line perfectly." Now your left." Again, a flawless read. "Now both," I requested. There was silence. He couldn't even read the large E on the top line. I turned and discovered that he had done exactly what I had asked; he was standing there with both his eyes covered. I was laughing too hard to finish the exam.

*

During a patient's two week follow-up appointment with his cardiologist, he informed his doctor that he was having trouble with one of his medications. "Which one?", asked the doctor. "The patch. The nurse told me to put on a new one every six hours and now I'm running out of places to put it!" The doctor had him quickly undress and discovered what he hoped he wouldn't see, Yes, the man had over fifty patches on his body! Now the instructions include removal of the old patch before applying a new one.

*

While acquainting myself with a new elderly patient, I asked, "How long have you been bedridden?" After a look of complete confusion she answered, "Why, not for about twenty years-when my husband was alive."

*

And of course, the best is saved for last.... I was caring for a woman from Kentucky and asked, "So how's your breakfast this morning?" "It's very good, except for the Kentucky Jelly. I can't seem to get used to the taste," the patient replied. I then asked to see the jelly and the woman produced a foil packet labeled "KY jelly."

---

Pharmacist: A lady walked into a pharmacy & spoke to the pharmacist. She asked: "Do you have viagra?" "Yes," he answered. She asked, "Does it work?" "Yes," He answered. "Can you get it over the counter?" she asked "I can if I take two," he answered.

Later,

Hannah Marie

"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"

Necrotizing Cellulitis, Osteomyelitis, Peripheral Neuropathy

VERY GRAPHIC. DO NOT LOOK IF YOU CANNOT HANDLE NASTY STUFF.
"All of this belongs to the following:
http://www.circulatorboot.com/casehistory/case198.html"

E presented in the Circulator Boot Clinic on Tuesday, March 3rd, 1998 with a oral temperature of 100.2 degrees F (37.9 degrees C). He had previously been seen in our diabetic office in 1979 when he was found to have diabetic retinopathy and peripheral neuropathy. He was introduced to home blood glucose testing and a multidose insulin program. In 1983, his insurance program led him to a family practice where he continued our insulin program with little change. He returned now concerned he needed the help of specialist. He had left work the previous Friday having worn new shoes all day. His foot was swollen. He thought he had flu because of nausea and vomiting. He stayed in bed from Friday until Tuesday when he presented with the foot shown below. After a culture was taken, his foot was infiltrated with gentamicin and vancomycin and he was given a Mini-Boot treatment. Immediate hospitalization was advised. His HMO physician, a new doctor to our hospital, preferred he report first to his office. On seeing the patient the doctor admitted him to the hospital and asked for consultants from infection disease and general surgery. Intravenous Unisyn and oral Levaquin were ordered along with vascular studies, foot x-rays and a bone scan. The latter two studies were negative. The vascular laboratory technician was unable to find any palpable pulses in the legs, but found pseudohypertension (ABI 1.72) at the ankles. The pulse volume in the left foot was significantly reduced.
Pictures are in order of latest to earliest onset of disease.
Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"

WeLcOmE!

Welcome To The MedicalGirl Blog!


This Blog Will Be Full Of Medical Jibber Jabber!
From a 15 year old.
Pretty Impressive?
Should Be!
Get ready for the humour, videos, text, and pictures!
Later,
Hannah
"Future RNFA, CRNA, ARNP, DnP, Ch.M, BSN, MSN"