Sunday, December 28, 2008


In the midst of the holiday season all I can think about is vacation. My body has officially decompressed and made the attempt to relax. In so doing, my stress compromised immune system leaves me vulnerable to illness.


With the visiting family gone, repeated meals of overeating, and very little fresh air, one of us were bound to get sick. Unfortunately, a few of us have and are doing our best to relish the remainder of our days off to return to normalcy. I do not fully understand all the bubbly noises and queasy feelings my abdomen has, nor do I understand the common sore throats and nasal congestion some of my family have to endure.

It makes me wonder what I would have done if I was completed with medical school and considered a physician in the eyes of those close to me. Would I suggest they see their family doctor or would I attempt to diagnose their symptoms? There is so much more to learn. In the meantime, I am watching Google's latest gadget - FluTrends - which is provided with help from the Center for Disease Control (CDC).

Using their time-tested search technology Google has honed in on specific search terms and put them to good use in identifying the spread of influenza. The CDC recognizes that Google FluTrends is able to show flu spread more readily than reported cases could.

Clinical Corner


This viral beast can be the cause of much misery. Fortunately, there is an annual vaccine that attempts to fight the most common strain of the flu to help ward off potential illness. The CDC has a list of common symptoms to look for and ways to alleviate them. In the meantime:

  • Keep an eye on the FluTrends in your area (Historically February has the most cases)
  • Reduce exposure to those who are infected
  • Wash your hands regularly

Sunday, December 21, 2008

A Welcome Vacation

This is essentially what I have looked like for the past five months. If my nose wasn't in a book looking for the answer, it was likely that I was in lecture or group study.

First Semester

The semester has come to an end and the final grades are not yet posted. Exams were an extremely nerve racking experience to have spent so much time preparing only to find I was partially being tested on the material I didn't review in detail. Fortunately, I had plenty of house to clean and other projects to occupy my time while I mulled over my responses. After a weekend of making furniture, I think I am prepared to see my grades for better or worse.

Overall this first semester started as an exhilarating experience. When the novelty of it all wore off and each day blurred into the next, the reality of medical school sunk in deep. Hard work, all the time. Coming into this I knew it would be the case, but the three classmates who dropped out didn't know what was coming. Medical school is difficult and rewarding at the same time. I am still very excited to be learning the art of medicine and have a much greater respect for the practicing physicians who have endured through a similar experience.

Living in Las Vegas I didn't expect to have a 'White Christmas', but we were all surprised when 3-8 inches of snow fell on our city. As the last time this happened was 30 years ago, everyone was in shock. The worst part yet is that schools were closed for a day including Touro, despite the final exams. As if that didn't add to our stress. Coming from a rich background in snowfalls much greater than 3 inches, I had a hard time swallowing a 'snow day'. Oh well, now to enjoy my two weeks of vacation before heading back to the grind.

Clinical Corner

Dietary Fiber

With oversized holiday meals, excessive treats and plenty of unhealthy goodies to temp us, I thought a healthy alternative would be good to discuss. Foods rich in fiber have many health benefits that we can not afford to neglect for now and our future.

Better than the sprinkle on fiber supplements are the foods with natural fiber (grains, fruits, vegetables etc). Benefits include:

  • Relieving and avoiding constipation - Fiber absorbs water making it easier to pass food without straining the bowel.
  • Prevent diseases - Cancer, heart disease, diabetes, diverticular diseases, and kidney/gallstones
  • Weight control - In addition to giving the feeling of satiety, fiber will bind to bile made in the gallbladder. Bile is used to break down fats in the diet. Normally, very little bile is lost, but when bound to fiber it is removed from the body in greater quantities and the body loses bound cholesterol more readily.
Have a great holiday and remember to eat healthy. Other great reading and recipes.

Sunday, December 14, 2008

Exam Week Three

Our last exams of the semester are finally here. Although they may not be exciting, it sure is nice to know there is a vacation only one week away.


Most recently we have focused our attention on the pelvic cavity and perineum in anatomy. This highly compact region holds an extensive network of veins, arteries and nerves that nourish organs of the reproductive, urinary and gastrointestinal systems. At first it seemed to be a mess of structures running this way and that with occasional stops at an organ or muscle. Now after hours of dissection, review and reading I think I have a better grasp on this intricate part of the body. While in the cadaver lab late at night and well into the next morning, my mind turned to those who have shared their bodies with us that we might be better physicians...if they only knew how much knowledge they have imparted.

I continually think of how lucky some of us are; to be in a healthy state is quite a feat. There are many problems that could arise during embryological development causing complications that would alter life, if it was even sustainable in the first place. The combination of embryology and the life giving organs of the body go hand in hand. It is amazing how everything works in concert to produce the person we see in the mirror.

Clinical Corner

Ectopic Pregnancy

Ectopic refers to a congenital displacement and in this case it is the fetus that has not implanted in the uterine wall. In the uterine (Fallopian) tube, the woman's egg will be fertilized by the sperm. Normally, they implant on the wall of the uterus to develop over the next nine months. When the fertilized egg implants itself elsewhere, it is considered ectopic.

Common sites of implantation include the lining of the uterine tubes, ovaries, the abdominal cavity or even the lower inner portion of the uterus. Depending on the location, it can be difficult to diagnose as ultrasounds are not always clear. Pain can result which often brings the mother to find medical help. This condition is a medical emergency as it can rupture the maternal organs or other structures within the abdominal cavity. Hemorrhaging (excessive bleeding) is possible, but the greater concern is for the mother's reproductive organs. Once they are damaged, it is likely that they must be removed and thus the likelihood of fertility decreases.

Rare cases have been reported where the fetus has grown to full term and been delivered. Although the causes are not fully understood, it is thought that damage to the uterine tubes may lead to an increased incidence of ectopic pregnancies. (Books to consider :Ectopic Pregnancy, Pregnancy)

Sunday, December 7, 2008

Cardiac Physiology

Considering the fact that this muscle never gets to rest, the heart is a rather impressive organ.

Cardiovascular System

We spent the majority of this past week learning the cardiac and systemic blood flow. As it moves through the chambers of the heart, to the lungs, back into the heart and ultimately into circulation, the blood provides nutrients to the body that sustain life.

Lectures went beyond the anatomy and included cardiac histology for completeness. The physiology or functional breakdown of its parts gets quite complex. Through hormonal, neural, and metabolic control blood vessels change size to distribute the blood where it is needed most. This regulation is a core consideration for many diseases as the blood affects every body system.

During our Physical Diagnosis lab we attempted to hear the many heart sounds on our partners and associate them with the various actions that were occurring. If you have ever tried this, you will agree it is definitely a learned skill. No wonder cardiologists are consulted so often. In my research, I came upon the blog of a cardiologist/electrophysiologist from the Midwest that may be of interest to those considering cardiology as a career. Dr. Wes, as he is known, gives a great peek into the life of a specialty physician. As I am still trying to decide what field to work in, this was a good starting point to explore.

Clinical Corner

With so many cases, conditions and diseases that come up I thought this would be a good forum to mention them both for my memory and for your reading pleasure. Should you happen to find information that is incorrect or interesting that you would like to add, please leave a comment for others to read.

Atrial Fibrillation

After a week of cardiology I could not resist considering an abnormal heart condition. Of the four chambers of the heart, the two atria receive blood from the body or lungs. Blood is pumped from an atrium into a ventricle as it continues on its way. This occurs as a result of electrical activity that starts in the atrium which moves by conduction to the ventricles. In a normal functioning heart, the rhythm is synchronized to move the blood through the chambers in order.

In a heart that is experiencing atrial fibrillation the conduction system is does not effectively reach the ventricles and the atria shake erratically. This will decrease the flow of blood and ultimately oxygen to the body with a potential risk of clot formation. This commonly leaves the individual weak and uncomfortable. This is one of the commonest heart problems and can be treated with medications or more invasive procedures if necessary. This video provides a more detailed look at atrial fibrillation.

Like you have heard it before, "use it or lose it." Regular exercise and a healthy diet will keep your heart and blood vessels in shape to meet the demands of everyday activities. Don't take good health for granted and your heart will thank you.

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