Sunday, March 28, 2010

Spring Break

Spring break is finally here, I just wish that truly meant time off and possibly an exotic location. Alas, one more block to go and then it's time to buckle down for board examinations. Spring break = head start on board prep.

A Breath of Fresh Air

I am not really certain if it was the excitement of break or the fast paced material, but this last set of exams was tough. Now, I am mustering all that I can to collect my mental capacities for the final chapter of a 25 year career in classroom education. That means extra sleep, exercise in any form, and semblances of healthy nutrition. Finding a way to create extra memory in my noggin and not lose too much of what was learned before will be a challenge. Crunch time is here.

In the meantime, when I am not stressing about the next three months, I like to imagine the cabana I hope to one day use in the Maldives. Believe me, I have already started saving for that trip years ago. Nevertheless, while my financial resources sort themselves out, I think I might stay close to home for a while. Perhaps a visit to the local state park, but nothing too costly; after all, student loans have already sent me out to drift.

Board Prep Question of the Week
A 28 year-old male of Jewish descent presents with abdominal pain, diarrhea and fever. Physical exam reveals a tender abdomen and a perianal fistula. A biopsy reveals chronic inflammation in the small intestine involving all layers of the intestinal wall. This patient may be treated with a monoclonal antibody which blocks which of the following cytokines?

A. IL-3
B. IL-5
C. IL-8
D. IFN-Beta
E. TNF-Alpha

Answer & Explanation

Sunday, March 21, 2010

Second Exam Week Five

We are on the verge of having one more set of exams behind us. With some quick arithmetic, that means spring break is almost here, and it's time for board studies to kick into full gear.


Somewhere along the way, one of our teachers mentioned that just by choosing to become a physician and going through the process, we would be decreasing our life span a significant number of years. Finding enough research to support this claim, on the other hand was not easy. Now, more than ever, I think I understand it's foundation. The never ending struggle to be on top of things and keep up with all the stress has had a deleterious effect on me mentally as well as physically.

Although this week's block exams may not lead to my demise, this profession might. Considering the alternatives, I am OK with this. As for life expectancies related to health conditions, World Life Expectancy has broken down the statistics to map out diseased counties. Unless you live in the middle of nowhere, it seems that we are all geographically at risk for something. My interpretation; eat healthy, exercise regularly and live happily.

Board Prep Question of the Week
A 4-year-old girl came home from day care and developed fever, abdominal pain, and diarrhea containing flecks of bright-red blood and pus. The girl did not ingest any food at day care. Which is the most likely causative organism?

A. Enterotoxigenic Escherichia coli
B. Campylobacter jejuni
C. Shigella dysenteriae
D. Vibrio cholera
E. Yersinia enterocolitica
Answer & Explanation

Sunday, March 14, 2010

Medical Fraud

This posting comes as the 100th, marking almost 100 weeks since being accepted to medical school. Time has gone faster than I could have imagined. Thankfully it wasn't any slower!

Never Give Up

With Spring Break around the corner, professors have scheduled quizzes and midterms to query our knowledge. Normally this is not a problem, but with a block only four weeks long, there is a lot of information to cram in there. As a result, after last weeks barage of graded interrogations and late nights, I was flat out exhausted. Thinking I was the only one having difficulties focusing and reviewing materials, I didn't say much to my peers. A few days later I was surprised to learn that the majority of us have had similar experiences.

I have heard this called the impostor phenomenon. We feel as though we are the only ones who are not pulling our weight, making advances, or in plain terms...frauds. It is not until we see our achievements and learn that our peers are in the same position that we begin to feel a sense of belonging. Now that I know I am not alone, or at least the only fraud in the class, it's time to get ready for the exams next week. Medical school is relentless - if it's truly where your heart is, you have no reason to give up.

Board Prep Question of the Week

A 25 year old from Massachusetts complains of increasing fatigue and pre-syncope. Upon further questioning, he admits to having had a rash on his arm a couple of months ago. He denies joint pain, photophobia or a stiff neck.

An EKG is taken which shows 3rd degree heart block (complete heart block). His laboratory tests are within normal limits. Blood cultures are pending.

What is the most appropriate treatment?

A. Ceftriaxone
B. Doxycycline
C. Implantable defibrillator
D. Penicillin G
E. Rifampin
 Answer & Explanation

Sunday, March 7, 2010

Cranial Osteopathy

A unique component of Osteopathic medicine, osteopathy in the cranial field, aims to treat the structural dysfunctions of the skull through manipulative techniques.

Osteopathy in the Cranial Field

Whether due to birth trauma, accidental injury, or abnormal strains, insults to the head can cause anyone distress. The cranium has numerous bones that move in an organized fashion to maintain optimal health. Like a dislocated joint, when one of these bones is forced out of alignment, somatic dysfunction ensues. This may present in the form of headaches, sinus congestion, neck pain, agitation, vertigo and a host of other complaints.

Initially difficult to comprehend and palpate, cranial alterations are smalll displacements of bones within the skull. Through diverse techniques the trained practitioner can treat everyone from neonates to elderly. As a student I am excited to be able to palpate the cranial rhythmic impulse (CRI). Apparently it can take hours and days before the CRI is appreciated. Despite making a step in the right direction, I find the cranial methods difficult to employ consistently as a beginner. Forty hour courses are available for extensive training, but the way tests keep coming my way, I don't think there will be much time to dedicate to this detailed study. For those who may be interested in learning more about this treatment The Cranial Academy has set up a website with course offerings and more.

Board Prep Question of the Week
A 50 year old woman with a history of headache presents with complaints of chest pain. She described the pain as pressure, and tightness in her chest. She said that the pain occured after taking a drug, the name of which she forgot. The most likely mechanism of this drug is:

A. Antagonist action at serotonin receptor
B. Agonist action at serotonin receptor
C. Release of nitric oxide
D. Inhibition of calcium channel opening
E. Decreased levels synaptic levels of catecholamines
Answer & Explanation

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