MED 4 Block 2 [re-cap]
[block 1]
“It is one of the strange ironies of this strange life… those who work the hardest, who subject themselves to the strictest discipline, who give up certain pleasurable things in order to achieve a goal, are the happiest men.”
~ Brutus Hamilton: Olympic track coach
“The harder you work, the harder it is to surrender.”
~ Vince Lombardi
i’m studying 10 hours each day outside of the 5 hours of class time and still feel like i’m getting my butt handed to me on a silver platter. this sucks.
pathology
- atherosclerosis
- aneurysm
- aortic dissection
- phlebothrombosis
- thrombophlebitis
- superior and inferior vena cava obstruction
- acute lymphangitis
- lymphedema
- hemangiomas
- angiosarcomas
- large, med, small vessel vasculitis
- bleeding disorder lab evaluations
- thrombocytopenia
- idiopathic thrombocytopenic purpura
- thrombotic thrombocytopenic purpura
- hemolytic uremic syndrome
- factor V leiden mutation
- DIC
- platelet disorders
- hemophilia
- edema
- hyperemia and congestion
- hemorrhage
- hemostasis
- thrombosis
- embolism
- infarct
- shock
- neoplasia
>> most interesting thing learned: cancer is really flippin’ complicated. but if you’re going to get one, choose papillary carcinoma of the thyroid.
pharmacology
- nitrates
- calcium channel blockers
- beta-blockers
- cardiac glycosides
- phosphodiesterase inhibitors
- ACE inhibitors
- angiotensin receptor blockers
- vasodilators
- loop diuretics
- potassium sparing diuretics
- thiazide diuretics
- osmotic diuretics
- antiarrhythmics
- HMG CoA reductase inhibitors
- fibric acid derivatives
- bile acid sequestrants
- niacin
- oral anticoagulants
- indirect thrombin inhibitors
- antiplatelet drugs
- hematopoietic drugs
- bronchodilators
- mast cell membrane stabilizers
- corticosteroids
- leukotriene blockers
- histamine blockers
>> most interesting thing learned: grapefruit juice is a liver enzyme metabolism inhibitor which can reduce clearance of certain drugs and make them work longer or harder or faster. danger! St. John’s Wort is an enzyme inducer which can increase clearance of certain drugs, meaning you might actually need more to get the same effect. be sure to tell your doctor about ANY over-the-counter drugs or herbal supplements you are taking. no matter how innocuous they may seem.
physical diagnosis
- skin
- head & face
- neck
- eyes
- ears & hearing
- nose & oropharynx
- thorax & lungs
>> most interesting thing learned: the word “fremitus” refers to the vibrations heard through the chest wall when someone speaks. in lab, we place the sides of our hands between the scapula and spinal cord and ask the patient to say “ninety nine”. increased fremitus indicates consolidation. and consolidation indicates pneumonia.
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looking for MED 1? or MED 2? or MED 3?
October 16th, 2008 at 6:00 pm
i love the interesting things learned … hmmm, i eat a lot of grapefruit ‘course am not on any drugs so am thinking its all okay ;-)
hugs!!
October 16th, 2008 at 7:21 pm
what I’m hearing here is that the next time I’m taking recreational substances, I should drink plenty of grapefruit juice so that I can stay hydrated AND extend my … recreation.
hey, fun! :)
October 16th, 2008 at 8:09 pm
I feel your pain about the 15 hour study days…
Thanks for explaining what the ninety-nine thing is all about, I always wondered!
Good luck with your exams :)
October 16th, 2008 at 10:47 pm
Funny to read this, we studied all this in the first year, reading your list reminded me that you will see it over and over. I just wonder how you learned everything else without knowing about molecular med first?
October 17th, 2008 at 2:28 am
Off topic somewhat, but you may want to add the Bee Gee’s Staying Alive to your iPod if it isn’t already in rotation!
xx
October 17th, 2008 at 6:58 am
Alexia: Wondering what medical school you go to that you are learning Pathology in the first year of medical school?? Must be one of the best KICK ASS medical schools ever right? There might be a few things on that list you learned at the beginning, however, I have plenty of friends in medical school in the states and I know they follow the same basics before moving into Pathology and Pharm. So if you could explain this first year of school it would be appreciated….
October 17th, 2008 at 11:16 am
We are system based, like many other med schools in the US.
1st trimester: Anatomy, histology, radiology, embryology. No path or pharm yet.
2nd: cell and molecular basis of medicine. By far the most time-consuming, difficult course. Pathology and pharm started here as we learned the normal functioning of the body, and then, obviously, disease process.
3rd (Now we are in specific systems): cardio/ pulm/renal…which included clinical, patholgy, physiology, pharm
2nd year:
GI: clinical, pathology, physology, pharm
GU: same structure, this is where I am at currently.
I don’t know how anyone learns from anything other than system based, but it is done I just don’t understand learning pathology and pharm, after you have learned the clinical stuff makes sense. Do you guys even get clinicians coming to lecture about what you will see, what tests you will do, in practice?!
We were also working on our clinical skills from week 1. It is a 2 year course that is separate from our ‘sciences’.
And yes, I do go to a ‘kick ass’ school.
October 17th, 2008 at 1:22 pm
And of course microbiology through every system, as well.
October 17th, 2008 at 1:43 pm
Another block! Youppi! I always enjoy so much the most interesting thing learned. Its always quite interesting! Take care!
October 17th, 2008 at 6:55 pm
alexia – i believe you are at a DO school, so our curricula are bound to be a little different.
and yes, we do have clinicians down here teaching us practical skills and letting us know what sort of things we will run into on the wards. all of our professors in Physical Diagnosis (and next year in Clinical Medicine) were practicing clinicians in the USA before retiring to the sweet life of Caribbean teaching.
October 17th, 2008 at 10:24 pm
Not sure that you really can compare the two programs. One is a DO school and one is an MD school. One is systems based while one is subject based. One is in the US while one is in the Caribbean. I never claim to have a clue how the state schools do their teaching and I never would compare my school to another school.
I know that everyone that wants to be a doctor, works hard, and passes the USMLE Steps deserves to be a doctor. Will the patient care if the doctor is an MD or DO?? Probably not. Will the patient care if the doctor learned by systems or subject? Probably not. Will the patient care that the doctor is certified and is able to help them? Of course.
I know it is difficult for people that are not in the Caribbean to understand what we go through down here so I am going to provide you with a rough idea of a day in the life of me down here on Nevis.
Nevis is tiny and has probably 14 restaurants that you would ever want to give a thought to eating at. The food is very expensive and time consuming. The grocery is far away and packed with people. Most people crowd in front of you if you are a student. I go to school from 11-5 and 8-5 on physical diagnosis lab days. After this, I come home and either focus on medical school or business school depending on which has something coming up that is due. Yes, it is true I am doing an on-line MBA course along with medical school. Either an assignment or test in business or a block exam in medical school. Everyone that makes it as a physician makes sacrafices. However, some of the students here make huge ones. Like not seeing family but one week out of every four months or one week out of every eight depending on how often you go home. You must attend 80-90% of classes according to the attendence policy. There are times like this week where you have no electricity and no water and you are unsure why. It is 90 degrees and maybe even hotter in the classroom. There are many challenges that we face on a daily basis that many people would never think of. It is hard enough trying to learn medicine, but when it is so hot in the library that you are sweating because the electricity has gone down yet again and blocks are two days away, stressful is a slight understatement.
I just wanted to let you know that I think it is amazing you got into an American school, but comparing that school to our school does not really make much sense because the challenges that you and I face are like comparing apples and oranges, it is a she said he said comparison.
Lastly but certainly not least, without these Caribbean students making it and coming back to the US, the physician shortage would be even greater than it already is. You may be surprised just how many of us Caribbean physicians there are practicing in the US : )
October 18th, 2008 at 12:15 am
I wasn’t comparing your school to mine at all. I made a short statement about what I noticed was different. Then, you asked me to fill you in, which I did.
I did not think much more about it than that. I know you are used to defending your education, however, this was not where I was going with that at all.
I personally love system based learning, I definitely don’t think it makes a school somehow superior if they teach this way, not sure where you got that.
November 4th, 2008 at 5:44 pm
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