“Ultimately, the only power to which man should aspire is that which he exercises over himself.”
~ Elie Wiesel

whew. it’s tough to stay motivated and force yourself to study when you’re daydreaming about life on the hospital wards and would rather be just about anywhere other than a cramped MUA desk. this is the discipline of med school, i guess. it’s training me to be a better person and awesome doctor someday, right?

*ahem* right??

there are only 3 blocks this semester. the last few weeks from March 9th through April 13th are spent on NBME subject examinations in Pathology and Clinical Medicine, a Clinical Skills Assessment practical exam and — drumroll, please — the comprehensive final.

pathology
- adult respiratory distress syndrome
- chronic obstructive pulmonary disease
- interstitial lung disease
- pneumonia
- pulmonary embolism
- pulmonary hypertension
- lung cancer
- valvular heart disease
- infective endocarditis
- cardiomyopathy
- congenital heart diseases
- ischemic heart disease
- tumors of the heart
- glomerular diseases
- tubular and interstitial diseases
- tumors of the kidney

>> most interesting thing learned: if you were to have a heart attack and (heaven forbid) die within 12 hours, your heart wouldn’t look any different to the naked eye. changes noted via microscopy include wavy fibers (30 minutes to 4 hours), coagulation necrosis (4-12 hours) and contraction band necrosis (12-24 hours).

also, the kidney is complicated and important. but we already knew that. i think it’s nice that Minimal Change disease is so common in kids because it sure is hard to diagnose something that, um, shows minimal pathological changes. it’s an easy guess when you’re stumped.

intro to clinical medicine
- chest pain
- heart sounds and murmurs
- cough
- hemoptysis
- dyspnea
- edema
- acid base disorder
- dysuria
- hematuria
- hypertension

>> most interesting thing learned: people are born with aneurysms. we all know that. Dean T told us this morning that as many as 2 people out of our class of 70 probably have some sort of congenital dilation of one of their arteries somewhere in their brain or body. it’s when those aneurysms rupture that you have a problem. you get blood in the brain or somewhere it’s not supposed to be and then all sorts of bad things happen. the large artery that branches off the top of your heart and travels down your abdominal cavity is called the aorta. some unfortunate folks are born with aortic aneurysms. and they can most certainly tear causing very bad things to happen.

anyway, on to the interesting thing. in learning how to manage dissecting aortic aneurysms, it is common to actually do next to nothing about a descending abdominal aortic dissection. if it’s not too bad, all you have to do is manage the blood pressure and it will heal on its’ own. but if the dissection is further up (preductal or ascending), you won’t live long without surgery.

and that’s it!

that’s right! we only have two classes this semester. what on earth could i possibly have to complain about??

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looking for MED 1? or MED 2? or MED 3? or MED 4?

photo: proof there are road signs on Nevis. forget the fact that this one is hidden away at a crossroad that no cars can drive down.

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