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[lovelyfadingyuj-blog]

us bake this income jet sake spirit maintenancebrown math port theater everyday deck Supreme sometimes

[chewestfly-blog]

L O N G I T P A R T V I I I @tuc_gabe haha ju hilarious! #chepebdaypartdos #CheWest #longit

[ontheshoulderofgiants-blog]

Longitudinal Clinic Round 2

So I'm paired with an Internal medicine doc at the hospital - Dr. B. She's super nice and very good about teaching before and after patients. We get along really well and we were cracking some jokes this week. So it's all good. 

There's only one thing wrong with her clinic - she has no patients!! Last week there were only 3 or 4 patients on her schedule for the entire afternoon. This week, we had only 3. THREE PATIENTS. I'm supposed to be there from 1pm-5pm and her patients are only scheduled until 3. Luckily she let's me go when there's nothing to do. 

So today two of her patients no showed. What does that mean?  Guess who got pimped for 2 hours until the third patient showed up? That's right yours truly. For those non-medical folks reading along at home being 'pimped' is getting asked questions until you get something wrong.

For example, on today's schedule we had someone who was supposed to come in for a chief complaint of "wheezing". Which means I was asked everything and anything that could be related to a symptom of wheezing. She spent half an hour asking me questions related to pneumonia and tuberculeosis, presentation, symptoms, signs, management  treatment, differentials etc etc. It's all really good because it reinforces stuff I learned in class- although it is also terrifying. 

So OTSG - tell me, how do you differentiate between pneumonia and TB? What does the chest x-ray look like? Signs/ sympoms. What meds do you give for TB? What are the criteria for hospital admission? What are the most common infectious organisms? For kids? Adults? What about HIV? What are the sequale. Etc. Etc Etc. Continue this for all of the chief complaints we had today. It get's pretty crazy!

You can see how this get's stressful/tiresome after 2 straight hours! I imagine this is how internal medicine rounds will be.  It wasn't done in a malicious way, just more of a non-stop barrage of questions. It feels really good to learn how to manage patients though. 

The patient who did show up today was super interesting though. Case was something like this (details have been changed). Young female, new onset headaches for the past 10 days presented to the ER last night. CT scan showed a SINGLE point of calcified neurocystericerosis  or possible vasculitis. No seizures etc. 

Neurocysticercosis is a tapeworm whose eggs can travel to the brain and cause a cyst. Since it was calcified it showed up on CT scan meaning that it's not acute. She didn't have any recent travel (and was confused as to why everyone was asking her if she had). 

Here is a pic of what a neurocysticerosis lesion would look like (it's the white dots). 

I got to perform a whole neuro exam (haven't done one of those in awhile). Came back fairly normal. She'll be back in 2 weeks for follow up so I will know more than. I even came up with a pretty good differential diagnosis, assessment and plan according to Dr. B. 

The moral of the story is this. I will have to do a lot more studying before I head to clinic again in two weeks.