Paragonimus-westermani drawing
today, dr hotez (our chief parasite celebrity) told a story of his trip to china where he was working with a bunch of other parasite specialists. he was the honorary guest and they brought out a huge plate of raw crab for everyone to eat. as the guest, he of course was expected to dive in first. unfortunately, raw crabs sometimes carry a flatworm larvae called Paragonimus westermani, known to cause lung inflammation and secondary infection (aka. Chinese lung fluke) and was going to teach them all about it during seminar the next day. he was momentarily petrified! he didn't know what to do. this was one of the critters he had traveled to china to teach them about! the irony.
then one of the hosts announced to him (upon seeing his hesitation) that the crabs came from a lake (?) that was known to not be contaminated with Paragonimus.
Caduceus symbol
Did you know.... the symbol for medicine (cadeucus) which depicts a "snake" wrapped around a stick is a heroic version of how Dracunculus medinensis worms (aka. Guinea worms) are extracted from a person's body?
The female worm, that's inside the host, forms a blister on the skin to squirt the eggs out of the host's body. To get her out of the host you have to wrap the worm around a stick and twist out a mm each day. And we're talking like 10cm worms! (That's a lot of worm) If you do it too quickly and break the worm, your body releases cytokines causing mass inflammation and ulceration. This has been the means of getting out the worms since biblical times!
Crazy! I'll never look at that symbol the same way...
Scott Speedster
I love my new bike! After a week of determination and shopping, I found the perfect bike. And then I checked craigslist and found the same exact bike (only a year older) being sold for half the price. Lucky day!! I was thrilled and glad to have the extra cash to buy all the other important things... like clip-in shoes. That will be an exciting day, learning to use those babies!
A little time to enjoy autumn
This weekend I went kayaking and last weekend I went for a long bike ride. The weather has been spectacular, making it all the more difficult to focus in and study. My brain is a little bit sluggish and doesn't have the same "attack" it did at the start of the year. These past two weekends are a little bit of a "break" before heading back into the thick of it again.
I've also been out to enjoy a few good places to eat in DC recently. Yesterday I went to a place called Hook for brunch and then to another place for lunch, that I can never remember the name of. Also I'm bike shopping and on the verge of buying a bike that I really like a lot. If I can work in the time today, I should go ride it again! All I want to do is go play, but I've got so many lectures to read up on that I'm almost afraid to list them. Ok... back to Parkinson's!
Pathology Small Group Case Presentation
•A 29-year‑old African American woman presented with a 6 month history of persistent lymphadenopathy, low grade fevers to 100.5 ºF, fatigue and arthralgias.
•
Which of the following disorders should be considered in the differential diagnosis of this woman?
- HIV infection
- Systemic lupus erythematosus
- Cancer
- All of the above
- 1 and 3
•Which of the following are important in the initial evaluation of this patient?
- –Clinical history
- Routine laboratory evaluation (CBC w/ diff, chemistry panel, UA)
- Immune serology panel (autoantibodies, anti-HIV, etc.)
- Lymph node biopsy
•
Washington and Lincoln Memorial at night
After studying at Kirsten's on Saturday night, I got back around midnight and realized how gorgeous the view of the monuments was so I had to take a picture. Though I didn't have my tripod, I think this turned out fairly well enough.
One of these days I'll take this view at sunrise. It's gorgeous! I'm happy to be in DC.
Decompressing after my path exam
Even though Giulia's doing her clinical rotations, I still get to see her most weeks. We walked over to Georgetown for a snack after my path exam. She's doing her psych rotation now and is serving as my motivation to get through second year. Third year is going to be so cool!
We checked out a new place that opened. It's a chain called Le Pain Quotidien. The food was good. Seating out back was great, though I was attacked by mosquitoes. Giulia's my partner in crime, when it comes to doing stuff beside studying. I'm not sure what I'd do without her!
Dog Lab outside!
I had never heard of Dog Lab before starting pharmacology during my second year of medical school. Luckily we don't actually use real dogs any longer. Instead we watch videos of dogs being injected with various pharmacological agents.
The first few weeks of pharm we studied the various arms of the autonomic nervous system, including receptors, neutrotransmitters, agonists and blockers. During Dog Lab we're mostly concerned with the systolic and diastolic pressures, contractility and heart rate effects on the doggies. After studying a list of drugs we split it up into groups and made flow charts to identify "unknown agents" that would be administered during Dog Lab, along with different "tool drugs" like beta blockers or alpha agonists. It was a pretty time consuming undertaking. At one point my group went to our profs office and had a mini-Dog Lab bow-wow.
Today, we had our first big pharm exam. It was a grueling 3 hours... the kind where 4-pages into the exam you begin to wonder whether it's really safe to think so hard! Your brain could just as easily pop out of your skull and then you realize that we're a lecture hall full of dogs, pumped full of epinephrine, xanthines and goodness only knows what else! Blood pressure was probably high, contractility increased and heart rates climbing...
And then we finished the day with a pathology lab "bucket autopsy". This time our case was missing the heart, though the liver was present. It's too bad the heart was missing. It might have been interesting, given her cause of death... septicemia from a badly abscessed bronchopneumonia. The lungs were heavy and slick. The abscess just melted straight through the lung tissue and across a few arterioles, which allowed the bacteria to go systemic and cause shock. It's rather mind blowing to see it and hold the tissue in your hands.
But why do we keep getting buckets of missing organs?! How in the world does this happen. Forget it... I don't even want to know!
