miss akay

Treponema pallidum

noreply@blogger.com (miss akay) — Fri, 16 May 2008 13:10:00 +0000

This spirochete causes syphilis. The pathogenesis is strange because although it is an obligate pathogen, it isn't intracellular and yet it causes granulomas called gummas.

First weekend of the semester

noreply@blogger.com (miss akay) — Fri, 18 Jan 2008 03:10:00 +0000

Bahar, Audra, Kirsten
Originally uploaded by akay

Well, we had to get out for a little bit of fun before the semester started! None of us are ready to study. In fact, we're a bit anxious to go out and party together since we never, ever have a chance. Now we're all rested up after break, feeling relaxed and super thrilled to have a night to let loose. And we had a blast!!

About a dozen of us gathered at Rita's for drinks and then we piled into cabs to head over to a new club in DC called Park. Except there were too many of us to get in. We ended up around the corner at Lotus Lounge. The place was pretty lame. Ehhh... whatevs! My friends were out with me having fun, so I'm not complaining. I was up until 5am and had a pretty lazy remainder of the weekend.

Monday was rough and all of us plodded into class, just to survive through another long day of heme onc!

Mmm... mango for dinner!

noreply@blogger.com (miss akay) — Fri, 11 Jan 2008 05:21:00 +0000

Mmmm... mango for dinner!
Originally uploaded by akay

I couldn't wait to slice up that mango and drizzle balsamic vinegar all over top of my spinach salad. Pecorno cheese, walnuts, radishes and cranberries... this was a masterpiece dinner. Why is mango and balsamic vinegar such a brilliant combination? I LOVE IT!

And tomorrow I learn to perform pelvic and prostate exams.

Walking home from Corcoran Gallery

noreply@blogger.com (miss akay) — Fri, 11 Jan 2008 05:15:00 +0000

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Originally uploaded by akay

Tonight I had a date with myself to go see Annie Leibovitz's photography on exhibit at the Corcoran. Maybe it was just a long day for me, but I wasn't as struck by her work as I had hoped. Her images make me feel uneasy. I don't take a deep breath, and let it out feeling restored. Some people are really into that whole tension in art thing. Ehhh... I can pass. I feel the same about movies that stir up internal "yuck", such as the movie "pi". Different story.

Her work is not disturbing, 98% of the time. I'm not saying I don't appreciate her talent! She's very skilled and has a worderful portfolio. Her portrait of the White Striped duo is priceless. The photo of Johnny Depp and what's her name model, you know the naked model... uh... uh. Anyway, that one is brilliant as well. The George Bush, Cheney, Rice and crew... was just pure evil! I walked past it 3 or 4 times, contemplating the circumstance the photo was even taken under. Portraits of Queen Elizabeth II were interesting.

You see, the thing is that I'm not sure anyone would be thrilled with the portraits she's taken of people. Except the one of Demi Moore, pregnant or the one of Demi and Bruce. But usually the photos taken by Annie Leib are a little bit uncomfortable.

And then I took another quick stroll through the Ansel Adams exhibit, one last time. (It's about to close) I realize I have a bias to his outdoors places. Especially to the places I've actually been and recognize. I learned that art's gotta be personal to really sing to me. I've never paid much attention to famous people. Perhaps if I knew them in personal their portraits would be more interesting. Maybe that's way the Bush clan really struck me... because they look naturally evil in that photo!

Conclusion of my '07-08 Holiday Break!

noreply@blogger.com (miss akay) — Mon, 07 Jan 2008 04:30:00 +0000

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Originally uploaded by akay

My last day was marked by the most severe storm I think I've ever experienced in San Francisco. It was so unusual in fact that my East Coast friends and family asked me all about it. The irony is that a storm like that on the East Coast is easily forgotten and often goes unnoticed. San Francisco typically doesn't get much in the way of weather!

I took the red-eye back to DC on Friday night. My flight was empty! I had an entire row to myself and so stretched out for a few hours of sleep. My parents fetched me and brought me to their house for coffee, where I waited for the sun to rise before I went grocery shopping. The rest of the day was spent trying to stay awake! I think I lay in bed for two hours with my eyes closed-ish, without drifting off. It took crazy discipline. I didn't know such a feat was even possible.

Around 5:30pm I drove back to my parents' house for dinner and watched the Redskins game. I taught them how to pause the game using DVR and have actually started to watch a little bit of football in short intervals. Though I admit most of the time is spent blankly staring at the screen, not even "seeing" the players run across the screen. I don't think that classification of mental status is possible with anything other than watching football. I fell asleep by 7pm and didn't wake up for 13.5 hours!

Today I unpacked my suitcase, went for a run around Iowa Jima, talked on the phone and worked on my Doris Duke application. It's nearly finished, at the expense of not doing my pre-reading for tomorrows lectures. Classes start again at 9am. At least they weren't completely evil by forcing us to show up for 8am lectures! I've been corresponding with a current Doris Duke fellow at UCSF. I'm hopeful to get the award, but still not 100% sure about taking next year off. My letters of rec have all been outstanding. If nothing else, it's nice to enjoy the ego boost from reading nice things about me written by people I respect a great deal. An excerpt from my favorite one:

Audra immediately immersed herself in the ongoing research projects in the laboratory, and I had the pleasure of working together with her as we refined our protocol for intraocular injections of bioluminescent retinoblastoma cells into newborn rat eyes to generate a xenographic model to test novel anti-cancer agents for the treatment of this ocular malignancy. Audra quickly mastered the microsurgical skills necessary to perform consistent intravitreal injections. She also showed initiative and insight in her ability to design experiments aimed at improving our protocol, permitting us to generate models more efficiently for our animal-model drug trials. Her skills were a tremendous asset to the laboratory and she is missed now that she has returned to her graduate medical studies at George Washington University.

In addition to her outstanding work with us in cancer research, Audra took an active interest in learning from the activities of our clinical service. She joined us in the operating room, clinic, and at our multidisciplinary tumor board conference. Audra showed a natural ease with patients, who appreciated her kind demeanor and empathy. In addition, Audra used to great advantage her past clinical experiences as a certified ophthalmic angiographer and a visual services assistant. As a result, she has ophthalmic skills and knowledge far exceeding her medical student peers. Audra has the natural sensitivity of an excellent clinician and obvious talent as a researcher. Without a doubt, she has the makings of an outstanding clinician-scientist.

Swan

noreply@blogger.com (miss akay) — Mon, 07 Jan 2008 04:12:00 +0000

Swan
Originally uploaded by akay

Just looking at this photo makes me hungry again for the delectable seafood experience. I dragged my friend to Polk Street, insisting we go explore a part of SF that none of us seem to know much about. My friend had a sudden oyster craving! I'm always game for a plate of Blue Points. We checked out this hole-in-the-wall place on Polk Street. It was everything you would ever expect from a first rate hole-in-the-wall. The food was divine and the people were just as big a treat. They didn't even take credit card. The only problem was that the prices were high enough to fill up the holes with gold. They even charged for bread and butter!

Christmas tree in McLean

noreply@blogger.com (miss akay) — Fri, 28 Dec 2007 00:46:00 +0000

Christmas tree in McLean
Originally uploaded by akay

Here's my family tree. We had a lovely gathering at my parents' house, on Christmas Eve and then spent Christmas Day at my Oma's. At night I went on a long drive through Virginia, DC and Maryland to check out the Christmas lights. The finale was the Mormon Temple! My Oma kept us out until past 11pm. She's the life of the party!

My Christmas Tree

noreply@blogger.com (miss akay) — Fri, 28 Dec 2007 00:40:00 +0000

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Originally uploaded by akay

While I studied for finals I yearned like crazy for the Holidays to finally arrive. This is my tree. We're not allowed to have live trees in my building and this seemed like the best solution! She's a happy little tree with a giant Haitian dragonfly underneath.

Paragonimus-westermani drawing

noreply@blogger.com (miss akay) — Fri, 26 Oct 2007 00:40:00 +0000

Paragonimus-westermani drawing
Originally uploaded by akay

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

noreply@blogger.com (miss akay) — Fri, 26 Oct 2007 00:37:00 +0000

caduceus
Originally uploaded by akay

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

noreply@blogger.com (miss akay) — Mon, 22 Oct 2007 23:19:00 +0000

Scott Speedster
Originally uploaded by akay

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

noreply@blogger.com (miss akay) — Sun, 21 Oct 2007 14:47:00 +0000

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Originally uploaded by akay

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

noreply@blogger.com (miss akay) — Wed, 03 Oct 2007 00:26:00 +0000

•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

noreply@blogger.com (miss akay) — Tue, 02 Oct 2007 03:17:00 +0000

Washington Monument and Lincoln Memorial
Originally uploaded by akay

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

noreply@blogger.com (miss akay) — Tue, 02 Oct 2007 03:03:00 +0000

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Originally uploaded by akay

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!

noreply@blogger.com (miss akay) — Tue, 02 Oct 2007 02:50:00 +0000

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Originally uploaded by akay

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!

First day of autumn... gorgeous!

noreply@blogger.com (miss akay) — Sun, 23 Sep 2007 23:08:00 +0000

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Originally uploaded by akay

There are some things I will always enjoy and one of them is exercising outdoors. It's the greatest pick me up in the world! I'm not much of a jogger these days, but since the swimming pool closed a week ago I decided it was time to take it outside and go jogging. My knees aren't so crazy about this idea. What I really want now is a bicycle!

Path lab, today!

noreply@blogger.com (miss akay) — Thu, 20 Sep 2007 00:15:00 +0000

Myocardium6-20070910
Originally uploaded by akay

Today in pathology our autopsy bucket-case had THREE hearts in it. Oops! We assumed it was a minor mix-up. I guess it all evened out when we realized our liver was missing!

Peach cobbler

noreply@blogger.com (miss akay) — Thu, 06 Sep 2007 02:52:00 +0000

Peach cobbler
Originally uploaded by akay

2006 was all about the cheese cake.
2007 is all about the cobbler!

Cafe Salsa in Old Town, Alexandria

noreply@blogger.com (miss akay) — Thu, 06 Sep 2007 02:51:00 +0000

Cafe Salsa
Originally uploaded by akay

We made it out to Old Town, after a little bit of persistence by my friend Sarah. Slowly she and I are working our way through the DC area, checking things off our list: Smithsonian Portrait Gallery, Old Town, First Friday, Cake Love, Cafe Deluxe, Washington Monument... We've nearly knocked out half of them since I got back from SF. Six of us head over to Old Town for dinner and a stroll down to the river, where we were targeted by two different groups of persistent young guys... one set near the river and the other set on the Metro. Whoever said that guys are intimidated by pretty girls in large groups was dead-wrong! These guys tried their darnest to get our whole group out with them... but we weren't having any of it. This was a girls' night!

Giulia and Audra poolside at night

noreply@blogger.com (miss akay) — Thu, 06 Sep 2007 02:43:00 +0000

Giulia and Audra poolside at night
Originally uploaded by akay

Swimming at night.... why, yes! Sometimes it is nice to live on the East Coast. The evenings have been wonderful. In fact, the weather in general has been great. I'm getting my taste of the heat to counter a cold July spent in San Francisco. Sandals and tanktops, only... no sweater necessary. It's lovely.

Swimming... who knew how much I'd love it! It's too bad the pool is now closed, because my favorite low-key evenings were spent swimming laps in the turquoise lit water. It's such a great work-out and so relaxing. Though it's closed during the week now, there are still two more weekends before I move my newly discovered love for swimming INDOORS.

Here we go! The studying begins...

noreply@blogger.com (miss akay) — Wed, 29 Aug 2007 00:26:00 +0000

Here we go!
Originally uploaded by akay

OK.... so the first step involves removing the shrink wrap and scratching off the lottery doo-hickie on the inside cover. This bad boy is going to be my bible for the next nine months. My very own BIG ROBBINS!!!

Community Service Day

noreply@blogger.com (miss akay) — Wed, 29 Aug 2007 00:23:00 +0000

Bread for the City
Originally uploaded by akay

On the second day of school we did our annual community service day, where we all went about DC and helped out wherever we could. My project was with 9 other students at Bread for the City in North West. What a fantastic operation. The photo is of the community garden, which is just a tiny sliver of what the program offers to the people. They offer clothes, food, legal services, health and social services. This year our school is opening a student run clinic, where we will volunteer health services to the underserved population of the area. It's a rather big deal and we're very excited about it!

Poolside before school starts

noreply@blogger.com (miss akay) — Sun, 26 Aug 2007 23:58:00 +0000

0824072119.jpg
Originally uploaded by akay

Nearly the same group as last years girls' night... minus Kirsten and Zoya who were busy. We spent the afternoon sunning ourselves while dinner was roasting upstairs in my oven. When it was time to eat, we ran up to fetch everything for a picnic by the pool and then the hallway fire alarm sounded. This was not my smoke detector, mind you. We gathered the chicken (hot out of the oven), knives, salad dressings, spinach, peppers, bread, cheeses, wine, Sarah's key lime pie... everything and anything we might need in case this was a real actual fire! The fire engines arrived as I carved the chicken, poolside. By the time we made it to dessert, the fire engines had left already. Dinner was delish! The pool was fantastic.

It feels so good to be back with our old crew of friends as we embark upon... dun, dun, duuuuuh.... Year-2 of Medical School!

Umpqua Lighthouse State Park

noreply@blogger.com (miss akay) — Thu, 23 Aug 2007 05:19:00 +0000

DSC_0614
Originally uploaded by akay

Gorgeous campgrounds that are well maintained and optimally located for whale watching and ocean go'ers. Camp hosts are super friendly and interested in keeping this wonderful destination a special place to return to. It is an escape from the brutal world that most of us city dwellers know too well. Please leave your stress behind if you visit! Camp out or splurge on a deluxe yert... $65 and it's cheaper than a hotel room and smells much better! Enjoy the olfactorgasms of pine, campfires and ocean air.

Attractions include a lovely lighthouse, woods, whales, water, harbor, fishermen, lovely locals that smile constantly. People are genuinely happy to live here. It is easy to understand why!