Baby Girl seeing Clearly For the First Time

WHAT DOES THE SPLEEN DO?

It primarily filters the blood… takes away the not so good erythrocytes(red blood cells or RBC for short). Now, why is this necessary? Well, seeing as your RBC’s dont have a nucleus (and the bio students may fill on this) the cells usually have a lifespan of about 120 days. So you gotta filter em out to replace with new ones.

Can YOU live without the spleen?!?!?!?

Thoughts Move Paralyzed Muscles

by Marsha Lewis, Inside Science

Ian Burkhart was 19 years old and enjoying a day at the beach when an accident occurred. Ian describes that fateful day:  

“I was playing in the waves in the ocean. I dove into a wave which pushed me down into a sandbar where I snapped my neck.  I injured my spinal cord at the C-5 level which means I have pretty good function of my biceps but no function from about my elbows down.  So, I can move my arm around but I can’t move my hands or anything below that.“

Now, Burkhart is a quadriplegic and is confined to a wheelchair most of the day. “The hardest thing for me being a quadriplegic is my loss of independence,” he said. “There are a lot of things I need to ask someone for help with now.” See the video below of the technology that links brain activity directly to movement.

Takotsubo cardiomyopathy or Broken heart syndrome. 

Takotsubo cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart and this weakening can be triggered by emotional stress, such as the death of a loved one, a break-up, or constant anxiety.

The typical presentation of takotsubo cardiomyopathy is a sudden onset of congestive heart failure associated with ECG changes mimicking a myocardial infarction of the anterior wall. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted (apical ballooning). It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name “tako tsubo”, or octopus pot in Japan, where it was first described.

Stress is the main factor in takotsubo cardiomyopathy, over 85% of cases are set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms.

The treatment of takotsubo cardiomyopathy is generally supportive in nature. Since the disease is due to a high catecholamine state, patients should not be given inotropes. Treatment recommendations include intra-aortic balloon pump, fluids, and negative inotropes such as beta blockers or calcium channel blockers. In many individuals, left ventricular function normalizes within 2 months. Aspirin and other heart drugs also appear to help in the treatment of this disease, even in extreme cases.

Pacinian Love

“I got you something to say I ♡ you”

*hands over a thin slice of skin*

#thingsonlypathologistsfindromantic

Venous Leg Ulcers

A venous leg ulcer (meaning, a breaking down of the skin allowing air and bacteria to infiltrate the underlying tissue) caused by insufficient blood flow to the area. Around 80% of cases are due to venous failure although there can be attributing arterial factors.

Epidemiology and Risk Factors

Around 1 in 50 people aged over 80 years in the UK will be affected by leg ulcers. The biggest risk factors include obesity, varicose veins and immobility. However, injury or damage to the leg or vascular system within the leg, such as broken bones or DVT, can also cause leg ulcers.

Causes

Venous insufficiency is the main cause of leg ulcers, responsible for around 80% of leg ulcers, although arterial insufficiency and other causes can also occur. Venous insufficiency refers to the inability of the valves in deep or superficial veins to prevent backflow of blood, therefore increasing the pressure on that area of the vein. This can cause damage to the surrounding area as fluid leaks out of the vein, causing swelling and eventually an ulcer.

Symptoms

Symptoms may include swollen, oedematous ankles, discolouration, hardening and darkening of skin around the ulcer, leg pain, aching, itching and a feeling of heaviness in the affected leg. Patients should also be aware that leg ulcers are highly susceptible to infection and so it is important to also watch for signs of this (pyrexia of more than 38 degrees; increased pain, redness, heat and swelling around the site).

Diagnosis

Diagnosis of a leg ulcer will follow assessment and examination of the area by a doctor or nurse, the taking of pedal pulses, and perhaps a Doppler examination to rule out peripheral arterial disease. Blood pressure in both legs will also be taken to compare with blood pressure in the arms.

Treatment

Compression bandages and stockings are the most commonly used form of treatment for leg ulcers, as they prevent swelling and encourage effective functioning of the valves. Compression therapy, carried out by a specialist nurse in a leg ulcer clinic (usually once or twice a week) can usually heal around 70% of leg ulcers within 12 weeks.

Ulcers themselves need to be effectively cared for and protected during compression therapy to encourage healing. They must be cleaned using warm water or saline at each bandage change and a clean, fresh dressing applied to the area, although studies have shown that the specific type of dressing used does not necessarily affect the rate of healing. Antibiotics may also be prescribed if the ulcer shows signs of infection.

Following the healing of an ulcer, compression stockings must be worn by patients at all times when out of bed, as there is a 25% chance of another ulcer occurring within 2 years otherwise.

If ulcers do not appear to be healing after 2-3 months, referral to further specialist services will be made and surgical options such as vascular repair may be offered.

Complications

If leg ulcers are not cared for properly and prevented, complications such as immobility, septicaemia, osteomyelitis and even tumours can occur as a result.

Prevention

Disclaimer: This is not an exhaustive list. These are just some things that I personally learned during my first year of medical school. I also have included some links to books and resources that I used as a first year medical student, but by all means, you can search for cheaper/older/online editions of these resources (I sure did). I wrote this post over several weeks, so it’s sort of all over the place. Apologies. This is just some things I wish I could tell myself on that first day of medical school.

1. You [probably] won’t be #1 in your class anymore. And that’s okay.

2. Anatomy lab isn’t going to be that bad. Just eat a good lunch beforehand because when you’re 4 hours deep into it and holding up a heavy, literally dead weight leg and your tummy is growling and your group dynamic is falling apart… you won’t be happy.  

3. You’re going to mess stuff up in anatomy lab. It’s okay, this isn’t surgery. So don’t be upset when you realize that in the process of removing the rib cage, you chomped right through the diaphragm. He didn’t need it anymore. Move on.

4. Take the advice of medical students, especially the M2s. They just survived it.

5. If you need an afternoon of laying in bed, eating popcorn, and watching Grey’s reruns (or whatever your favorite guilty pleasure is), then do it. Take you breaks. This is a marathon, not a sprint.

6. Feed your head: talk to professors about topics and issues that challenge or inspire you. 

7. Feed your heart: If something inspires you, hold onto it. If a patient’s story moves you, if it brings you to tears, then hold onto that. That’s why you’re here in the first place: the stories of others. Write them down (mind privacy of the patient, though). 

8. Forgive yourself for your crappy studying days. You have intentions to study all day. You really listen to music and snuggle in your bed a lot. You glance at a few notes. By 11pm, you’re feeling guilty about your lack of productivity. Have some tea, forgive yourself, and realize that tomorrow is another day. 

9. An hour is not enough time to get serious studying done. Go to the lunch talk. 

10. Draw it out. That pathway that seems impossible, that enzyme cascade you keep staring at… draw it out, draw it again, draw it without looking at it.

11. Ask for Starbucks gift cards for birthdays and holidays. Because caffeine.

12. There are going to be people in your class, sometimes even your friends, who are super smart and you think they’re doing great, but are actually failing one or more of the classes. Wipe that shocked look off of your face, medical school is hard. 

13. There are people who are good at hiding their negative emotions, but are really hurting. Be kind to everyone as much as possible.

14. Offer to help, but don’t patronize.

15. If you need help, do not hesitate to seek it. This goes for academics as well as your mental health. 

16. Just go to the gym. Just go for that run. You’ll feel better for it. No, seriously, put that book down and go.

17. DO NOT talk badly about your grades in front of other people. For example, “ugh, I’m so stupid, I only got a 70 on that test! So many stupid mistakes…” because someone who got a 60 might overhear you. 

18. NONE OF THE PEOPLE IN YOUR MED SCHOOL CLASS ARE STUPID. NONE. NOT YOU, NOT HER, NOT HIM, NOT ANY, OKAY?! Socially awkward? Probably. Not a good test taker? Maybe. But not not not stupid.

19. Oh so you made a really cool drawing that has helped you really learn a difficult concept? Share it with you classmates. You never know who you can impact by doing this simple task.

20. Summer research? Be realistic because the summer flies by. You might think you have time, but you don’t. Work efficiently.

21. Shower cry. Okay, this may seem so depressing and scary, especially for those soon-to-be MS1s. But honestly, I know several other med students who would take a shower as a study break and just have a good, cathartic, cry. Let it out.

22. Shadow when you can! Take advantage of the extra time that you have during first year (although it feels like you have zero time) to shadow in the fields that interest you. Get a feel for what their day is like, their lifestyle, the specialty in general.

23. Get multiple pairs of scrubs for gross dissection lab. Wash them often. Throw them away at the end. Ew.

24. Anatomy flashcards: study on the bus, waiting in line, getting a pedicure, whatever.

25. BRS physiology. This saved me. The BRS series are very concise books about the subjects, written in bullet points with important graphs and diagrams. I highly recommend going over the BRS chapter several times prior to the test, because if a bullet point confuses you, then you need to dig deeper into the concept and study it more.

26. Practice questions. Do them early, as you study a block rather than the night before the test. Do as many as possible. There are tons and tons of resources on this. For example, I used Gray’s Anatomy for Students  and the Michigan quizzes for anatomy questions. I used Physiology Pretest for physiology questions.

27. For anatomy, I also loved having two books: one color atlas (I used Netter), and one that shows pictures of cadavers. I would learn the structures from the bright, colorful, and well-labeled Netter Atlas. Then, when I felt that I knew them well, I would bring out the book with the cadaver pictures and go through them again. Why? Because when you open your cadaver, it ain’t bright and colorful in there. Things run together. Muscles aren’t intact fully. It can be confusing.

28. Get some more professional clothes, get them for all seasons. Get comfortable, professional shoes. Get a small notepad that will fit into your white coat. These are essential for clinic days or shadowing. 

29. Speaking of clinic days or shadowing, take notes, ask questions. Look up the diseases and diagnoses that the patient had once you get home. These real cases help to solidify concepts.

30. Drink water. Take your vitamins. Treat your body well. 

31. Take 10 minutes every day to clean something in your apartment. Again, the tunnel vision will make you think that you have no time to do anything but study. Ten minutes, that’s it.

32. Get organized. This goes for you school supplies, your folders on your computer, your books, your clothes, everything. Make daily activities as simple and streamlined as possible. 

33. Pay attention during orientation! So, you’ve sat through 3 hours of boring presentations on where you can park, the library hours, and student health. But at least know where you can access information online or who the go-to person is for IT, the library, student health, academic office, etc. There is always this sense of urgency in medical school that didn’t exist in undergrad because your daily agenda simply does not have the same amount of free time.

34. For the first time in my life, I started actually scheduling haircut appointments at regular 8 week intervals. It’s important to look well-groomed and put together, especially in professional settings. So, whatever your hygiene routine is: get the schedule down early so it won’t get away from you. (In college, I would go 5-6 months without a haircut sometimes. Hello split ends.)

35. Tea. Don’t go for that 5th cup of coffee. Have some tea instead. It’ll give you the caffeine boost that you need during that study session without giving you the jitters. Try alternating and switching up your caffeine source. 

36. Listen up: get First Aid. Get it early. Study it alongside your lecture material. Not only is it another resource for you, but when it comes time for the step review, it won’t be the first time you’ve seen a particular diagram or chart on a subject. 

37. Write your mnemonics for things in the relevant sections of First Aid. 

38. Colorful pens, nice notebooks, fun highlighters. Go all out, you’re going to be spending a lot of time with these items, so you might as well get the good stuff.

39. The decent sized whiteboard is great for: writing things over and over, erasing them, and writing them again, drawing diagrams, making flowcharts, drawing out the anatomy. I also knew a girl who just got a giant roll of white paper, like the things cheerleaders used to make banners with in high school. Whatever works for you.

40. Medical school is toxic. The pace is unnatural. Some people will be rotten. Things are not going to be all unicorns and rainbows. 

41. Sometimes, you’ll find yourself questioning why you came to medical school while your friends travel Europe or get married.

42. Someone in your family will hear you talking about your anatomy class and start asking you about this mole on their back, or a rash on their kid. You’re not a doctor, yet. You can answer their questions, but emphasize that you’re not a doctor and you actually know nothing. You’re Jon Snow. Remember that.

43. Oh, you went to google the name of a drug you didn’t recognize and you black out, and 10 minutes later you’re on Facebook. You don’t have time for this nonsense in medical school. Try this app. 

44. So and so in your class will get a divorce.

45. _____ and ______ will start dating, but you’ll see him with this other girl in your class.

46. Someone will have a family member die, go home for the funeral, and not come back.

47. People will drop out. They’re smart and their grades are stellar, but they hate it. And they’ll leave. Someone else will love it and they’ll fail out. 

48. Remember how lucky you are to be where you are.

49. Petty drama will still exist in your class, try not to be involved in it.

50. Granola bars. Trail mix. Snacks that fit in the white coat pocket.

51. Don’t wear your white coat in places that you don’t need to be wearing your white coat.

52. It’s 11pm the night before a big test. Sleep. Medical school examinations are not blunt recall of information that you had in undergrad. You’ll need a well-rested body and mind to solve the problems and recall information on the tests.

53. High and yield. If something isn’t “high yield,” don’t focus on it. Your study sessions should be honed in on what is most important, most high yield concepts first. Details come once you have these concepts down.

54. Volunteering at the free clinic is actually quite amazing, you can learn a lot if you pay attention.

55. Cramming isn’t going to work for you like it did in college.

56. You’ll have to study on the weekends now, too. Sorry, boo.

57. You can still go out and have fun, lounge on the beach, or see a movie. It just requires more planning and scheduling.

58. “I don’t need to write this down, I’ll remember it.” Biggest lie you’ll tell yourself.

59. If lecture doesn’t help you learn, then don’t go.

60. You’ll diagnose yourself with a AAA or hyperthyroidism or a brain tumor. You’ll panic for about 4 seconds until you realize that many med students do this. You’re probably fine.

61. Don’t buy any books until you’ve heard what the previous year’s students have to say.

62. Summer before MS1? Go on vacation. Spend time with your family. Do not crack open a single medical textbook. DON’T. I see you poking around in First Aid, STAHP IT.

63. Easy on the Red Bull, okay. 

64. Earplugs. During tests, during study sessions, while you sleep. Get them. Tune the world out.

65. Noise-canceling headphones for watching lectures, youtube videos, or just for background music.

66. THIS on noise-canceling (or regular) headphones while studying. I prefer rain+ocean waves. I can’t study with music as well. 

67. YouTube videos! I made a post before about the incredible Armando Hasudungan and his helpful youtube videos. Additionally, you can search almost any topic that you’re struggling with on youtube and watch educational videos. Also, add “Step 1″ to the search bar and BAM, high yield city.

68. Make your dentist appointments, get your car inspected, stock up on shampoo, toothpaste, and toilet paper. Try to be prepared as possible prior to the semester’s start so that you’re not running out to the store as often. 

69. A big study desk that’s clean and well-lit. 

70. Prioritize. Medical school will eat up all of your time. Make time for the people you care about. However, realize that you won’t be lounging around every single weekend with your buddies. Getting through medical school requires you to put medical school as your top priority. Your day will revolve around classes and studying. Please explain this to your friends and family early on. Busy is an understatement. 

Wow, the feedback from this is a lot more than I would have expected! I’ll keep updating this as you guys keep adding more (or you can just message me/send me an ask!) If this gets more extensive, and I’m feeling ambitious I’ll totally make this into a google calendar haha.