The Path to Specialty Choice: From Pre-Med to Match Day
In celebration of the completion of my last night of call until the start of my intern year (July 2012), I present to you:
MY WHITE COAT IS HEAVY
From the top left:
Laminated cards with pediatric developmental milestones (from my last rotation)
White coat clipboard with schedule, patient info, notes from lectures, etc. The back of the clipboard has helpful normal lab values and such.
Beeper (since it’s the end of the year and we all dread hearing our beepers go off, we have all taken to yelling “not it!” when someone’s beeper goes off in the lounge)
A set of trauma paperwork, because when a trauma code gets called, there’s usually not time to go get the paperwork. Always be prepared.
3 strings of sutures tied in knots (formerly tied around my button holes on the coat)
2 packs of sutures, for more knot tying practice.
Lip gloss
Name badge, substance abuse counseling card, LifeLink organ donation reminder card on handy-dandy pull cord
Pediatric drug dosage card
Maxwell— wonderful compact little book with lab values, examples of different types of progress notes, ACLS algorithms, etc.
Oily face thingies… because 30 hours is a long time to go without washing your face.
Card with beeper numbers for all the surgery residents
Lil bucket of peanut butter, because we steal food from the doctors’ lounge whenever we’re in there, regardless of if we need it.
Lemon juice and Splenda packets, because tea time is important. Usually I have one or two tea bags in my pocket too so I’m prepared.
Alcohol wipes to clean my stethoscope.
Business card from one of the family med guys, reminding me to e-mail him some paperwork.
Pin for my lapel
2 monofilaments to test diabetic feet. Don’t ask me why I have 2. I used to have 3.
A book of some sort. It changes daily. This and the clip board are what really weigh me down.
Quality clicky pens.
$1.11 in change
small stack of ones for vending machines
paperclip, because my attending told us we all needed a paperclip in our pockets just in case we need to mark something on x-ray.
nametag
eye drops, so I don’t look like a pot head at the end of those 30 hour shifts.
**Missing from shot: pack of crackers or granola bar (just ate my last bar), stethoscope (because it’s usually around my neck and not in the coat pockets)
What’s in your pockets?
Listeria monocytogenes,
Killing cancer with radioactive microbes
The war on cancer is waged on many fronts, with many weapons, from chemotherapy and nanoparticles to monoclonal antibodies and targeted ultrasound.
In a new commentary published this week in PNAS, Aladar A. Szalay, PhD, in the Department of Radiation Oncology at UC San Diego Moores Cancer Center, and colleague Jochen Stritzker discuss a new (sort of) approach: Microorganisms carrying radioactive antibodies that infiltrate and kill cancer tumors and cells.
To be completely accurate, the work, described in the May 6 online issue of PNAS by Wilber Quispe-Tintaya and colleagues at Albert Einstein College of Medicine in New York City, is not entirely new. In 2009, Robert Hoffman, PhD, in the Department of Surgery at UC San Diego School of Medicine and colleagues reported on experiments with engineered salmonella bacteria, showing that it can kill mouse cancer cells, including metastases of pancreatic cancer.
But the latest Einstein College research is encouraging. It uses a different microorganism – an attenuated or weakened version of Listeria monocytogenes, a food-borne pathogen responsible for listeriosis - to which scientists attach radiolabeled antibodies, then inject the combination into mice with cancer. The reported results have been notable.
In mice injected with just the live L. monocytogenes, primary tumors were reduced in size by 20 percent and metastatic burden – the presence of cancer cells in the body – dropped by 40 percent. Mice injected with just the antibodies experienced no therapeutic effect. In combination, however, the bacteria-and-antibodies treatment reduced primary tumor size by 60 percent and detectable metastases by more than 90 percent.
Just as important, the approach showed no harmful side effects on healthy tissues or liver function. Szalay and Stritzker say the results should stimulate further experimentation, perhaps expanding to other bacteria and viruses with a particular preference and ability to infect and replicate in cancer cells, such as Escherichia coli.
Normal chest x ray.
(Picture by http://www.anatomybox.com/).
Thyroid Hormone Synthesis
Autodesk 3Ds Max, Mudbox, Adobe Photoshop, Illustrator
© Julianne Pasini 2012
Paradise of Canadian Rockies by *porbital
A 14-year-old boy presents to the emergency department (ED) after “feeling a pinch” on his left foot. On arrival, heart rate is 125 bpm, blood pressure is 172/122, temperature is 99.6°F (37.5°C), respiratory rate is 22, and oxygen saturation is 98%. He is diaphoretic and complaining of diffuse muscle cramps to his extremities and trunk. Electrocardiogram, routine laboratory tests, and toxicology screens are negative. What envenomation could produce this reaction?
A. Brown recluse spider
B. Centipede
C. Black widow spider
D. Tick
E. Hymenoptera
(Photo & Question via @Medscape)
Cattiness in the Workplace Sets Women Back 100+ Years
Sexism between women, in general, manifests itself as competition and jealousy. Women feel quite negative and hostile about other women, successful women in particular. Women in medicine can be particularly hostile towards one another because of the various degrees of “success” that exists in the workplace. That success could be academic, socioeconomic, or physical. The list is endless but it is no reason to be bitter. (Read More…)
Repair of ventricular sepal defectThis photograph shows the surgical repair of a traumatic ventricular septal defect (VSD). A VSD is a hole between the right and left ventricles of the heart and is usually seen as a congenital condition, known as a ‘hole in the heart’. A traumatic VSD, as seen in this case, is a rare complication of chest injury. It might manifest immediately after trauma, leading to heart failure and an inability to stabilise a patient, or it might be delayed and detected months later. Traumatic VSDs can be treated in a variety of ways, depending on the effect they have on the patient. Treatment options range from monitoring and a conservative approach to open surgery, as is depicted here. In this image, the VSD is seen at the bottom, and a bovine patch is being parachuted and stitched into place to seal the defect.
Credit: Henry De’Ath, Royal London Hospital / Wellcome Images
#inspiration for the day: “You can be miserable, or you can motivate yourself, the choice is always yours.” #usmle #studyingcanbecool #comlex #step1 #firstaid2013 #studybuddies
