Saturday, December 29, 2012

Blisters, diarrhea and giants - an accurate roundup of med school

Merry (slightly belated) Christmas to you all.

(Happy Festivus if you are into that sort of thing.)

Meant to write pretty much everyday this month, but real life intervened in the form of OMG FINALS. If you spent the last three weeks frantically refreshing this page or kept re-reading past gems from this blog, I apologize profusely and sincerely. I am back now with fresh material to ensure this venerable little corner of the vast internet will not go unmanned (Or un-botted. You have no way of knowing if I am a highly proficient AI).

Recently concluded block numero tres of second year of med school. Only three more blocks to go before most of my classmates get shipped to the hospital wards and get presented with real patients with real illnesses.

This block's material explored interesting material and answered some critical questions. Like: what do you blame when your "hormones act up"? Is the pituitary gland really the "master gland"? Is there more to diarrhea than inconvenient trips to the shitcan? (Hint: yes) Can a skin rash be both macular and papular? Read on to find out.

Gastro: All about the fun stuff that goes on in the extensive set of tubing inside you. Biggest surprise for me was the time and attention they devoted to teaching the nitty-gritty details of diarrhea. The presence or absence of certain substances in the intestines (e.g. sugar-free gum, nasty bacterial toxins) can affect what "type" of diarrhea you'll suffer through. This may seem like academic voodoo magic at its finest - after all, why would you care if you had secretory or osmotic diarrhea? - and I thought so too, but knowing if your diarrhea was caused by cholera or too much sugar-free gum can make the difference between life and death because it can guide treatment.

Rest of the class was mostly about cancers. And the liver. Yeah the liver's a beast. Respect it. Fear it.

Endocrine: Deals with glands that release hormones that are responsible for an astonishing array of effects from growth to blood pressure control (for the time when you eat too many salty funyuns). These endocrine glands are scattered throughout the body, each with its set of functions. Control of these glands is nominally achieved by the pituitary gland, which is safely ensconced inside your skull. Traditionally the pituitary has been called the "master gland" (because it regulates the functions of other glands from its perch), but frankly that's a load of horseshit. In reality the pituitary is nothing a mere servant of the true mastermind (cue dramatic music), the hypothalamus - a section of your brain. It pulls all the strings and makes the magic happen.

If you made it this far, here is an image for your efforts:

This is Andre the Giant, who achieved fame as a wrestler and as an actor. His condition is caused by excess secretion of growth hormone by the pituitary gland. Fascinating, eh?

Dermatology: Skin rashes galore! In many ways the most convoluted, maddening subject this block. Kudos to the instructors, who in their crisp business-like fashion, simplified their domain for us lowly second-years. Terminology is a huge barrier.I suspect a cabal of derm's top brass got together and devised this terminology just to keep the casual learner out of their hallowed halls. A skin blemish (what you or I might call a rash or a bump) can be a macule, papule, plaque, patch (each with its own precise definition). Dermatology is probably the only area where something called lichenoid has a distinct meaning from lichenification.

Oh and in case you didn't know, the skin can get some pretty horrific maladies. Blisters,sores, rashes, flakes, infections. Most of them are caused by autoimmune processes (your body's immune system attacks its own cells for no discernible reason), which caused me to lose a lot of respect in the immune system. Images? Why here you go:

This is Bullous Pemphigoid. (Not to be confused with Pemphigus Vulgaris or Pemphigus Foliaceus) The blisters are caused because the immune system causes the top layer of the skin to "lift" from the deeper layer.

That's it for now. Come back for more!

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