#cavitary

[roetrolls]

Nice ribs! Sorry about the stomach acid

HBDBBDBDJSJFJNXFJS ANON

#PLEASE THIS IS SO FUNNY #sidenote if any of you can help me understand what the fuck ‘cavitary lesion’ actually means #ill like. wed u or something.

[headoverheelsforramsey]

The Seal Of Zeal (1/3)

Book : Open Heart (Book 3)

Pairing : Dr. Ethan Ramsey x F!MC (Dr. Meera Bose)

Series Summary : Ethan Ramsey and Meera Bose do not back down from challenges. But what happens when they challenge each other?

Chapter Summary : Ethan helps Meera study for her boards with the help of an innovative method.

Category : Fluff

Warnings : Implied NSFW

Rating : Teen (just to be safe)

Word Count : 642

A/N : Hello everyone! I am back after a long time. This time with a mini series. This chapter is short due to my inability of writing smut and laziness in researching medicine. 😂 But don't worry the next two will be longer. Please bare with me as I dip my toes into cringy smut. All medical inaccuracies are mine as I am not a medical professional. Happy Reading! 💜

"Ugh! I'm never gonna pass like this!" Meera cried, tossing away the flashcard and plopping down on the couch. 

"Hey hey, you better take that back we don't quit in this house," Ethan put down their fourth cup of coffee. 

"It's easy for you to say, you freaking genius," she rolled her eyes. 

Ethan sighed, taking his seat across from her.

"Why don't we mix things up a bit, raise the stakes, have some fun?" 

"What do you mean?" 

"I propose, we turn this into a game," Ethan stacked the flashcards together, "for every answer you get right, I take off one item of clothing and for every wrong one you do the same," he leaned back, eyes clouded with desire as he looked at his girlfriend. 

Meera's expression changed from doubt, to surprise to finally a cheeky grin. "Not bad Ramsey, not bad at all, but can your old heart survive the surprise that is waiting inside," Meera teases slightly lowering the neckline of her shirt to expose the familiar black lace underneath. 

His hungry eyes wandered over every curve of her body, "game on rookie."

"A 24-year-old patient presents by referral from the ER for evaluation of shortness of breath. On review of the ER records, the patient has presented frequently over the past 4 months with shortness of breath, mild respiratory distress, mild wheezing, and intermittent stridor. Empiric treatment with albuterol and intramuscular epinephrine did not alleviate the symptoms. The symptoms subsided spontaneously each time."

"What about the oxygen saturation, physical exams and vitals?" 

"Oxygen saturations were normal at each presentation. The physical examination and vital signs were also normal."

"Okay that rules out… ," Meera murmures to herself "medical history and any medications?" she asks bringing her voice back to level. 

"Unremarkable and no," Ethan answers without a second glance at the card. 

"Easy," Meera scoffed, "Paradoxical vocal cord motion. Am I right or am I right?" 

Ethan raised an eyebrow and removed his sock and put it on the table as Meera did a little victory dance. 

"Next, a 50 year old man with history of hypertension, seizure and alcohol abuse presents in the ER with persistent cough, fever, chills and difficulty in breathing. On physical exam the temperature is 102.5F, HR 110bpm, and diminished breath sounds in the right upper lobe."

Meera thought in silence turning the information over in her head, "I'd get a chest X-ray"

Ethan's lips curved into a hint of a smile which assured Meera that she was on the right track, "Chest x-ray shows cavitary infiltrate with air fluid level in the right upper lobe." 

"Aspiration Pneumonia?" 

"Is this an answer or a question Dr. Bose?" 

Meera closed her eyes for another ten seconds, "no pulmonary embolism, final answer." 

Ethan turned the card with the smugest smirk in the history of mankind and read out loud, "lung abcess, pay up Bose." 

"Okay okay no need to get too excited," Meera pulled down her ponytail and put the scrunchie on the table. 

"Hey that doesn't count," Ethan protested. 

"Anything that's on me does, next card," Meera rubbed her hands together in excitement. 

Several flashcards and several rounds of questions later the couple lay in each other's arms panting and covered in sweat, each of them recovering from their individual highs. 

"That was freaking amazing!" Meera exclaimed, "I officially declare you the best study buddy!" 

"I am flattered," Ethan replied kissing her forhead, "although next time, try and beat me rookie." 

"What do you mean? I definitely won, you were basically naked, Ramsey." 

"Not more naked than you, Bose." 

"You know what I can beat you all over again, let's have a rematch." 

"Absolutely I am not running out of cards any time soon. Get dressed rookie." 

"Yes doctor," Meera captures his lips in a passionate kiss before getting ready for round two.

Thank you so much if you have read till here, it means the world to me. Hope to see you go on other different adventures with me, Ethan and Meera, till then sending love and hugs your way! ❤️

Taglist : @starrystarrytrouble @mm2305 @charisworld @choicesfanaf @potionsprefect @genevievemd  @shanzay44 @little-flowers-on-heaven @schnitzelbutterfingers  @coffeeheartaddict  @gryffindordaughterofathena @chemist-ana @adiehardfan-deactivated20211021 @custaroonie @ireneadlerisseggsy @takemyopenheart @natureblooms24 @mainstreetreader @lawyerlies @a-crepusculo @quixoticdreamer16 @starryeyedrookie @sincerelyscarring @thebluestonedpendant @kit-rookie-princess @wanderingamongthewildflowers @peonierose

+ @openheartfanfics @choicesficwriterscreations

Please let me know if you want to be added or removed. 💜

#pixelberry choices #pixelberry #choices : stories you play #choices the stories you play #choices stories we play #choices stories you play #playchoices #choices fanfic #choices fanfiction #choices #choices fic writers creations #choices fandom #choices open heart #open heart fanfic #open heart #open heart fanfics #open heart fic #open heart fanfiction #open heart fandom #open heart ethan #dr. ethan ramsey #ethan x mc #ethan ramsey #ethan ramsey x mc #dr. ethan jonah ramsey #ethan jonah ramsey x mc #ethan jonah ramsey #ethan x meera #dr. meera bose #meera bose

[corneliaavenue-ao3]

Bill, please! Give us Bill for diagnosis.

Bill worked in Egypt and in tombs which I am going to equate to caves for many years so he got Malaria from the flies and he got Histoplasmosis from spelunking.

Malaria - prophalaxis is Mefloquine, doxycycline, and atovaquone-proguanil (I did have to google that one to spell it). You need to start prophylaxis 2 weeks before, the entire time during, and 4 weeks after returning from the trip. Symptoms include cyclic fevers, so they will have a fever, be afebrile for 1-2 days, and then get a fever again. They also have vague symptoms like headache and fatigue. To diagnose it you will do a blood smear and see the parasite there. Sickle Cell trait and disease are protective against Malaria!

Histoplasmosis - found in the Ohio River Valley (which is not Egypt but you will have to pretend with me on this one). Symptoms include respiratory symptoms like cough and cavitary lesions in chronic disease. Erythema Nodosum on the shins. Treat with itroconazole or Amphotericin B for disseminated cases. Dx is a blood or urine antigen test

So send me a Harry Potter character, and I will tell you what their disease is

#harry potter diagnosis

[didanawisgi]

#biofilm #covid-19 #sars-cov-2 #microbiome

[lupine-publishers-tooaj]

Lupine Publishers | Multiple Focal Choroidal Excavations in Association with Protein Rich Diet

Introduction

Choroidal excavation is a novel entity that is diagnosed with optical coherence tomography (OCT). In 1959, Klien, et al. [1] first described a concave-shaped chorioretinal abnormality with undifferentiated choriocapillaris and retinal pigment epithelium. Then in 2006, Jampol [2] defined similar changes with OCT and first used the term of focal choroidal excavation (FCE). In 2011, Margolis, et al. [3] described two FCE patterns, based on the shape of the lesions: nonconforming, if the photoreceptors are detached from retina pigment epithelium (RPE) and conforming, when the RPE follows the photoreceptor layer without any optically clear space between the outer retina and RPE. These two forms are also thought to convert to each other during the clinical process of the disease [4]. Although it is known to be mostly idiopathic, its relationship with central serous chorioretinopathy, choroidal neovascular membrane and inflammatory diseases such as multiple evanescent white dot syndrome and Vogt Koyanagi Harada disease has been reported [5]. In this report, we present a patient with multiple focal choroidal excavation following protein-rich diet.

Case

21-year-old male patient applied with blurred vision in his right eye since one week. He was on a protein rich diet since he was doing bodybuilding and had been using approximately 2g/kg/day protein powder since 3 months. His best corrected visual acuity was 0,6 in his right eye (RE) and 0,9 in his left eye (LE). There was no refractive disorder. Slit lamp examination and intraocular pressure were normal. Fundus examination revealed cavitary lesions in the macula of the RE (Figure 1a) and pigmentary changes above the macula of the LE (Figure 1b). OCT showed multiple conforming (Figure 2a) and non-conforming (Figure 2b) type of focal choroidal excavations with small retinal pigment epithelium detachments in the right eye and a small retinal pigment epithelium detachment in the left eye (Figure 2c). When evaluated with fundus autofluorescence (FAF), there have been hypo and hyperautofluorescent areas in the macula of the right eye in accordance with the pigmentary changes (Figure 3a) and hypoautofluorescent area above the macula of the left eye (Figure 3b). Fundus fluorescein angiography showed multiple hyperfluorescent window defects in the macula of the RE and hyperfluorecence consistent with window defect above macula of the LE. There was no ischemia, leakage, macular edema and all vascular structures were normal . Protein powder stopped and the patient was examined 6 months after the diagnosis. No changes in the findings were detected.

Read more about this article : https://lupinepublishers.com/ophthalmology-journal/fulltext/multiple-focal-choroidal-excavations-in-association-with-protein-rich-diet.ID.000158.php

Read More About Lupine Google Scholar:    https://scholar.google.com/citations?view_op=view_citation&hl=en&user=T4c9RDkAAAAJ&citation_for_view=T4c9RDkAAAAJ:blknAaTinKkC

#neuro-ophthalmology #eye diseases #lupine publishers group #ophthalmic history

[lifoviqebo]

Sindromes pleuropulmonares en pediatria pdf

 SINDROMES PLEUROPULMONARES EN PEDIATRIA PDF >>Download (Herunterladen) vk.cc/c7jKeU

  SINDROMES PLEUROPULMONARES EN PEDIATRIA PDF >> Online Lesen bit.do/fSmfG

           31.03.2021 — Antecedentes Patológicos Personales: Síndrome de Down. Se encuentra en Cuidados No lesiones pleuropulmonares. Reportado de grave.04.10.2022 — Síndromes pleuropulmonares #spotlightmed #spotlightmedicine #spotlight #medcoach #medcoaching #medicine #medschool #medstudentlife Examen del Modulo 2 universidad michoacana de san nicolás de hidalgo departamento de idiomas academia de alemán semester prüfung menschen b1 modul briefe.Die Gegenstände - Das Möbel 1.- Das ist mein Schrank es ist studocu.com › es-mxstudocu.com › es-mx Síndromes pleuropulmonares #spotlightmed #spotlightmedicine #spotlight #medcoach #medcoaching #medicine #medschool #medstudentlife #medstudent #enarm Das könnte Ihnen auch gefallen. SINDROMES PLEUROPULMONARES. Monserrat Diaz Zafe. 2 - Semio Torax. Angela Angel. Examen Físico de Tórax. José Luis Padgett. SÍNDROMES PLEUROPULMONARES CONDENS ATELECTA CAVITARI RAREFACC DERRAME NEUMOTO ACION SIA O ION PLEURAL RAX Mov. Resp. Vib. Vocal. Ruido Mate Mate Hiperclar

https://www.tumblr.com/lifoviqebo/698064450909061120/matura-maj-2011-matematyka-arkusz-pdf, https://www.tumblr.com/lifoviqebo/698063554431057920/they-say-i-say-pdf-templates-s, https://www.tumblr.com/lifoviqebo/698063554431057920/they-say-i-say-pdf-templates-s, https://www.tumblr.com/lifoviqebo/698063816320253952/churchill-1979-scale-development-pdf, https://www.tumblr.com/lifoviqebo/698064450909061120/matura-maj-2011-matematyka-arkusz-pdf.

[ijcmcrjournal]

Mycobacterium Paraffinicum: A Rare Non-Tuberculous Mycobacterium Pulmonary Infection by Santiago HOC

Abstract

Introduction: Mycobacterium paraffinicum has been isolated from numerous soil samples from widely distributed oil fields. In 1971 M. paraffinicum was not considered a legitimate Mycobacterium species because of the phenotypic confusion with M. scrofulaceum. However, after an extensive molecular sequence analysis in 2010, it was finally reincorporated into the taxonomy.

Case presentation: An 85-years-old, former smoker man came to the emergency department complaining of worsening exertional dyspnea of several months of evolution. A chest CT scan revealed a large cavitary lesion associated with multiple smaller nodes with central cavitation throughout both lung fields. A flexible bronchoscopy was performed and the bronchoalveolar lavage culture was positive for M. paraffinicum.

Conclusion: To our knowledge there are only two published cases of pulmonary infection by this pathogen. To date there is no standard drug therapy regimen for M. paraffinicum infection. More research and development are needed in this field as to improve diagnostic and treatment for this rare disease.

Keywords: Mycobacterium paraffinicum; Taxonomy; Flexible bronchoscopy; Nontuberculous mycobacterium

Abbreviations: AFB: Acid Fast Bacilli; NTM: Nontuberculous Mycobacterium; RIPE: Rifampin Isoniazid Pyrazinamide Ethambutol; PPD: Purified Protein Derivative.

Introduction

Mycobacterium paraffinicum has been isolated from numerous soil samples from widely distributed oil fields [1]. Originally isolated in 1956 and described as a long, slender, strongly acid-fast rods showing Much's granules with Ziehl-Neelsen stain; which produced yellow, waxy, wrinkled colonies. In 1971 M. paraffinicum was not considered a legitimate Mycobacterium species because of the phenotypic confusion with M. scrofulaceum. However, in 1991 a review of rarely encountered mycobacterial diseases acknowledged that it had obviously different biochemical responses from M. scrofulaceum and after an extensive molecular sequence analysis in 2010, it was finally reincorporated into the taxonomy [1]. Investigation of antimicrobial susceptibility was done, and results showed that M. paraffinicum’ strains were susceptible in vitro to rifabutin, linezolid, clarithromycin, and amikacin [2].

Case Presentation

We present an 85-years-old, former smoker man with a past medical history of colon adenocarcinoma status post colostomy, hypertension, hypothyroidism, and glaucoma complaining of worsening exertional dyspnea of several months of evolution. He denied cough, unintentional weight loss, fever, chills, night sweats, hemoptysis recent travel, and exposure to tuberculosis, asbestos or silica. Physical examination was unremarkable. Initial chest CT scan revealed a large cavitary lesion of approximately 4.5x4.2 cm, in addition to multiple smaller nodes with central cavitation throughout both lung fields (Figure 1). PPD skin test was negative. PET-Scan showed increased FDG concentration with uneven distribution on the upper lobe posteromedial aspect of right lung with a maximum SUV of 12.3. A flexible bronchoscopy was performed and the bronchoalveolar lavage sample was positive for Acid Fast Bacilli smear (AFB), for which he was started on RIPE therapy. Unexpectedly, AFB culture revealed M. paraffinicum growth and thus, RIPE therapy was discontinued and intravenous imipenem, azithromycin and amikin were started. In view of adequate clinical response, he was discharged approximately one month later with azithromycin and ciprofloxacin. Subsequent chest CT scan was performed 3 months later in which marked improvement was noted compared with the previous images.

Figure 1: (A) CT thorax with (B) sagittal and (C) coronal views showing a large cavitary spiculated mass seen in the dependent portion of the superior aspect of the right lower lobe with surrounding sub-centimeter branching centrilobular nodules.

Discussion

M. Paraffinicum is a slow growing mycobacterium, and a rare cause of clinical Nontuberculous Mycobacterium infection (NTM). It was initially described in pseudo outbreak; however, it is capable of causing symptomatic lung disease [3]. To date, little is known about its pathogenic potential, drug susceptibility profile, and treatment outcome. To our knowledge there are only three published cases of pulmonary infection by this agent, all treated with similar antibiotic regimen with adequate clinical response [1,4,5]. More research and development are needed in this field as to improve diagnostic and treatment for this rare disease.

Conclusion

To date there is no standard drug therapy regimen for M. paraffinicum infection. More research and development are needed in this field to improve diagnostic and treatment for this rare disease.

Acknowledgement

We would like to thank all the other staff from Auxiluo Mutuo Hospital and San Juan City Hospital who have contributed to this case report.

For more information about Article : https://ijclinmedcasereports.com/

https://ijclinmedcasereports.com/ijcmcr-cr-id-00129/ https://ijclinmedcasereports.com/pdf/IJCMCR-CR-00129.pdf

#Acid Fast Bacilli #Nontuberculous Mycobacterium #Rifampin Isoniazid Pyrazinamide Ethambutol #Purified Protein Derivative. #Santiago HOC #IJCMCR #clinical studies

[truckcompliance]

To save you time, we've put together a list of the best Refractories Companies in Dubai, UAE. These cavitary businesses are well-known for providing excellent service at reasonable prices. So, whether you're searching for an Iron & Steel Company for residential or industrial use, you can just check through their list and acquire the product without worrying about your finances!

#Refractories

[mcatmemoranda]

Today, the fellow went over how to read chest X-rays with me, which is good because I need to review that.

First, you need to determine whether it's an anteroposterior (AP) or posterior-anterior (PA) view. That just means whether the X-ray was taken from the front (AP) of the pt or the back (PA) of the pt. The heart will look enlarged on an AP view, so the PA view is better to determine whether or not the heart is actually enlarged. The scapulae are further out in a PA view than an AP view. The PA film also comes with the lateral view.

Then you want to say whether there is good inspiratory effort. If you can see at least 8 to 10 ribs, then you know the pt had good inspiratory effort. If you see more than 10 ribs, there is hyperinflation (e.g., COPD, where you would also see a flattened diaphragm).

Next you say whether the film is well penetrated, over-, or underpenetrated. In a good CXR, you can see the spinous processes and as you go down the spine towards the diaphragm, you should be able to see the intervertebral discs. If you can't see the intervertebral discs near the diaphragm area (i.e, it's all just white, you can't see any less dense areas between the vertebral bodies), then the film in underpenetrated. If you can see the discs too much (black spaces between the vertebral bodies), then the film is overpenetrated.

Determine whether or not the pt is rotated. You do this by looking at the distance between the spinous processes and the clavicular heads. If you're looking at a PA view, the side with the clavicular head further from the spinous processes is the side to which the pt is rotated. It makes sense if you just think about the anatomy--if you are rotated to the left, the left shoulder is further behind you than the right one, so the space between the left clavicular head and the spine will be greater than the space between the right clavicular head and the spine. If the distance between both clavicular heads and the spine is the same, then it's well aligned.

Next look at the bones. Look for any rib fractures. If there were a rib fracture, you would also look for a pneumothorax (broken ribs can puncture the pleura).

Next, look for any hardware (e.g., ET tube, lines, etc.)

Then look at the soft tissue. You can appreciate the pt's body habitus based on the amount of soft tissue there is (e.g., you could say an obese pt has abundant soft tissue). Look for any soft tissue masses.

Next, look at the heart. The heart should be 1/3 on the left and 2/3 on the right with respect to the spine. Also look at the mediastinum (the space between the lungs); see if it looks enlarged.

Then look at the lung parenchyma. Talk about the upper, middle, and lower zones of the lungs, the costophrenic angles, the hila, any opacities/nodules.

A pt we have today has chronic bronchiectasis and came in C/O hemoptysis. He has a history of smoking marijuana, vaping, and snorting cocaine. The damage to his lungs is what caused the bronchiectasis, so any irritation to the lungs now can trigger an exacerbation of it (more hemoptysis). He also had a left lower lobe wedge lobectomy due to a cavitary lesion that may have been an aspergilloma, but turned out not to be. Before he had the lobectomy in 2016, you could see air crescent sign on his CT scan. In his current CXR, the heart is more shifted to the left in this pt (probably becaue of the left lower lobectomy/atelectasis, which draws the lung to the same side).

The air crescent sign (ACS), also called the meniscus or cap sign, appears on radiographs or computed tomographic scans of the chest as air interposed between an intracavitary, ball-like mass and the cavity wall. Its shape ranges from crescent-like to that of total encapsulation,2 and its volume varies greatly.

An air crescent sign describes the crescent of air that can be seen in invasive aspergillosis, semi-invasive aspergillosis, or other processes that cause pulmonary necrosis. It usually heralds recovery and is the result of increased granulocyte activity.

It should not be confused with the Monod sign 2 which describes the air that surrounds an aspergilloma. Unfortunately, the air around the fungal ball is also crescent-shaped and the term air crescent sign is often used interchangeably in that instance - opinion as to the validity of this latter use is controversial.

The Monod sign (often misspelt Monad sign) simply describes gas that surrounds a mycetoma (most commonly an aspergilloma) in a pre-existing pulmonary cavity 1-3.

It should not be confused with the air crescent sign which is seen in recovering angioinvasive aspergillosis 4. The air crescent sign heralds improvement in the condition.

In practice, it is likely that the term Monod sign will receive blank stares. The gas around the mycetoma is often crescent-shaped and hence, the term air crescent sign is used interchangeably by many to refer to both pathological processes.

For a pt with a bronchiectasis exacerbation, you want to limit the pt's coughing so he doesn't worsen the bleeding. This can be done by giving dextromethorphan, a cough suppressant. The pt should also lay on the side of the bad lung so that if he coughs up blood, it doesn't go into the other lung.

Ground Glass Opacity (GGO) in one area can be active alveolitis. Infiltrates on the CT means he needs antibiotics (and he was given cefepime). Have to rule out infection (his Quantiferon is negative and he's not immunosuppressed, so the Quantiferon is good; he also got acid fast bacilli [AFB] culture x3).

Histomplasmosis can cause calcified nodules called "histoplasmomas."

Histoplasmoma is the name for a specific kind of nodule secondary to granulomatous reaction to histoplasmosis infection often described as having a pathognomic target lesion appearance. Histoplasmomas can appear in the lungs or central nervous system. Although classically conceived as a solitary lesion, there are reports of multiple histoplasmomas in a single patient 1. Histoplasmomas vary in size and may grow over time, and can even exceed the technical definition of a pulmonary nodule's size (i.e. greater than 3 cm) 3.

The fellow also taught me about dosing for heparin. Heparin drip is given for pulmonary embolism. I think she said you have to check the PT/PTT every 6 hours when the pt is on heparin drip and the number should be 60. Heparin can be reversed quickly.

LMWH (enoxaparin [brand name Lovenox]) therapeutic dose is calculated by taking the pt's mass in kg and giving them that number in mg/mL subQ every 12 hours.

#CXR #air crescent sign #bronchiectasis #lung nodule #pulmonary nodules #heparin #heparin dosing #LMWH #pulmonary #pulmonology

[teachingrounds]

The disease spectrum of chronic, pulmonary aspergillosis runs from localized aspergilloma to progressive destructive cavitary disease. Patients with chronic aspergillosis may be entirely asymptomatic, or they may have mild constitutional symptoms such as fever, malaise, and weight loss. Suspect chronic aspergillosis in immunosuppressed patients and/or those with preformed lung cavities due to tuberculosis, emphysematous bullae, or lung surgery. By contrast,allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis.

For more info, see Chest. 2014;146(5): 1358-1368; and European Respiratory Review 2011; 20: 156-174.

Image: Yale Rosen, "Aspergilloma Complicating Tuberculosis," Wikipedia. "Cavitation in tuberculosis is the result of necrosis of lung tissue that is then extruded through a communicating bronchus thus forming an air-filled cavity. In this specimen the fungus ball exhibits areas of retraction from the wall of the cavity resulting in the presence of air between the fungus ball and cavity wall; this forms the basis for the diagnostic 'air-crescent sign' seen in imaging studies. The bronchus that communicates with the cavity is well demonstrated."

#TeachingRounds #FOAMed #pulmonology #infectious disease #ID

[missnoodliness]

Pathology Rotation

This is a weird rotation in many regards. I am very skeptical by nature and was very unsure that I would like this rotation. My hours were typically within the 8-5 range which made me and Coriander very happy.

Most days I spent my mornings doing clinical pathology

I made blood smears, cytology preps of tumors, cytology prep of cavitary fluids, doing manual white blood cell differential counts which is great except for when it isn’t, made urine preparations for sediment analysis. The list goes on.

We also did a lot of labwork analysis. This meant we pooled data from a patient’s CBC, Chemistry, VBG, urinalysis +/- coags +/- extra testing and tried to explain every minor elevation or decrease. I spent a lot of time on eClinpath trying to remember how living beings function on a biochemical level. We had these cases on an almost daily basis with in depth assignments that we then had to present to our classmates the following day, plus clinical skills competencies we have to pass to graduate, plus we would have slides assigned to be completed on our own time for practice so that we could talk about them as a group. We also had a midterm exam and a final exam. These were each a very in-depth case which took me a considerable amount of time and whose write-ups totaled 9 pages each. This portion of the rotation made me feel like I was swamped.

In the afternoons, we drove to our diagnostic laboratory and biosecure facility for necropsy. I enjoyed this part of my rotation more than I thought I would. The staff and faculty were extremely relaxed and welcoming. I did not feel out of place here. I of course called dibs on any non-traditional companion animals and my classmates were more than happy to oblige me. It also gave me a chance to really shine in rounds because hardly any of my classmates know differentials for these critters.

My family was surprised that this rotation did not bother me, but I think the veterinary community has a very different view on death than the average person. Being surrounded by death all day was a non-factor for me (aside from the smell) and it felt more like being an investigator than anything else.

Most of our caseload was comprised of cats, dogs, and cows, but there was so much more:

A Russian domesticated fox – primary pancreatic carcinoma with serosal, hepatic, and pulmonary metastasis

Bison bull calf with heavy Trichuris parasitism and BVDV

Hedgehog with Wobbler’s Syndrome – unknown cause but cool to look at on histopathology

A rabbit with severe dehydration

A wallaby joey with e.coli related septicemia

A macaw with an unknown diagnosis

A ball python with Spider Wobble

A Colobus with uterine adenocarcinoma

A mouse from our research lab on campus with mammary carcinoma

We had two assignments for this portion of the rotation related to necropsy sampling for a given case (I chose a meat rabbit case) and a diagnostic toxicology case. What I now know is that Zinc Phosphide is scary and humans need to be more careful about how we bait ‘pest’ species. A lot of these toxins can end up in our wild birds.

Aside from being constantly swamped with work, this was good information for my upcoming NAVLE which I take 12/9. The anxiety is setting in and it feels as though there is absolutely no way in the world I will be prepared for it. I am tossing around the idea of getting a piercing or tattoo following it to reward myself.

On a brighter note, my next rotation is a small animal externship where I take Coriander for his veterinary care. They are a very dedicated group of vet professionals that I am excited to work with. Bring on the critters!

#vetblr #vet med #vet student #pathology #necropsy #dead #dead animals #euthansia #death #clinical pathology #future dvm #anxiety #pre NAVLE #7/8 #i cannot wait to be done with this

[carnival-phantasm]

Bad news...

I've finally been able to talk on the phone with one of the vets that consulted my dog. According to them they suspect of cavitary hemangiosarcoma in his liver, which is terrible news, plain and simple. It's a cancer that has terrible prognosis when it inflicts visceral organs and even when surgery is possible, dogs don't usually live much longer than very few months.

We'll still need to do the exploratory laparotomy to see the how it looks. If it's operable, we'll also do the histopathologic test to see what we have. I'm praying it's not hemangiosarcoma, because in that case it's no longer a matter of money.

Either way I will try to go to my parents town this weekend. Hopefully it won't be to say goodbye to Don.

#sorry for the downer #don #text #i'm forever thankful for he kind messages and support you all have been giving me

[eclecticsublimenacho-blog]

Sad Lung Noises

Student: Why do we hear bronchial breathing in cavitary lesions in lung?

Professor: Because Normal lung acts as low frequency pass filter, but cavitary lesion the lung loses it ability to remove higher frequency and allow low frequency.

#bronchial respiratory medical auscultation

[dogtornugget]

Nov 19, 2019

Today was my first necropsy in over a week so it took me a hot second to think about things and remember things. But overall I think it was fine. I remembered to weigh the heart and liver this time so that’s a bonus.

I had a cat (unknown age, feral) that I believe had just died on its own? It came in with another cat, I guess this lady just takes care of some feral cats. My classmate’s cat had a lot going on. It had tri-cavitary effusion, it’s liver was nasty, it’s lungs were weird... Mine was pretty boring, tbh. It had some edematous lungs that’s for sure, and the intestines were thickened. Also both had roundworms. Otherwise I didn’t have much to say about my cat. I put the pulmonary edema on the top of the list for morphs since I felt it had to have been the most pertinent information regarding the demise of this cat. I think I put the intestinal thickening second and the parasitism third. I figured maybe IBD or GI lymphoma for the intestines. Who knows? I guess I can check back in and see what they say in a few days about what they find on histopath.

Also I’m 13 days from NAVLE. I’m simultaneously feeling like I know nothing and like I can barely study any more. I just hope I pass the first time and don’t have to deal with the struggle of going again. I know there’s no shame in it, but mentally that would really eff me up if I had to do it again.

#dogtor nugget #dr nugget #veterinary #vet #veterinarian #vet student #veterinary student #diagnostics #necropsy

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5 Points You're Possibly Doing Wrong In The Shower.

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