Monday, October 5, 2009

Before the storm

This week has been one massive heart-throbbing head-splitting race to study for the first examination of second year medicine - Pathobiology of Disease (PBD). Yesterday, in the final throes of serious crammage, I had some genuinely gratifying moments. For a few brief seconds, I felt competent.

Andy: So, are you partying tonight?

Sandlot: I don't know. It all depends on my friend. He went to the doctor because he thought he might have bronchitis. So, if he does, then obviously not.

Andy: Bronchitis.

Sandlot: Yup.

Andy: Apparently, most people expect antibiotics for bronchitis, and they get them even though they're mostly viral.

Sandlot: Oh yeah? Then what are you supposed to get?

Andy: They're mostly self-resolving.

Sandlot: But how long does it take to self-resolve?

Andy: I forget... like a week?

Sandlot: 'Cause he's had it for a month.

Andy: What kind of symptoms does he have? (I'm like reviewing at your friend's expense)

Sandlot: Hmm... from what I remember, cough... mucous... his ears started to get plugged. That's all I can remember.

Andy: Maybe he has a bacterial sinusitis. The only thing I can remember right now is to suspect bacterial sinusitis if cold-like symptoms persist for more than 5-7 10-14 days.

Sandlot: What's bacterial sinusitis?

Andy: It's like an infection of the air spaces around your nose.

Sandlot: But his nose isn't affected?

--- about an hour later ---


Andy: BAM! I think I should stop studying now.

After all those hours of studying, my brain felt like it was liquefying. My MSN status message at that time read: Liquefactive necrosis of the brain.

Stewie: I would've thought it would be coagulative... PBD-induced ischemia!

Andy: Is it coagulative in the brain too? I know you can get liquefactive in the brain - not sure what it's from. I know coagulative is like MI.

Stewie: Liquefactive I thought has to be bacterial or fungal.

--- several minutes later ---

Stewie: Oh damn, nevermind. You're totally right.

Stewie: "For unclear reasons, hypoxic death of cells within the central nervous system also results in liquefactive necrosis."

Andy: Haha, win!

And, of course, we all spent a fair share of time stressing out over our practice runs through past exams.

Kushima: I continually achieve new records in dealing with procrastination, which is what I meant by the squeeze phrase.

Kushima: For which one of the following skin diseases would a topical anti-fungal agent be most appropriate as treatment?

a) Atopic dermatitis
b) Psoriasis
c) Scabies
d) Tinea corporis
e) Zoster (shingles)

Kushima: Try this question.

Andy: Hmm... not E and not C. I am tempted to say A, but it sounded like that might not be right. D?

Kushima: Hah, I have no clue. Make up your mind.

Andy: D.

Kushima: Yes.

Andy: w00t!

Kushima: Good job. Looking at the question I can't recall even a single fact about any of those options.

Andy: Herpes zoster is a virus. Scabies is a parasite... little bug. Atopic dermatitis is eczema.

Kushima: Hmm, yeah, I forgot about those.

Kushima: Which one of the following principles is most important in ensuring maximum benefit from antibiotic treatment in the management of septic shock?

a) Administration 30 minutes before corticosteroids
b) Administration in conjunction with inotropic agents
c) Administration of synergistic combinations
d) Administration through a central venous access line
e) Administration within 2 hours of the onset of hypotension

Kushima: Try one more.

Andy: Uh... I have no idea. E?

Kushima: Damn, you're a good guesser.

I got the bonus question on the 2008 exam also.


shirls said...

LOL! Brilliant!

Haircut time?

a_ndy said...


Joyce said...

LOL! You are full of win!

sandlot said...

wow... if only all exams had that question.

anyway, you're on your way to become dr. awesome. my friend was very impressed with your diagnostic skills.

a_ndy said...

Hopefully, they will only improve with time (and by improve I mean less guessing and um-ing).