This will likely not even be amusing to anyone not in the medical fields, but we got to watch it during cardio physiology the other day and couldn't stop laughing. It's describing a phenomenon called Wenckebach or AV Block Second Degree. Basically what happens is your atria depolarize normally but sometimes the conduction to the ventricles gets skipped and you lose ventricular depolarization for that cardiac cycle.
Cardio is great - I'm really enjoying it overall, and it makes a whole lot of sense (which is a relief since the exam is next week!).
Anatomy is still messy and gushy as always - we're now in the abdominal cavities of our cadavers and are comparing GI tracts which are very different from each other as well as the dog and cat. The ruminants (goats and calves) have huge multi-chambered stomachs and a very looooong jejunum and large intestine. The large intestine even does this awesome coil at one point! The horse is just weird and has an expanded cecum and long, torturous, winding large intestine which makes you realize why they colic so much (10% of horses annually!). Also, our goat is pregnant so we're really excited to start the reproductive tract dissections in a few weeks to see the placentation of the uterus.
The class is chugging along as a whole. The consensus is that immunology isn't the greatest class ever - it's way too condensed and chopped for the density of information. Some things (like biochemistry or immuno) are actually easier to understand if you have to learn and memorize a ton of details. It makes everything clearer in the end. This course is being taught as a very broad overview of a lot of things and it isn't going to have that nice neat moment of clarity at the end. Oh well. Exam also is coming up early next week, so this weekend will involve a lot of book-time.
On a non-class related note, I'm trying to eat a little better this semester and stick with salad every night for dinner when possible. I don't care much for the three or four pounds I've gained since vet school. I wish I had the willpower to give up the lunch meetings but it's one of my favorite things during the day!
Wednesday, January 26, 2011
Wednesday, January 19, 2011
Fun facts!
What I learned in cardiology today:
Ventricular fibrillation = heart spazzing out = death sentence
Atrial fibrillation = heart spazzing out but significantly less = can normally function
Also, ECGs are crazy-awesome in how much they can tell us but are also going to be crazy-tricky to really get a handle on reading. And if you mess up on reading ectopic ventricular contractions and give lidocaine to fix a non-existent problem, you'll end up severely compromising or killing your patient. Huh.
Ventricular fibrillation = heart spazzing out = death sentence
Atrial fibrillation = heart spazzing out but significantly less = can normally function
Also, ECGs are crazy-awesome in how much they can tell us but are also going to be crazy-tricky to really get a handle on reading. And if you mess up on reading ectopic ventricular contractions and give lidocaine to fix a non-existent problem, you'll end up severely compromising or killing your patient. Huh.
Tuesday, January 18, 2011
Productivity...?
First week down and it's time to get serious! It was super-difficult to get motivated to study much in the past week - we just started, had a few snow delays, not much coming up exam-wise, boy was here this weekend, etc. Plenty of excuses and justifications for that. Now that the first week is over, I think it's high time to get started with the hard-core studying routine.
So far classes are going great - no major duds or anything thus far!
Physiology - LOVING it! We're doing cardiac physio to start the semester, and I'm actually really liking it so far. The notes are clear and really interesting, so it's the perfect way to start the day at 8 am.
Anatomy - Now that we're in large animal/comparative anatomy, the labs are definitely a LOT messier! We're doing dissections on a calf, pony, and goat in each group and are using pig pro-sections for additional comparison. We are FLYING through material, too. A lot of it sounds at least familiar or similar to last semester but there are also a lot of changes. Not quite sure how to think about or approach the exams yet, so we'll see how this one goes. But the lectures and textbook are very entertaining thanks to the guy teaching!
Virology - Just had one lecture of this so far, and the professors seem really great and enthusiastic. I don't know too much about viruses yet, so I'm excited to learn more.
Immunology - I had a pretty in-depth course in undergrad, so this seems like cake right now. I'm actually really thankful I have a background in what we're doing in the course, because they're flying really quickly through the material. Our labs are going to consist of small group case discussions which will hopefully give some good practical skills to go along with the book learning.
Embryology - Also a new subject to me, but it seems very straight-forward and the teacher is very sweet. Only have this one once a week, so I doubt it'll be too intensive.
Behavior - Eh. Seems pretty basic and simple so far (even though it's not really my cup of tea), but we do have to complete an animal training project. And since I have no animals here to speak of I'll need to attach myself to a friend and their dog to finish it.
Production Medicine - More of the same from last semester. We get an additional lab with each of the major large/food animal species, and it seems like this semester has a slight focus on nutrition for each species.
And that's it! It's been great to get back into a routine and see my classmates after a long hiatus. Winter break was definitely super-long now that I think about it, and I'm ready to start the learning process again. I've also managed to get a lot of my summer research project squared away - I'll (hopefully) be studying epithelial to mesenchymal cell transition in pulmonary tissue. That's a change that occurs frequently in fibrosis disease patterns, and there's a new gene of interest that controls a lot of this process that is actually considered a cancer gene. Should be interesting!
So far classes are going great - no major duds or anything thus far!
Physiology - LOVING it! We're doing cardiac physio to start the semester, and I'm actually really liking it so far. The notes are clear and really interesting, so it's the perfect way to start the day at 8 am.
Anatomy - Now that we're in large animal/comparative anatomy, the labs are definitely a LOT messier! We're doing dissections on a calf, pony, and goat in each group and are using pig pro-sections for additional comparison. We are FLYING through material, too. A lot of it sounds at least familiar or similar to last semester but there are also a lot of changes. Not quite sure how to think about or approach the exams yet, so we'll see how this one goes. But the lectures and textbook are very entertaining thanks to the guy teaching!
Virology - Just had one lecture of this so far, and the professors seem really great and enthusiastic. I don't know too much about viruses yet, so I'm excited to learn more.
Immunology - I had a pretty in-depth course in undergrad, so this seems like cake right now. I'm actually really thankful I have a background in what we're doing in the course, because they're flying really quickly through the material. Our labs are going to consist of small group case discussions which will hopefully give some good practical skills to go along with the book learning.
Embryology - Also a new subject to me, but it seems very straight-forward and the teacher is very sweet. Only have this one once a week, so I doubt it'll be too intensive.
Behavior - Eh. Seems pretty basic and simple so far (even though it's not really my cup of tea), but we do have to complete an animal training project. And since I have no animals here to speak of I'll need to attach myself to a friend and their dog to finish it.
Production Medicine - More of the same from last semester. We get an additional lab with each of the major large/food animal species, and it seems like this semester has a slight focus on nutrition for each species.
And that's it! It's been great to get back into a routine and see my classmates after a long hiatus. Winter break was definitely super-long now that I think about it, and I'm ready to start the learning process again. I've also managed to get a lot of my summer research project squared away - I'll (hopefully) be studying epithelial to mesenchymal cell transition in pulmonary tissue. That's a change that occurs frequently in fibrosis disease patterns, and there's a new gene of interest that controls a lot of this process that is actually considered a cancer gene. Should be interesting!
Tuesday, January 11, 2011
Semester Two - GO!
We started our second semester bright and early on Monday morning...and then proceeded to have an ice day today and a delayed opening already on the books for tomorrow. The whole doing-nothing thing is great, but at this point I'm just ready to get back to a schedule. We started our anatomy lab dissections yesterday (large animal this time!), and diving into a goat, horse, and cow is much sloppier than with cats and dogs. Definitely wearing my rubber boots to lab this semester! Other than that we had a brief intro to cardiovascular physiology in the morning and embryology in the afternoon - nothing too taxing. Overall the semester looks like a lot of fun with comparative anatomy, physiology (cardio, pulmonary, renal, gastrointestinal), virology, embryology, behavior, immunology, and more production medicine on the docket.
Christmas break was great between seeing family and friends, spending lots of time with the boy, and shadowing back at the home vet hospital for a few days. It was a really weird transition to not be in a classroom each day or be studying in my apartment each night. Vet school goes quickly but you really do feel as though you've been there forever after only a few days.
I also came back to Raleigh in time to work with the neurology department in the teaching hospital for a week. LOVED it! I'm really having the very serious problem of falling in love with some aspect of every new bit of vet med I encounter. It's not helping the whole "figure out what I want to do with my life" issue. Once again, the senior clinicians and residents were amazing and the fourth-year students were so helpful and great to learn from.
Some of the top things I learned in neurology that week?
1) Neurologists get to actually perform surgery in addition to handling non-invasive cases! Totally did not know that those procedures aren't done by the hospital surgeons. I got to scrub in and watch several hemilaminectomies performed by the neuro residents. These involved slowly drilling away the vertebral bone covering the spinal cord and removing the herniated vertebral disc out of a tiny surgical window. Super delicate work!
2) Use of an MRI is commonly used in a full neuro work-up (yes, even in animals). The imagery is absolutely amazing, and the use of different contrasting agents or exposures lets the physician visualize different things on different views. The use of a single contrasting agent allowed us to perfectly see a hemorrhagic brain lesion in a seizing dog!
3) "Grand mal" is kind of an outdated way to describe seizures. Who knew!
4) Phenobarbital and bromide, the two main drugs of choice for a lot of neurological conditions, are both over 100 years old and still going strong.
5) Neuro sees a lot of dachsunds. A loooot. The breed has vertebral discs that actually calcify by a young age, so instead of being springy and jelly-like and normal, they get hard and brittle and kind of unhappy. Then they like to slip out into the vertebral canal and put pressure on the spinal cord rather than staying where they belong. About 25% of the breed actually develops clinical signs from a herniated disc during their lifespan!
6) Orthostatic tremors are tremors that occur only when the patient is standing still and disappear when prone or moving.
7) I actually probably should remember all of those cranial nerves from anatomy - testing their function is one of the first steps of a neurological exam! Poor functioning of a nerve could indicate a brain lesion in a specific location.
8) Both cancer and an infectious process (like meningoencephalitis) can show up on an MRI in a similar way. At that point, performing a spinal tap to remove and then study cerebrospinal fluid (CSF) is a good diagnostic tool.
9) Loss of deep pain requires a very traumatic and complete lesion or injury and is associated with a much poorer prognosis for the patient.
10) Isolating where a neurological problem is occurring is very much like a puzzle or mystery. Is it peripheral or central? Brain or spinal cord? Complete or unilateral? Which vertebrae? Which part of the brain? Which nerve? You have to use observation, tests, and sometimes a little diagnostic imaging to find the problem and only after it's found can you think about fixing it. Pretty cool!
Tonight my goal is to get some paper reading done and finish my research proposal write-up for my summer work. I've been putting it off out of sheer Christmas laziness, but that is definitely not an excuse anymore!
Christmas break was great between seeing family and friends, spending lots of time with the boy, and shadowing back at the home vet hospital for a few days. It was a really weird transition to not be in a classroom each day or be studying in my apartment each night. Vet school goes quickly but you really do feel as though you've been there forever after only a few days.
I also came back to Raleigh in time to work with the neurology department in the teaching hospital for a week. LOVED it! I'm really having the very serious problem of falling in love with some aspect of every new bit of vet med I encounter. It's not helping the whole "figure out what I want to do with my life" issue. Once again, the senior clinicians and residents were amazing and the fourth-year students were so helpful and great to learn from.
Some of the top things I learned in neurology that week?
1) Neurologists get to actually perform surgery in addition to handling non-invasive cases! Totally did not know that those procedures aren't done by the hospital surgeons. I got to scrub in and watch several hemilaminectomies performed by the neuro residents. These involved slowly drilling away the vertebral bone covering the spinal cord and removing the herniated vertebral disc out of a tiny surgical window. Super delicate work!
2) Use of an MRI is commonly used in a full neuro work-up (yes, even in animals). The imagery is absolutely amazing, and the use of different contrasting agents or exposures lets the physician visualize different things on different views. The use of a single contrasting agent allowed us to perfectly see a hemorrhagic brain lesion in a seizing dog!
3) "Grand mal" is kind of an outdated way to describe seizures. Who knew!
4) Phenobarbital and bromide, the two main drugs of choice for a lot of neurological conditions, are both over 100 years old and still going strong.
5) Neuro sees a lot of dachsunds. A loooot. The breed has vertebral discs that actually calcify by a young age, so instead of being springy and jelly-like and normal, they get hard and brittle and kind of unhappy. Then they like to slip out into the vertebral canal and put pressure on the spinal cord rather than staying where they belong. About 25% of the breed actually develops clinical signs from a herniated disc during their lifespan!
6) Orthostatic tremors are tremors that occur only when the patient is standing still and disappear when prone or moving.
7) I actually probably should remember all of those cranial nerves from anatomy - testing their function is one of the first steps of a neurological exam! Poor functioning of a nerve could indicate a brain lesion in a specific location.
8) Both cancer and an infectious process (like meningoencephalitis) can show up on an MRI in a similar way. At that point, performing a spinal tap to remove and then study cerebrospinal fluid (CSF) is a good diagnostic tool.
9) Loss of deep pain requires a very traumatic and complete lesion or injury and is associated with a much poorer prognosis for the patient.
10) Isolating where a neurological problem is occurring is very much like a puzzle or mystery. Is it peripheral or central? Brain or spinal cord? Complete or unilateral? Which vertebrae? Which part of the brain? Which nerve? You have to use observation, tests, and sometimes a little diagnostic imaging to find the problem and only after it's found can you think about fixing it. Pretty cool!
Tonight my goal is to get some paper reading done and finish my research proposal write-up for my summer work. I've been putting it off out of sheer Christmas laziness, but that is definitely not an excuse anymore!
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