Now that I've passed the midterm point of Diagnostic Imaging II, I believe I feel confident enough to start refering to diagnostic imaging as dxi, pronounced "die-eye" LOLI think I did reasonably well on today's dxi midterm, probably better than the average. I think I'll get a grade of B or B+. I'd be sorely disappointed with anything less than a B and quite ecstatic with an A! :)
Ironically enough, the pic I had in yesterday's blog of osteitis condensans ilii (OCI) was on the exam and I kind of figured it would be but, when I read the differential of the question I wrote down an answer of OCI even before we saw the corresponding x-ray on screen. Seeing the x-ray on screen simply confirmed what I already knew BUT ...I may have been a little too cocky because had I actually *read* the entire question (according to other people) the question asked what question we should have asked the patient about their past and, of course, that question would have pertained to the patient having any multiple full term pregnancies. So, I probably took a hit on that question.
These dxi exams are some of the most interesting test we take. They've got a little bit of everything in them starting with slides we must answer questions about in both multiple choice and fill in the blank format. After the slides we have the written portion of the exam which also includes multiple choice, fill in the blank and matching.
There was a purportedly great "Money pony" document consisting of a collection of factoids which were supposed to be strongly correlated with this exam but, upon completion of the exam I quickly concluded that money pony was worth maybe 34 cents and anybody that solely relied on it for their preparation will probably be disappointed with their grade. Our tutor told us flat out, ahead of time, that even with the pony people still got D's and F's last semester.
For readers unfamiliar with the term "pony" it's a loosely used acronym which stands for test which students "Pass On to Next Year"
The money pony had 7 matching questions on it but, I was able to build that up in the preceding days to encompass over 50 matching questions in a nice little table format. I'm certain with a little more preparation and discipline and I can improve upon all the scores I got on these midterms come finals.
Exams are good. Up until now it's kind of like shadow boxing and never getting hit. These test hit us and punch us and bloody us up and help us focus our efforts. Fortunately, I didn't perceive any low blows this semester and whatever grades I got were pretty much what I deserved.
Quite often and usually around New Years Eve many people resolve to do better but I can't wait until New Years Eve. I was thinking today of how that resolve has to be a daily event. One in which each day is perceived as a wellspring of great opportunity for improvements. Thinking further I've contemplated the notion that each moment needs to be looked at in that manner. An omnipresent attitude of hope is good but also seems to require a larger picture view to take in account for things like exhaustion and various activities of daily living.
Speaking of exhaustion, yesterday's nap didn't turn out so well, mainly due to soliciting phone calls, but I was in a horizontal type position for nearly an hour then I snuck in some cat-nap time this morning from 3 to 4 a.m. and got to school at 5 a.m.
It's not quite 6:30 in the evening but I don't think I'm going to make it much longer. It's time to get this ship battle ready again as quickly as possible. I'll need to get back in the gym, upgrade my eating, not stay up so late on school nights and probably work on cutting way back on the number of cigarettes I smoke while commuting. Cutting out the commuting smokes could save me about 1/2 pack a day. Not sitting out in the garage with my laptop (as I'm doing now) could probably cut out another pack. I was a bit inspired one day when I heard in class that cutting down to something like 10 cigarettes a day can cut certain risk by 20% which reminds me of what Dr. Kuhn said about benefits from weight reductions of 10 to 20% when dealing with patients. He advised us, when dealing with patients, to make sure they knew they didn't have to fit back into the clothes they wore in high school but that even a modest weight reduction would have healthy benefits.
OK - Todays picture is going to be of Ochronosis! I spent quite a while finding a picture of this on the Internet. It's a rather fascinating disease. The patient with ochronosis is lacking an enzyme to metabolize homogentisic acid which is a waste product somehow related to tyrosine. It takes a good 30 years for enough of this waste product to accumulate in the system before the patient notices any the ill effects of the disease. One remarkable finding associated with the disease is disc calcification along the entire spine. I figured there may be other diseases that could have this effect but, at this point in our student career, we don't know about them which makes that particular radiographic image pathognomonic for ochronosis. In other words, it can only be one thing. I was anticipating this question on the exam and it was in the form of a fill in the blank question. This was another one where I wrote the answer down prior to the slide being shown. But, the question associated with the slide mentioned a 36 year old patient so I knew we were in the correct age frame. Today's pic is similar to what we saw on the exam.
When you look at that picture (and recall you can click on the picture to make it bigger) you're looking at the lumbar vertebrae (the bones in your lower back). Notice the brighter white lines that run horizontal, separating one vertebrae bone from the next. Those white lines are where your cushioning disc are supposed to go and, on x-ray, those disc should appear black. They appear white because they've been calcified which is kind of like a transition step on the way to becoming solid bone. With ochronosis, that calcification of disc can occur along the entire spine.
Currently, there is no cure for ochronosis.
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