Pretty wiped out today. I was up kind of late last night and am still running on four hours sleep. The Gonstead class seemed pretty cool. We're meeting in one of our radiology rooms which has a good sized conference table. There's about a dozen of us retaking the class but most of the people from my class are waiting to take it over. We're going to be meeting four days this week and then 6 days straight next week.
I went to the Part IV Board Reviews after my Gonstead class. There were a lot of people in there who had already graduated and still needed to get through Part IV in order to get licensed in the state they wanted to practice in. Part IV is definitely going to take some work. I only stayed through the lunch break because I was so wiped out (kind of wondering what I'm still doing up)
I only saw two other people from my class taking this round of Part IV reviews. I was happy that everything we covered I was already familiar with ...well, almost. We need to know what test to order for each malady we come across.
We covered Cullen's sign (bluing around the umbilicus), Caput medusa (portal hypertension) and Grey Turner's sign (ecchymosis of flanks) but didn't mention Sister Mary Joseph nodule which was one of my favorites ;) but ...probably not to the person who has SMJN since it refers to a metastasis of a malignant cancer. I guess it would be more accurate to say, it's one I remembered well from our Physical Diagnosis class and ...I'm just happy about remembering anything!
For the stomach, test may include Barium, GUAIAC, Stool culture, endoscopy and biopsy. The Pancreas is divided up into the head and the tail with DX US, amylase/lipase, biopsy, stool, UE and CT for the head and FBS, US, dipstick, ghycosylated Hb, GTT and AIC test for the tail. With the tail we're thinking more along the lines of Diabetes and with the head leaning more towards infections & cancer. Pain from pancreatic cancer or pancreatitis can manifest in hte T-10 vertebrae and other s/s include Grey Turner sign, fetal position, steatorrhea and jaundice. That fetal position is one of the first examples I ran across of muscle splinting.
With the Gall Bladder and ...I'm thinking a positive Murphy's sign we'll order a CBC w/ diff, bilirubin, UA, Cholecystogram, dx US and cystography. Basics were mentioned such as cholecystitis (aka cholangitis) or dochoangitis but left out another favorite of mine which is choledochocystitis. But, they did mentione cholelithiasis which, is just kind of fun to say.
The s/s for cholelithiasis (gallstones) are a bit irreverent with reference to females but, just remember the F's - Fat, female, 40's, flatulance and pretty much any other F thing you want to put in there ...along w/ multiparous, pain in the inferior right scapula, statorrhea (fatty stools) and jaundice.
Pale - clay - gray - poop ...what you get without bilirubin.
and ...once again we get another look at Nephritic vs Nephrotic - same word except for the I and the O. I know I've mentioned these two cuties in a previous post. We'll associate infection with Nephritic and Death with Nephrotic.
I like the s/s w/ nephrotic because they all go together quite nicely and make sence. HTN, Edema, protenuria, etc.
Let's call the bladder a cyst then it makes more sense to talk about Cystitis. We'll see this in older males due to the prostate and in younger females due to sex.
I'm wondering now if rigid abdomen w/ appendicitis was my first exposure to muscle splinting.
I'm kind of all over the place tonight. I have a Gonstead quiz tomorrow morning and would like to get to school early enough to study over the material.
One big benefit of having to get up early all these days over break is that I'll already be in the groove when Tri-8 starts.
still have a ton to take care of. Need to see what the clinic hours are during break then get some people in to still hit my 50 adjustments. Need to find an advisor/teacher to sign my blue sheet for my senior project ....and maybe also figure out what the heck I'll be doing the senior project on.
I also have to figure out what the heck I'm going to do about this weekend and going to Minnesota for my brother's 4th wedding reception ....
Radiology is this weekends review and we've got a board certified radiologist giving the lecture. I'm sure i'd have more fun at the reception but a weekend of radiology could go a long way in helping me through my 4th Diagnostic Imaging class coming up ....and those Dx Imag classes always test cumulatively so, anything we've seen over the past two years is fair game ...so much to remember ...
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