Med School - Blog Posts

I feel like this a lot lately, especially bc uni started again and I'm using a wheelchair now. The other day in anatomy class I was constantly apologising and being just my general awkward self. A friend of mine and fellow med student messaged me later to ask if I felt like I was in the way with my wheelchair and to remind me that I belong there just as much as anyone else🥺 so thankful for the few friends I have found in medschool who are genuinely kind and accepting when it comes to my disabilities.

I'm in medschool and I'm the only visibly disabled student in my semester. I'm not very social outside of classes so I can't be certain, but I'm fairly sure I'm the only visibly physically disabled med student in multiple years. I've heard about one other who is atleast 4 years ahead of me. So, in doing the math I can conclude that I'm 1 out of 2 visibly physically disabled med students out of roughly 3500 med students at my university.....

if you feel like you’re ‘getting in the way’ as a mobility aid user, particularly with larger aids like wheelchairs, rollators/walkers, gait trainers and service dogs, That Is A Fault Of The Space (and potentially the people), not of you. You deserve all the space you take up and more.

I recently started using a cane everyday and so my previously invisible disability is suddenly visible. I also started medschool. It's been a while since I was properly social so I have questions...

People don't walk next to me. And if they accidentally do, they leave to walk next to someone else even if that means squeezing in three people on the sidewalk. No one talks to me if it's not to ask me "what's wrong". I have really tried to make an effort and talk to people but I don't know what to do.

Can it have something to do with my disability and my cane? Like they're scared to say the wrong thing? Or maybe it's because they've sensed the autism?;)

First day of med school some of the older students "dress up" as and pretend to be first years. I spotted four of them within 15 minutes and one of them was in a wheelchair with a leg and an arm in casts and a neck collar on. So basically, he was pretending to be disabled. And most of us knew that he was a fake first year and I overheard people joking about pushing him out of his wheelchair to prove he was faking it. I don't understand how a group of future doctors sat around a table and decided it was a good idea to have a fake disabled person there. It just perfectly sums up the attitude of most doctors.

trying to figure out what i want my career to be 😞 life seems so hard

i hate biochemistry 《•》_《•》 who tf even invented it.. i just wanna have a lil chat...that may or may not end in me murdering someone... they're probably already dead tho right

ARS LONGA, VITA BREVIS

(Art is long, life is short)

A league of extraordinary people

Medicine + October

"Learning to defeat yourself is learning to live."

- Eliphas Levi

Medicine meets Dark Academia

"Vita brevis, ars longa, occasio praeceps, experimentum periculosum, iudicium difficile"

Medicine Student + Dark Academia

MEDSCHOOL MOODBOARD

Cryptid & Distinguished, much prefer getting compliments on their intellect and hard work, obessive, well-versed…

It's been ages since I was here. I used to love the smell, the touch, the feeling of fascias separating...and now I remember why I loved both Anatomy and Surgery ❤️

Maybe when we chose this profession we were not very aware that not only were we going to study Medicine, but we had, as well, to become doctors. ✨⚕️

This is a drawing by Quaestor Valdemar that I did (before) Anatomy class a while ago~

Recently I returned to medical school with a more than fortunate situation. My effort paid off and it has encouraged me to give my best this year as well ✨ The dissections that I am now doing are not entirely like the ones I used to do last year, but I like them a little more. It is no longer simply to practice the surgical technique but really to see the Anatomy of all the organs ❤️

MEDSCHOOL + DARK ACADEMIA

Haemosiderin staining

"Haemosiderin staining" describes orange/red/brown skin hyperpigmentation caused by haemosiderin (an iron-containing pigment found in blood) leaking into the skin.

Causes:

Chronic venous insufficiency (in lower legs)

Skin inflammation

Trauma e.g. wound, fracture, surgery

Pigmented purpuric dermatoses

Haemochromatosis

Haemosiderin staining may be exacerbated by anticoagulant use as this increases extravasation (leakage) of red blood cells into the skin.

See an example here.

Causes of drug-induced lupus

SHIP

Sulfasalazine & Sulfonamide Hydralazine Isoniazid Procainamide & Phenytoin

This is by no means a definitive list (they are many!) but these are some of the most common causes.

Common ototoxic medications

"FAV Q&A"

Furosemide (and other loop diuretics) Aminoglycosides Vancomycin Quinine Aspirin

Hypokalaemia ECG changes

U have no pot and you have no T but you have a long PR and a long QT

Low potassium causes:

U waves (small deflection immediately after T wave)

Flattened/inverted T waves

Prolonged PR interval

Apparent prolonged QT interval (due to fusion of T and U waves)

Also:

Increased P wave amplitude

Widespread ST depression

Oedema - pitting vs non-pitting

Oedema is swelling due to excess fluids in tissues.

In pitting oedema, pressing on the affected area leaves an indentation (that persists after removing the pressure). In non-pitting oedema, the area feels firm to touch and does not form indentations.

Pitting oedema:

The excess fluid is mainly composed of water

Commonly caused by heart failure, venous insufficiency, or nephrotic syndrome

Non-pitting oedema:

The excess fluid consists of water WITH protein and salts

Usually indicates a condition of the thyroid / lymphatic system

Different types:

Lymphoedema is due to a build-up of lymphatic fluid (e.g. due to a tumour blocking lymphatic flow / after removal of lymph nodes).

Myxoedema occurs in hypothyroidism and often affected the pretibial or periorbital area.

Angioedema is localised swelling of the skin and is usually due to allergic reactions. It typically affects the face, tongue, larynx, abdomen, arms, and legs. When the larynx is affected, it may affect breathing, which is an emergency!

Lipoedema is when fat accumulates in subcutaneous tissues - it usually affects the legs/buttocks and almost exclusively occurs in postpubertal females (not the same as cellulite!)

If patients present with oedema, it's always important to test if it's pitting or non-pitting as this helps to determine the cause and correct treatment!

Causes of Acute Pancreatitis

In the UK and US, the main causes are gallstones and alcohol.

Use the mnemonic 'I GET SMASHED':

Idiopathic

Gallstones

Ethanol

Trauma

Steroids

Mumps / Malignancy

Autoimmune

Scorpion stings

Hypercalcaemia / Hypertriglyceridaemia / Hypothermia

ERCP

Drugs (including azathioprine, mesalazine, bendroflumethiazide, furosemide, steroids, sodium valproate)

Cranial nerves mnemonic

On, on, on, they travelled and found Voldemort guarding very ancient horcruxes.

Olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal.

On - Olfactory nerve (CN I)

On - Optic nerve (CN II)

On - Oculomotor nerve (CN III)

They - Trochlear nerve (CN IV)

Travelled - Trigeminal nerve (CN V)

And - Abducens nerve (CN VI)

Found - Facial nerve (CN VII)

Voldermort - Vestibulocochlear nerve (CN VIII)

Guarding - Glossopharyngeal nerve (CN IX)

Very - Vagus nerve (CN X)

Ancient - Accessory nerve (CN XI)

Horcruxes - Hypoglossal nerve (CN XII)

clearance = (urine concentration x urine volume passed over time) / plasma concentration

the only useful thing my prof ever taught me for the renal physiology portion of my physiology course is that clearance is calculated by the equation “pissing under the sun” ( C = UV/P)

Distribution of calcium in the body

Bone calcium (99%)

Ca^2+ and PO4^3+ form hydroxyapatite

Plasma calcium

Diffusible pool

~50% of plasma calcium is free/unbound ionic Ca2+ (physiologically important form)

~10% of plasma calcium is complexed with small molecular weight compounds (citrate, phosphate)

Non-diffusible pool

~40% of plasma calcium is bound to calcium-binding proteins and plasma proteins (albumin)

The body utilises plasma albumin-bound calcium as a circulating reserve

Basic pharmacology of neuromuscular junction

ACh acts on N2 receptors (ligand-gated Na+/K+ receptors)

Block Na+ channels that propagate nerve impulse - local anaesthetics (lidocaine), tetrodotoxin

Inhibit ACh release - tetanus toxin, botulinum toxin

Competitive antagonists - vecuronium

N2 agonists - suxamethonium

Flaccid paralysis

Only cleared by plasma cholinesterase

Reversible anticholinesterases - edrophonium, neostigmine, physostigmine

Block activity of AChE

Diagnose and treat myasthenia gravis and treat glaucoma respectively

Irreversible anticholinesterases - organophosphates (pesticides, nerve gases)

Long-lived flaccid paralysis

Treat with pralidoxime within 10 minutes - cleaves OP-AChE complex

Management of acute MI

Reduce anginal pain

Morphine (+ anti-emetic)

Oxygen

Nitrate

Initiate reperfusion

Anti-platelet (aspirin, clopidogrel)

Thrombolytic (rtPA)

Primary angioplasty (PTCA)

Anticoagulant (heparin)

Protect myocardium

Beta-blocker

ACE inhibitor

Secondary prevention

Aspirin

Lipid-lowering (statin)

Lifestyle

Helpful mnemonic foe MI treatment.

Carpal bones mnemonic

So Long Till Pinky, Here Comes The Thumb

Scaphoid

Lunate

Triquetrum

Pisiform

Hamate

Capitate

Trapezoid

Trapezium

(going anti-clockwise in this diagram)

I laughed so loud someone asked if I was okay

Me: Who lives in a pineapple under the sea!?!

My med student best friend who’s had 3 hours of sleep in the last 2 days: Aye aye captain!!

Several seconds of silence

Her: Wait...

Me, putting a hand on her shoulder: It’s okay

good afternoon from your resident med student. had the first phase of my research competition at 10am today. pretty simple and was very general so I’m sure I (and almost everyone else who signed up) passed. currently studying mechanisms of ventilation. will be taking a quick lunch break soon.