#Medblrs

[flyonthewallmedstudent]

The weirdness of high school.

And university too maybe.

Plus or minus med school. But not residency. Watching THis is Us and other bingeable shows recently.

There's a lot of flash backs and flash forwards in the show.

There's the high school ones, which like all TV shows is very stereotype'd. They go to an alumni event, and the nerdy girl now surgeon is estactic to hang out with the former football star/cool guy. Who is very thick.

I was a super weird, nerdy, socially awkward kid. Afraid of a lot of social things, but not afraid of science, history anything academic or what I looked like. I wore oversized sweats all day everyday. I never knew how to say the right things or act in a crowd. I hated crowds. 2 or 3 close friends was great, and the best I could muster. I was terrified of their parents.

But funnily enough, I never knew I was weird. I wasn't unhappy either.

I liked having 2-3 close friends, nothing more or less.

Then close to graduation, one of the guidance counselors (the non-crazy one) said to me, she didn't have a great high school experience either. But it gets better after high school. I'll see. It took me years as a teenager to understand what she meant.

Later on I realized that other people felt sorry for me. Thinking because I didn't have the stereotype of the great high school experience I was some how sad, ashamed, unhappy.

Ironically I never even thought about it and was actually happy in my own world and space. I had my separate universe in academics. Like it never dawned on me that I was missing out on anything.

I felt embarassed, in a strange way as an adult reflecting on those experiences. Slightly embarassed for me, but more embarrassed for the small town/city around me. I did not fit in that place, but I didn't know it either back then or didn't care to. We were very much ships passing in the night. I didn't and don't hate where I grew up, I actually loved it in my own way. I got a great education there, and it got me where I wanted to go.

Looking back, plenty of kids probably made underhanded mean comments or passive aggressive statements - but it all went over my head. I suppose I would have been unhappy, had I read between the lines back then. Someone even stole my math text the week of the math exam, but I was actually flattered. That hey, someone thought I was that smart (imposter syndrome starts when you're young). It was one of the best days of my life.

It was also hilarious to me then, that stealing the text of one of the nerds during exam week would sabotage anything - because they spend their entire free time studying the whole year. They don't cram. Cramming was a terrible habit I acquired in university/undergrad. In med school, I'd fail exams because I crammed.

Another time I had left my draft math home work in a common room table, a classmate told me (2 weeks after the fact) that 5-6 different kids grabbed it and copied it. unfortunately for them, it was a draft full of errors, so I completely disregarded as trash. the final copy I submitted with the correct formulae was substantially different. Our math teacher of course realized that everyone had the same errors, but couldn't figure out the source. No one ever said anything mean or confronting, so it wasn't hard to brush aside. they self-sabotaged themselves, nothing actually happened to me.

Again, it was like we lived on different planets. Had they asked, I probably would have helped them out, I didn't get the grades I got by myself either. My far smarter co-nerd friends taught me a lot. On the other hand, I was intensely shy, they probably interpreted it as being "aloof." Or worse, condescending.

I'd felt my entire time during school, that it was the path to something else. I wouldn't get there till about 10-15 years later. Maybe even 20. It was a means to an end. If I was going to be working, then I wanted that work to have meaning. Or what would the point of all those hours. My parents worked in jobs they grew to hate to just go home and be tired.

Med school was a bit like high school. After the first few months of first year, i spent most of it hiding from other med students. (They were fucking crazy, a good chunk of them although not all, the anxiety, stress, competitiveness, the back stabbing, entitlement and bravado --> by the way, people do mature and get better. of course not all them do. anyhoo).

It was after selecting a vocation and starting residency that I found "home." Where I suddenly was comfortable having more than 2-3 friends and happy to be in crowds. Because everyone in the crowd was pretty much like me. We wanted to talk about all the same things. Maybe I grew more comfortable in my own skin along the way too.

But you know, it wasn't me that need to grow and change. I had found the environment where I finally could be myself in.

#medblrs #medblr #med school

[medstudiees]

favorite spot to study except for my room - it looks like a library but is actually a coffee shop

the holidays always kind of overwhelm me 🫠

#mine #studyblr #study blog #studyinspo #med studyblr #medical studyblr #study aesthetic #med school #studyspo #study hard #study #medblr #medical school #medical study #med student #med stuff #study space #study tips #student #study motivation #study notes #studyblr community #studygram #studyspiration #studywithme #bookblr #book blog

[medstudentblues]

journaling on a rainy day, in an unfamiliar country i keep getting lost in :)

#study #studyblr #studyspo #med #medblr #medspo #notebookist #noodledesk #tbhstudying #myhoneststudyblr #stuhde #lawyerd #studycommunity #bujo #desk #productivity #bookblr #bullet journal #notebook #medicine #cancerbiophd #jeonchemstudy #adelinestudiess

[equinesandeducation]

Study date time!!!! Bestie support is essential, as well as unlimited snacks 😌

#studyblr #studyspo #vetblr #vetmed #bujo #light academia #medblr #study vibes #studying #studyspiration #study movitation #writing #notebooks #keyb #keyboard #keebs

[nerdgirlnarrates]

Even though it's been months since I switched from neurosurgery to internal medicine, I still have a hard time not being angry about the training culture and particularly the sexism of neurosurgery. It wasn't the whole reason I switched, but truthfully it was a significant part of my decision.

I quickly got worn out by constantly being questioned over my family plans. Within minutes of meeting me, attendings and residents felt comfortable lecturing me on the difficulties of having children as a neurosurgeon. One attending even suggested I should ask my co-residents' permission before getting pregnant so as not to inconvenience them. I do not have children and have never indicated if I plan to have any. Truthfully, I do want children, but I would absolutely have foregone that to be a neurosurgeon. I wanted to be a neurosurgeon more than anything. But I was never asked: it was simply assumed that I would want to be a mother first. Purely because I'm a woman, my ambitions were constantly undermined, assumed to be lesser than those of my male peers. Women must want families, therefore women must be less committed. It was inconceivable that I might put my career first. It was impossible to disprove this assumption: what could I have done to demonstrate my commitment more than what I had already done by leading the interest group, taking a research year, doing a sub-I? My interest in neurosurgery would never be viewed the same way my male peers' was, no matter what I did. I would never be viewed as a neurosurgeon in the same way my male peers would be, because I, first and foremost, would be a mother. It turns out women don't even need to have children to be a mother: it is what you essentially are. You can't be allowed to pursue things that might interfere with your potential motherhood.

Furthermore, you are not trusted to know your own ambitions or what might interfere with your motherhood. I am an adult woman who has gone to medical school: I am well aware of what is required in reproduction, pregnancy, and residency, as much as one can be without experiencing it firsthand. And yet, it was always assumed that I had somehow shown up to a neurosurgery sub-I totally ignorant of the demands of the career and of pregnancy. I needed to be enlightened: always by men, often by childless men. Apparently, it was implausible that I could evaluate the situation on my own and come to a decision. I also couldn't be trusted to know what I wanted: if I said I wanted to be a neurosurgeon more than a mother, I was immediately reassured I could still have a family (an interesting flip from the dire warnings issued not five minutes earlier in the conversation). People could not understand my point, which was that I didn't care. I couldn't mean that, because women are fundamentally mothers. I needed to be guided back to my true role.

Because everyone was so confident in their sexist assumptions that I was less committed, I was not offered the same training, guidance, or opportunities as the men. I didn't have projects thrown my way, I didn't get check-ins or advice on my application process, I didn't get opportunities in the OR that my male peers got, I didn't get taught. I once went two whole days on my sub-I without anyone saying a word to me. I would come to work, avoid the senior resident I was warned hated trainees, figure out which OR to go to on my own, scrub in, watch a surgery in complete silence without even the opportunity to cut a knot, then move to the next surgery. How could I possibly become a surgeon in that environment? And this is all to say nothing of the rape jokes, the advice that the best way for a woman to match is to be as hot as possible, listening to my attending advise the male med students on how to get laid, etc.

At a certain point, it became clear it would be incredibly difficult for me to become a neurosurgeon. I wouldn't get research or leadership opportunities, I wouldn't get teaching or feedback, I wouldn't get mentorship, and I wouldn't get respect. I would have to fight tooth and nail for every single piece of my training, and the prospect was just exhausting. Especially when I also really enjoyed internal medicine, where absolutely none of this was happening and I even had attendings telling me I would be good at it (something that didn't happen in neurosurgery until I quit).

I've been told I should get over this, but I don't know how to. I don't know how to stop being mad about how thoroughly sidelined I was for being female. I don't know how to stop being bitter that my intelligence, commitment, and work ethic meant so much less because I'm a woman. I know I made the right decision to switch to internal medicine, and it probably would have been the right decision even if there weren't all these issues with the culture of neurosurgery, but I'm still so angry about how it happened.

#I would love to do something about this but I have no idea how to #even the faculty that I do really admire and respect seem entrenched in some of these attitudes #it's really hard to convince people that women aren't traitors in the making #simply because we might get pregnant one day and need time off #oh I also heard people shittalking a resident that was on maternity leave #and saying she wasn't serious about neurosurgery #so it's just inevitable #I'm not the only female student that feels this way btw #there's a reason no women have applied to nsgy from my school in years #sexism #neurosurgery #surgery #medicine #medical school #med school #med student #medblr #my content #my text posts

[snowandstarlight]

caught an episode of one of those old medical reality shows they used to do (like where they actually filmed in real hospitals) and one of the surgery residents was quitting because she didn't want to work 100+ hour weeks anymore

cut to the chair of the department talking about how men are more suited for surgery because they can handle the long hours better 🙄

#this is an extremely famous surgeon #one who my current attendings still look up to as the be all and end all of the field #so it's especially encouraging #medblr

[mochaya]

03.06.23

Officially entering my 3rd year of medicine 🤓

#aya's #blog #feed #studyblr #warm #aesthetic #med student #medstudent #medblr

[themedicalstate]

Two neurons sensing each other and trying to connect

Credit: @rockatscientist

#science #medicine #neuroscience #medblr #academia #scientific illustration #anatomy #health

[studymoons]

life lately is gloomy days and early mornings. studying for boards is a bit more stressful than i’d imagined, not because of all the material i need to review, but more because im struggling to build up the stamina for an 8 hour exam (it’s been years since i last took one and im significantly more exhausted at this point in my life than i was then). but nothing i can do but continue working! still making time for art and friends to keep myself in a good mental space and continuing to try my best :-)

my etsy

#studyblr #mine #food #drinks #studyspo #med student #med studyblr #studying #med school #study motivation #study aesthetic #study inspo #study inspiration #studygram #medblr #medical student #medical school #study blog #study space #coffee shop #cafe #matcha #heyjojo

[kylejsugarman]

making a new post for it but if u have considered donating to a palestinian cause, specifically the palestine children's relief fund, please consider doing it through my link: https://pcrf1.app.neoncrm.com/pediatricians-for-palestine

the money u donate will go directly to the PCRF just as if u had donated through a general link, but with this link, u will help me with my goal of establishing a concrete foundation for a palestine-focused organization at my medical school and its associated teaching hospital. the physicians in palestine who have been martyred and continue placing themselves in unfathomable danger to help their patients should serve not just as an inspiration but be assisted by their fellow physicians across the world in caring for palestine.

if u would like something in return for ur donation, just say the word!! provide me with ur receipt and i will find a way to thank u for ur generosity. please help the PCRF and please prove to an institution that has the best specialized pediatric programs in the state that the children of palestine should and must be included in their charitable efforts.

"If I go, who will treat my patients? ... You think I went to medical school and for my post-graduate degrees for a total of 14 years so [I'd] think only about my life and not my patients?" — Dr. Hammam Alloh, martyred in November 2023

#syd squeaks #the qr codes kept expiring and a link just seems to work better on here #anyway: even if u dont donate thru my link just please keep giving ur money. dont sit around feeling helpless please donate #palestine #palestine children's relief fund #medblr #studyblr

[iheartvmt]

Gotta love vet techs lol

#veterinary #vet tech #vetblr #human medicine #nurblr #medblr #needles

[flyonthewallmedstudent]

Q Fever

Aka, Query fever. What a weird name for a disease. Imagine telling people that's what you got.

in the 30s-40s, an Australian pathologist in QLD/Brisbane, came across an outbreak of the same or similar illness among abbatoir or slaughterhouse workers.

At the time, he called the disease "Q" fever or query as a temporary name until the pathogen could be identified. Unfortunately it stuck.

decades later, now nobel prize winner and virologist, MacFarlane Burnett isolated and identified the microbe responsible. I think this discovery contributed to his prize. i forget already.

Microbe responsible: Coxiella burnetti. Named for Burnett and HR Cox, the American bacteriologist who found the genus Coxiella where C burnetti falls under.

Initially they felt it was related to Rickettsia, responsible for Rocky Mountain Spotted Fever, but as science progressed, this was disproven.

Now for a Case Report

A 55 yo Italian man with a history of aortic valve replacement was diagnosed with pyrexia of unknown origin twice. Further signs included myalgias/splenomegaly/night sweats. The 2nd time he was admitted for PUO he deteriorated rather dramatically and was put on meropenem and teicoplanin.

A host of organisms was tested for on serological testing based on the man's travel and epidemiological history, all negative. Even a rheumatological panel was done, also less revealing. He also had a history of MGUS (a haem disoder), which is kind of a red herring here.

Cultures were negative, no vegetations were seen on a TTE - so they did consider IE. Which is an important differential for PUO.

Eventually a PET-CT was done (often favoured when investigations do not yield much for a sick patient with fevers), finally revealing a focus of infectious on his ascending aorta, where he'd also had previous surgery done. And in a round about way, they also further identified Coxiella Burnetti. He was treated doxycycline and hydroxychloroquine. As it's so rare in Italy, it wasn't really considered even though he mentioned rural travel.

Bottomline: Q Fever is an important consideration in the work up for culture negative IE. Further to this, always consider IE in the differentials for PUO particularly if they're at increased risk for IE (prosthetic valves, damaged valves, select congenital heart issues, previous IE). IE can present with night sweats, fevers, weight loss and splenomegaly. It can be insidious and chronic in nature. other risk factors can be more suggestive as we'll get into below.

Causative organism

Coxiella burnetti, it's a zoonoses - i.e. transmissible from animals. Special powers: very tough/hardy, can survive extreme environments (high temps and UV light etc.) over prolonged periods and is resistant to many common disinfectants/surface cleaners.

It's an intracellular pathogen and gram negative coccobacilli (PINK!)

name coccobaccili reminds me of cocopuffs.

it's mainly associated with farm animals, which the CDC so wholesomely displays on its website on Q fever (wtf).

goats, sheep, cattle typically (but many other animals, even birds, dogs and horses can be reservoirs)

in particular bodily fluids - amniotic fluid, placenta, faeces/urine, milk etc.

you can get it through unpasteurized milk and through inhaling it if it lands on dust in the area

ever visit a farm or petting zoo lately? OMG WASH YOU HANDS.

That said, it's typically inhaled in inorganic dust. You inhale it, it goes to the lungs, and then the bloodstream.

Increased risk for Coxiella burnetti (What to take on history of exposures and when to strongly consider it)

live on a farm or near one

exposure to a farm

work as a vet on a farm

farm worker, dairy workers, researchers on these animals/facilities

slaughterhouse/abbatoir

Also from CDC:

Clinical presentation

Most won't get sick after exposure and remain asymptomatic, a very small minority does. even though it is highly infectious.

incubation time is 2-3 weeks (consider this time in your history of exposure, did they work on the farm 2-3 weeks ago as opposed to yesterday).

Nonspecific acute infectious symptoms:

nonspecific systemic fevers/malaise/arthralgias/myalgias--> key is high fevers though and can be associated with headache and photophobia.

non specific GI - N/V/diarrhoea

respiratory ones - SOB or cough, consider it as atypical cause of community acquired pneumonia.

rare: hepatitis and jaundice (granulomatous) or encephalitis with neurological complications such as demyelinating disease or CN palsies, also haemolytic anaemia and HLH (yikes)

really it's the history of exposure that will lead you down the garden path to Q fever.

Chronic Q fever is perhaps worse, and can present as culture negative IE/PUO. Months/years later, as B symptoms as above above + LOW/LOA, night sweats. More likely to occur if you are predisposed for IE as above, have a weakened immune system for any reason, including pregnancy.

Chronic Q fever has a mortality of 10% if left untreated. About <5% of those with acute Q fever develop this if left untreated. Speculation is that it's more of an autoimmune process or abnormal immunological response to the bacteria.

To be honest, most who walk in the door with community acquired pneumonia get treated empirically for atypicals anyway, (standard course of doxycycline), so we hardly really ponder the question of Q fever in every patient. But if they present chronically and did not have atypical cover at the onset of acute symptoms, then it's something important to consider.

Other important conditions - can cause complications in pregnant women and 20% will get post Q fever syndrome. like chronic fatigue.

investigations

Serology! nice and easy. Look for IgG antibodies in the chronic presentation. Or PCR. Down side to serology - can take 2-3 days for the body to make said antibodies to the bacteria for detection. PCR can be done on any fluids/tissue sent.

Cultures useless, hence it fall under the umbrella of culture negative (hard to grow outside a host cell, it is an obligate intracellular pathogen).

Other hints on bloods (as serology/PCR takes time to return) - elevated or low platelet's, transaminitis with normal bili, opacities in CXR with hilar lymphadenopathy, CSF will show raised protein levels if done when encephalitis is suspected.

imaging can also support the diagnosis.. as illustrated by the case report.

Treatment

Acute disease - as standard for atypical bugs, doxycycline 100 mg BD for 14 days. Alternatives - TMP SMX or Clarithromycin.

Chronic Q fever or IE:

native valves: doxycycline and hydroxychloroquine (200 TDS) for 18 months

prosthetic: same but 24 months

why hydroxy: enhances the action of doxycycline (increases the pH of the phagolysosome)

Follow-up: look for 4 fold decrease in IGG

Sources:

CDC

Stat Pearls

Wiki as linked above

#australian history #medblr #medblrs #infectious disease #infectious diseases #q fever #coxiella #coxiella burnetti

[medstudiees]

our professor said that hepatitis B is probably the most complicated human infection and I have to admit he was right 😮‍💨

#mine #studyspo #studyspiration #study motivation #study notes #medical study #study space #med student #study #student #study tips #med studyblr #medical studyblr #study aesthetic #study blog #studyblr #studyblr community #studygram #studyinspo #med school #medblr #medical school #book blog #taylor swift folklore #folklore #study hard #bookblr #taylor swift

[lujain-37]

" ألتمسُ من اللهِ الأجرَ في كلِّ ليلةٍ غالبتُ فيها النومَ، في كلِّ ألمٍ تجاهلتُه،وعن كلِّ وقتٍ كنتُ فيه أغيبُ عن عائلتي وأصدقائي. أقولُ لنفسي: اللهُ اختارَ لي هذا الدربَ وحبّبني به، فإن كان مُعتِمًا، فمنه النورُ، وإن كان شاقًّا، فمنه اليُسرُ، وإن الذي جاءَ بك إلى أولِه، ويسَّرَ لك مُنتصفَه، لن يترُكَك إلا عند التمامِ..

ياربِّ، جهدي قليلٌ، وكرمُك واسعٌ! ياربِّ، صدقتُك بالسعي، فلا تُخيِّبْ رجائي في الوصولِ! ياربّ..ياربّ. "

#ياارب #دعاء #تصويري #دراسة #aesthetic #photography #studyspiration #study aesthetic #medblr #medical studyblr #study motivation #اقتباس

[virtuosicstudyblr]

Apparently it’s fall season for my pictures as well. Why are they coming down the wall? 🍂🍁 If you know any good and rent friendly wall sticky tape, please let me know! || 31.10.2023 Lux

#studyblr #studying #inspiration #university #aesthetic #college #med school #medblr #medizinstudium #med student #studyblr desk #old desk #study setup #fall inspo

[obakanosandoitchi]

9-09-2023

loving today's view ⛰️🌲

wish me luck being productive today 🤞🏻

#medblr #medblog #med studyblr #academic validation #studyblr community #studyblr