Medical Examinations

Always laugh when you can. It is cheap medicine

39 notes

compoundfractur: This poor guy had to have a large portion of his jaw removed due to cancer. In some cases bone can be grafted and the removed mandible can be regrown. The cancer was linked to years of smoking.

compoundfractur:

This poor guy had to have a large portion of his jaw removed due to cancer. In some cases bone can be grafted and the removed mandible can be regrown. The cancer was linked to years of smoking.

45 notes

determined4medschool: ucsdhealthsciences: Caring for an aging population: a Q & A with our geriatric specialist It’s not news that America is getting older. In 2009, the percentage of the country’s population that was 65 and older was 12.9 percent, which worked out to roughly 40 million people or one in every eight Americans. By 2030 that figure is projected to grow to more than 72 million elderly Americans or 19 percent of the population, one in five. An aging America presents many challenges, not least of which is how to adequately care for them. Getting older means, alas, a greater likelihood of aches, pains, ailments, conditions and disease, but attracting and training doctors specialized in the particular health needs of the elderly has become an increasingly daunting task. We asked Kwi Bulow, MD, a professor and geriatric specialist at the University of California, San Diego School of Medicine to talk about treating older patients and finding the doctors to do so. Q:  Why is it difficult to attract medical school students and new doctors to the practice of geriatric medicine? A: Students go into clinical medicine because they want to cure diseases and positively impact people’s lives. As a medical student I saw a patient come in with severe pain from gallstones, undergo surgery and experience prompt relief from pain, much to the mutual satisfaction of both the patient and the surgeon. In geriatrics, the results are sometimes subtle and a long time in coming, even though they are definitely there. Experienced physicians who have long-term relationships with patients know that they can do things that can make positive and meaningful differences in their patients’ lives. When students see patients one afternoon in a clinic, it’s hard for them to see that impact. Older patients do not bounce back quickly from illness, so that when students see a very ill older patient in a hospital, they do not see how the patient improved over time in a rehabilitation center and then at home over the ensuing weeks and even months. Our hospitals, clinics, and care protocols are not very friendly to older patients who may have sensory deficits or have trouble moving quickly or are prone to complications. That also adds to the frustrations of trainees who are trying to get through a busy day taking care of many patients quickly and efficiently. Ideally, there should be an environment that is optimal for treating these vulnerable patients and sufficient number of geriatricians who can model excellent care. Students are also discouraged by older patients who often have diseases for which there are no effective interventions, though we are now beginning to see some very exciting developments in diagnosis and treatment of diseases like Alzheimer’s. That may help stimulate greater interest in the care of older patients. Another barrier is that some students feel it is depressing to work with older patient when, in fact, they often have fascinating personal histories and wonderful personalities. To challenge stereotypes about aging and help students learn more about older people, we offer an elective course in which six medical students and six pharmacy students are paired up with 12 seniors in the community to engage in interactive learning. These seniors recognize the need to train health care professionals and they are willing to volunteer to make the difference. Some of them previously had negative experiences with doctors who were not prepared to care for older patients. For example, one woman related that her doctor would address her daughter instead of her, assuming that she must be demented just because she is old. Read More Understand those >65 y/o are people too, so treat them with respect and compassion. Be understanding, patient, and caring. There is so much to learn from older adults. You’ll be old one day too. 

determined4medschool:

ucsdhealthsciences:

Caring for an aging population: a Q & A with our geriatric specialist

It’s not news that America is getting older. In 2009, the percentage of the country’s population that was 65 and older was 12.9 percent, which worked out to roughly 40 million people or one in every eight Americans. By 2030 that figure is projected to grow to more than 72 million elderly Americans or 19 percent of the population, one in five.

An aging America presents many challenges, not least of which is how to adequately care for them. Getting older means, alas, a greater likelihood of aches, pains, ailments, conditions and disease, but attracting and training doctors specialized in the particular health needs of the elderly has become an increasingly daunting task.

We asked Kwi Bulow, MD, a professor and geriatric specialist at the University of California, San Diego School of Medicine to talk about treating older patients and finding the doctors to do so.

Q:  Why is it difficult to attract medical school students and new doctors to the practice of geriatric medicine?

A: Students go into clinical medicine because they want to cure diseases and positively impact people’s lives. As a medical student I saw a patient come in with severe pain from gallstones, undergo surgery and experience prompt relief from pain, much to the mutual satisfaction of both the patient and the surgeon. In geriatrics, the results are sometimes subtle and a long time in coming, even though they are definitely there. Experienced physicians who have long-term relationships with patients know that they can do things that can make positive and meaningful differences in their patients’ lives. When students see patients one afternoon in a clinic, it’s hard for them to see that impact. Older patients do not bounce back quickly from illness, so that when students see a very ill older patient in a hospital, they do not see how the patient improved over time in a rehabilitation center and then at home over the ensuing weeks and even months.

Our hospitals, clinics, and care protocols are not very friendly to older patients who may have sensory deficits or have trouble moving quickly or are prone to complications. That also adds to the frustrations of trainees who are trying to get through a busy day taking care of many patients quickly and efficiently. Ideally, there should be an environment that is optimal for treating these vulnerable patients and sufficient number of geriatricians who can model excellent care.

Students are also discouraged by older patients who often have diseases for which there are no effective interventions, though we are now beginning to see some very exciting developments in diagnosis and treatment of diseases like Alzheimer’s. That may help stimulate greater interest in the care of older patients.

Another barrier is that some students feel it is depressing to work with older patient when, in fact, they often have fascinating personal histories and wonderful personalities. To challenge stereotypes about aging and help students learn more about older people, we offer an elective course in which six medical students and six pharmacy students are paired up with 12 seniors in the community to engage in interactive learning. These seniors recognize the need to train health care professionals and they are willing to volunteer to make the difference. Some of them previously had negative experiences with doctors who were not prepared to care for older patients. For example, one woman related that her doctor would address her daughter instead of her, assuming that she must be demented just because she is old.

Read More

Understand those >65 y/o are people too, so treat them with respect and compassion. Be understanding, patient, and caring. There is so much to learn from older adults. You’ll be old one day too. 

17 notes

mynotes4usmle:

MICROSCOPIC SEQUENCE OF CHANGES AFTER A MI

  • 1-4h: wavy myocyte fibers & contraction bands
  • 4-24h: coagulative necrosis (no nuclei)
  • 1-3d: neutrophilic infiltrates
  • 3-7d: macrophages
  • 7-28d: grannulation tissue (fibroblasts+macrophages)
  • 6 weeks: fibrotic scar

(via medicineisnotmerchandise)

10 notes

thisfuturemd:

Frank Breech Position

Fetal malpresentation occurs in about 4% of all term pregnancies. The most common malpresentation by far is breech presentation, where the fetal longitudinal lie is oriented parallel to the long axis of the uterus and the buttocks are near the cervix. There are 3 types of breech presentation: frank (hips are flexed and the legs are extended), complete (hips and legs are flexed), and footling or incomplete (incomplete flexion of one or both hips).