Wellll this may be out of my knowledge zone soI’m going to defer follow up on this question to anyone who thinks they can answer it better than I can.
pancreatic transplants are done, but in specific cases. Usually I think it’s for people with TypeI diabetes who have several other comorbidites, but i think the main one is end stage renal disease/failure.
Cancer wise, pancreatic cancer is one of the most tricky to diagnose and when it is usually it’s already spread to lymph nodes and metastasized to other areas of the body. There have been several times we’ve caught pancreatic cancer in the ER if I remember correctly, but all of those cases brought with it a terminal diagnosis. It is also highly malignant and even without transplantation there is a high chance of recurrence. Patients who receive transplants also must take immunosuppressive drugs for the rest of their life, highly increasing the chance of a returning malignancy. The pancreas is also extremely involved in the Gi system, sharing vasculature and other connections with the stomach, liver, gallbladder,spleen (?), intestines, and the mesentery. This makes malignancy a high probability for pancreatic cancer patients so giving them a cancer free pancreas wouldn’t do any good at all if it’s already spread, which it usually easily does.
Like I said, someone correct me if I”m wrong because this is stepping outside of my knowledge base.
Although that means in exchange I’m going to send you all the drug seekers to make room for all of your trainwreck patients
sounds fair to me! :)
Well I’m back
The test went well, I think.
Although this week there have been some interesting first for me
ALSO another surprising guest star in my “justifying why I’m sleeping” dream series was CRANQUIS. I was having quite the interesting dream in which I was talking to a floating head of Hugh Laurie (who called himself cranquis) who told me that “TOADS never sleep!”.
Quite an interesting week and I’m really glad it’s over.
So there was this question on one of my practice tests and I want to know if I got it right, so I’m forcibly going to enlist all y’all knowledgeable folk out there to answer this question:
“A 17 year old female presents to the ER with complaints of an obviously broken leg. This is her second fracture in two months, and you are seriously concerned about her health. A social worker reports that her family life is stable and there is no evidence of abuse. You decide to order a blood calcium level and it comes back markedly high. You also notice an abnormal growth/swelling in her neck. What do you think the problem is and why?”
OKAY so this is possibly out of my depth and I don’t know why it was even a problem, but my first thought was like Primary hyperparathyroidism (before I used the google machine) from a parathyroid adenoma(??? I only guessed that because I thought they were the main type of growth for hyperparathyroidism???) but I wanted some feedback.
What do y’all think?
It was definitely the one time a mother came in to visit her son while he was in the ER and when she bent down to hug him she leaned against the phone in her pocket and accidentally turned the porn she had evidently been watching before coming in. The most awkward part of it was that all 5 other people but me and the physician in the room did a class act job of pretending they weren’t hearing anything, including the mother.
IMAGINE TRYING TO DO A HISTORY AND PHYSICAL WHILE THERE IS PORN PLAYING IN THE BACKGROUND
CODE BROWN TO THE 5th FLOOR would have been much more appropriate. I could have even brought some depends.
NAPOLEON BONE APART IS THE BEST NAME EVER HANDS DOWN
Okay all of the smartypants people out there I have a question about a patient that I had no clue what going on:
A woman in her 40s in relatively good health presented to the ER s/p a syncopal episode in the parking lot of the hospital. She was at the hospital to visit her mother who was having some type of procedure. She presented with normal VS, no hypoxia, no ST, no hypotension. She denied any chest pain, SOB, abd pain, Ha, dizziness, or really any remaining symptoms other than “feeling funny”. Her EKG was normal, cardiac enzymes normal, CXR and CT head were normal. D-Dimer was normal.
Her only PMHX was an SBO that was secondary to adhesions in which she had a colostomy bag placed a few months previous. No HTN/DM/CAD/MI/CVA/ect
Her only abnormalities was that she had a CO2 of 11, an anion gap 28, a glucose of 130, and a serum acetone of .8. So she was acidotic(right???). What would be the source of that? It wouldn’t be DKA, would it? She didn’t have a hx of DM and I wouldn’t expect her slightly elevated glucose to lead to DKA (but then again I don’t know much of anything so I’m just confused).
This is one of those times I wish I could go up on the floor whenever I wanted to and actually have some continuity of care.
You can use the GenderAnalyzer to analyze if a blog is written by a man or a woman. The good news is they are 85% sure you are a woman. genderanalyzer.com
This is awesome. Here’s some results from the gender analyzer:
You win the Girl-bro award, friend.
Looks like it doesn’t quite have all the kinks worked out yet.
Welllll I am a very sassy guy in real life so I suppose this is okay.
(Cranquis and I need to go shopping for some new outfits)