Week 16: Calm Before The Storm

          It was about one foot in length, eight inches in width, and one foot in height, and after my professor dropped it onto a desk in the front of the classroom, I could swear I felt the ground beneath by feet vibrate. What appeared, at first, to be a moderately-sized shoe box, was unfortunately nothing of the like. It wasn’t until my professor opened the flap of the object and began shuffling through its pages, when I finally realized that it was a book…yes, a book. A book larger than one I have ever seen before. And as my professor flipped through the pages of this book, he explained that its content includes every drug imaginable. Not only that, but for each drug, an explanation of its action, instructions for its dosage and administration, its side effects and contraindications, and so on. It’s this book, my professor explained, that we have thirty weeks (two semesters) to learn, from cover to cover; put bluntly, but honestly by my professor, a virtually impossible feat to accomplish. Not only is it essential to learn these drugs, but also to understand the interactions that each drug has with one another. So, before writing that final prescription, there are many, many factors that must be accounted for, and that’s what this course, Pharmacology, will teach us.

          Three new courses began this week: Pharmacology, Clinical Skills, and Endocrinology. As should be apparent by now, Pharmacology seems like it will be an extremely informative and interesting class, but a big challenge, no doubt. This week in Pharmacology we focused less on drugs and more on the sales representatives that will be selling the drugs to us, like what their business incentives are, and how to put all of what is disclosed to us about the nature of a drug into perspective. In Clinical Skills, we learned how to perform a comprehensive patient history, which is basically a series of nearly one hundred questions that are asked to patients when they present for an H&P (history and physical exam). The history of the patient is a very important tool, especially when attempting to formulate an accurate diagnosis. Finally, in Endocrinology, we focused on diagnosing disorders of the pituitary gland (gigantism, diabetes insipidus, pituitary tumors…etc). It amazes me how changes in the amount of a single body substance, like a hormone, can have such drastic physical outcomes (just search for images of individuals with “gigantism” on the internet and you’ll see what I mean).  

          So, after four days, three new classes, one snow day, and a treacherous, painstakingly long (3 hour) drive home, I’ve completed the first week of this second semester (16th week of the program). Returning on Tuesday, sitting in the same seat as I did throughout the entirety of last semester, it truly felt like I had never left. The past four weeks of my winter break blurred and I quickly drifted back into my PA school mindset. Luckily, the workload did not pile on too quickly this week (calm before the storm, no doubt). Next week, four new classes are added to the schedule, making a final count of seven courses…now that’s more like it!

Question of the week: Would you expect a hormone called anti-diuretic hormone (ADH) to increase or decrease an individual’s volume of urine output?

Last week’s answers: Electrocardiogram; Ears; Eyes; Four times a day; Swallowed

The Middle: Didactic Phase, Semester Two

          I’m back! It’s been a great (and cold) winter break, but my time off is quickly coming to an end…too quickly. Over the past four weeks, I’ve completed all of the work assigned back in December and began preparing for the first few weeks of this upcoming semester. I enjoyed reading Freakonomics (one of the reading assignments), and I am starting to get the hang of interpreting EKGs (the other of the two reading assignments). In fact…dare I say it…I enjoy reading EKGs and find it fairly relaxing (I say that now…). Interpreting an EKG is like completing a puzzle; if you can interpret all of the bits of information an EKG supplies (heart rate, heart rhythm, heart position…etc.) and then piece all of that information together, you can formulate an accurate diagnosis—it’s really cool. I was also assigned the job of completing two online certification courses: a Basic HIPAA Privacy & Security certification and an Infection Control certification. I also received many of my syllabi for this upcoming semester, so I have been trying to read assigned material for each course, enough to at least keep me somewhat caught up through the first two or three weeks. Let me fill you in on what’s going on this semester…

          I’ll be taking a total of fifteen credits. The four medical specialties we will cover this semester are Cardiology, Endocrinology (study of disorders of glands, like the thyroid, pancreas, pituitary, and adrenal glands), Pulmonology (study of lung disorders), and Nephrology/Urology (study of kidney disorders/urinary tract disorders). Like last semester, each specialty will take seven weeks to study, and we begin the first half of the semester with Cardiology and Endocrinology. Other courses include Clinical Lab Medicine (how to interpret the results of lab tests (like blood tests, urinalyses…etc.) that are ordered for patients), Informatics in Medicine, and Epidemiology (the study of the spread of disease). I will also begin my first of two Pharmacology (the study of drugs) courses. I have heard Pharmacology is one of the most difficult courses I will take throughout the schooling, but appropriate prescribing and dosing of medications is arguably one of the most important tasks of this field, so I would rather it be a more challenging course. Lastly, I will begin my first of three Clinical Skills courses. Finally, I get to start using some equipment! Clinical Skills is all about the hands-on work that this field entails. This first semester of Clinical Skills focuses on how to document a complete patient history and how to examine half of the body systems typically analyzed during a physical examination of a patient. And yes…we are graded on our hands-on skills using standardized patients, you know, the same ones I encountered last semester. Needless to say, this course requires a lot of materials: a stethoscope, otoscope, opthalmoscope, blood pressure cuff, tuning forks, Snellen eye chart, reflex hammer, and penlight, to name a few. I acquired limited exposure to the usage of this equipment throughout by undergrad studies, but I can’t wait to hone these skills this semester!

          So, there it is—semester two in a nutshell. It’s definitely going to be busier than last semester (if that’s possible). I do feel, however, that I am beginning this semester with a better indication of what to expect when I begin next Tuesday (January 21st). I have, what I think, is a good head start on the first couple of weeks, and I’ve also accepted the fact that it’s truly impossible to learn every detail prior to each midterm or final. Like last semester, I plan to use the pop-quizzes/exams to my advantage and always expect to be tested on a weekly basis to keep up with the material as best as possible. I do plan to blog every Friday, as I did last semester, time permitting. I can’t believe I’m saying this, but I think I’m ready to begin this semester…just give me a few weeks before I probably regret saying this. Okay…let’s do this…

Questions of the Week:

  1. What does ECG/EKG (interchangeable) stand for?
  2. A P.A. may use an otoscope to examine your _______.
  3. A P.A. may use an opthalmoscope to examine your _________.
  4. A P.A. prescribes a medication to be taken “qid.” How many times per day will you be taking this medication? Hint: The “q” gives you the answer (think Latin…or, in this case, Italian, which is what I prefer!).  
  5. A P.A. prescribes a medication to be taken “po.” So, will this medication be injected, swallowed, or applied to the surface of your skin? Hint: The “o” gives you the answer (think in a similar manner as you did for question #4).