Week 20: Just Unnecessary

          Well, the result of my Cardiology EKG exam was emailed to me last Saturday morning at around 12:30 a.m., and I’m thrilled and extremely relieved to say that the result was great. I’m so thankful that the time I spent practicing paid off (really, I was panicking leading up to the exam). For now, it’s nice to get a little break from EKGs and rather spend time studying for my other classes (until Cardiology starts up again next week). As I said last week, snow days have really been disrupting our lecture schedules, but the professors have been doing well with making up for the lost time…a little too well. This week, the material for several courses was double the amount as would be taught in a given week (to make up for lost time), so, once again, I find myself trying to catch up…trying…

          This week in Clinical Lab Medicine, we doubled-up on lecture time, and learned when to order and how to interpret the lab results of toxicology (drug ) screening, lipid panels, cardiac enzymes (when you suspect someone has had a heart attack), liver function tests, immunological tests, and endocrine function tests (like those for thyroid, adrenal hormones…etc). This class is really the first to begin integrating information we have learned thus far in all of the courses we have taken or are currently taking, so the content requires much critical thinking. Sometimes, what’s most important is knowing when not to order a test, knowing when a test is just unnecessary, especially for the patient. In Pharmacology we continued to focus on the prescription of antibiotics for both pediatric and adult patients. It’s unbelievable how much thought must go into the ultimate decision of what to prescribe to a patient. Once again, what’s just as important, is knowing when prescribing a drug, like an antibiotic is just unnecessary based on the patient’s presenting symptoms. From what I’ve learned, It’s definitely better to be conservative in the prescription of antibiotics.

          Yesterday was our last Endocrinology lecture, which focused on the diagnosis of disorders of the parathyroid glands, bone disorders (which might result from such parathyroid disorders) and lipid metabolism disorders. Next Thursday is our Endocrinology final, so I have a lot of information (as always) to review before then. After the one-hour final, we begin the first lecture of our next specialty course: Pulmonology (the study of lung disorders). I did enjoy Endocrinology very much, but I think I’ll be prepared for the change by next week.

          P.S.: I’m already twenty weeks into PA school…1/3 of the way through my didactic phase…15 months away from my clinical phase…regardless of how I think of it, I just can’t get over this!

Question of the week: Your patient presents with symptoms, which you identify as those of a common cold. The patient requests that you prescribe him an antibiotic to shorten the course of his cold and alleviate the severity of his symptoms. You should undoubtedly prescribe him the antibiotic he is requesting, right?

Last week’s answer: When performing a skin self-examination, the ABCDE rule is often used as an important screening method for detecting potential melanomas. Any lesion should be assessed for Asymmetry, irregular Borders, Color variation, Diameter, and Evolution/Elevation. 

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