Week 26: Lub-Dub

          Lub-dub…Lub-dub…Lub-dub—the sounds of a beating heart, sounds generated by the impeccably coordinated opening and closure of the heart’s valves, sounds I must become very accustomed to listening to from this point on. This week in Clinical Skills, we learned how to perform a cardiovascular physical exam, from identifying and assessing pulses to listening to the soothing melody of the heart, something I’ve been waiting a while for. Just as with the lung physical exam, it’s important for us to learn the sounds of a regular heart before being able to identify heart murmurs (abnormal heart sounds)…and there are many. Luckily, there are a lot of internet resources that have examples of what the abnormal heart sounds sound like, but for now, it’s more important to learn how each murmur is described in writing (at least for testing purposes). I’m sure it will take a lot of time, patience, experience, and heart-listening, before murmur identification becomes a bit easier…

          This week was definitely more manageable than last week (the Cardiology final-induced stress). In Clinical Lab Medicine, we focused on blood transfusions and the risks associated with them. An extremely high amount of caution needs to be taken when administering transfusions, especially double and triple-checking that the blood of the donor (giving the blood) and the recipient (receiving the blood) match, otherwise the resulting reaction can be catastrophic. In Informatics in Medicine (I haven’t spoken much about this course), we have been focusing on phone and other hand-held device applications frequently used in the medical field, in addition to the use of electronic medical records. I only have this course once a week for one hour, so, as I said at the beginning of the semester, it’s a breath of fresh air. Today in Epidemiology (another course I rarely mention), I (and four other classmates) presented a group project in which we had to critique a published medical article. Our topic focused on the potential side effects of azithromycin (an antibiotic), specifically in patients with cardiovascular risk factors. I think the presentation went smoothly, but we haven’t received any feedback from the professor just yet.

          Yesterday was my Pulmonology final, and it went well. I find that, at least with Pulmonology, if you know the signs/symptoms that a patient is experiencing, his or her age, and the results of his or her chest x-ray (if they had one performed), all of those pieces of information tend to fit nicely together into the ultimate diagnosis/treatment plan. It’s like solving a mystery. Next week I have two more exams, one of which is my Epidemiology final, and then, I think I may not have another big exam for a couple of weeks. But, I’m sure there will be several pop-quizzes to fill in that too-good-to-be-true gap…

Question of the week: After identifying a heart murmur in your patient, you believe that the murmur is derived from the heart valve located between the right atrium and right ventricle. Are you considering the heart murmur is derived from the tricuspid valve, pulmonic valve, bicuspid/mitral valve, or aortic valve?

Last week’s answer: Nephrons are the microscopic components, which comprise the kidneys.

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