INTERESTING TIMES

I'm not going to rewrite the whole case, but I will summarize it here, then answer the questions. 38 yo male moves heavy stuff and wakes up one morning with a kink in his neck. It gets worse, with cramping, burning pain in his neck and shoulders. He can't sleep, and goes everywhere with his arm over his head (Bakody's sign) because that's the only position in which he gets relief from the pain. A day later he goes to the urgent care center and they prescribe narcotic pain meds and muscle relaxers, but the pt won't take them because he's a recovering addict. They don't take any xrays.
( notes on the case and answers to the homework )

I was pretty shaky but I did it. Poked a needle in a classmate's arm and actually hit a vein on my first try ever, pulled a tube of blood. I was stoked. She took a stab at my arm too. The needle glanced off the vein but otherwise she was smooth. I am excited because I fully intend to draw and evaluate blood samples in my medical practice. I also totally believe in the value of getting a complete blood panel every year or three. Even if you are totally healthy, it's worth getting them, just for a baseline.

Came home on my bike, about 9:15 pm after finishing my security shift at the school. Kitten greeted me in the driveway, but then the invader cat (that I threw down the stairs yesterday) was on MY porch. It came out making its rough sound and kitten ran off, hissing. She's scared of THAT thing? Bummer. I chased it off---it really ran this time--and eventually, after I had the door unlocked and was halfway in, the kitten showed up again. Once inside I turned on the fan to bring the night air into my hot attic box (aka the Crow's nest), and gave the kitten a thorough petting, but then feeling impatient with the heat and the small space I headed up onto the roof for some night air. Ahhh. Sat down with my backside against the chimney and looked west to lights of the city and the University buildings up on the West Hills. The train horn in the distance was a familiar tone. Kitten came out and joined me. For the first time that I know of, she jumped up onto the brick chimney, and sat down right over my head. I sat there for a while cooling off mentally and physically, and she stayed on the chimney. I stood up and walked around on the roof, feeling soft spots in the tarpaper cover. I came back to the chimney and petted the kitten. I came down in here and turned on the computer.
( more )

I got my grades in the mail yesterday. I passed everything, and was pleased to find that I rated honors in both Immunology and Hydrotherapy. I wasn't even really going for honors, I was just trying to pass. That is a hopeful thing. Having passed all my first year classes, I am now officially an ND2.

What thyroid condition causes a persistent sore throat with a painful thyroid and fever?
Dequervain or giant cell thyroiditis, aka subacute granulomatous thyroiditis
more in women 10-40???

An elder whose CHF has just gotten worse may have what thyroid condition?
"apathetic" hypothyroidism

If someone just had a coxsackie virus infection and now is hyperthyroid, what do you suspect?
( self quiz, use the scroll bar to see what you know, this info integrated, moved post to 2008 for archive )