INTERESTING TIMES

MYELOPROLIFERATIVE DISORDERS:
--caused by clonal expansion of pluripotent stem cell in bone marrow (BM) causing abnormal production of erythroid, myeloid, andmegakaryocytic precursors
--reflected in PB smear and CBC results
--multiple BM cell lines usu affected, but one cell line may dominate
--TYPES:
1. Polycythemia Vera
2. Myelofibrosis
3. Essential Thrombocythemia
4. Chronic Myelogenous Leukemia (CML)
( specifics on the first three, the fourth is in leukemia post )

If you die 5 years and 1 day after a cancer diagnosis, what are you?
( notes from Dr Thom's lecture )

Thoracic Outlet Syndrome Tests have poor validity, as there is a false positive rate of 53-92%. So if someone does this test on you and you have a positive result (usually a + is elicited pain/numbness/tingling or loss of a pulse), it doesn't mean anything for sure. Positive tests should be "assessed cautiously".
( more )

FAMILY: Gentianaceae
MORE SPECIES: Gentiana calycosa is native to the PNW. Varieties found all over the planet.
COMMON NAMES: bitter root, bitterwort, gall weed, gentiana, gentianae radix, pale gentian, stemless gentian, yellow gentian, wild gentian, quin jiao
( more )

Phew. Seems like I am constantly on the edge, but I keep passing, so I guess I'm doing something right. I even got honors in a couple classes, including the one in which I was shaking so hard that it was really tough to draw blood. Phew. Now I'm officially an ND3. I am still on the 4 year track, slated to graduate in 2011 with a lot of clinical experience already under my belt. I can't relax yet. I'm studying biochemistry today, in preparation for the Basic Science Boards. August 5. I'll get to relax after that.

I will be taking the first ever case-based NPLEX exam for ND's. What this means is that instead of having five sections (pathology, biochemistry, anatomy, physiology, microbiology) it will have many cases each with 5 questions relating to the case. This makes it more interesting to me. I am studying biochemistry by looking up metabolic dysfunctions and understanding their chemical pathogenesis.
( biochemistry nerdiness: mucopolysacchariosis nutshell )

Be prepared to perform grade IV - V manipulations from this list:
1) prone rib elevation
2) prone rib depression
3) upper thoracic rotation or extension (bedside move)
4) upper rib posterior to anterior manipulation prone (bedside move)
5) supine flexion ("anteriority" move)
6) alternative positioning supine flexion ("anteriority")
7) supine rotation
8) supine rib posterior to anterior manipulation
( we're learning to manipulate spines and ribs from chiropractor Agresta )