medical-gal - Tumblr blog

[medical-gal]

More importnatly....penicillin wouldnt probably work in rl for this kind of wound. Strep or clostridia? Sure. I love the series but this just irked me. I dont remember if they specified it in the game tho.

Got to wondering if injecting penicillin directly into Joel’s wound would actually work so @downbythebay4 did a search and…

PENICILLIN GOES IN THE BUTT

WE COULD OF HAD THAT PEDRO BUTT

[medical-gal]

“Never doubt that thousands of invisible hands are helping you at all times. Love is everywhere, even if you can’t see it. The tenderest care will arrive when you least expect it, and from someone whose name you will never know.”

— Elizabeth Gilbert

[medical-gal]

Me: i am calling for prof.awesomesauce

Prof.awesomesauce: yes hi its me. What is this about?

Me: its about your patient mr.badluck who has agamaglobulinemia

Prof.awesomesauce: yes. What is this about.

Me: he is in prison.

Prof.awesomesauce:....excuse me?

Me: your patient mr.badluck is in prison. He is gonna be here at least for one year.

Prof. Awesomesauce: well..thats a problem. He suppose to get immunoglobulines every month so he doesnt die.

Me: yeah i know. Thats why I am calling so we can come up with a plan.

Prof.awesomesauce: ok! Good. He will have to come here on this date every month.

Me: yeah thats a problem. The inmates cannot know the dates when they leave the prison for any reason.

Prof.awesomesauce: ....u kiddin me.

Me: i wish.

Anyway we did come up with a solution. I was kinda afraid bc my experience with professors is usually not good but this guy was so nice and accomodating.

Anyway

I have a small gig in a local prison hospital.so far its interesting and way less stressfull than hospital work.thats saying something about hospital work i'd think.

[medical-gal]

HYPER, a case report

20 something years old man of Asian descent presented with a history of 1 week of temperatures, retrosternal chest pains and just not doing that hot. COVID test was negative.

During his physical, I could tell he was sick, pale, sweaty, tachypneic and tachycardic. His pressure was normal. Meningeal signs are negative. Neuro negative. Abdomen negative. No peripheral signs of emboli or rashes. There was a bit of a weird chest sound (listed I have been doing ID for some years but for the life of me sometimes I can't tell which one it is...I just know it's not supposed to be there)) and I think I heard a heart mummer.

His labs: high white cell count, elevated CRP and procalcitonin. In the differential, neutrophils took the prize. Lactate thru the roof. Liver enzymes were elevated (transaminases).

He got a chest x-ray which was clear. Ultrasonography of the abdomen was negative.

His history was insignificant, he doesn't have any preexisting medical conditions, and he is updated on all his vaccinations. He is straight, married for a few years. He likes to play football with his friends who are all of Asian descent. They don't have kids but they have a dog. He is a teacher, he teaches English. He hasn't been to his country of origin since he was a child and nobody around him has travelled anywhere lately. He doesn't travel, he hates flying.

I admitted him and started him on co-amoxicillin with metronidazole bc all I had was tachypnoea and fevers. Tho his chest x-ray was negative, we decided to order a chest and abdomen CT scan, his ddimeres were elevated so I wanted to make sure he doesn't have a PE, which he did not. However, what the CT scan described - was 2 small abscesses peripherally liver approximately 3cm each.

Meanwhile, his blood cultures came back positive for...

GIF by thegalaxyrailways



Klebsiella pneumoniae, the hypervirulent kind

lol

ok. I wanted to prescribe cefta+avibactam. My boss laughed and laughed and laughed and asked from which pocket that will go so...

In the end, we did a CT navigated drainage and gave him colistin.

He did well.

But I think it's something he got from the community. At least it's what the lit says.

Do u have any experience with hypervirulent Klebsiella pneumonia infection? Drop a msg in my inbox I wanna hear all your tips and tricks!

Also, I hope all my ID folks are having the best time at ID week. I hope I will be able to go one day!

[medical-gal]

Apperently an internet famous pet emu has an avian flu. And the owner is posting pics and posts where she is being very close to this highly infectious bird. Without ANY PPE.

People of course say that its a pet and how would we behave if it was a dog for an example.

....like one global pandemic aint enough for some folks. (Btw if.my dog got a disease which is almost always deadly and/or they suffer I would do the humane thing and send him off...but that doesnt count when its an internet famous bird🤷‍♀️)

[medical-gal]

“You are strong enough to face it all, even if it doesn’t feel like it right now.”

— Unknown

[medical-gal]

A twenty-three-year-old Viennese woman, depicted before and after contracting cholera in the first epidemic in 1831. According to the original caption, the second image shows her only an hour after contracting the disease, and she died four hours later.

[medical-gal]

[medical-gal]

Soooo

Monkey pox.

[medical-gal]

If anyone has some experience with managing esophageal pulmonary fistula

Hit me up.

Thnx

[medical-gal]

psychically smacking my new hire with a spoon like "no, don't work off the clock" "yes, we give you breaks" "no, we aren't nice for doing this, it's literally the law" it feels like I've adopted a shelter cat

[medical-gal]

“It’s your road and yours alone. Others may walk it with you but no-one can walk it for you.”

— Rumi

[medical-gal]

I girlbossed too close to the sun and now I am an ID fellow.

[medical-gal]

“One of the hardest decisions you’ll ever face in life is choosing whether to walk away or try harder.”

— Ziad K. Abdelnour

[medical-gal]

What I have learnt while studying for my boards?

With almost all diseases u can say they are able to be asymptomatic and there is 99% chanc3 u r gonna be right.

[medical-gal]

What part of ID do u love the most.

Mycology for me.

I could talk about blasto and histo for ages. Tho I have never seen a case. Not endemic where I live. We get a shitton of invasive candidosis, few pulmo aspergillus (never seen disseminated). Have seen and took care of a patient with Mucor. Did not end up well.

Also loads of invasive nosocomial C. Glabrata and Krusei. Multiresistant of course. Once I had a patient with IE C. Albicans. Only echinocandins were possible. Of course my boss was super pissed bc its hella expensive. But the patient also had endophtalmitis. And 3stage renal failure. So...anyway he ended up doing fine.

Anyway

Mycology🥰

Anyway 9 days till boards 🙃🙃🙃

[medical-gal]

Btw guys I had to use my vacation days so I could study for my board exams.

Which I find kinda funny that employers r not actually giving us free paid time to further our knowledge and/or certification.

And by funny I mean demented.