WILTIMS makes its triumphant return for the 2nd year homestretch! Only three more weeks until finals and then our 6-week dedicated study period for the Step 1 board exam. Yipee!
MondayIL: HbA1c is a great marker for long term hyperglycemia, but is unreliable in patients with changes in red blood cell formation or destruction, as in anemias. Hemoglobin A1c (HbA1c) is an irreversibly modified molecule of hemoglobin that essentially has been floating around in sugary blood so long that it gets chains of glucose stuck to it. This hemoglobin can only be recycled once the red blood cells themselves are recycled every 120 days. If you are anemic, you lost some red blood cells before their 120 days were up, which will skew the HbA1c level.
MondayIL: HbA1c is a great marker for long term hyperglycemia, but is unreliable in patients with changes in red blood cell formation or destruction, as in anemias. Hemoglobin A1c (HbA1c) is an irreversibly modified molecule of hemoglobin that essentially has been floating around in sugary blood so long that it gets chains of glucose stuck to it. This hemoglobin can only be recycled once the red blood cells themselves are recycled every 120 days. If you are anemic, you lost some red blood cells before their 120 days were up, which will skew the HbA1c level.
Hyperpigmentation can be caused by high adrenocorticotropic hormone (ACTH) levels associated with primary adrenal insufficiency. The ACTH molecule comes from pro-opiomelanocortin (POMC), the same precursor as beta endorphin and melanocyte stimulating hormone (MSH). The latter does exactly what its name says, it stimulates the cells that produce pigment in the skin.
TuesdayIL: Diabetes is a particularly annoying chronic disease because it doesn't force you to deal with it. Other conditions, like asthma, hepatitis C and arthritis, all have debilitating symptoms that spike when a patient either doesn't seek treatment or does something that exacerbates the condition. Diabetes just slowly, quietly progresses - making the patient a little more thirsty and need to pee a little more each day for years. Even at more advanced stages, diabetes just makes you swell and get numb - not exactly ER-worthy symptoms. Thus the undiagnosed stay undiagnosed, and the sick get sicker.
Insulin lispro is an insulin analog made by reversing a lysine-proline amino acid pair in the protein. Hence, lys-pro → lispro.
Neutral Protamine Hagedorn (NPH) is an intermediate-acting insulin analog named for the guy who first figured out how to complex protamine (originally found as, I kid you not, trout sperm basic protein) with zinc and insulin. The aforementioned guy, Hans Christian Hagedorn, also founded the company that would become Novo Nordisk, a major pharma company that specialized in diabetes treatments.
TIL: Facies is a word. This is one of those words that I just assumed was a typo for "faces," but alas, I was wrong. Facies means a facial appearance that is associated with a disease. So, pretty much just faces...
Old men who are wheelchair bound and double-diapered can become feminized due to the heat of the diapered area interfering with the testes' production of testosterone. Easy fix: less diaper!
Job's syndrome, aka hyperimmunoglobulin E syndrome, is named for the biblical story of Job, because terrible things keep happening to patients with this disease. Common symptoms (and/or punishments from on high) include repeated infections, puss-filled skin lesions, easily broken bones and tooth deformities.
This last fact I learned at a Rare Disease Bingo Night! It was actually lots of fun. We made our own bingo cards from a list of many dozens of rare diseases. One of our deans/professors/radiologists led us through diagnostic studies and descriptions, quizzing us to earn our Xs.
This last fact I learned at a Rare Disease Bingo Night! It was actually lots of fun. We made our own bingo cards from a list of many dozens of rare diseases. One of our deans/professors/radiologists led us through diagnostic studies and descriptions, quizzing us to earn our Xs.
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