I had a lot of fun playing with kids in the office today. One boy was dragged to the office for his babysitter's appointment and decided to romp around the room while the doctor and social worker tried to figure out the patient's biopsychosocial situation. I made it my job to distract him so the others could have a productive conversation. We played step-on-each-other's-foot, then jump-on-the-office-scale, followed by some retractable-student-ID-strangling-hazard and finally a few rounds of no-that-glove-won't-fit-your-3yo-hands.
Family med is a great opportunity to compare adult and pediatric medicine since you regularly treat both age groups. My takeaway thus far has been that while adults are usually aweful as patients and, at best, boring, children are usually really cool when you're not shoving things in their orifices (which is pretty reasonable in my opinion) even if occasionally a few are terrible (usually because of bad parenting). Two weeks ago I was feeling pretty confident I was heading towards internal medicine, but now peds is making a resurgence. Third year sure is a roller coaster when it comes to life decisions.
TIL: TURP stands for transurethral resection of the prostate... and now makes me wince!
The false positive PPD test for TB that can be caused by the BCG vaccine fades over time. This vaccine is not given in the US but is common in parts of the world where tuberculosis is more prevalent. One of the annoying side effects is that the standard screening test for TB, the purified protein derivative (PPD) test, will show a false positive reading for many years. Studies have shown, however, that if the PPD shows >15mm of induration that it is far more likely to be true TB than a vaccine induced false positive.
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