So unfortunately, I haven't been able to update here since I've been so tired over the past week. Working the overnight shift on the weekend can certianly mess things up. Anyhow, I spent the past week on Gastroenterology which was pretty nice.
The other thing that happened this week was that I started getting interviews for fellowship. Gah! The season is starting! But we'll see how it all goes.
So my nicest and most interesting patient this week had recurrent ascites. She was getting tapped 4L for months and came in on an elective admission to try and figure out what it was. The primary team thought she had chylous ascites as she had a history of Hodgkins disease and fallopian tube cancer and "it looked like being in a milk carton" when they took a look at her. She had no liver problems, no pericarditis, and the fluid most definetly not chylous ascites with a meager triglyceride level of 9. There were no malignant cells and no signs of portal hypertension so our best guess was that there may have been some peritoneal irritation from prior intraperitoneal chemo. We started her on some lasix and spironolactone and sent her on her way.
Our noon lectures this week have been on cancer. Yesterday we covered myelosysplastic syndrome and AML. All I remember is:
-myelodysplastic syndrome can present with hypo or hypercellular marrow
-AML is defined as having >20% cells as myeloblasts on the diff
-the M3 subtype of AML is the one that is different from all the others
The other cancer lecture we had was on breast and prostate cancer.
We had a good resident report case on a patient who came in with back pain who turned out to have spinal mets from an angioma. The other one had painless hematuria. There was also a CPC case on Conn's syndrome.
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