“The next lady we’ll be visiting has COPD. Can either of you tell me what to expect in this patient?”
Yes! We’re studying respiratory phys right now. I can’t believe how perfect this is.
“High residual volume, and a higher fraction of functional residual capacity per volume.” The doctor does a second take. What did I do wrong?
“I meant her arterial blood gasses.” Well. This is embarrassing. Because the second she walks into the ER, she’s far more likely to be put on CPAP immediately (like she is right now) than for someone to whip out a spirometer to measure her residual volume.
The other med student perks up. ”High carbon dioxide.” And, as the teens say nowadays, I just got owned.
I could have answered that with my art history degree alone, had I been thinking about the straightforward answer. Occham’s razor: the simplest answer is always right.
What I promise you, future med students: if you’re going to a subject-based school (and not systems-based), the first year will be catching everyone up to the same basic science level. (And diabetes. First year might as well be renamed: THE YEAR IN WHICH YOU LEARN ABOUT DIABETES.) Only in 2nd year do you focus on pathologies, and (or so I’ve heard) only in third and fourth year does it all make sense.
To residual volumes!
Diabetes in first year? I’d say my first year was the year I learned about the citric acid cycle and the coagulation cascade…but that perception is probably skewed by my cohort’s general dislike for that topic.
Although, now I think about it, diabetes does come up at least once a semester.
We definitely just finished the citric acid cycle and coag- but now I think every other lecture is about diabetes
It’s so true. Everything starts coming together during third year… every day I have a realization about something I thought I knew first or second year but I really had no idea.
I can’t wait till it all makes sense!!
That’s what I call a “guess what I’m thinking question”, and they’re almost impossible to get right because you have no idea what the doc is looking for. I would’ve said expiratory wheeze and prolonged expiratory phase, which would also not have been the answer he was looking for but still would’ve been findings on the patient.
I have yet to learn those symptoms
But duly noted!
I agree, that is most definitely a “guess what I’m thinking question.” The right answer is still not the right answer.
The first 2/3 of my first year was subject based… And I agree, it is mostly catching everyone up to the same level (just for you to forget it again by the time you need that kind of information again).
Looks like I’ll have to get used to these questions
I detest “guess what I’m thinking” questions – which this, of course, was. But it’s cool. I still usually learn something from whatever answer the attending has settled on as the one, true, and only answer.
But I still HATE them.
I need a bit more clinical experience to have a better idea of what they’re looking for with these questions. But then, that’s what shadowing is for! It is nice to get out of the library
Like your blog! I am excited to read more in the future!
http://www.myfirstpatient.wordpress.com