List things that were taught repeatedly, but will never see

[yaah]

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I have seen two cases of fractured penis, though! 😱

I saw a case of peyronie disease (penile fibromatosis) with metaplastic ossification in the scar tissue. Thus, a true penile "boner."

 

[anon-y-mouse]

I saw a case of peyronie disease (penile fibromatosis) with metaplastic ossification in the scar tissue. Thus, a true penile "boner."

Reminds me of this dude:
http://forums.studentdoctor.net/showthread.php?t=35811&pp=20

Oh, and I have seen serotonin syndrome 4 times (in 2 weeks!)... so it is definitely fairly common, though I guess relatively rare.

 

[Scaredshizzles]

What about Hirschsprung's Disease?

I've heard about it 5-6 times already but does this thing actually show up? I have no clue how common it is.

If you've seen enough Down's kids you're bound to have seen it.

GBS is also fairly common.

The others for the most part I agree we're lucky to see 1 case of all of these in med school.

 

[yohimbine1]

Niemann Pick and many of the lysosomal diseases. Peutz Jeghers.

 

[Ashers]

Niemann Pick and many of the lysosomal diseases. Peutz Jeghers.

I know it's not seeing it, but after the lectures M1 year about that stuff, a few of my friends were talking about how they're carriers for Niemann Pick or Tay Sachs.

 

[Gut Shot]

Whipple disease.

There are like 1000 cases in the last 100 years. Most doctors don't ever see one in their careers.

Fellow resident had one.

 

[Gut Shot]

I have yet to see a positive urine Legionella antigen, for example, despite the fact that nearly every patient who shows up with a pneumonia gets one done.

We had an outbreak of Legionella pneumonia near my hometown a number of years ago. They traced it to a hot tub display at Lowe's.

 

[mac61]

Dracunculus medinensis....hands down. I won't consider myself a real doctor until I've rolled and 10 inch worm out of some guys leg with a match stick; could be a long wait. To be fair though we only had it in 3 classes (micro, parasitology, and path) so I'm not sure if it counts as "repeatedly" being taught.

 

[Scaredshizzles]

Dracunculus medinensis....hands down. I won't consider myself a real doctor until I've rolled and 10 inch worm out of some guys leg with a match stick; could be a long wait. To be fair though we only had it in 3 classes (micro, parasitology, and path) so I'm not sure if it counts as "repeatedly" being taught.

You need to take an elective in Africa or Asia to see this stuff....There are some US soliders returning home with Leishmaniasis though apparently.

 

[chrisisinnocent]

Temporal Arteritis. That thing showed up on every shelf it seemed.

 

[Blade28]

Temporal Arteritis. That thing showed up on every shelf it seemed.

I've seen that 2-3 times on Vascular.

 

[Blade28]

I didn't know about Oahu. There's a few on Maui. My dad had a leprosy patient that recently died. Since I'll be on Maui, I still hope to see it there. 😀

I'll say hi to Hawai'i for you, Blade. 😀

Nice thanks! 🙂

 

[Smurfette]

Some of the things listed above I've seen (as a surgery resident):
Addison's (not that rare)
Hirschsprung's (fairly common)
serotonin syndrome
peyronie's
guillain-barre
temporal arteritis (actually is not uncommon)

funky things I've seen that I never thought I would when I learned it in med school:
ascariasis (2)
IgG nephropathy
Poland syndrome
Patau's syndrome
dextrocardia
Kawasaki's
Aspergillosis (3)

 

[Blesbok]

Some of the things listed above I've seen (as a surgery resident):
Addison's (not that rare)
Hirschsprung's (fairly common)
serotonin syndrome
peyronie's
guillain-barre
temporal arteritis (actually is not uncommon)

funky things I've seen that I never thought I would when I learned it in med school:
ascariasis (2)
IgG nephropathy
Poland syndrome
Patau's syndrome
dextrocardia
Kawasaki's
Aspergillosis (3)

Kawasaki's was the one that suprised me last month on peds. I saw three cases of it on my team alone.

 

[TheRealMD]

I had the wonderful ability of giving a few med students at UTSW the ability to see malaria first-hand about 10 years ago. Apparently it required a few calls to the CDC in Atlanta to confirm.

Gotta love those overseas trips! 😛

 

[ZagDoc]

Anyone ever seen Lesch-Nyhan Syndrome? The NIH doc that gave our lecture on metabolic disorders said he had seen several cases, but then again he's knee deep in the field and our school is the referral for all metabolic disorders for the whole state.

That one always stood out to me because of the self-mutilation behavioral aspect of it.

The ones that come to mind are: CJD, Diphtheria, African trypanosomiasis, Rabies, Ebola

Saw diphtheria in the peds ER. Kid presented with the classic "grey" mucosa of the posterior pharnx and a nice swollen neck.

 

[ATrain]

I know it's not seeing it, but after the lectures M1 year about that stuff, a few of my friends were talking about how they're carriers for Niemann Pick or Tay Sachs.

I had a girl with Neimann Pick as a client when I worked in developmental disabilities services. Sad condition.

 

[radslooking]

The ones that come to mind are: CJD, Diphtheria, African trypanosomiasis, Rabies, Ebola

if you see ebola, please tell me. right after you contact the cdc

 

[radslooking]

Temporal Arteritis. That thing showed up on every shelf it seemed.

not that uncommon. 10% of polymyalgia rheumatica patients get it, and there's plenty with PMR

 

[radslooking]

Kawasaki's was the one that suprised me last month on peds. I saw three cases of it on my team alone.

strawberry tongue! treat with aspirin! 😉

edit////also gamma globulin 😉

 

[racerx]

Plummer-Vinson Syndrome. Saw it on step 1 too.

 

[Depakote]

anyone actually prospagnosia?

 

[bjolly]

anyone actually prospagnosia?

yep. Pt also had L sided neglect.

 

[Depakote]

cool.

That's the problem with M1. They teach you about all these diseases but give you no perspective as to whether you'll be seeing them daily or once in your career.

 

[Depakote]

anyone actually prospagnosia?

wow, I grammared that good

 

[anon-y-mouse]

anyone actually prospagnosia?

I saw 2 cases, both s/p CVA... posterior cerebral artery

 

[mjl1717]

I had the wonderful ability of giving a few med students at UTSW the ability to see malaria first-hand about 10 years ago. Apparently it required a few calls to the CDC in Atlanta to confirm.

Gotta love those overseas trips! 😛

Yes, in the U.S. unlesss someone has traveled its uncommon.. But globally and in topical areas malaria is relatively common...{what?- merozoite (in liver), schizont, tropozoites, seen with light microscope... high fever , chills, malaise, lassitude, splenomegaly with possibly herpes labialis .}👍

 

[cubsrule4e]

I was assigned two patients with moyamoya in the same week back when i was on peds. And this was in Louisiana, not Japan!

 

[Gut Shot]

Inspired by my other thread


Pancreatitis from a scorpion sting
Goodpasture's

Zima intoxication in a heterosexual male.

 

[GoofyDoc]

Progeria
Leprosy

 

[Depakote]

Zima intoxication in a heterosexual male.

You should do a case study... that's gotta be a once in a lifetime find.

 

[Dedikated2liftn]

 

[Dedikated2liftn]

^^ Takes care of it for me.

 

[njac]

I just remembered this - remember those little details! A couple years ago I was achy and had weird bruises all over my legs and a lot of joint pain in my knees/hips. I was living in Tucson, AZ at the time. I'd just gotten back from MD and thought I'd seen a deer tick there, but no rash. So I assumed Lyme's. My mother was sure it was leukemia or something.

Anyway, my regular doctor was out, so the IM bigwig saw me, with a med student in tow. Who recognized my presentation of Valley Fever (cocci). They ended up pulling half the residents in the hospital in to look at me. I was certainly impressed with the med student that day, and she probably won't forget that either.

 

[45408]

The ones that come to mind are: CJD, Diphtheria, African trypanosomiasis, Rabies, Ebola

We got a lecture from the physician who was the one of the first ever (if not the first) to actually cure a girl of rabies.

 

[45408]

You need to take an elective in Africa or Asia to see this stuff....There are some US soliders returning home with Leishmaniasis though apparently.

Yeah, my medicine attending is an ID doc who does tropical med, and he's been seeing it over at the VA. It's endemic in Iraq.

 

[Ashers]

I just remembered this - remember those little details! A couple years ago I was achy and had weird bruises all over my legs and a lot of joint pain in my knees/hips. I was living in Tucson, AZ at the time. I'd just gotten back from MD and thought I'd seen a deer tick there, but no rash. So I assumed Lyme's. My mother was sure it was leukemia or something.

Anyway, my regular doctor was out, so the IM bigwig saw me, with a med student in tow. Who recognized my presentation of Valley Fever (cocci). They ended up pulling half the residents in the hospital in to look at me. I was certainly impressed with the med student that day, and she probably won't forget that either.

Was that 2001ish with the big Valley Fever outbreak? I want to get tested with a cocci PPD just to see if I'd react, since I lived there then, and I did get sick a few times in college.

 

[njac]

Was that 2001ish with the big Valley Fever outbreak? I want to get tested with a cocci PPD just to see if I'd react, since I lived there then, and I did get sick a few times in college.

pretty much everyone whose been to the SW will test positive. This was summer 2002 - the barn where I was keeping my horse was doing some serious landscaping with heavy equipment in the desert. I just figured I got one hell of an innoculation being out there in all that moving dirt.

It wasn't a bizarre diagnosis, especially considering the area. But it was an atypical presentation (I told my ID prof in pharmacy school and he was super excited that I'd had subcutaneous manifestations) and she nailed it before the attending did.

 

[Ashers]

pretty much everyone whose been to the SW will test positive. This was summer 2002 - the barn where I was keeping my horse was doing some serious landscaping with heavy equipment in the desert. I just figured I got one hell of an innoculation being out there in all that moving dirt.

It wasn't a bizarre diagnosis, especially considering the area. But it was an atypical presentation (I told my ID prof in pharmacy school and he was super excited that I'd had subcutaneous manifestations) and she nailed it before the attending did.

Cool. 2001-2002 was the big Valley Fever outbreak (we even learned about the outbreak in micro at my med school). UA medical center even has a Valley Fever center.

I didn't know many people who had Valley Fever bad, but 2 of the PhDs I worked with in an immunology got West Nile Virus in summer 2004.

 

[Strength&Speed]

pretty much everyone whose been to the SW will test positive. This was summer 2002 - the barn where I was keeping my horse was doing some serious landscaping with heavy equipment in the desert. I just figured I got one hell of an innoculation being out there in all that moving dirt.

It wasn't a bizarre diagnosis, especially considering the area. But it was an atypical presentation (I told my ID prof in pharmacy school and he was super excited that I'd had subcutaneous manifestations) and she nailed it before the attending did.

no respiratory symptoms? Just joint aches and bruises? Definitely playing in the dirt is where you got it....

 

[njac]

no respiratory symptoms? Just joint aches and bruises? Definitely playing in the dirt is where you got it....

yup, nothing respiratory symptom-wise. Are you saying I didn't catch it via respiration? What other modes of transmission are there (I don't recall any open wounds and I was working at a horse farm, not exactly rolling in the dirt, but close!)?

Anyway, I was almost 19 so they just sent me home with some Ibuprofen and told me to come back if it got worse. Like 500 miles away here in albuquerque the only cocci I've seen is meningitis from someone on the reservation in AZ. I guess it is endemic in the southern part of the state but I don't know if it's considered in the differential so much up here as it was in Tucson.

 

[Doctor J]

Yeah, my medicine attending is an ID doc who does tropical med, and he's been seeing it over at the VA. It's endemic in Iraq.

The Baghdad Boils, as I recall.

Another item that's been taught repeatedly but I will most likely never see... Encephalitis from Naegleria fowleri.

At least I hope I never see it. :cry:

 

[Agent Splat]

Serotonin Syndrome

saw it on psych consults. Pt started on an SNRI and primary team never d/c'd tramadol. She was also on a tricyclic before the SNRI was started.

 

[mjl1717]

How about Marie Charcot Tooth Disease?

Ive seen one: can be A.D.. but has multiple heterogenecity...distal weakness, distal sensory loss, maybe foot drop..

Also has anyone seen Oslers Disease.. (Osler Rendu Weber)? [its A.D. also, with Family history, telangiectasia, AV malformations..{scratch and bleed?}

 

[MeowMix]

Serotonin Syndrome

saw it in a kid presenting with small bowel perf after being stepped on while riding a bull. Anesthesia wondered why his vitals were so unstable during surgery, we wondered why he was flushed in a 56-degree room draped in only a sheet, and finally the *med student!* says, "serotonin syndrome!" Turned out he had a history of carcinoid that he somehow did not think was important enough to mention in the H&P.

 

[Strength&Speed]

yup, nothing respiratory symptom-wise. Are you saying I didn't catch it via respiration? What other modes of transmission are there (I don't recall any open wounds and I was working at a horse farm, not exactly rolling in the dirt, but close!)?

Anyway, I was almost 19 so they just sent me home with some Ibuprofen and told me to come back if it got worse. Like 500 miles away here in albuquerque the only cocci I've seen is meningitis from someone on the reservation in AZ. I guess it is endemic in the southern part of the state but I don't know if it's considered in the differential so much up here as it was in Tucson.

no, i meant that kicking up the dirt, you inhaled some of those hardy spores. you may be right...if you are in more mountainous areas it may not be so common. not sure, we just think of it as a southwest disease in general, but may be more nuanced than that.

 

[TamarMD]

I've seen CJD. I'm a CNA and one of my patients that I take care of has CJD.
Posted via Mobile Device

 

[ksav]

How about Marie Charcot Tooth Disease?

Ive seen one: can be A.D.. but has multiple heterogenecity...distal weakness, distal sensory loss, maybe foot drop..

Also has anyone seen Oslers Disease.. (Osler Rendu Weber)? [its A.D. also, with Family history, telangiectasia, AV malformations..{scratch and bleed?}

at one of the patient panels at our school they brought in 2 different cases.... CMTD1 and 2.

 

[mjl1717]

at one of the patient panels at our school they brought in 2 different cases.... CMTD1 and 2.

Acknowledged!!

For that matter has anyone ever seen Oslers nodes!

 

[TheMightyAngus]

I've seen CJD. I'm a CNA and one of my patients that I take care of has CJD.
Posted via Mobile Device

Are you sure? CJD is diagnosed by autopsy.