Ramblings of a serial procrastinator

A patient presents with isolated speech disturbance ?confusion.

You attempt to obtain a history but the patient answers inappropriately with repetition of words such as “nine, nine nine, nine, nine nine nine” with occasional correct words.

Her rapport and social behaviour appears normal. The patient can follow instructions when accompanied by gestures, but cannot when the gestures are removed.

The patient cannot read anything apart from their name. When attempting to write, words are formed but are nonsense and repetitive. 

The patient attempts to repeat after you, but cannot do so. 

Assuming this is a TIA/stroke, where would the lesion be and what artery would be involved? Bonus points, how you would classify the dysphasia?

What I got up to on my medical elective part 1 … Here is a photograph I took at Barranco base camp at 3800m on mount Kilimanjaro.

I watched a fascinating programme by Dr Michael Mosley on the truth about exercise. There are a number of interesting points made which may motivate you if you have not been into exercise before now. I really recommend you catch it on iPlayer. 

Summary:

A new school of thought with regards to exercise and health benefits is that HIT high intensity training is extremely beneficial health wise for very minimal time spent exercising. Essentially cycling for 20 seconds (three times) as fast as you physically can three times a week (grand total of 3 minutes exercise a week) improves your blood glucose levels and could prevent diabetes. 

Also, after you exercise you induce the production of the enzyme lipoprotein lipase. This means that the following day when you eat a fatty meal your body is more efficient at moving the fat/energy around. So you have 1/3 lower levels of fat in your blood stream = Lower risk of heart disease. 

P.S. as this post is about exercise I felt justified in a GPOY of me exercising hah.

It was tough! 

Tips for clinical examinations;

• 1) Forget about the typical run of the mill conditions
• 2) Learn as many obscure eponymous syndromes as possible
• 3) If they tell you they won’t examine you on something until finals, ignore that and revise it along with everything else…

Practical exam tomorrow, two real patients I have to diagnose and suggest management… I’m looking forward to the pub afterwards! 

my-bloody-underground:

oatsodanbarleypop:

Here is an example of an excellent imported beer that you should buy.  Brewed in Belgium (the home to some of the best beer in the world), this strong pale ale not only boasts badass pink elephants on the label, but also a 8.5% alcohol by volume.  As the cliche goes, lets just say there is a reason its name means “trembling madness” in Latin.  Overall, Delirium Tremens is a great introduction to Belgian beer for all curious consumers interested in some solid pallat-expansion.

Due to its increasing popularity (it was named best beer in the world in 1998), you should be able to find it fairly easily in the imported section of most places that sell beer.  However, as always, Bevmo will be your safest bet.  I’ve also seen it at a bunch of bars, so just keep an eye out.

Gezondheid (yeah, apparently they say cheers in Belgium the same way we often respond to sneezes, weird).

need to get some of this

This is pretty funny, a beer named after the withdrawal symptoms alcoholics get when they go cold turkey… Interesting marketing! 

http://en.wikipedia.org/wiki/Delirium_tremens

(via beer-in-the-bidon)

young-medic:

medicalstate:

The word “poetic” could not have been a more apt description for this story. Michael Houghton from the University of Alberta, who led a team of scientists to the discovery of Hepatitis C in 1989 announced earlier today that he has discovered the vaccine. With the diversity of hepatitis C strains, it was long thought to be impossible to develop a vaccine that could target all of them. Ten years of research and development has led to this discovery. 

As Houghton admits, there are still more tests to be run to check its efficacy and safety but so far the vaccine candidate is showing great promise.

Awesome….

(via thecheerfulmedic)

Picked up my HIV post exposure prophylaxis kit today to take with me to Tanzania. The cost price of these few tablets (5 days worth) is approximately £70.

Edit - Yup they really are that big! 

florenceandthings:

And this is why it takes so long to decipher post op notes….

I’ve seen every one of those… 

Personally I’m probably a ‘Every 4th word legible’ kinda guy. I honestly try but I’ve always been bad. I think I’m too inpatient and want to write quicker than I really can. Also when your stood up supporting the notes with your left hand it’s bound to make things tricky.  

(via navamon)

caineadam:

my-bloody-underground:

caineadam:

my-bloody-underground:

enofisenough:

It’s so rare for me to have somebody to catch when doing my Medway Miles loop and to have a pair to catch was a double bonus. Spotted them coming out of Newington and caught them on pretty much the only decent little climb on the loop, then proceeded to gun it past them. THEY WERE NOT HAPPY! The one at the front even shouted summat at me! “OI ……” put a proper smile on my face.

you like overtaking other cyclists? I always feel kind bad and imbarrrased.
how very british of me 

Zac wtf? I love over taking other cyclists even if it’s just a hipster on a gay bike with his stupid clothes! No matter who they are or what their story is I try my hardest to over take them and put groud between us!

Kind of like what I did to you when we sprinted for the border! Although you had the route so I had to let you catch up and stay in front!

stfu! you got like 2 sprints at the start of the ride when i wasn’t paying attention and even then you were hardly more than a 2 feet in front of me. when we got to any inclines you were dropped like a stone and i was soft pedaling trying to wait for you………

catching people is akward. ppl get scared when they’re not expecting/ don’t know theres a rider behind, usually try and talk, sometimes try and hang on and sometimes they TRY AND RACE.

passing other people doesn’t make you better than them, and racing against people you don’t know is fucking stupid. if I’m on a zone 2 ride then I’ll stick riding zone 2, if I’m riding intervals I’ll either ride fast or slow depending which part of the ride it is, If I’m doing a fast ride I SHOULD BE RIDING FAST ANYWAY, NOT FOR AN EGO BOOST BY PASSING SOMEONE. 

Lmao, ok no need to rub it in that I suck at climbing :( forced hill climbs and such will improve this.

I don’t do it for an ego boost when I do do it it’s like a goal i set something to focus on when I’m on the same old route, makes it fun. I can’t really explain better than that.

When I’m on my MTb it’s a different story flying past people on the track gives you a real exhilarating boost.

I’m pretty sure Zac has this right. You don’t know if the person you are overtaking is a pro who is taking it easy or a novice pushing them self as hard as they can. If you overtake it’s good to have some decorum and just accept that you were on a quicker ride at that point in time. Say a few pleasantries and go on your way, happier for having had an encounter with a fellow cyclist.