Podcast 008: Trauma Surgery With Dr Jeremy Hsu

PATIENT IS BLEEDING! EVERYBODY PANIC!

That’s not what it’s really like in a trauma setting, is it?

Perhaps one of the most heavily glamourised fields in medicine, trauma is portrayed as being chaotic and exciting. Dr Jeremy talks about the ups and downs of life in trauma, as well as the different training paths that can lead to it.

Podcast

About the guest speaker

Dr Jeremy is the Director Of Trauma at Westmead Hospital. His training is in general surgery and in addition to his trauma work, he’s involved in breast clinics and medical teaching.

Music credits

Opening and closing themes by Lily Chen.

Sexually Transmitted Acronyms

Imagine how awkward it would be if sexually transmitted acronyms existed.

“OMG!” the first person would say.

Then they would engage in sexual intercourse with another individual.

“OMG!” the second person would subsequently say, having been transmitted the pathological acronym.

In that way, it would spread and society would rapidly become infiltrated.

That would be a scary world. But on the plus side, sexually transmitted acronyms don’t yet exist.

Rather, the medical conditions that people generally care about are sexually transmitted infections.

Here’s a way to remember them: “Cghhs!” It’s the noise someone makes when they’re gagging during sexual intercourse.

“Cghhs!” This stands for chlamydia, gonorrhoea, hepatitis B, HIV and syphilis.

Isn’t it catchy? “Cghhs!”

Standard asymptomatic STI screening

Urine or swab

Chlamydia: an important, frequently asymptomatic plague of so-called “young people”. Those awful whippersnappers! Frolicking around and spreading heresy everywhere! A first-pass urine test is the most convenient screening method, but it’s better to do an endo-cervical swab if a Pap smear is already planned. Alternatively, it can be appropriate to opt for a patient-collected vaginal swab if greater accuracy is sought and an examination is not being performed.

Gonorrhoea: the diagnostic process is similar to chlamydia. This is an additional test to consider.

Blood (for high-risk patients)

Hepatitis B: there is a multi-dose vaccine for this viral infection.

HIV: the test is not effective immediately, as there is a conversion window of at least 6 weeks.

Syphilis: the king of painless genital ulcers and chancres.

References

  1. Australian STI Management Guidelines (2017). Standard asymptomatic check-up. [online] Available at: http://www.sti.guidelines.org.au/standard-asymptomatic-check-up [Accessed 2 Jul. 2017].
  2. The Australian Immunisation Handbook. (2017). Immunise – 4.5 Hepatitis B. [online] Available at: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-5#4-5-4 [Accessed 2 Jul. 2017].
  3. Melbourne Sexual Health Centre. (2017). Window Period. [online] Available at: http://www.mshc.org.au/WP#.WVhWkBir2Rt [Accessed 2 Jul. 2017].
  4. Australian STI Management Guidelines (2017). Syphilis. [online] Available at: http://www.sti.guidelines.org.au/sexually-transmissible-infections/syphilis#clinical-presentation [Accessed 2 Jul. 2017].
  5. Centers for Disease Control and Prevention (2017). Syphilis – CDC Fact Sheet. [online] Available at: https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm [Accessed 2 Jul. 2017].

Hypersensitivity Reactions

Type I: Allergy and anaphylaxis

Type II: Cytotoxic and complement-mediated

Type III: Immune complex

Type IV: Delayed-type hypersensitivity

References

  1. McDaniel, B. (2014, November 24). Type 1, 2, 3 & 4 Hypersensitivity. Retrieved from Stomp on Step 1, http://www.stomponstep1.com/hypersensitivity-type-1-2-3-4-urticaria-anaphylaxis-immune-complexes-i-ii-iii-iv/.
  2. Ghaffar, A. Hypersensitivity reactions. Retrieved from Microbiology and Immunology On-line, http://www.microbiologybook.org/ghaffar/hyper00.htm.

Podcast 007: Ophthalmology With Dr Neil Rowe

Imagine life without adequate sight! Everything would be dark and sad, especially if you couldn’t browse this blog. But at least you could still listen to the podcast.

Without a doubt, you have eyes and they are very important. Hence, we have ophthalmology.

Dr Neil is an experienced ophthalmologist who talks about life in his specialty and honest career considerations for those thinking about undergoing the training.

This episode is dedicated to Sarah, gushing fan and amazing supporter.

Podcast

About the guest speaker

Dr Neil is an ophthalmologist who works in public and private practice and has trained in a variety of hospitals across Australia and the UK. As well as his medical work, he has a strong family life and appreciates sports immensely.

Music credits

Opening and closing themes by Phil Poronnik.

Podcast 006: Surgical Oncology With Dr Julie Howle

In the endless battle against cancer, there are those brave warriors who specialise in cutting it out.

They’re called surgical oncologists and they do far more than just operations.

Dr Julie talks about the life of a surgical oncologist, patient interaction, the training pathway and her success in maintaining a hugely interesting existence outside medicine.

Podcast

About the guest speaker

Dr Julie Howle is a specialist surgical oncologist with a background in general surgery. She now handles a variety of pathologies, such as melanoma, sarcoma and thyroid issues.

On top of her experienced clinical work, Dr Julie is an avid athlete who regularly undergoes triathlons and holds a world champion title.

Music credits

Opening and closing themes by Phil Poronnik.

Musculoskeletal Elbow Pain From Repetitive Strain Injury

Both of the following conditions would have local epicondyle tenderness.

Extensors

Lateral epicondyle: tennis elbow.

Pain is triggered by resisted wrist extension, because the forearm extensors are affected and this exertion induces tenderness.

Flexors

Medial epicondyle: golfer’s elbow.

Conversely, pain is triggered by resisted wrist flexion.

References

  1. Walker, B. R., Colledge, N. R., Ralston, S., & Penman, I. D. (2014;2013;). Davidson’s principles and practice of medicine (22nd ed.). Edinburgh: Churchill Livingstone/Elsevier.
  2. Tennis Elbow (Lateral Epicondylitis). (2017). OrthoInfo. Retrieved 11 April 2017, from http://orthoinfo.aaos.org/topic.cfm?topic=a00068
  3. Tennis Elbow and Golfer’s Elbow. (2017). Patient.info. Retrieved 11 April 2017, from https://patient.info/doctor/tennis-elbow-and-golfers-elbow

Regulators Of Bone Formation

Stimulates bone formation

Wnt: Wow! Let’s have bone formation!

Wnt proteins bind to LRP5 receptors on osteoblasts, triggering bone formation.

Inhibits bone formation

Sclerostin: Stop! No bone formation here!

Sclerostin is a factor produced by osteocytes. It inhibits the above Wnt process.

References

  1. Walker, B. R., Colledge, N. R., Ralston, S., & Penman, I. D. (2014;2013;). Davidson’s principles and practice of medicine (22nd ed.). Edinburgh: Churchill Livingstone/Elsevier.

Plaster Makes Warmth

After you apply some wrapping around wet plaster, you might notice that the patient’s limb feels warm.

Is this simply a product of insulation?

No, it’s not just this reason.

It’s primarily because plaster and water form an exothermic reaction, so heat is released.

People can be burned by this!

https://howtowinfriendsandinfluenza.com/wp-content/uploads/2017/04/aa165-milpool.png

References

  1. Burghardt, R. D., Anderson, J. G., Reed, R. A., & Herzenberg, J. E. (2014). Exothermic properties of plaster–synthetic composite casts. Journal of Children’s Orthopaedics, 8(2), 193-201. doi:10.1007/s11832-014-0563-6