Monthly Archives: April 2015

I heard you speaking about Laura Palmer…

Unknown… One day, my Log will have something to say about this.

As Soren Kierkegaard tells us,

There are two ways to be fooled. One is to believe what isn’t true; the other is to refuse to believe what is true.

Agent Cooper knows this well and is therefore perfectly positioned to solve the case of Laura Palmer.

Although, even Coop has to confront doubt once in a while.

By the way, now that you’ve learned to love Twin Peaks, You might also want to try Lynch’s other series, the much more approachable, Northern Exposure.


Posted by on April 29, 2015 in Uncategorized


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Developing Lymphocytes – an extra credit question for micro

Both B and T Cells express surface antigen receptors, the B Cell Receptor (BCR) and T Cell Receptor (TCR), respectively. During development each of these kinds of immature lymphocytes will express early versions of these receptors on their surface (Pre-BCR and Pre-TCR).

What is the purpose of expressing these receptors long before they will ever come into contact with antigens?

answer quickly – the first correct (and complete) answer gets 3 pts extra credit on the upcoming exam!


Posted by on April 29, 2015 in Uncategorized


Case Study

IndianJRadiolImaging_2013_23_1_81_113621_u3A 25 yo man presents at the ER with abrupt, intense pain in the right flank and ipsilateral lower abdomen. In addition to abdominal pains, he also feels  pain in the right testicle and has had to urinate frequently and always with pain. Imaging was done to aid in assessment.

Given this information, what diagnosis might you suggest? Explain the symptoms and what is revealed by the imaging. What treatment do you suggest?


Posted by on April 28, 2015 in Uncategorized


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Pediatric Presentation

2-131115150520392A patient presents in your pediatric office with her 5 yo son. She reports that he recently had a cold with a fever and still doesn’t look right after several days and has reduced micturition. He has obvious noticeable as puffiness around the eyes, and upon examination you find that he has a taut belly, and swelling of the hands and feet, which you interpret as generalized edema, or anascara.

You run some tests and find that he has hypoalbuminemia and proteinuria.

What is your diagnosis? And explain the bold type symptoms. (2pts)


Posted by on April 26, 2015 in Uncategorized


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For another two points…

A female patient presents at a walk-in clinic. She has been experiencing back pain, along with painful urination, chills and nausea for the past two days. She recently came home from a camping trip where she and her boyfriend hiked for three days. The trip was great, although the weather was hot and sunny.

Prior to the trip she had been urinating frequently and with some pain, and was given antibiotics by another doctor. She took them for three days prior to the camping trip and was feeling much better, so when she forgot to pack them for the trip, she wasn’t worried.

How do you interpret her case?


Posted by on April 25, 2015 in Uncategorized


Invitation to submit questions for Renal System Exam … and a quick extra credit opportunity

As always, I invite students and non-students to submit multiple choice questions appropriate for the upcoming exam on the Renal System (Physiology and Pathophysiology questions). Post questions with answers (three wrong and one right) in the comments section below.

Also, here’s an opportunity for two points of extra credit on the upcoming exam:

Submit your answer quick – only the first correct response (also posted in comments) earns points. I will try to post several more questions over the weekend – note, these extra credit vignettes may come from any of the chapters we studied this semester)


A 62 year old man presented at the ER with sudden sensation of food being caught in his throat while swallowing. The patient is highly agitated and convinced he is choking although he appears to be getting air.

LESAn emergency endoscopy reveals food stuck in the esophagus. With pressure, food bolus passed into the stomach successfully. A subsequent barium swallow and X Ray produced the image here.

What is the diagnosis?


Posted by on April 24, 2015 in Uncategorized


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Structures of the Female Reproductive System, Focus on Terminology

Review of Ob/ GYN

The Bony Pelvis is central to any consideration of Ob/GYN because it is the location of the sexual organs as well as the site of gestation and particularly because birth involves the transit through the pelvis.


Like every other aspect of biology, the pelvis comes in variety of shapes and sizes. In general the female pelvis comes in four basic shapes, the Gynaecoid, Android, Platypelloid, and Anthopoid.

The Gynaecoid pelvis, with its round brim, flat walls, and non-prominent ischial spines that allows passage of the baby with the least amount of trauma is the the ‘genuine female’ pelvis.

The Android pelvis has a less symmetrical, heart-shaped opening is more common amongst tall, narrow-hipped or African women. This shape may lead to longer, more traumatic labor.

The Anthopoid pelvis is oval with the obstetrical diameter being longer. Once the baby enters the pelvis birth often proceeds without complication.

The Plattypelloid pelvis is also oval, with the transverse diameter being longer. Although the baby may have difficulty in entering the pelvis, birth should proceed without difficulty.


Internally, the female reproductive tract is straightforward and laterally symmetrical. Many of the terms, meaning prefixes and roots are similarly named to other body parts.


The womb / uterus (Gr. metra) is comprised of three layers. Internally it is lined with an endothelial layer called the endometrium (inside the womb). Under the endothelium is a muscular layer called the myometrium (muscle of the womb). The external part of the womb is covered with a perimetrium, or serous layer derived from the visceral peritoneium.

The vagina leads to the cervix (or more properly cervix uteri, neck of the uterus) which is comprised of a cervical canal connecting the vagina to the uterine cavity. The cervical opening on the uterine side is known as the internal os, while the opening to the vagina is the external os. (L. os – mouth). Within, the cervix is comprised of numerous folds of the endocervix corming crypts in which sperm can be released into the uterus over several hours.

Two ovaries are ‘connected’ to the uterus via fallopian tubes (named for a 16th century Italian anatomist, Gabriele Falloppio).


falopio[1]The Infundibulum (L. Funnel) of the fallopian tube (or oviduct) with extended fimbriae is the opening of the imagesfallopian tube proximal to the ovary through which ova move during ovulation. The tube continues as an ampulla (the diminutive of amphora, the double handled jugs used for storage and trade, see illustration), isthmus (stretch of land), and finally the interstitium (space between objects) that crosses through the muscular wall of the uterus into its lumen.

Fertilization and early pregnancy

Human_FertilizationFertilization occurs very soon after ovulation as sperm (typically) meet the ovum while it is en route through the fallopian tube toward the uterus. The (haploid) egg and (haploid) sperm fuse to form a (diploid) zygote that begins dividing immediately. About seven days later, the early embryo (now a blastocyst) will implant into the endometrium, where it will continue to grow into an fetus.

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Posted by on April 15, 2015 in Uncategorized


HCV, briefly

Viral Hepatitis comes in a number of flavors, named HAV, HBV, HCV, HDV, and HEV (not to mention any subtypes). HCV, identified as recently as 1990, is a serious form of Hepatitis causing cirrhosis of the liver, chronic infection, and often hepatocellular cancer. Prior to 1990, the most common way to become infected was through transfusion with contaminated blood. However, after identifying the virus, tests became available to prevent this form of passage, leaving the primary mode of transmission being sharing of needles between IV drug users and sexual contact.
Unlike other viruses (HAV), few people ever clear HCV and, instead, become chronically ill. This may, in part, be due to the inability of the body to generate protective, neutralizing antibodies. Those antibodies that are produced are mostly usable only as markers of disease. Symptoms of disease include fatigue, nausea, vomiting, loss of appetite, abdominal pain, jaundice, dark urine, and clay colored feces. The CDC definition of a case is: (sorry this isn’t clearer)


Serum alanine aminotransferase (ALT) levels greater than 400 IU/L indicate hepatocellular damage. This enzyme is normally found only in
liver cells, but is released into the blood when these cells are injured. Normal ALT should not exceed 60 IU/L, providing a fairly clear altmeasure of cell injury.This can be seen clearly below as serum levels of ALT spike with symptoms of disease and then return (however not down to normal, ‘healthy’ amounts) to lower levels following resolution of symptoms.


There is no vaccine against HCV, so the best way to avoid it is to avoid contact with blood or other bodily fluids that may be contaminated.

Don’t forget to check out my comments on the novel ‘Rosemary’s Baby’ on my other blog. I highly recommend this book to anyone who enjoys thrillers / light horror (a la Stephen King).

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Posted by on April 12, 2015 in Uncategorized


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Exam Time Again

Pathology is closing in on another exam – this one covering  the Digestive System. That means it’s time to solicit possible questions to include. As always, there’s no promise that any submitted questions will appear on the exam, but any well – written multiple choice question (with the correct answer indicated) stands a good chance.

I really want to write something about the insane film I’m watching, but there are no words.

Rare Exports: A Christmas Tale

It’s apparently a Finnish comedy(?) about finding a demonic santa claus buried deep in the arctic ice.

And his demonic, nude old men helpers

and how some little kid sacrifices himself in order to  – I don’t know … save christmas?


Krampus? – No, just an elf

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Posted by on April 8, 2015 in Uncategorized