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    (Original post by SMed)
    Please elaborate. We will be you soon. We need to know what to expect.
    I ward round for four hours a day with any one of at least eight different consultants (I've lost count), just the two of us. While this happens, I have to find the notes, find the drug chart, find the obs chart, close the curtains, document the consultation, amend the drug chart (including writing up everything that's been forgotten - like the ****ing VTE form), help the patient sit up (or whatever else), find a working computer to display xrays and have a working knowledge of what's been done to this patient so far. When I did this as a housie, there were three or four juniors to help share the load and there was a better than even chance that you had at least met the patient before.

    I spend the remaining four hours of my day writing referrals, chasing other parts of the hossie to do their job, filling in forms, writing discharge summaries and generally just trying to keep a track of what's happening to 20 odd patients before they disappear off deeper into hossie whilst fielding requests from nurses, OTs, PTs, SLTs, ward clerks and rellies about the other 20 patients who aren't mine.

    The next day it will be a different set of patients and a different consultant but exactly the same ****.

    I appreciate that this is part of the job and it's something that needs doing but, in my slightly childish rant, I did my house jobs, why do they want me to do it again?
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    (Original post by Kinkerz)
    You'll pick this stuff up in your clinical years (reading, talking with doctors, etc.).

    Mind, if you find a good mechanism for how the immune system goes wrong in Crohn's, let me know. Oh, and collect your global recognition for it too.
    I think there’s a combination of environment and genetic factors which contribute to developing the disease as it’s common in Ashkenazi Jews and there was a link found between having childhood measles and later developing the disease (so perhaps a primary infection which activates the auto-immunity). I don’t think anyone really is clear on the exact mechanisms but many theories.

    Spoiler:
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    The alimentary canal contains the highest number and variety of commensals in the human body; the number of commensals is ten times higher than that of host cells and there are 400 different species of bacteria.

    In Crohn’s disease, this mucosal tolerance to commensals is lost and there is an overaggressive inflammatory response to the bacterial flora. In normal individuals this would not occur as there is a downregulation of the immune response to luminal antigens of the bacteria, but in Crohn’s disease antigen presenting cells such as dendritic cells and intestinal macrophages recognize the antigens are pathogenic and present them to T cells. Which then secrete cytokines which leads to an exaggerated and continued mucosal inflammatory response. This response is then magnified and prolonged by leukocyte recruitment from gut vasculature. The inflammatory response seems to be mediated by T helper cells, in particular Type 1 T helper cells causes upregulation of nuclear transcription factors such as NK –kB.

    Don't know if this pic helps:
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    Had to write a dissertation comparing two patients with Crohn’s vs Acute pancreatitis.


    (Original post by digitalis)
    What Kinkerz said. I remember getting tutorials on it in hospital but at the end of the day, you will still have to do some of your own reading (remember what I said to you about reading OHCM even as a preclinical student?) You have enough knowledge now to understand most of the stuff now so it is all about fleshing out your knowledge now and in third year.
    As for differentiation, simple rules would be:

    -If it extends outside the colon (ileocecal valve to rectum) it is Crohn's.
    If you see granuloma's or crypt abscess on histology, then it is Crohn's.
    -If you have bloody diarrhoea, it is UC.

    Treatment is immunosuppression and antinflammatories. Total colectomy for UC is curative, doesn't help for Crohn's.
    Will rep when I can.

    In terms of treatment I remember Budesonide is the steroid of choice as it carries much less systemic ADRs than prednisolone as it only becomes pharmacologically active in the bowel. Also very important to give B12 supplementation as the terminal ileum is commonly affected in Crohn’s (logical as that’s where Peyer’s Patches are) and where B12 is absorbed into circulation.

    Table given to us by Leicester:
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    Since when does image shack ask for registration





    Hmm I want to go back to Medicine soon. Does anyone want to do some literature reviews for me?
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    (Original post by _Andrew_)
    Revieved exam results today, done well, and now feeling a mass anti-climax and deflation - anyone else feel like this after exam results?!! Anyway, time to get get royally wrecked on post-exam results night out!
    I generally failed exams first attempt, so when I passed the resits it was a massive relief and jubilation. Felt so good, for even just scraping by. Passed my first clinical year at first attempt, and it was even better.

    Sorry, but:

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    (Original post by Supermassive_muse_fan)
    Hmm I want to go back to Medicine soon. Does anyone want to do some literature reviews for me?
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    (Original post by _Andrew_)
    Revieved exam results today, done well, and now feeling a mass anti-climax and deflation - anyone else feel like this after exam results?!! Anyway, time to get get royally wrecked on post-exam results night out!
    Yeah I get that - like you expect to suddenly feel awesome and free but I think I muck around so much anyway I don't feel special haha
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    (Original post by Philosoraptor)
    What kinda surgery - possibly up for this? :p:
    Emergency surgery. On call as from tomorrow evening!
    I dont mind honest.

    I have major assignment to do - the worst part is deciding on the bloody topic. As soon as that is decided i will be on a roll!
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    (Original post by fairy spangles)
    Emergency surgery. On call as from tomorrow evening!
    I dont mind honest.

    I have major assignment to do - the worst part is deciding on the bloody topic. As soon as that is decided i will be on a roll!
    As in trauma stuff? Sure.

    Shoot me down guys if you want, but I just can't stand General surgery, I find it sooo boring. And it's gonna be so important for final year argh, damnit, will have to grin and bear it
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    Doing an A&E project next week. Was given a tour of the department by my consultant and it's absolutely massive. Can't wait.
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    (Original post by Philosoraptor)
    As in trauma stuff? Sure.

    Shoot me down guys if you want, but I just can't stand General surgery, I find it sooo boring. And it's gonna be so important for final year argh, damnit, will have to grin and bear it
    I agree. My current firm. But I get to run away to anaesthetics for 2 weeks soon :woo:
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    I submitted my essay for the Royal Society of Medicine Intellectual Disability Student Prize and was a runner up! I have a 'sections meeting' on September 19th. How exciting! I suppose that makes up for me being on the verge of failing this BSc. I hate labs.
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    (Original post by SMed)
    Money - Exams = Winning
    Exams = Money + Not Winning

    I've spent £550 in the last 6 months on the first of my exams.
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    (Original post by i'm no superman)
    I submitted my essay for the Royal Society of Medicine Intellectual Disability Student Prize and was a runner up! I have a 'sections meeting' on September 19th. How exciting! I suppose that makes up for me being on the verge of failing this BSc. I hate labs.
    Congratulations! :elefant::elefant::elefant::elefant::elefant:
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    So basically found out today I have to submit an abstract on an essay I haven't written yet by Monday. Best get off TSR then.
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    Sitting through a 9am lecture whilst fighting the urge not to vom into a coke bottle from a god-awful hangover, reminds me of being a fresher again..ah good, times..
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    1 page down, 50 to go... 'sgonna be a fun month =\
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    2 days to make notes on 18 lectures on hormones-dependent systems and cancer. This will be the first time looking at these again since doing them in October, and the exams are in 12 days. :ashamed2::bawling:
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    First draft of abstract done, that wasn't too harrowing!
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    Slightly depressing that I feel today was productive when all I did was put in a cannula, attend radiology lectur and get a free lunch.
    I did teach the SHO how to use the vacutainers for blood cultures too I suppose.
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    Why am I procrastinating? I have to write up 1500 words of reflective writing (/w references) and create my portfolio, write a 1500 word essay for or against PBL (/w references) due tomorrow afternoon and START my presentation on malaria that I'm presenting next Wednesday but I have to submut by Monday afternoon.

    That's not even mentioning the paper review that's due in April, the exam I have in four weeks or the essay and presentation I have to do for my MedSoc due in a month. I have SO MUCH **** I could be getting on with but all I want to do is get mashed >.>
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    ive decided that im going to do my assignment on the effect of revision on obesity..........i intend to start with this packet of malteasers!
 
 
 
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