/sci/ - Science & Math » Thread #12484803

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/med/ - Medicine General

Anonymous Sat 19 Dec 19:53:16 2020 No.12484803 View Reply Original Report

Quoted By: >>12484807 >>12484827 >>12486503 >>12491560

Asshole surgeon edition.
last: >>12459650

This thread is aimed at medical professionals. We discuss research, clinical experiences, treatment discrepancies and other 'issues' that come with the profession. If you want studying or career pathway advice, ask >>12484651. If you need medical advice, ask your family physician since we cannot help you without examination, tests or your half-assed attempts at description.

Fuck Premeds
Fuck Evidence Based Medicine
And Fuck Jannies

Anonymous

Anonymous Sat 19 Dec 2020 19:54:34 No.12484807 Report

Quoted By: >>12484814 >>12487314

>>12484803
Unclamp.

Anonymous

Anonymous Sat 19 Dec 2020 19:56:02 No.12484814 Report

Quoted By: >>12487314

>>12484807
Although this OP is already looking pretty unclamped. For now it;s adequate that /med/ get redpilled, but ultimately it must transcend pills altogether.

Anonymous

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Anonymous Sat 19 Dec 2020 19:58:55 No.12484827 Report

Quoted By:

>>12484803
Anyone knows if someone has developed a pediatric fluid calculation model based on Winter's data? I'm sick of using the shitty arbitrary rule of thumb that almost seems someone took out of their ass.

Anonymous

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Anonymous Sun 20 Dec 2020 04:59:26 No.12486503 Report

Quoted By:

>>12484803
Has any of you seen someone die without a ventilator? Which would be best for someone who you know is not coming back?

Anonymous

Anonymous Sun 20 Dec 2020 10:07:01 No.12487177 Report

Quoted By:

fifth for i love nurses

Anonymous

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Anonymous Sun 20 Dec 2020 10:46:36 No.12487311 Report

Quoted By:

Shit thread, you forgot to put THE THREADLY FUCKING REMINDER ON THE SECOND POST AND FORGOT TO ANNOUNCE THE NEW THREAD IN THE LAST ONE.

Anonymous

Anonymous Sun 20 Dec 2020 10:47:38 No.12487314 Report

Quoted By: >>12488086 >>12488093

>>12484807
>>12484814
First two posts are schizo. Janny, pls delete this thread so someone can make a proper one, thx.

Anonymous

Anonymous Sun 20 Dec 2020 10:49:04 No.12487321 Report

Quoted By: >>12487344 >>12487997

Lads, which monitor would be better for productivity and study - 29” ultrawide 1080p or 25” 16:9 1440p?

Anonymous

Anonymous Sun 20 Dec 2020 10:58:35 No.12487344 Report

Quoted By:

>>12487321
any monitor as long as you use OneNote.

Anonymous

Anonymous Sun 20 Dec 2020 11:38:20 No.12487433 Report

Quoted By: >>12487445 >>12487605 >>12487877

Non-med here. Have a friend from the past who is on the path to becoming a gynecologist. Is he just a pervert or what’s the general consensus here?

Anonymous

Anonymous Sun 20 Dec 2020 11:41:44 No.12487445 Report

Quoted By: >>12487605 >>12487773

>>12487433
Ob/gyn is pretty based desu. Can do obstetrics, gynecological pathology, depends on the preference. I doubt he's a pervert considering he is going to see diseases vaginas that look gross and some old hag pussy from time to time. Mad props to the lad.

Anonymous

Anonymous Sun 20 Dec 2020 12:14:35 No.12487497 Report

Quoted By:

god damn this thread is shit. way to go lads, I'll wait for the next one.

Anonymous

Anonymous Sun 20 Dec 2020 12:42:19 No.12487554 Report

Quoted By: >>12487559 >>12488011

for crohns why do they sometimes use biologics that suppress TNF-a and others IL6 considering both immunomodulators exist in inflammation

Anonymous

Anonymous Sun 20 Dec 2020 12:45:35 No.12487559 Report

Quoted By: >>12487580

>>12487554
TNF induces IL6 response. Your aim is either the source or the product of it.

Anonymous

Anonymous Sun 20 Dec 2020 12:51:50 No.12487580 Report

Quoted By:

>>12487559
thank you sir

Anonymous

Anonymous Sun 20 Dec 2020 13:03:13 No.12487605 Report

Quoted By: >>12487773

>>12487433
if it was the 50s and every doctor was male I'd do ob/gyn due to >>12487445 reasons
but nowadays women have taken over the profession and I'd rather not deal with all the bitches in ob/gyn let alone elsewhere

Anonymous

Anonymous Sun 20 Dec 2020 13:55:48 No.12487773 Report

Quoted By:

>>12487445
>>12487605
What I'm saying is y'all gotta be really careful who you allow as gyn. Not sure they were with the case of my friend. He's nice sure, but if you know him you know he’s also a sly one. The feeling of weirdness grew when I once before saw a link from here to some indo-british guy’s youtube channel who in my opinion was a the definition of a creep. His practice was gyn of course. You can feel there’s Probably a lot of facebook groups with angry women trying to grow the seeds of a #meetoo directed at male doctors. Just saying, be cautious.

Anonymous

Anonymous Sun 20 Dec 2020 14:39:23 No.12487869 Report

Quoted By: >>12487878 >>12487890 >>12488020 >>12493044 >>12494545

M3 in my 3rd month of clerkship. I'm ashamed to say it, but I've realized that the respect of my peers/outsiders means a lot to me and what I want to do.

I'm on psych right now, which coming into the rotation I had ranked pretty highly on the list of things I want to do. I've since learned that everyone shits on psych and the patient population is by and large not one I want to deal with

So, /med/, what specialties are looked upon the most favourably by both healthcare providers and people not in healthcare?

Anonymous

Anonymous Sun 20 Dec 2020 14:44:44 No.12487877 Report

Quoted By:

>>12487433
>pervert
GynObs is fucking nasty, you know. People go into it when they want to do surgery but don't want to deal with surgeon's bullshit attitude. It's more hands on action than internal and pediatrics, and academically easier. The only problem is, in the recent years more women think they can be gynecologists just by being women, and since it's got quite the pressure they become irredeemable bitches.

Anonymous

Anonymous Sun 20 Dec 2020 14:45:05 No.12487878 Report

Quoted By: >>12487909

>>12487869
I think it varies from country to country. Here in the 3rd world the most respected spec is Infernal Medicine and its subs; mainly because "le dedicated brainy docturr".

Anonymous

Anonymous Sun 20 Dec 2020 14:50:36 No.12487890 Report

Quoted By:

>>12487869
Nobody respects medics and it's getting worse every year. You've got your priorities wrong, so drop the fuck out.

Anonymous

Anonymous Sun 20 Dec 2020 15:05:36 No.12487909 Report

Quoted By:

>>12487878
Interesting. In my shit hole, soon to be residents pick plastics, ENT, optho and gyn like crazy.

Anonymous

Anonymous Sun 20 Dec 2020 15:35:38 No.12487966 Report

Quoted By:

Can Covid make other viruses become active and attack the body? (Lyme, Epstein Barr for example)

Anonymous

Anonymous Sun 20 Dec 2020 15:51:56 No.12487997 Report

Quoted By:

>>12487321
whichever you can get three of

Anonymous

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Anonymous Sun 20 Dec 2020 15:57:25 No.12488011 Report

Quoted By:

>>12487554
Sometimes these biologics don't show any response, or they lose efficacy over time. Switching class is just another tool in the toolbox. It's about finding the right target in the inflammation cascade.

As far as I know there are no anti-IL-6 drugs approved for Crohn's yet, but as biologics go there's an anti-IL 12/23 (ustekinumab) and anti-integrin (vedolizumab).

Anonymous

Anonymous Sun 20 Dec 2020 16:00:25 No.12488020 Report

Quoted By: >>12488694

>>12487869
>I've realized that the respect of my peers/outsiders means a lot to me a
the systems needs suckers to function so no shame in admitting it

Anonymous

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Anonymous Sun 20 Dec 2020 16:33:15 No.12488086 Report

Quoted By: >>12488093

>>12487314
Clamped.

Anonymous

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Anonymous Sun 20 Dec 2020 16:34:58 No.12488093 Report

Quoted By:

>>12487314
>>12488086
Unclamp.

Anonymous

Anonymous Sun 20 Dec 2020 19:27:10 No.12488694 Report

Quoted By: >>12489057

>>12488020
I think medical specialties should simply go the way of dentistry. It's pointless to keep people wasting time on bullshit for 12-15 years when you could get them ready in 6. Theres far too many medics because the subject matter itself isnt hard, and once you take a specialty you forget about the rest to focus on few stuff. If I need to have a patient checked regarding a mouth ulcer, toothache or even facial trauma, I call a dentist and he solves shit I could have never done after many years of study.

Anonymous

Anonymous Sun 20 Dec 2020 20:40:28 No.12489057 Report

Quoted By:

>>12488694
dentists have specialties too in decent countries

Anonymous

Anonymous Sun 20 Dec 2020 22:13:46 No.12489444 Report

Quoted By: >>12489610 >>12489896 >>12490235

hi med, retard here

my surgeon is either unable to or will not explain what's going on in my pathology reports. simply says "they say it's benign, but they recommend we remove it completely" here it is;

20 year old male with localized swelling mass and lump on chest

Reviewed are four slides labeled xxx-xx-xxxx. Sections show epidermal acanthosis overlying a poorly circumscribed dermal proliferation of fibrohistiocytic cells. These cells demonstrate fusiform and stellate shapes and are embedded in a thick collagenous stroma with entrapment of collagen bundles in the periphery of the lesion. The cells are predominany spindled and arranged in fascicles. There is a central epidermal attenuation overlying horizontal dermal fibrosis and scattered chronic inflammation. The proliferation extends into the upper subcutis. Margins are involved.

extra context, my GP tried cutting out what was, at the time, a small pea sized lump. he failed miserably. lab report indicated weird cells, recommended re-excision on margins. was sent to a surgeon, he cut out the previous scar. this report is from that excision. once again, the lab report said it was likely benign, but a complete re-excision was recommended. doctor cut me open again, much larger section, but the lab report once again said odd cells are on the margins, re-excision recommended. what the fuck is going on

Anonymous

Anonymous Sun 20 Dec 2020 23:05:23 No.12489610 Report

Quoted By:

>>12489444
>what the fuck is going on
Well, it's pretty obvious. You have sections showing epidermal acanthosis overlying a poorly circumscribed dermal proliferation of fibrohistiocytic cells. These cells demonstrate fusiform and stellate shapes and are embedded in a thick collagenous stroma with entrapment of collagen bundles in the periphery of the lesion. The cells are predominany spindled and arranged in fascicles. There is a central epidermal attenuation overlying horizontal dermal fibrosis and scattered chronic inflammation. The proliferation extends into the upper subcutis. Margins are involved.
That'd be 100USD + tip.

Anonymous

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Anonymous Mon 21 Dec 2020 00:00:23 No.12489780 Report

Quoted By: >>12489850 >>12489896 >>12490240

Is dying of liver failure that bad? Asking for a friend.

Anonymous

Anonymous Mon 21 Dec 2020 00:22:49 No.12489850 Report

Quoted By:

>>12489780
Yes. Your only hope would be falling into hepatic encephalopathy before the anxiety, pain and itching become a living torture. And even then, I'm not sure if encephalopathic patients stop feeling.
Your friend better commit sudoku.

Anonymous

Anonymous Mon 21 Dec 2020 00:36:47 No.12489896 Report

Quoted By:

>>12489780
It's a fucking mess to deal with even with good palliative care.

>>12489444
You have a Fibrohistiocytic tumor/neoplasm. Probably benign but chopping it out with margins is the only way to get rid of it for sure.

Anonymous

Anonymous Mon 21 Dec 2020 02:49:59 No.12490235 Report

Quoted By: >>12490572

>>12489444
Just a fibroma, but it may keep growing back because stromal cells dig into... stroma. How did the thing look like initiall? Was it homogeneous? Did it grow quick? How much area have they scraped out of you?

Don't worry about it though, the important thing in a biopsy report is that lacks "atypical nuclei" or that sort of thing.

Anonymous

Anonymous Mon 21 Dec 2020 02:52:05 No.12490240 Report

Quoted By:

>>12489780
If you don't mind gasping for air over being swollen and prone to disease because your liver doesn't make proteins anymore for a couple of decades, nah it's a regular death.

Anonymous

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Anonymous Mon 21 Dec 2020 03:36:34 No.12490357 Report

Quoted By:

how does this image make you feel?

Anonymous

Anonymous Mon 21 Dec 2020 05:10:14 No.12490572 Report

Quoted By: >>12490831

>>12490235
at this point i've got a healing scar 2 inches across my chest. initially, it was some sort of blackhead or ingrown hair that i tried popping and it just got inflamed, seemed to get deeper, tried to get it out a few more times but to no avail. after about a year, it felt like it was pretty well below the surface. i never noticed much growth. it was entirely below the top layer of skin you can pinch, so i went to a doctor, expecting it to get dr pimple popper'd. it was just a hard, semi-mobile little lump. no idea what you mean by homogenous, but if it's any help, the very first report reads as follows;

Sections of skin show a proliferation of atypical spindle cells in the deep aspect of the specimen. The spindle cells show oval nuclei with focal prominent nucleoli. Scattered mitotic figures are seen

Anonymous

Anonymous Mon 21 Dec 2020 07:07:04 No.12490831 Report

Quoted By: >>12491840

>>12490572
As he says, it seems to be a Benign Fibrohistyocitoma. You must be watchful though, since this is a connecive tissue tumor, and these always try to infiltrate deeper into connective tissue. I don't know what the treatment is for such a persistent case, ask him if seeing a dermatologist is needed, but do comply with the necessary escisions. The most worrisome scenario would be if the pathology report said there's a disorganized clusterfuck of cells from all stages, then it would be officially cancer and chemo would be needed, which he would tell you of course.

Often doctors will be discreet about cases that are not so simple like yours. In any case don't worry, but be watchful.

>Is it cancer or not
Not yet.

Anonymous

Anonymous Mon 21 Dec 2020 11:27:23 No.12491382 Report

Quoted By: >>12491923

what is with sci and ebm lately? why is it bad?

Anonymous

Anonymous Mon 21 Dec 2020 11:33:57 No.12491393 Report

Quoted By: >>12491527 >>12491961

/med/bros I thought pharma rep sluts were a meme and only a film trope until I started my dermatology rotation.

Anonymous

Anonymous Mon 21 Dec 2020 12:43:59 No.12491527 Report

Quoted By:

>>12491393
Did you fugg?

Anonymous

Anonymous Mon 21 Dec 2020 13:00:44 No.12491560 Report

Quoted By: >>12491623

>>12484803
hello men of science,

what happens to the effectiveness of a vaccine when a virus mutates?

t. HumbleTard

Anonymous

Anonymous Mon 21 Dec 2020 13:31:24 No.12491623 Report

Quoted By: >>12491943

>>12491560
Mutations are unpredictable. Vaccines are designed in such way to allow the immune system to get familiar with some molecular components of the targeted microorganism.
SARS cov 2 and all newly mutated viruses create a ruckus because of this fact, because there is not a proven way to deal with the unknown.
UK is being the mediapig of today because of that mutation but let's not forget the fact that Italy discoverd a newly mutated strain just a couple weeks after the virus scaped from China.
Depending on the population density and public healthcare protocols a virus can mutate in less than half a year. Chances are all countries have their own unique strain as we speak, the thing is most of the world technology is concentrated in 15 countries so we can never know with certainty the whole extension of a pandemic event.

Anonymous

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Anonymous Mon 21 Dec 2020 13:58:22 No.12491683 Report

Quoted By: >>12491692 >>12491955

I ignored the Jews kvetching at me to pay a doctor to allow me the privilege of taking a scheduled drug to treat my mild asthma symptoma, popped into Walgreens and picked up this instead. Can breathe fine now, but I feel like I just got stabbed in the chest. Do the controlled substances stab you less?

Anonymous

Anonymous Mon 21 Dec 2020 14:02:37 No.12491692 Report

Quoted By: >>12491697

>>12491683
Ask Dr Walgreens. It's not ethical to interfere with your treating physician.

Anonymous

Anonymous Mon 21 Dec 2020 14:05:30 No.12491697 Report

Quoted By: >>12491760

>>12491692
What's the real difference between the FDA cartel and the Mexican one?

Anonymous

Anonymous Mon 21 Dec 2020 14:32:21 No.12491760 Report

Quoted By: >>12491775

>>12491697
FDA cartel henchmen are trained professionals that could answer and even fix the idiotic crap you get into.

Anonymous

Anonymous Mon 21 Dec 2020 14:38:29 No.12491775 Report

Quoted By:

>>12491760
You mean to say that Paco with the crack was a charlatan this whole time?

Anonymous

Anonymous Mon 21 Dec 2020 14:55:34 No.12491840 Report

Quoted By:

>>12490831
thank you, i really appreciate the answers. my surgeon wants to let it heal until april, take another look at it, then see what we wanna do about it. either way, i'm not too worried, just curious about what's happening on my chest

Anonymous

Anonymous Mon 21 Dec 2020 15:24:15 No.12491923 Report

Quoted By:

>>12491382
Because the aporoach is retarded and has created a generation of retards who won't treat patients as the sum of their problems and instead they're approached as a case in an algorithm. Most of medical research is done by non practicioners, and hardly ever they are actual medics. They take one very specific aspect of a disease and "correlate" it with another extremely esoteric trait to draw the conclusion that "maybe it has to do with it, maybe not". This applies even though working models already exist.

For example take the strategy against SARS-2 spread. Everyone and their mother knows a shitty cloth mask doesnt stop all droplets, they do make the wearer more conscious of their situation and careful of their hygiene. However the EBM approach went full retard and said "DONT WEAR ANY MASK, ITS FUTILE". The WHO didnt release intuitive cheap decontamination guidelines such as solar exposure, steaming, washing with soap or coating with alcohol, because no studies were available at the time. In fear of saying something that would not be an absolute truth they decided to let the disease run its course.

Anonymous

Anonymous Mon 21 Dec 2020 15:31:49 No.12491943 Report

Quoted By:

>>12491623
It's also worth to mention that the only mutations that get recognized are those that are actually studied in countries who can afford that research.

There is something you can epidemiologically notice about this disease. On many countries the lethality drop down about 6 months ago. There was probably a lethal strain running its course which has already died down mostly. As the disease is now worldwide endemic it will be mutating from time to time making local waves of lethality that nobody will study and will be solving on their own.

Anonymous

Anonymous Mon 21 Dec 2020 15:35:23 No.12491955 Report

Quoted By: >>12492013 >>12492102

>>12491683
Do you skip beats often? How often are your asthma attacks? The treatment of asthma is based on corticosteroids, using that shit won't solve anything. As the package says, its immediate relief only.

Anonymous

Anonymous Mon 21 Dec 2020 15:37:42 No.12491961 Report

Quoted By:

>>12491393
It makes me pissed you cant get toys and gadgets from pharma reps anymore thanks to FDA glowniggers.

FUCK WHO, FUCK THE AFRICAN PUBLIC HEALTH CARTEL, FUCK FDA, EBM AND FUCK JANNIES.

Anonymous

Anonymous Mon 21 Dec 2020 15:56:16 No.12492013 Report

Quoted By: >>12492904

>>12491955
That immediate relief got me up the hill on the way home double time without suffering what coincidentally also feels like being stabbed in the chest but with more wheezing and mucus buildup. It's a shame it wore off though; for just a while I was able to speak and not sound like Bob Dylan.

Anonymous

Anonymous Mon 21 Dec 2020 16:28:06 No.12492102 Report

Quoted By:

>>12491955
>imagine working for free

Anonymous

Anonymous Mon 21 Dec 2020 20:18:09 No.12492904 Report

Quoted By:

>>12492013
The usual treatment is both the steroid and an epinephrine derivate, albuterol, which gives less side effects than that epinephrine stuff, which is the reason you got the chest pain.

Just go see a mexican doctor or any other latin american doctor couch surfing in an attempt to get an internship so he can get through the bureaucratic kikescam that ERAS and the US medical licensing system is.

Anonymous

Anonymous Mon 21 Dec 2020 20:51:45 No.12493044 Report

Quoted By: >>12494537

>>12487869
surgery.

Anonymous

Anonymous Tue 22 Dec 2020 05:35:25 No.12494537 Report

Quoted By:

>>12493044
Surgery is busy as fuck. Imagine running around a shit ton of hospitals to see which will rent you the OR the cheapest and not jew you out on the materials.

Anonymous

Anonymous Tue 22 Dec 2020 05:40:11 No.12494545 Report

Quoted By:

So, I came across PAs for the first time recently (UK). Holy fuck, the NOTICE ME SENPAI, I'M AS GOOD AS YOU I JUST CHOSE TO MIDLEVEL, I SWEAR over-compensation is unreal.

>>12487869
>So, /med/, what specialties are looked upon the most favourably by both healthcare providers and people not in healthcare?
People suck the dick out of surgery because that is the most tangible change in treating a patient. Followed by something like Emergency Medicine, if it's any medical speciality at all. But I don't know what the US training pathway is like, but lol @ Brits that pick surgery as a speciality only to be doing closing sutures and holding retractors until they're like a decade into their careers.

Anonymous

Anonymous Tue 22 Dec 2020 05:41:59 No.12494552 Report

Quoted By:

Also, white coats are for nonces.

Anonymous

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Anonymous Tue 22 Dec 2020 06:51:31 No.12494666 Report

Quoted By: >>12494832 >>12495400 >>12495505

Did the medical profession lead to your eventual misanthropy /med/?

Anonymous

Anonymous Tue 22 Dec 2020 08:25:23 No.12494832 Report

Quoted By:

>>12494666
Why would it? People are shit, but they really don't know better, and nothing in their lives tell them they should. Maybe they've got the right of it living without worrying. Moms that neglect kids do piss me off.

What the medical profession has done to me is make me think we really do nothing. People are like candles. The lives of people are spent by themselves, Sometimes the candle in shorter, sometimes it's cut down in half by something, but no matter what, the candle will be consumed. As a medic you can only blow on it, try to delay the fire, but its impossible to prevent the candle from being consumed.

Anonymous

Anonymous Tue 22 Dec 2020 13:49:18 No.12495400 Report

Quoted By:

>>12494666
Joke's on you Satan. I was already an unironic misanthropist.
Not because I disdain humanity or have any animosity against subhumans, but because all the wasted potential and blatant stupidity moat of us willingly commit. This goes without mentioning neglecting the less fortunate or abusing the weak.
I would not mind seeing most of the human race killed off because it is unworthy of the gift of life.

Anonymous

Anonymous Tue 22 Dec 2020 14:40:25 No.12495505 Report

Quoted By:

>>12494666
I love mankind, I hate people. Shit people, I do not care about more than the absolute minimum I need to. We're only here for a short amount of time and most of us will be forgotten in a generation, so it's not worth investing the energy because quite simply, some people do not deserve it. As a whole, we can and do achieve amazing things, despite all the shitbags that we'd be better off without, that that in itself is a miracle.

Anonymous

Anonymous Tue 22 Dec 2020 15:35:59 No.12495601 Report

Quoted By:

Why my pee smells like ramen and antibiotics

Anonymous

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Anonymous Tue 22 Dec 2020 15:41:27 No.12495608 Report

Quoted By:

I'll just spam this picture of a 15th century medic I just found in a manuscript from 1492... just because I find these glasses to be pretty kino.

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