playing house!

April 5, 2009 at 9:05 pm (med, school)

10:10Nicholas
Ethan! u want to join me for 20-30 min jogging tomorrow?

10:10pmNicholas
oh but u said u hate joggin… sry

10:14pmEthan
hahaa sat mornings are my foootball days! interested?

10:17pmNicholas
oh no, im terrible at football

10:20pmEthan
alternative pathway of complement activation is this part of innate or adaptive. its innate right?

10:26pmNicholas
complements are part of innate immunity. i think.

10:26pmEthan
haha ok. still working on cutting down the damned thing

10:26pmNicholas
yeah me too. nearly done. i have in my notes that the alternative pathway is activated by gram- bacteria. our staph is gram +

10:29pmNicholas
do u have any notes on septicaemia?

10:29pmEthan
did u include pathophysiology of shock?

10:29pmNicholas
haha yeah

10:29pmEthan
i don’t even haf any idea why its included..

10:30pmNicholas
i’m working on shock now and i think septicaemia caused the shock…but i dont have any notes on septicaemia

10:31pmEthan
where did the case say she was in shock?

10:31pmNicholas
she collapsed during the night b/c of the adrenal crisis. collapsed there means shock i think. no sry she collapsed because she had septic shock

10:32pmEthan
don’t think so. An adrenal crisis would have caused her levels of Cortisol and Aldosterone to fall dramatically. The consequences of this would be a reduced blood glucose concentration, reduced circulating volume, and reduced blood pressure. This seems to have lead to Elaine going into shock (insufficient blood perfusion to the body), due to her falling BP and decreased circulating volume. She may have also become hypoglycaemic, leading to weakness – this would have contributed.

10:33pmNicholas
i c. and the adrenal crisis was caused by the infection?

10:34pmEthan
yeah! likely

10:37pmNicholas
Thanks mate! Thats why its better if you work with others. So septicaemia is irrelevant?

10:38pmEthan
yeah. i did abit of research on this one. that’s how i came with the above conclusion. what do u think makes sense right? most logical deduction directly linked to adrenal crisis

10:40pmNicholas
makes perfect sense!

10:40pmEthan
as opposed to

• I think Elaine has Critical Illness Related Corticosteroid Insufficiency Syndrome (CIRCI). This is a condition of adrenal crisis without the adrenal part. Cytokines involved in the inflammatory response, especially TNF-α and IL-1, suppress the Hypothalamic-Pituitary-Adrenal Axis and prevents the release of Cortisol. TNF-α inhibits the release of ACTH. Furthermore, these cytokines increase tissue Cortisol resistance by down-regulating production of the glucocorticoid receptor. So not only is circulating levels of Cortisol low, the tissues are less responsive to it, compounding the problem. The reasoning for this immunoendocrinological process is because of Cortisol’s immunosuppressive effects, suppressing it allows for a greater inflammatory response.

lol

10:41pmNicholas
that’s bullshit. i checked it half an hr ago. this guy’s over-researched.

10:42pmEthan
hahha. yeah probably

10:42pmNicholas
i will use his shock paragraph though.

10:42pmEthan
considering what we’ve been taught in endocrinology it’s likely that my reason is the answer since we nvr learnt before about the disease that guy came up with lol

10:43pmNicholas
he is trying to play House MD. he is a very smart guy but this time he got it wrong- big time

10:44pmEthan
hahaha. i don’t know. i guess he just missed the simpler link but if you think about it that disease does also make sense assuming its correct. after all it does explain it as well, no?

10:46pmNicholas
it does but so do a million others. its a weird, fancy illness that fits into the puzzle. so does harry potter vanishing her adrenal glands – that makes sense. (or not)

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