Human Anatomy at Colby

Grand Rounds Bi265 013019: HIV and Antiretroviral Resistance

February 7th, 2019 · Comments Off on Grand Rounds Bi265 013019: HIV and Antiretroviral Resistance

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Laurel Edington: Grand Rounds – Celiac Disease

February 23rd, 2015 · Comments Off on Laurel Edington: Grand Rounds – Celiac Disease

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During the last week of class, we presented our grand rounds talks that we’ve been working on all semester. This was a great experience because it allowed us to practice giving a grand rounds lecture, which is a common presentation in the medical community. Each group of three picked a topic, which could be a case study or an overview of a disease or medical treatment, and then presented as if they were doctors talking about an interesting patient, new procedure that they’re performing, etc.

This year, the weather didn’t exactly cooperate with us. We were supposed to have a practice session during class on Tuesday and then go to Augusta to present our talks along with Kents Hill students at Maine General. Because of the snow day and horrible driving conditions, neither of these events happened and we had to present our final product with little group practice. Thankfully, my group was able to practice together before the weather was too bad, but practicing during class and at Maine General would have been helpful.

My group decided to present a case study on a 42 year old man with chest and abdominal pain. We found this study through the New England Journal of Medicine and it was used as a hugely teaching moment instead of a typical grand rounds talk. In this case study, the man’s symptoms were textbook for celiac disease but physicians performed a number of tests, including an invasive and non-diagnostic procedure, before even thinking of the possibility of celiac disease. This case study was not used to teach medical students and medical professionals about a rare disease or an interesting case, it was used to enforce the fact that celiac disease is becoming increasingly common and physicians need to be aware of it and perform the simple diagnostic blood test for the disease when a patient comes in presenting characteristic symptoms.

Through this presentation, we learned the difference between celiac disease and non-celiac gluten sensitivity. With celiac disease, there is damage to the intestines and an IgA tissue transglutaminase and IgA endomysial antibody tests can be performed to diagnose the condition, this is not the case with a gluten sensitivity. Both conditions, however, are treated with a strict gluten-free diet. This is becoming a popular new diet in people who don’t suffer from celiac disease or non-celiac gluten sensitivity. People who are using this fad diet and who don’t have celiac disease or a gluten intolerance are at risk for developing new gastrointestingal problems.

This project was a great way to expose us to this sort of presentation since the majority of the class is interested in the medical profession and grand rounds are a common occurrence. This was an especially interesting experience because we were able to present in front of nurses and doctors, which made the experience that much more real. It also reinforced the material we had learned throughout the class because we had to explain the disease based on the anatomy and physiology. I’ve been to multiple grand rounds during my summer internships and I never thought that I would be able to understand a case as well as those doctors, but this experience showed me that I am more than capable and therefore, was an awesome experience.

Tags: Grand Rounds

Allison O’Connor: Grand Rounds Presentations

February 22nd, 2015 · Comments Off on Allison O’Connor: Grand Rounds Presentations

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As a part of our Anatomy and Physiology course this Jan Plan, we worked in small groups to research and present a case study to our peers and a few health care professionals during a mock Grand Rounds presentation. Grand Rounds is a tradition in the medical field in which physicians present case studies to their peers, other medical professionals and medical students on a medical topic to share things that they learned in particular cases, so that others can learn from these cases. The Grand Rounds presentations were a highlight for me this JanPlan. Not only was it interesting to explore a case study of our choosing and get to learn about a particular medical condition, but it also exposed me to the format of Grand Rounds presentation and gave me the opportunity to practice my public speaking skills (which is something that is very anxiety provoking for me).

 

My group used the New England Journal of Medicine’s database to find a case study that we all found interesting. After reading through various case studies, we settled on the case of a 32 year old female, who three weeks post partum presented to the emergency department with substernal chest pain that radiated to her jaw. Substernal chest pain can be a result of many different complications including: cardiovascular complications, respiratory problems, gastrointestinal complications and musculoskeletal problems. Although cardiovascular complications are the most common cause of chest pain, it is not typically a complication that is expected in an otherwise healthy 32-year-old female. However, the fact that this patient was postpartum increases the index of suspicion for myocardial infarction, pulmonary embolism and coronary artery dissection because of the hormones present during pregnancy. An angiogram in the emergency department revealed a left anterior descending coronary artery dissection with a 35mm segment of narrowing and 90% stenosis.

 

Coronary artery dissections occur when the inner and outer layer of the coronary artery separate and blood pools in the area between the layers, causing decreased blood flow to the heart. There are two major types of coronary artery dissections, those that are spontaneous and those that are mechanically precipitated. Given this patient’s postpartum status and the events that precipitated her dissection, her coronary artery dissection would be classified as spontaneous. Within spontaneous coronary artery dissections, there are four sub-classifications, however only two of those are relevant to this case: postpartum coronary artery dissections and idiopathic spontaneous coronary artery dissections, which are dissections that are result of increased hemodynamic pressure caused by shear stress. Based upon test results, the patient’s postpartum status and the lack of disease in her other arteries, the patient was diagnosed with a spontaneous postpartum coronary artery dissection. Since postpartum spontaneous coronary artery dissections are relatively rare, there is not a universal treatment protocol. Conservative treatment is preferred, however sometime more invasive measures are required. In this case, conservative treatment was the most appropriate plan since the patient was stable, was experiencing very little pain and only had slight cardiac ischemia. The patient was treated with an intra-aortic balloon pump for two days to make her coronary artery more patent and was also given β-blockers, aspirin (an antiplatelet agent) and heparin (an anticoagulation agent). After two days, the patient was showing significant signs of improvement and was discharged from the hospital after eight days. The patient was able to return to life as normal and at the time that the case was presented had no further complications.

 

Since we had used the New England Journal of Medicine database to find our case study, we were actually able to get our hands on the PowerPoint that was used in the original Grand Rounds presentation given at Massachusetts General Hospital. The PowerPoint contained videos from the angiograms done in the hospital as well as other helpful pictures and background details of the case that we would not have had access to if we had not been able to obtain this PowerPoint. Having the actual angiogram videos from this patient enhanced our presentation immensely and made the case study feel more real.

 

I found this topic to be especially intriguing because it combined two of my clinical interests: women’s health and cardiology. I have always been drawn to women’s health issues particularly pregnancy and birth and for a while now have considered becoming an OBGYN or midwife. Spontaneous coronary artery dissections (SCAD) are a rare complication of pregnancy, so it was really valuable to learn about the presentation and treatment options for SCAD and this knowledge could potentially be useful in my future career, which made the information feel very relevant. This JanPlan I discovered a new interest in the heart and cardiology. I had never considered cardiology to be a field I was particularly interested in, but the cardiovascular unit in this class really opened my eyes to the wonders and intricacies of the heart and has left me wanting to learn more. This topic fit my interests perfectly and I thought it was really cool that we got the opportunity to study a case and explore our personal interests in an incredibly relevant way. Postpartum SCADs are very rare and are often overlooked, but now I know what to look out for which will hopefully help me provide the best care possible to my future patients. I also felt that I learned a lot of important and relevant information from my peers presentations. It was really fun to get to watch my classmates present topics that they were passionate about. Grand Rounds was a very rewarding and interesting endeavor and was definitely a highlight of my month.

 

 

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Alexandria Lucas: Grand Rounds / Oligoastrocytoma

February 22nd, 2015 · Comments Off on Alexandria Lucas: Grand Rounds / Oligoastrocytoma

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The grand rounds project, which consists of research on a particular topic and a final group presentation that is open to the public, I think was perhaps one of the most valuable parts of this class, for it really did require a lot of individual learning and the students really had to take things into their own hands, be independent, and put a final product together all outside of class, much like the way things will happen in medical school. I very much appreciate that Dr. K always pushed us to work hard in this way to prepare us for much harder tasks that are to come in the future in our post-Colby years, and the Grand Rounds project was easily one of those things.

My group wanted to do a case study for our project, so we first began by looking through a list of different case study articles when one caught our attention titled: “32 year old woman with episodes of unconsciousness.” We were very curious what was causing these episodes, because it really could be a wide range of things, so we choose this as our topic because of its very intriguing symptoms.

The next part of the project consisted of breaking up the material into sections, such as symptoms, differential diagnosis, diagnostics tests, and more, and then each group member doing research on their assigned sections. We then worked on putting together a PowerPoint presentation and a one-page synopsis on the topic. Some groups did a lot of this work together, but it is always hard to find a time that everyone can meet, so we ended up doing most of this work alone and communicating over email and Google docs which I think actually worked really well.

On the second to last day of class, each group presented their PowerPoint on their topic for about 15 minutes. I found this to be one of my favorite class times throughout the whole semester. I really enjoyed hearing about medical cases that I know nothing about, as well as see the different groups be so intrigued and excited about the topic they choose to research, and in addition seeing how much knowledge we had all gained over the past few weeks.

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It was, however, a little nerve-racking to be put in front of the class speaking about something that is often quite advanced and perhaps a little over a college students’ head, but having the class there and Dr. K in front being very supportive, the presentation did not end up being as scary as I thought it was going to be. Our case, of the 32 year old woman with episodes of unconsciousness, was mainly a result of an Oligoastrocytoma, which is a tumor consisting of mixed cells. It was located in the temporal part of her brain, which was causing her unconscious episodes. However, what makes this case even more interesting is that she had a genetic predisposition to neurocardiogenic syncope (fainting, loss of muscle both due to abnormal control of the brain over the heart), which led to her case being complicated by ictal asystole (stopping of the heart during her epileptic seizures, which is very rare). Not only during this Grand Rounds project did I have the opportunity to be an independent learner as well as a group member, but I also learned a significant amount about this woman’s case and Oligoastrocytoma’s, as well as recognizing the fact that although certain medical cases can easily explained by one disease, that does not mean that is always the only thing going on.

Tags: Bi265j · Grand Rounds · Human Health

Human A&P Grand Rounds Presentations

January 23rd, 2015 · Comments Off on Human A&P Grand Rounds Presentations

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Our Human Anatomy and Physiology class will be presenting a series of talks on various diseases this coming Wendesday, January 28th 2015 from 9 until 11 AM on Colby’s campus in the Olin 01 auditorium, beneath the Olin Science Library. Each of the five 15 minute talks will be followed by a brief Q&A and will cover the following topics:

  • Celiac Disease
  • Oligoastrocytoma
  • Atypical Hyperplasia of the Breast
  • Postpartum Coronary Artery Dissection
  • Coronary Artery Bypass Grafting vs. Stent Implantation

The presentation is free and open to the public and light refreshments will be served.

Tags: Grand Rounds · Human Health · Special Activities · Uncategorized

We made the paper!

January 31st, 2013 · Comments Off on We made the paper!

Check it out! We made The Morning Sentinel.

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Grand Rounds

January 29th, 2013 · Comments Off on Grand Rounds

Our class is to present our final projects to the public on January the 30th at 9:00 am in Olin 001.

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