Human Anatomy at Colby

Phoebe Hughes: My Experience in Human A&P

February 14th, 2014 · Comments Off on Phoebe Hughes: My Experience in Human A&P

Phoebe Hughes

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In anatomy and physiology this year we did a ton of cool activities. We got to go to the Maine General Hospital in Augusta, learn about all the body systems, dissect a pig heart, and much more. Two activities I found interesting were the Robert Lusting video and going to Maine General Hospital. Although the labs were fun, the class was also difficult. It challenged and pushed me, but I enjoyed it and learned not only about A & P but also some valuable study skills.

During the first week and a half, the class was mostly lectures. It was really hard to absorb all the information and be quizzed on it the next day. In high school, I had never had to study very much. However when you’re learning a new body system every day, it is hard do to well without studying a ton. Although I studied some for the first lab test, I did not do as well as I would have liked. The class taught me to go over the material every night (not only the new information but old material too). After using this method, I felt much more prepared for the second lab test.

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[Here is a subset of the participants in the Metabolic Analysis Lab collaboration between the Colby A&P class and the Waterville High School cross country team. Left to right: Phoebe Hughes, Rob Stanton (WHS cross country coach), WHS athlete, Thom Klepach (Instructor Human A&P)]

After getting the hard core lectures out of the way, we were able to do more labs and go on field trips. One place we went was to the Maine General Hospital. Kasey and I were showed around the hospital by a very nice third year med student named Lincoln. He showed us the behind the scenes of the hospital. He even let us see the maternity ward (a very exclusive place). One amazing aspect of the hospital is how it serves the public and the doctors. For the patients there are single rooms and family waiting rooms all through the hospital and for the heroes of the hospital, the doctors and nurses and residents and med students, there are rooms to sleep in while they are on call at night, medicine transporters to make access easier for nurses, and areas for research and paper work. Additionally the hospital is platinum LEED certified. As Lincoln showed us through the hospital, he also explained how these aspects of the facility make a big difference in the community. It was a remarkable place to visit and made such an impact on me.

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The Bi265j class from Colby, Kents Hill A&P with Alex Wall and the UNE medical students.

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The Robert Lusting video, The Complete Skinny on Obesity, also made an impression. Some members of my family have weight issues and therefore metabolic syndrome concerns me greatly.  I recommend a few of them to watch it and learn about possible consequences of obesity. It is a considerable problem in the United States. The severity of obesity in children surprised me and I found the increase of obesity in the past fifty years shocking. This is a problem the nation must address in more ways than the standard calorie counting diet which the video discredits. It explained that it is not the calories that are the problem but what type of calories.  My mother always tries to follow weird diets (including counting calories), which do not exactly work, but I never truly understood why. The video helped explain that the increased sugar consumption is our main dietary issue. Sugar is mostly fructose, which can only be used by the liver to make fat. And although fat does secrete leptin, a hormone which tells your brain you are full, in obese people this hormone does not work causing over eating. As a whole, the video made me think about my diet and how to be healthier.

"If you have no choice, how can it be personal responsibility?  We've been told what to eat by the nanny state of the food industry, and we've gone along with it because it's sweet."- Dr. Robert Lustig

“If you have no choice, how can it be personal responsibility? We’ve been told what to eat by the nanny state of the food industry, and we’ve gone along with it because it’s sweet.”- Dr. Robert Lustig

Healthy living is a concept Dr. Klepach adamantly promotes throughout the class. He stresses the need of eight hours of sleep, keeping a healthy diet, and exercising. In his class, he leads by example, making him a great professor. He provides us with everything we need to succeed in the class. He puts up the power point presentations of the lectures and labs on Moodle and even records them for us to view later. These power points and videos are a great way to study and they allow me to focus on learning the information better in class rather than having to just copy it all down. This being said, the class is still extraordinarily challenging. I learned a great deal and enjoyed it, but unless you want to work in the medical field, I would not recommend taking this class. It is very time consuming, with three hours and forty five minutes of class and another two hours of studying per night. However, if I had the opportunity to go back in time and redo my Janplan selection, I would still choose Anatomy and Physiology. I liked learning about all the different body systems and being able to apply my knowledge. In fact, today at dinner we were talking about blood pressure, and because of this class, I was happily able to answer one of my friend’s questions.

Tags: Maine General

Grand Rounds: Creutzfeldt-Jakob Disease – An 80-Year-Old Man with Fatigue, Unsteady Gait, and Confusion

January 29th, 2014 · Comments Off on Grand Rounds: Creutzfeldt-Jakob Disease – An 80-Year-Old Man with Fatigue, Unsteady Gait, and Confusion

By: Kasey Kirschner, Jenna Passaggio, Phoebe Hughes

Four weeks before admission an eighty year old man presented with fatigue, insomnia, confusion, and difficulty walking. These symptoms may seem normal for elderly, but they were very uncharacteristic for him.  As his symptoms worsened, he was admitted to the hospital.  However, all tests conducted showed normal results. The test for 14-3-3 protein, which could indicate Creutzfeldt-Jakob, came back negative.  An MRI showed loss of brain volume and changes in his white matter. He was given multiple drugs for insomnia, and he was released three days later.  Cognitive abilities continued to decline, and he began experiencing tremors in his left arm and leg.  He was readmitted to the hospital fifteen days later. Though many tests were done, all returned normal. Nevertheless, his symptoms continued to worsen, and he died after twenty third day of readmission.

The diagnosis was sporadic Creutzfeldt-Jakob disease with MM1. This diagnosis is most likely because of the rapid progression of the patient’s myoclonic jerking and dementia. Additionally, the patient presented with multiple symptoms consistent with other patients diagnosed with Creutzfeldt-Jakobs, including confusion, insomnia, and cerebral ataxia. Despite this, other tests which may indicate Creutzfeldt-Jakobs, such as an MRI or tests for the 14-3-3 protein did not confirm the diagnosis. Upon autopsy, a loss of neurons on the thalamus and spongiform changes of the cerebral cortex were found. This, combined with other symptoms, is indicative of sporadic Creutzfeldt-Jakob disease. However, the patient’s visit to England may suggest the variant form of Creutzfeldt-Jakobs. Only the brain was autopsied, and no other tissues were searched for presence of the PrPSc protein. The PRNP gene was sequenced and showed no mutations, which ruled out familial Creutzfeldt-Jakob disease.  Ultimately, the final diagnosis was sporadic Creutzfeldt-Jakob disease.

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Creutzfeldt-Jakob is hard to diagnose because there is no single test to confirm it, and the tests available can sometimes be misleading.  There are a few which may help indicate the disease such as MRI’s, tests of the cerebrospinal fluid, and EEG’s. The presence of the 14-3-3 protein in the cerebrospinal fluid, high signal intensity on an MRI of T2 weighted images in the basal ganglia, or triphasic spikes on EEG can signify Creutzfeldt-Jakobs. In this case study, none of these tests showed signs of the disease.  An autopsy of the brain and spinal cord may be done to see spongiform changes and neuronal loss.

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Creutzfeldt-Jakob disease is a rare disease affecting approximately one in a million people. It is caused by an infectious prion misfolding. This prion in its active state causes other proteins to misfold as well.  Prions are resistant to proteinase K, which breaks down proteins.  This makes them hard to destroy.  It can be transmitted through transfusions or transplants.  However, the sporadic form of Creutzfeldt-Jakobs disease causes the prions to misfold and become infectious spontaneously. The accumulation of misfolded prions causes holes in the brain which degenerate the brain matter. The neurodegeneration causes numerous and various problems in the patient.

Although some clinical trials are underway, no cure is currently available.  Various treatments have been tested, and some patients have shown very brief periods of improvement, but nothing is available that stops CJD completely.  This disease is treated by alleviating symptoms of the disease to make the patient more comfortable prior to death.

 

 

References:

1. “Creutzfeldt-Jakob Disease Fact Sheet.” National Institute of Neurological Disorders and Stroke. National Institutes of Health, 31 Dec 2013. Web. 12 Jan 2014. <http://www.ninds.nih.gov/disorders/cjd/detail_cjd.htm>.

2. Richard T. Johnson, M.D., R. Gilberto Gonzalez, M.D., and Matthew P. Frosch, M.D., Ph.D. Case 27-2005 — An 80-Year-Old Man with Fatigue, Unsteady Gait, and Confusion. N Engl J Med 2005; 353:1042-1050.September 8, 2005.DOI: 10.1056/NEJMcpc059024

Tags: Grand Rounds