Kronicles of Karla: Lub-Swish-Dub-Dub

Rotation Schedule‏

8/31-9/20: Field Services
9/21-10/11: Small Animal Internal Medicine
10/12-11/1: Clin Path
11/2-11/22: Community Practice
11/23-12/13: "Vacation" (to study for the BCSE)
*12/1-12/8: ECFVG-BCSE
12/14-12/20: Anesthesiology
12/21-12/27: Holiday A
12/28-1/3: Holiday B
1/4-1/10: Anesthesiology
1/11-1/31: Food Animal Medicine
2/1-2/21: Animal Shelter
2/22-3/14: Radiology
3/15-4/4: ICU
*4/12-4/24: NAVLE
4/5-5/3: Zoological Medicine
5/3-5/23: Equine Medicine
5/24-6/13: Diagnostics
6/14-7/5: Small Animal Medicine
7/6-7/25: Equine Surgery
7/26-8/15: Preceptor (Externship)
8/16-9/6: Preceptor (Externship)

Random Facts

~ A fat cat that stops eating is a veterinary emergency (seriously).
~ All chickens have a cleft palate, called a choane.
~ Avocados are toxic to birds.
~ Bunnies can be normal and have red urine that glows under a black light. To my dismay, so can Guinea Pigs. Always check with a vet though.
~ Cats are not dogs, nor are dogs cats. Cows, sheep and horses aren't the same either.
~ Eyes that glow at night are actually reflecting light off the tapetum lucidum. Squirrels, pigs, birds, red kangaroos, and ALL non-Lemur primates (including humans), lack a tapetum lucidum, therefore, it is highly improbable that Sasquatch would have 'red glowing eyes.' The tapetum lucidum of oppossums reflect red, horses blue, and cats yellow.
~ Grapes are highly toxic to dogs.
~ Greyhounds are the universal blood donors in the dog world.
~ Guinea Pigs and Primates are the only animals that can't synthesize their own Vitamin C, and will get Scurvy without supplementation.
~ Infection by Erysipelothrix rhusiopathiae, a bacteria, causes square bruises. In pigs and turkeys this is called Diamond-skin Disease or Erysipelas, but in humans it is called Erysipeloid because Erysipelas had already been used to describe a cutaneous Streptococcal infection.
~ Manatees and two-toed sloths have 6 cervical (neck) vertabrae, while the three-toed sloth has 9. All other mammals have 7.
~ Ninety-five percent of cats have type A blood.
~ Not all blue eyed white cats are deaf, just most.
~ One bite of Polar Bear liver has enough Vitamin A to kill you.
~ Ostriches have 2 toes. Emus and Rheas have 3. Other birds have 4.
~ Parakeets are prone to cancer. An otherwise healthy parakeet that limps on one leg most likely has a renal tumor.
~ Poison Hemlock and Parsley look the same, but taste completely different.
~ Texas Bluebonnets (and other Lupinus spp.) can cause limb deformities in calves (arthrogryposis).
~ The average college grad has an IQ of 115. A child's IQ is calculated by (mental age/actual age)*100. The IQ reference range for adults is between 35 and 165 (SD 16). Mensa requires 132 (top 2%), and anyone who boasts an IQ of 165 or more (off the chart) is a mental midget.
~ The Sea Cow (Hydrodamalis gigas), 4 times the size of a Manatee, is extinct.
~ The umbilical cord of a foal must be between 36 and 83 inches.
~ Vampires exist; it's called Porphyria.
~ Whales can live for well over 100 years.
~ While humans are XX and XY, a hen is ZW and a rooster is ZZ. This quality in reptiles and fish enable them to switch from female to male, which explains the movie 'Jurassic Park.'

Saturday, August 4, 2007

Lub-Swish-Dub-Dub

In a land where avocados are the size of coconuts and jungle fever doesn't only mean lusting over a black man... a semester comes to an end.

So I have been scarce not only because I was studying, busy, was at the beach, the power was out rendering the internet useless, but mainly because I've been sick.

I use the term 'sick' loosely because I might as well have had the plague. Maybe I’m being a little melodramatic, but what do you call a person unable to maintain a body temp above 96F covered in blankets in the Caribbean heat? Let me add to that, a pulse of 140 bpm and a standing blood pressure that was nearly undetectable. I've been on a diet to look better in my bikini, but went from 126-128lbs to 118lbs in 4 days. Icky icky sicky. I arrived here weighing a heafty 135lbs.

This is where my physio notes came in handy: while listening to my heart trying to bound out of my chest, I heard 3 distinct heart beats, like a horse cantering along! I attribute it to my great love of horses, but it’s known as an S3 heart sound. Normally you only hear S1 and S2, which is better known as the characteristic “lub-dub” of a heartbeat. But wait there’s more!

I also heard a swoosh between the lub and the dub, so a “lub-swish-dub.” Murmurs between S1 and S2 are systolic murmurs and generally involve the atrio-ventricular valves (AVV), while murmurs after S1 and S2 are diastolic murmurs and generally involve the semi-lunar valves (SLV). Then you have swish murmurs that are due to insufficient valves and whistling murmurs due to stenotic valves. AVV are between the atria and ventricles while SLV are between the ventricles and pulmonary veins on the right or aorta on the left. (I'll make a murmur chart.)Mine is a problem with the left AVV, called the mitral valve in human medicine, confirmed by an ultrasound (echocardiogram).

So each leaflet of a valve is composed of three layers: the atrialis, fibrosa, and spongiosa. In classic mitral valve prolapse, there is excess connective tissue from dermatan sulfate (a glycosaminoglycan) that thickens the spongiosa which separates collagen bundles in the fibrosa. This thickening weakens the leaflets and adjacent tissue, resulting in increased leaflet area and specifically the elongation of the chordae tendineae (valve strings). Elongated chordae can break causing major problems which I choose not to think about.

So the good news is that I feel much better now and I wasn't anemic or dehydrated or stressed or had and electrolyte imbalance! The cardiologist I went to thought the heart problems I had that lead to us discovering this was the result of a viral infection, which I have now cleared. I was really impressed, she was educated to the states and more knowledgeable than most MD’s I’ve been to. With 2 med schools on island, all bets are off at the local hospital though.

The bad news is this is an inherited defect and when I'm older I'll probably need that valve replaced. Right now there’s really not much that can be done, so don't worry and don't fly down, I'm not in critical condition. I've learned that ~2% of people are diagnosed with is and an estimated 15% might have it, but according to eMedicine on WebMD, MVP is prevalent in 7% of autopsies in the United States.

You can read more and listen here:
http://www.merck.com/mmpe/sec07/ch076/ch076d.html