Cleaning is proving to be a challenge. Yesterday was the easy bit--shuffling stuff from the living room until it was all in respective piles. Turns out it's hard to get beyond that point. Every surface is dusty, and choosing a spot to start sweeping is harder than it looks (the more motile dust bunnies escape to all four corners. Some of them take refuge on the carpet, which means I'm going to have to vaccuum too. I just vaccuumed a month ago!)
I also have a lot of recycling and garbage to take down to the basement. This sounds less intimidating than it really is. To take anything to the basement requires the unlocking and wrenching open of one door, traversing the stairs, and unlocking and shoving open a second door. It's not truly strenuous, but around the third trip I get really tired of the doors smugly slamming themselves shut as soon as I let go of the handle.
I took a break to make spritz cookies. I found the recipe in a batch of post-it notes on the refrigerator, which I think have been there for two years. Yum, spritz. Butter! I ate three or four and my tongue went numb, which I think means metronidazole is incompatible with almond extract. Pity. It's probably more important for me to finish the antibiotics than the cookies.
At least there's lots of commercial-free Christmas music on the radio!
Friday, December 25, 2009
Merry Christmas!
I'm on call today! I plan to get a lot of cleaning done. Due to the weather's decision to festively glaze every surface with ice, I won't be going anywhere (unless I get called in, of course). I got Christmas dinner though--my dad decided we were going to have roast, so I went home yesterday and helped prepare it (and eat it). Traditionally we have Yorkshire Beef on Christmas Eve. Yorkshire beef is essentially sloppy joe covered with eggy custard and cheese. It is delicious. But prime roast is better.
I got most of my grades back. Still waiting for Pathology (not expecting anything stellar, just hoping to pass). It seems that I got a low B in each class. Wait...I got an AB in Epidemiology. It doesn't surprise me terribly, but I had hoped that the ancillary work in some of the classes would have compensated a bit more for the exams. Or vice versa.
But next semester...! I shall OWN parasitology! And clin path! Well, maybe not clin path. At least not "own", per se. More...borrow on a month-per-month basis?
But today: Christmas songs on the radio and exhaustive cleaning! And maybe a trip to the clinic.
I got most of my grades back. Still waiting for Pathology (not expecting anything stellar, just hoping to pass). It seems that I got a low B in each class. Wait...I got an AB in Epidemiology. It doesn't surprise me terribly, but I had hoped that the ancillary work in some of the classes would have compensated a bit more for the exams. Or vice versa.
But next semester...! I shall OWN parasitology! And clin path! Well, maybe not clin path. At least not "own", per se. More...borrow on a month-per-month basis?
But today: Christmas songs on the radio and exhaustive cleaning! And maybe a trip to the clinic.
Wednesday, December 16, 2009
Finals tomorrow...
Why aren't I studying? AAargh!
Seriously...I spent an hour wandering around a bookstore yesterday and more time than that today on things that had nothing to do with virology or bacteriology. Suddenly the most important thing is making dinner?! Self-control, please!
Seriously...I spent an hour wandering around a bookstore yesterday and more time than that today on things that had nothing to do with virology or bacteriology. Suddenly the most important thing is making dinner?! Self-control, please!
Thursday, December 10, 2009
Rose Waaler
The note-taking continues!
Detection of Rheumatoid Factor
Rheumatoid factor=antibody to antibody.
Sheep red blood cells are reacted with appropriate concentration of anti-SRBC antibodies, made from rabbit or dog (odd, but apparently it works).
Appropriate concentration means it won't quite agglutinate.
Dilutions of the patient's serum are added to antibody coated SRBCs, known as sensitized SRBCs.
If the patient's serum contains RF, the RF cross links with anti SRBC antibodies and the red blood cells agglutinate. If there's no antibodies in the patient, there's no agglutination.
Colostral and milk immunoglobulins:
colostrum: IgG > IgA > IgM
non-ruminant milk: IgA > IgG > IgM
ruminant milk: IgC >IgA > IgM
Detection of Rheumatoid Factor
Rheumatoid factor=antibody to antibody.
Sheep red blood cells are reacted with appropriate concentration of anti-SRBC antibodies, made from rabbit or dog (odd, but apparently it works).
Appropriate concentration means it won't quite agglutinate.
Dilutions of the patient's serum are added to antibody coated SRBCs, known as sensitized SRBCs.
If the patient's serum contains RF, the RF cross links with anti SRBC antibodies and the red blood cells agglutinate. If there's no antibodies in the patient, there's no agglutination.
Colostral and milk immunoglobulins:
colostrum: IgG > IgA > IgM
non-ruminant milk: IgA > IgG > IgM
ruminant milk: IgC >IgA > IgM
Hypersensitivies
Using the blog for notes today. (Why? Because. It's here. I like to try new note taking formats.)
Type I:
antibody: IgE
antigen: foreign
effector mechanism: Activation of mast cells and mediators
skin test is available
Time to onset: seconds to minutes
Examples of the disease: include hay fever and anaphylaxis.
Type II:
antibody: IgG and IgM
antigen: Cell or tissue antigens AND cell surface receptors work as antigens.
Effector mechanisms: Complement activation, which leads to phagocytosis; also, cell signalling altered by antibody.
No skin test available.
Minutes to hours for onset.
Examples of disease: transfusion reactions, autoimmune hemolytic anemia, pemphigus vulgaris, and some drug allergies.
Other diseases include Grave's disease, myasthenia gravis, and type 2 diabetes.
Type III:
antibody: IgG aand IgM
antigen: Immune complexes work as the antigen; they activate complement system and phagocytosis. "Why would phagocytosis or complement activation of immune defenses lead to tissue damage? Why is the pathology of mycoplasma immune-mediated? It's because mycoplasms are bound so tightly to the cells that the immune defense can't differentiate. It's bystander damage."
skin test: Arthus reaction (inject antigen and circulating antibodies bind, forming an immune complex and resulting in 'weal and flare').
Inappropriate immune response to antigen, and also excessive.
How do allergy shots, desensitization, work? Kicks the body into T helper 1 response, with IgG. This moves it away from TH2, where IgE activate mast cells for massive degranulation.
6-8 hours to see reaction.
Examples: rheumatoid arthritis, serum sickness, systemic lupus erythematosus (SLE). What is serum sickness? Let's say someone with hepatitis is discovered to have helped prepare food; everyone who ate some is given a massive dose of anti-serum to mop up the hepatitis. (And yes, I know hepatitis is technically just a word for unhappy livers)
Not all hypersensitivities are auto immune.
Type IV
Antibody: none
antigens: foreign, cell antigen...or cell associated.
Effector mechanism: macrophage activation by TH1, plus inflammation
Or CTL mediated cytotoxicity (and inflammation) (if antigen is cell associated).
Skin test: most certainly. It takes 48-72 hours (though the TB skin test in cattle can be nicely simulated in under an hour by using chicken blood cells. On the other hand, you can also induce anaphylaxis, hypersensitivity type I, with chicken cells...apparently reversible).
Examples: contact dermatitis, tuberculin reaction, type 1 diabetes, multiple sclerosis. CTL mediated: acute graft rejection ("omg alien invasion kill kill kill!" scream the CTLs)
Hemolytic disease in newborns: the mother makes antibodies to the fetal antigens (just think of the fetus as an allograft; this is why pregnant women are immunosuppressed). This is a problem for horses; the mare concentrates antibodies in her colostrum. The foal is born without any problems and nurses, and ingests what is essentially anti-foal colostrum. The complicated bit is that this doesn't happen with the first foal she has by that stallion; it takes that first pregnancy to introduce her immune system to the foreign genetics. By breeding her to a different stallion each time, she never builds up the antibody response. The other option is to feed the foal colostrum from a different mare. HOWEVER, the replacement colostrum should be from a mare on the same farm. Horses develop very localized immunity; the endemic pathogens of one farm are not the same as what may be endemic on a different farm.
Type I:
antibody: IgE
antigen: foreign
effector mechanism: Activation of mast cells and mediators
skin test is available
Time to onset: seconds to minutes
Examples of the disease: include hay fever and anaphylaxis.
Type II:
antibody: IgG and IgM
antigen: Cell or tissue antigens AND cell surface receptors work as antigens.
Effector mechanisms: Complement activation, which leads to phagocytosis; also, cell signalling altered by antibody.
No skin test available.
Minutes to hours for onset.
Examples of disease: transfusion reactions, autoimmune hemolytic anemia, pemphigus vulgaris, and some drug allergies.
Other diseases include Grave's disease, myasthenia gravis, and type 2 diabetes.
Type III:
antibody: IgG aand IgM
antigen: Immune complexes work as the antigen; they activate complement system and phagocytosis. "Why would phagocytosis or complement activation of immune defenses lead to tissue damage? Why is the pathology of mycoplasma immune-mediated? It's because mycoplasms are bound so tightly to the cells that the immune defense can't differentiate. It's bystander damage."
skin test: Arthus reaction (inject antigen and circulating antibodies bind, forming an immune complex and resulting in 'weal and flare').
Inappropriate immune response to antigen, and also excessive.
How do allergy shots, desensitization, work? Kicks the body into T helper 1 response, with IgG. This moves it away from TH2, where IgE activate mast cells for massive degranulation.
6-8 hours to see reaction.
Examples: rheumatoid arthritis, serum sickness, systemic lupus erythematosus (SLE). What is serum sickness? Let's say someone with hepatitis is discovered to have helped prepare food; everyone who ate some is given a massive dose of anti-serum to mop up the hepatitis. (And yes, I know hepatitis is technically just a word for unhappy livers)
Not all hypersensitivities are auto immune.
Type IV
Antibody: none
antigens: foreign, cell antigen...or cell associated.
Effector mechanism: macrophage activation by TH1, plus inflammation
Or CTL mediated cytotoxicity (and inflammation) (if antigen is cell associated).
Skin test: most certainly. It takes 48-72 hours (though the TB skin test in cattle can be nicely simulated in under an hour by using chicken blood cells. On the other hand, you can also induce anaphylaxis, hypersensitivity type I, with chicken cells...apparently reversible).
Examples: contact dermatitis, tuberculin reaction, type 1 diabetes, multiple sclerosis. CTL mediated: acute graft rejection ("omg alien invasion kill kill kill!" scream the CTLs)
Hemolytic disease in newborns: the mother makes antibodies to the fetal antigens (just think of the fetus as an allograft; this is why pregnant women are immunosuppressed). This is a problem for horses; the mare concentrates antibodies in her colostrum. The foal is born without any problems and nurses, and ingests what is essentially anti-foal colostrum. The complicated bit is that this doesn't happen with the first foal she has by that stallion; it takes that first pregnancy to introduce her immune system to the foreign genetics. By breeding her to a different stallion each time, she never builds up the antibody response. The other option is to feed the foal colostrum from a different mare. HOWEVER, the replacement colostrum should be from a mare on the same farm. Horses develop very localized immunity; the endemic pathogens of one farm are not the same as what may be endemic on a different farm.
Monday, December 7, 2009
Doctors and doctors-to-be
Nowadays when I have a doctor's appointment, I find an opportunity to tell the doctor that I'm a vet student. I'm sure some level of my brain does this because it doesn't want the doctor to think it is a silly brain for using medical terms. Everyone knows that patients find medical terminology to be incomprehensible jargon, so the patients who try putting forward a vocab word or two of their own probably spent an hour of quality time with some medical websites.
But Mayo's help page does not a doctor make...so I try to clarify where I got my information. Otherwise, we get conversations like this:
Me: "So, I suppose one of the things that could be causing stomach pain, if it's not just stress related, could be Crohn's?"
Doctor: "Ah, so you've been doing some reading online, then?"
"Um...we went over it in class a month ago. Did I mention what I'm in school for?"
Granted, vets aren't supposed to diagnose human disease. We had a session on this today: if a woman comes in with a ringworm positive cat, and she has what is obviously a ringworm lesion on her forearm, you are allowed to diagnose the cat and start it on treatment, but you can't tell the woman anything beyond, "Maybe you should go see your doctor."
But Mayo's help page does not a doctor make...so I try to clarify where I got my information. Otherwise, we get conversations like this:
Me: "So, I suppose one of the things that could be causing stomach pain, if it's not just stress related, could be Crohn's?"
Doctor: "Ah, so you've been doing some reading online, then?"
"Um...we went over it in class a month ago. Did I mention what I'm in school for?"
Granted, vets aren't supposed to diagnose human disease. We had a session on this today: if a woman comes in with a ringworm positive cat, and she has what is obviously a ringworm lesion on her forearm, you are allowed to diagnose the cat and start it on treatment, but you can't tell the woman anything beyond, "Maybe you should go see your doctor."
Saturday, December 5, 2009
How to relax (or not)
Perhaps reading about how smallpox hasn't really been eradicated after all is not the best way to relax. However, the fun part of reading "Demon in the Freezer" is realizing that now I know some of the techniques used in those high-biosecurity labs.
It's been a hard week, what with getting exams back and having papers to turn in. I reviewed my e-mails to non-vet people one day, as well, and found out my writing has deteriorated badly since the beginning of the semester. As the months go by, everything unrelated to infectious disease becomes incoherent and disjointed, and I start talking about salmonella and flaviviridae with increasing fervor.
I talked to the supervisor at work about fixing the on-call schedule so we don't get called in for twenty-four hour stretches. The alternative was probably going to be me giving two month notice and resigning. In some ways, that was an attractive option. I find being on-call to be a loathsome experience. The pager is like a black box of portable stress. If it doesn't go off, I'm worried I might have missed it, so I have to keep checking for the little blinking light. There's always the one long moment where you look at it and wait for it to blink.
If it does go off, that's the next four hours (at minimum).
Some of the people who no longer do this job assure me that, well yes, there are crazy times when you get called in the entire night every time you're on call. But then there are stretches where nothing happens at all! They say this as if it makes everything okay. "There might be times you don't get called in, isn't that awesome?!" Although to be honest, getting called in is not really the problem. Surgeries are exciting, and you learn a little more every time you help with one. No, the problem is cleaning up after the surgery, because then there is no more excitement and it usually takes about as long as the surgery itself. I like to think that it is a less important part of education at this stage; at any rate, I would rather be studying bacteria.
It's been a hard week, what with getting exams back and having papers to turn in. I reviewed my e-mails to non-vet people one day, as well, and found out my writing has deteriorated badly since the beginning of the semester. As the months go by, everything unrelated to infectious disease becomes incoherent and disjointed, and I start talking about salmonella and flaviviridae with increasing fervor.
I talked to the supervisor at work about fixing the on-call schedule so we don't get called in for twenty-four hour stretches. The alternative was probably going to be me giving two month notice and resigning. In some ways, that was an attractive option. I find being on-call to be a loathsome experience. The pager is like a black box of portable stress. If it doesn't go off, I'm worried I might have missed it, so I have to keep checking for the little blinking light. There's always the one long moment where you look at it and wait for it to blink.
If it does go off, that's the next four hours (at minimum).
Some of the people who no longer do this job assure me that, well yes, there are crazy times when you get called in the entire night every time you're on call. But then there are stretches where nothing happens at all! They say this as if it makes everything okay. "There might be times you don't get called in, isn't that awesome?!" Although to be honest, getting called in is not really the problem. Surgeries are exciting, and you learn a little more every time you help with one. No, the problem is cleaning up after the surgery, because then there is no more excitement and it usually takes about as long as the surgery itself. I like to think that it is a less important part of education at this stage; at any rate, I would rather be studying bacteria.
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