Anyone have anything abnormal discovered durring PEX?

[Guest moo]

Ok, so today, my preceptor for Physical Exam skills course discovers I have a torn ACL. A few years ago, I had a snowboarding accident, went to the ER, where the resident thought I had a knee sprain. Apparently it was a lot worse than that. Has anyone out there have something pointed out to them during PEX? This is quite freaky... what if I had like a lump or something discovered that was cancerous?

[Guest UWOMED2005]

My clinical exam skills (we don't call it PEX here) prof thought I had an enlarged thyroid. The family doc I followed up with, not so much. Just goes to show these things aren't always black and white. . . and that not all practicing physicians know their physical exam skills like they should!

[Guest moo]

yeah, but my preceptor is one of the team doctors for the chicago blackhawks... so i kinda trust him on this

[Guest UWOMED2005]

Yeah, I would definitely trust him on that. . .

[Guest monkey]

its funny you mentioned the enlarged thyroid coz a guy in my clinical methods team was 'diagnosed' with the same 3 weeks ago. maybe we have the same preceptor? or maybe its a lot more commonly 'diagnosed' than i thought it was.

 

of course like you, when the guy had it checked out with his family doc it was found to be nothing.

[Guest RAK2005]

I recommend getting that ACL tear followed-up as well. ACL instability pre-disposes you to meniscal tears and more importantly, the instability can lead to articular cartilage damage and ultimately osteoarthritis

[Guest not rex morgan]

I was just going to warn about the osteo arthritis. 80% of people with no menisci will develop this. The chance is a bit lower with an ACL tear, but it still predisposes.

 

I know of someone who was diagnosed with Ehlers Danlos Syndrome in clinical skills.

[Guest MayFlower1]

I damaged the medial meniscus of my left knee about 15 years ago playing football...I fell on my knee, hitting the only rock on the field it seemed...my knee was sore for about 2 weeks...then it seemed fine. About a year later a "clicking" thing started...followed by locking of my left knee. I had arthroscopic surgery...all was fine for a while...I had to have arthroscopic surgery for debriding of the joint again about a year ago...the left knee is definitely arthritic...my surgeon has recommended taking pain and antiinflammatory meds until I can't cope and then recommends a high tibial osteotomy...a significant surgery with significant risk as you all can appreciate. The reason I bring this up is that I strongly second (or third) the recommendation to follow up on this promptly...you don't want osteoarthritis...it aint' fun.

 

Peter

[Guest moo]

I am definitely going to follow up on this, but I am not too sure about getting surgery. The rehab takes 4-8 months and the time commitment I hear is great. With school, I just don't think I have the time right now.

[Guest UWOMED2005]

For some reason, seems like everyone (or at least a lot of us) in the 2005 class at UWO have been having their knee reconstructed.

[Guest summervirus]

Nothing huge but a guy in my class found out that he has "lid lag"...

[Guest RAK2005]

The rehab varies, but it usually involves a couple (maybe three) visits a week to the PT Clinic, with treatment lasting about 1 hour. Once you start improving (i.e. after 4-6 weeks) most can be done at home... Summer is a good time to have it done (e.g. April or May surg.).

[Guest jmh2005]

Well, I'm still in the process of the investigations...but I now think that I have a congenital bicuspid aortic valve (systolic 2/6, holosystolic)...for those of you not in medicine, the aortic valve should have 3 cusps (tricuspid, not bicuspid)...I did know that I had a small murmur (I was told in undergrad, but was always told it was nothing)...now that I'm done cardiology, I'm a bit pissed at the Doc that told me that it was nothing (potentially, yes it could have been nothing, but she should have sent me for an echo regardless...)...I asked my preceptor to check me out (3rd year Int Med Resident, soon to be nephrologist...) who told me to definately get an echo..

 

On the screen I could only see 2 cusps, but the cardiologist is the expert...should have the results in the next few days...I guess its not that big of a deal, but now I'm all paranoid I'll develop Aortic Stenosis at an early age (which we all know is not good...) and need a valve replacement (also, not good...)...no more eating crap I guess...

[Guest kellyl20]

what is lid lag? anything to do with droppy eyelids?

[Guest not rex morgan]

Lid lag is one of the clinical signs of hyperthyroidism. To test it, you get the person to look down. As the term suggests, the lids lag behind the eyes in their decent. This happens b/c there is an excess sympathetic axis and the eyelids are set to stay wide open. Alone, it may mean nothing. Other signs of hyperthyroidism include goiter (enlarged thyroid), tons of energy and fidgeting, cold-seeking (you have a high basal metabolic rate and thus produce alot of heat...you want to cool down), high heart rate, and our old favorite, diarrhea.

[Guest Nightrider]

well...I'm not a med student yet...but I do have one of those weird diagnoses that turns up by accident...I had had a couple of LOC incidents, and was sent for an MRI to rule out an arachnoid cyst (b/c one of my ventricles was enlarged)...anyhoo, they happened to notice that I have a non-functioning pituitary adenoma...so they keep sending me for MRIs to monitor it...and now it looks like I am doomed to biennial MRIs for years to come...yee haw.

[Guest Tal]

I think that slighty enlarged thyroids are probably pretty common. I know that hypothyroidism is very common (especially in women). I alone know at least 5 women diagnosed with it. But what a lot of people seem not to know is that this condition can be worsened, and sometimes caused by many of the foods we eat. For example soy was found to actually cause goiters(!) in completly healthy individuals who consumed large quantities after only 3 months. Anyway, sometimes I just think that more people (especially doctors) should know about these links. Maybe these diagnosed enlarged thyroids are nothing really right now (for example, maybe they are slightly enlarged, but the doctor feels it's nothing to worry about), but maybe there's some other symptoms along with them and being informed about these foods, and other things, that could worsen the condition seems like a good idea to me. Anyway I thought this might interest some people. If you'd like to know more about the soy study, let me know and I'll find out the name.

(Sorry this is slightly off topic from the original post.)

[Guest IRNBRUD]

Tal

I would be interested in the soy study if you don't mind finding out the details.

Thanks,

IB

[Guest Tal]

Hi guys,

Sorry it's taken me so long to reply to this post with the info on the soy study. Here's the info though, if you just plug in these names in at http://www.pubmed.com it'll come up with the abstract:

Ishizuki Y, Hirooka Y, et al. The effects on the thyroid gland of soybeans administered experimentally in

healthy subjects. Nippon Naibunpi Gakki Zasshi – Folia Endocrinologica Japonica 67:622-9 (1991).

I hope you're still interested, sorry again!

[Guest Lakers4life]

We call our course ASCM and I had a few lymph nodes that were palable during the HEENT week...kinda got me a little bit worried until I had by blood work done!