earlier today we were discussing about rheumatic heart disease in medicine, and i said "hard" instead of saying "stiff" or "inflexible"... or "rigid". they are synonymous but they all reacted and laughed. hahaha...
doc: "what is the pathophysiology of rheumatic heart disease? how does it cause damage to the heart"
nyc: "in rheumatic heart disease, what happens is, the patient gets infected with beta hemolytic streptococcus. this pathogen has a glycoprotein that mimics the antigens in the heart. so that in the body's effort to erradicate the pathogen, antibodies attack the heart valves....."
doc: "what are corresponding physical findings of the 2D-echo: mitral stenosis, mitral regurgitation and aortic stenosis"
"in mitral stenosis, you would hear a murmur during the diastolic phase"
doc: "what about the opening snap? what causes the snap"
mike: "there is forceful closure of the valve...."
doc: "are you sure of what you're saying? "opening" snap nga eh, tapos closure..."
dim: "doc, the sound is produced by the pulmonic...."
doc: "you.. what causes the opening snap?"
me: "doc, the mitral valve causes the opening snap"
doc: "why does it produce a snap?"
me: "doc the mitral valve becomes hard.. (because of the...)"
doc: "hard? hahaha, are we talking about the same thing?"
group laughs
doc: "she's right. pero don't use hard"...
group laughs... hehehe...
discussion continues... at favorite na ko ni doc.. grr
....
doc: "the atrial contraction, the stretching of the muscle and the filling of blood in the left ventricle which is the ______...?
me: "preload doc"
doc: "preload. this causes the mitral regurgitation... so what do you do to decrease preload"
jc: "give diuretics, restict salt...
....
doc: "what is afterload?... you...
me: "doc, it is the resistance to the shortening ...(of the muscles...)" -shempre inunahan ako
doc: "shortening naman ngayon..."
group laughs
doc: "right, afterload is the resistance to the shortening of the muscles or the contraction."
doc: "what happens ba during afterload...?" (grr, ako nanaman)
me: "doc, systolic contraction...."
doc: "so there is rapid...____ (smiling)...
(grr.. hay nako, lam ko na agad kung bakit sha ngumingiti)
me: "rapid ejection... (of blood)... (shempre, hihirit nanaman si doc)"
doc: "ejection ha, hindi ejaculation"....
group laughs...
loco talaga yun... grrr, wala lang.
