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Malaysian
Forum Guru Topics: 28 Posts: 778 |
Dear bactitech, I doubt it if you can remember me however I was an avid fan(and still am) of yours and was regularly posting micro. questions at you and learning from your experience.I gave the step 1 USMLE last month.......hence my absence all this while.Just wanted to let you know I passed.And am eternally indebted to you for sharing your knowledge and experience........like I always used to say 'I just love reading your posts'.....I hope I can thank you in person some day in the future you're simply a wonderful person and a huge asset to the microbiology forum.You just make it more lively and always so helpful.Do you check your inbox on this forum???Wishing you Happy New Year and a wonderful year ahead. Bye for now.Regards.
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bactitech
| Forum Newbie  Topics: 31 Posts: 606
Why thank you for such a nice post! I hope you pass everything. I'm not sure how all this testing for your MD works. How many steps before you get your degree? I assume the testing starts after the second year. Years ago I dated a med student - we had gone together through our last two years of college. I graduated in 1971 and he went on to med school in fall of 1971. We weren't together when he started all the testing (things happen :-() so I don't know the sequence of events, and I don't even know if it's the same now as it was back then. If you'd like to write me I'll surely check my inbox :-). Keep on posting - I'll be glad to help you or anyone any way I can. Please realize, however, that I'm just not up on the theory any more. It's been way too long. I live in the practical every day world of medical microbiology. This is the world where you will live too once you get past all these examinations. This is what I'm trying to help you all with. We get calls all the time from bewildered residents who just don't know their micro or antibiotics. One wanted to treat enterococcal Group D strep and he didn't know if trimethoprim sulfa would cover it (not a good choice - we only report ampicillin and vancomycin on this organism routinely). Another wanted to know if Vanco would work against a gram negative rod (it won't). The antibiotic end is really the hardest to learn. When you get into practice don't hesitate to call in infectious disease for a consult if you have problems. It's really better to do that early on and admit you're not sure how to handle it then mess around giving the wrong drug and having the ID people just shake their heads in bewilderment later. I realize you guys all are competitive or you wouldn't have gotten into medical school. You can't know EVERYTHING though. Ask for help. There's tons of other stuff you have to know besides micro to practice medicine. Know your basic stuff, though, for the type of practice you'll be in. One recent case come to mind - identity of the person involved will not be given out.... Patient A, an elderly woman 75+ years of age complained of a cold and pressure in her sinuses, with headaches. It was determined by the doctor that she should go on antibiotics for sinusitis, but he didn't have samples of Z-Pak in the office (Azithromycin, a great drug that will nail most of the respiratory tract stuff, especially the beta-lactamase producers). Because of financial considerations, he prescribed amoxicillin. However, three days into the amoxicillin, the patient was getting worse, and was even starting to go into chills and fever. The patient was switched to Z-Pak and is starting to recover, but very slowly. Lesson learned: elderly people can get really really sick with respiratory stuff, and they don't recover quickly. Many bugs produce beta lactamase which amoxicillin won't touch. I know - I see them every day. The Strep. pneumos are WAY more resistant than they were ten years ago or even five years ago. The mortality rate from pneumonia with elderly patients is pretty high. I went to a seminar back in the early 90's when Biaxin and Azithromycin were first coming out. I remember a Pulmonary specialist chiding the family practice and internal med docs for not agressively treating pneumonia with strong enough antibiotics. He groused that these sick people would then end up on his doorstep half dead (I don't think he used those exact words but you get the idea) and then his job would be that much harder. He pretty much told them not to mess around when it came to pneumonia, especially with patients over the age of 50. It is always better to ask questions than to play dumb and screw up :-(. Happy new year to you also!
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