We are officially done with the first block in Clinical Medicine of our final semester of Didactic Year, and to celebrate, we got a three-day weekend (well, really due to the Inauguration, but I would like to think it was a gift for being rockstars). I wanted to go ahead and share some of the best ways I found to study for this block, as well as some of the most interesting things we learned.
- Get the physiology down. Normally I just go off of my base knowledge of physiology from our summer semester, as well as paying attention when we have a lecture on it. But for the GI block, I found it SO helpful revisit the chapter in our physiology book and spend a little more time going in depth into what was going on in the GI tract. There are a ton of different enzymes, all with very unique jobs, that really affect some of the different diseases and are the causative factors. Also, unlike some systems, the different portions of the GI tract are really different! And its important to understand how those differences cause problems.
- Compare and Contrast. Ulcerative Colitis and Crohn’s Disease are both considered Inflammatory Bowel Disease, but there are some pretty big difference between the two. It was really helpful to sit down and make some charts for the different conditions and either highlight or bold the characteristics that set the apart. Additionally, charts are just helpful in getting down the major things you want to know about a condition-presentation, epidemiology/etiology, diagnosis, and treatment.
- Get the names down. Self explanatory-especially when you have Cholangitis, cholelithiasis, cholecystitis, choledocholithiasis. I went back to the roots here and broke down each word to understand WHY the disease was named that.
- Think about your own body, and your own experiences. We’ve all had food poisoning or diarrhea in our lives. Think about how you felt. Figure out where all those GI organs are for you (basic anatomy woo). Think about how you would feel if something was going on there.
- Study imaging. The definitive diagnosis for most of these conditions is imaging! Learn what it would look like, or what kind of imagining is going to give you the best diagnostic ability. You want to be able to hear Gall Stones (Cholelithiasis) and immediately think of doing an ultrasound and upright plain films. You hear apple core lesion and think of colon cancer.
Once you get these 5 things done, studying for the exam (and for future practice) becomes a lot easier! You’ll be able think about the information you’re studying in relation to the things you already did, and it will start to fit a lot easier (at least in my opinion!)
Interesting GI tidbits:
- Irritable Bowel Syndrome is a diagnosis of exclusion, and one of the treatment options can be giving the patient an SSRI. There is thought that depression or anxiety can contribute to flair-ups of the illness.
- Bilirubin has to be at least doubled for a patient to have jaundice. So, unlike common thought, it is actually a sign of later illness.
- NASH (non-alcoholic fatty liver) is increasing in prevalence- maybe associated with the increased number of obese patients?
- After some GI surgeries, mainly those that create a “blind loop” (think gastric bypass), you can have an increase and Small Intestine Bacterial Overgrowth (SIBO). Mainly I just really like the name of this condition
- Meckel’s Diverticulum can present nearly identical to Appendicitis, BUT it is in the LLQ and not the RLQ. Meckel’s Diverticulum is when the passageway from the intestines to the umbilicus does not close completely after birth.
- Think Pancreatitis when you hear the patient is unable to lay down without pain, but that they get some relief from learning forward.
Comment below on your thoughts about these GI study tips, as well as any others you find helpful! I’m always looking for new ways to learn.
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