This morning I woke up thinking about chalazions & hordeolums which are stys found either inside or outside of the eye respectively. The inside the eye one doesn’t hurt and the one outside the eye does hurt. These thoughts quickly parlayed into cotton wool exudates seen on fundoscopic (eye) examinations as I recalled that being asked about on a previous Part III exam.
The cotton wool exudates most commonly result from diabetes or hypertension. Hypertension thinking leads my brain directly to the heart and cardiovascular diseases which kill the most people every year.
When you see Ischemic heart disease as number 1 you can kind of think of “heart attack” similarly, a stroke may be thought of as a “brain attack” since similar mechanisms are at work in either case just different (and very important) parts of your body. #8 would be another cardio type of disease and if you add those three together you get about 7.2 million deaths annually while the combined total of the remaining 7 causes of death total 6.9 million deaths.
If we look at high income countries which, would include places like the US we find similar statistics.
Here we see 1.26 million deaths related to the cardiovascular system and 1.2 million for all other deaths combined.
The above list accounts for about 40% of all deaths with heart diseases accounting for 28% which is about 70% of the reason for the top 10 list. It’s huge. I always think about all the press breast cancer gets but a promotion towards heart health could save a lot more women (and men) each year than breast cancer. Just from the figures above a female patient is almost 8 times more likely to die from a heart related condition than from breast cancer.
I’ll probably get an instagram post up relating this reality it just takes some thinking to post something with one picture a few lines of text and high degree of accuracy.
Rock Red Metallic
Is that about the sharpest color you’ve ever seen on a car? This is where my brain went shortly after thinking about hypertension, the eyes and Part III boards. I was driving back from Iowa yesterday and since I’m totally ready for a new car in my future I tend to notice everything that drives by. I noticed a Malibu that went by and thought that was pretty sharp then I saw a newer model Impala so I looked it up on my phone and then noticed the base price on the Camaro was around $3,000 cheaper and had tons more sex appeal.
The base model 2015 Camaro pumps out 323 go with a 3.6 litre engine – that’s over 3x the horsepower I have in my Saturn right now so, I’m good with the smaller engine option. The picture of the car up top was the final result of me playing with the online Build & Price your own car option. I do believe I could look at that car for hour – in fact, I probably already have 🙂
Maybe I’m getting old or just a bit more practical but the first time through the build your own section the only extra add-on I picked was an extra $60 for a cargo net to help hold stuff in place in the trunk. Some of the options are just ridiculous. An upgraded brake system can add $7,200 and upgraded wheels & tires can add over $6,000.
For some reason, a spare tire is not included. A can of Fix-O-Flat is included and a compact spare wheel & tire is $150. I’m thinking the 1LT model which includes a 7″ diagonal color screen, USB port and a slightly upgraded interior might be the way to go. Plus – with the 1LT model we can add a Premium 9-speaker sound system from Boston Acoustics which pumps out 245 watts of music! $495 extra for the bolstered music system is well worth it in my opinion 🙂
Anyway, that’s my fantasy.
I keep learning more and more about this Part III exam and one thing I learned new this past weekend is that, as a doctor, you kind of want to be average in certain respects. This kind of goes towards the possibility of being in court where it is best to do, be and make decisions based on what the average doctor might conclude in various situations with a patient.
One chest x-ray we had to look at showed horizontal ribs which I was taking as being somewhat pathognomonic for emphysema and based my initial diagnosis on that (along with a few other things) but, when asked for a ddx or differential diagnosis one of the correct answers had to be heart attack which, i did not pick since that was quickly ruled out.
Well ….it looks like 90% of my online blogging time here has been spent looking at various car sites – kbb.com, cars.com, edmunds.com …
Kelly Blue Book did give the Camaro a 9.2 out of 10 customer satisfaction rating. The six cylinder automatic gets 30 mpg on the highway.
I LOVE that color – Rock Red Metallic – add 323 hp and a 245 watt audio system … mmmmmm 🙂
The 1LT has a 1LT Preferred Package option that gives you an automatic transmission and 19″ bright aluminum wheels for only $1495 extra – that seems awesome considering the automatic transmission option alone is around $1295 and upgraded wheels cost a fortune. I’m not that smart about cars so I’m not sure what the increased tire size does in terms of performance but I know upgraded wheels can add drastically to the look of a vehicle. I like the idea of alloy wheels and not something that’s painted. So, here is my upgraded fantasy with the upgraded 19″ wheels …
yeah …it’s hard to see 2 and 3 hour runs over the next couple of weeks. I’m only a mile away from the school in Kansas so commute is no big deal. Back in St Louis the commute will be close to an hour each way so that 9 a.m. to 6 p.m. agenda becomes more like 8 a.m. to 7 p.m. I’m pondering increasing frequency and cutting back on distance/time.
Originally, I was going to brag that the running helped me stay more alert during the review classes and it probably did but once we hit the 9-6 routines there was about one time each day where I dozed off a bit. Still, that’s an improvement over times in the past.
Looks like it’s time to get back to my 105hp albeit super reliable 40 mpg Saturn and get her packed up for tomorrow mornings trip. Other than that I’m thinking a bottle of bleach to help clean up the garage floor where the pets took some “liberties” while I was away as well as super cleaning any other countertops which …I thought I did a pretty good job cleaning before I left last week but … leave out one dish or miss taking out a single can of garbage and it’s like fly heaven! yuck.