So we wrote the Gastro exam. And I know I passed. And now I want to move on with my life.
Except, it won’t let me.
While studying for the Resp exam, I was going through some ChemPath (Chemical Pathology). When it got to the section on pleural effusions, I was just going through the motions-you know, Light’s criteria and such-so that I could confirm that I know the work. Except, now that we’ve done Gastro, it seems to be pervading every aspect of the work.
Causes of transudate: congestive heart failure, nephrotic syndrome, hypoproteinaemia, liver cirrhosis…
Ooh! Liver cirhossis. I can totally see why. Portal hypertension leads to an imbalance in hydrostatic and oncotic pressure, of course a pleural effusion can result. In fact, so can oedema. And oesophageal varices. Speaking of which, management of oesophageal varices should be non-surgical so one would have to be very sure of that diagnosis. Treatment? Banding, ligation…beta blockers if it’s a major bleed and not contra-indicated. Wait a second! Beta blockers? Wouldn’t beta blockers be contraindicated in severe asthma? Oh crap! I’m doing RESP NOT GASTRO!!!
Gastro, please, I beg you: leave me alone!