Psychopharmacology Seminar, PBL, and Clinical Skills

We had a ridiculous amount of reading for today, and I didn't come close to finishing it all. But I probably got about halfway, which is enough to let me fake it anyway.

The same psychiatrist who did the disastrous child development seminar last Friday talked to us again today about antipsychotics. This time we started more or less on time. There are two main antipsychotics that he wants us to know about, one that is low potency (clozapine) and one that is high potency (haloperidol) for dopamine-2 receptors. Dopamine is one of the neurotransmitters in the brain. It's the same one that gives cocaine users their high, which hopefully none of you know about from personal experience. ;-) Clozapine has some nasty side effects like an increased risk of seizures, significant weight gain, and increased risk of high blood sugar. Oh, and it can lower your white blood cells, which isn't such a good thing for your ability to fight off infections. The second half of the seminar was given by another psychiatrist who is just awesome. He looks like he's about our age, and he was just a lot more interactive. I actually paid attention for the entire hour.

This week's PBL case has an interesting twist to it. It turns out that the diagnosis we made on Monday was not right. We weren't completely off base though. And to be fair, I think the people who wrote the case purposefully withheld some of the pertinent info so that we'd go down this wrong turn because they wanted us to study both diseases. There are only four learning objectives for Friday, so I don't have to do one this time.

We had our last regular clinical skills class this afternoon. For the rest of this year, we'll be doing special clinics like pediatrics and subacute care as well as taking our OSCEs. I'll explain more about the OSCEs later, but they are basically a practice session for Step 2 CS. Step 2 CS is a part of the medical boards that we'll be taking our senior year. We have an OSCE review session next week, so I'll know more myself then. Our communications and physical diagnosis skills for this week were to discuss alcohol use with patients and to do the abdominal exam. The abdominal exam is pretty easy. Actually, EVERYTHING is pretty easy compared to the neuro exam!

I am more excited than I realized about the fact that after today, we don't have to go to these communications sessions any more. Plus this is the last week of NMS block. Finally, things have GOT to start easing up....