TWS - OSCEs, Sepsis, and A.I. Productivity

📝 Rx

Hi friends,

This past week we had our "Observed Structured Clinical Experience" (OSCE) review lecture where the school broke down what to expect for our final exams. For the un-initiated, OSCEs are basically simulated patient consults that are graded for us. We get 2 minutes to read a scenario outside a room, think about what to do, then go in and chat with an actor that's playing the role of a patient. The stressful part is that a doctor is also in the room as a fly in the wall and is grading your interaction.

We've had these before in years 1 and 2 to some extent, but the challenge now is that there's a lot we should be able to do so the scenarios can be pretty random. I guess it plays to what would happen in real life general medicine. If anyone's wondering, the strategy for me is gonna be looking in to our school's handbook and just practicing my physical exams on my inpatient and volunteer clinic days as much as possible.

There is confidence in repetition, so that's gonna be the name of the game for the next few weeks because I tend to over-stress about these things.

🩻 Diagnosis of the Week:

Sepsis

What is it: Sepsis is a pretty broad term, but in general think: severe infection.

But that's tricky because being "septic" doesn't really mean that the bacteria is killing you, at least not directly.

Bacteria (like viruses, parasites, and other bad things) tend to leave behind little footprints called "antigens" wherever they go. Our immune system can then track these "antigens" to find invaders, attack them, and then remember what they look like for the future.

In sepsis, what happens is the response to infection by our immune system is extreme. This can happen either because there's a lot of bacteria, or because the specific bacteria involved causes a very strong reaction. Either way, our body is fighting so hard it actually starts to damage itself, and this is what makes sepsis deadly. Our own cells and organs can start to get damaged from the battle happening inside.

The overwhelming immune response to the infection is what's dangerous, so the solution: treat the infection to make the immune system chill out.

Key signs:

• Few different signs here, but generally people like the SIRS criteria (so I've been told), so if you have 2 or more of these it's a red flag for sepsis:
  • Temperature too high (>100.4°F/38°C) or too low (<96.8°F/36°C)
  • Heart rate >90 beats per minute
  • Respiratory rate >20 breaths per minute (or if PaCO2 <32mm Hg which just means you're breathing a lot of CO2 out)
  • White blood cells >12,000 or <4,000

🤓 Dose of the Week

A.I. Productivity

Motion (the app) is an AI scheduler + calendar all in one.

It's been on my Instagram feed for what feels like ages and I finally decided to test it out this past week. It's been interesting, but not as "AI" run as I was expecting. It feels less hands off than ChatGPT, at least for now.

Might need some work to make it a true automatic schedule assistant tool, but it's a step in the right direction from something like Google Calendar which doesn't just reschedule things for you. The big thing with Motion is that if you don't check off a task, it will auto schedule them for later in an open space in your calendar.

Plan on using this for a month to see how I feel after. Hoping their ads are true and my productivity increases by 137% ....which is a very specific way to advertise something.

How does someone even come up with this figure? 🧐