Birthmarks and Skin markings

From an article on "Vascular Anomalies" (skin markings) that are usually present at birth:

Most vascular anomalies involve the skin, the largest organ of the body, and, therefore, are notable at birth. For centuries, vascular birthmarks (nevi) were referred to by colorful names derived from false traditional beliefs that a mother’s emotions or types of food she ate could "mark" the skin of her unborn fetus. Old medicals texts are dotted with references to brightly colored foods that best described the appearance of an unusual cutaneous lesion ("lesion"= any abnormal change in the body).Depending on the culture, the mother was blamed for eating too much or too little red fruit during her pregnancy. The modern use of such terms as ‘‘cherry,’’ ‘‘port wine stain,’’ and ‘‘strawberry’’ to describe various skin findings in a newborn can be referenced to that old belief.

From: Christison-Lagay ER -Surgical Clinics of North America - 01-APR-006

Week in Images

Rounding on patients in the pediatrics ward.

On Call

Tonight is my first "real" on-call night of my medical school career. I'm on the Pediatrics rotation for the next two months, and I have call every 5 days or so at the hospital.
I thought I'd let you follow me around...
(The next few posts might all be seperate ones until I can sit down another day this week and condense them all into one long "First On Call" post).

3 pm, Tuesday: Call officially begins.

4:34 pm: I'm told to head down to the Emergency Department to check on an 18 month old girl having asthma complications. When I get down there, she's already been given a breathing treatment and is looking much better! I interview the father (...by the way...I'm noticing a trend in Pediatrics that fathers often know FAR LESS about their babies than the mothers do!) who says he doesn't know how bad the girl was before the treatments because he just got to the ED to sit with the kid.
She seems to have improved a lot, but just to be cautious the Attending decides to admit the girl to our Pediatrics floor for overnight observation.

5:10 pm: Two hours into this and I'm already missing Heather, so I con her into meeting me for a quick dinner at Chipotle (cool website by the way).

5:40 pm: Back in the medical student lounge.

7 pm: A patient who has been in the hospital for 2 days because of Diabetic Ketoacidosis (due to lack of insulin production, which makes these kids have really, really high blood sugar) supposedly just ate dinner and now has a blood glucose of 430 mg/dL
That's really, really high.
[Normal should be anywhere from 80 to 120].
I go check on him and make sure he's not having any problems, and I explain to Mom that the high sugar is probably because he just ate dinner.
"I'll come back in a few hours to check on him again," I say, as I leave the room and head back upstairs.

9:08 pm: Headed to the newborn nursery to see if there are any new babies to examine and writeup.
Edit- no new babies.

10:33 pm: The OB/GYN resident informs me that they just delivered a baby. I'm headed down to the nursery to look over the chart and begin writing a Newborn Hospital Admission Note. Guidelines say that you should wait 4 hours to perform an exam on the baby, because their breathing, pulse, etc are still a bit crazy from the birthing process itself. If you wait about 4 hours, you'll be able to decide if the breathing, pulse, etc are normal or not.


12:30 am: Back in the student room. The new baby definitely has a working set of lungs. I wrote as much of the Admission Note as I could without examining the baby, and will go back down after 2am to do the physical exam and use the information gained from it to finish the Admission Note.
I guess it's time for a quick nap until then....

8am, Wednesday: Went to bed at 3am. Another baby was born at 3:05am. What luck. Now it's time to present my patients from last night to the Pediatric team at "Morning Rounds"

Went to bed at 3am. Another baby was born at 3:05am. What luck. Now it's time to present my patients from last night to the Pediatric team at "Morning Rounds"

12:30 am Back in the student room. The new baby definitely has a working set of lungs. I wrote as much of the Admission Note as I could without examining the baby, and will go back down after 2am to do the physical exam and use the information gained from it to finish the Admission Note.
I guess it's time for a quick nap until then....

9:08 pm Headed to the newborn nursery to see if there are any new babies to examine and writeup.
Edit- no new babies.

10:33 pm The OB/GYN resident informs me that they just delivered a baby. I'm headed down to the nursery to look over the chart and begin writing a Newborn Hospital Admission Note. Guidelines say that you should wait 4 hours to perform an exam on the baby, because their breathing, pulse, etc are still a bit crazy from the birthing process itself. If you wait about 4 hours, you'll be able to decide if the breathing, pulse, etc are normal or not.

On-Call

Tonight is my first "real" on-call night of my medical school career. I'm on the Pediatrics rotation for the next two months, and I have call every 5 days or so at the hospital.
I thought I'd let you follow me around...
(The next few posts might all be seperate ones until I can sit down another day this week and condense them all into one long "First On Call" post).

3 pm, Tuesday: Call officially begins.

4:34 pm: I'm told to head down to the Emergency Department to check on an 18 month old girl having asthma complications. When I get down there, she's already been given a breathing treatment and is looking much better! I interview the father (...by the way...I'm noticing a trend in Pediatrics that fathers often know FAR LESS about their babies than the mothers do!) who says he doesn't know how bad the girl was before the treatments because he just got to the ED to sit with the kid.
She seems to have improved a lot, but just to be cautious the Attending decides to admit the girl to our Pediatrics floor for overnight observation.

5:10 pm: Two hours into this and I'm already missing Heather, so I con her into meeting me for a quick dinner at Chipotle (cool website by the way).

5:40 pm: Back in the medical student lounge.

7 pm: A patient who has been in the hospital for 2 days because of Diabetic Ketoacidosis (due to lack of insulin production, which makes these kids have really, really high blood sugar) supposedly just ate dinner and now has a blood glucose of 430 mg/dL
That's really, really high.
[Normal should be anywhere from 80 to 120].
I go check on him and make sure he's not having any problems, and I explain to Mom that the high sugar is probably because he just ate dinner.
"I'll come back in a few hours to check on him again," I say, as I leave the room and head back upstairs.

9:08 pm: Headed to the newborn nursery to see if there are any new babies to examine and writeup.
Edit- no new babies.

10:33 pm: The OB/GYN resident informs me that they just delivered a baby. I'm headed down to the nursery to look over the chart and begin writing a Newborn Hospital Admission Note. Guidelines say that you should wait 4 hours to perform an exam on the baby, because their breathing, pulse, etc are still a bit crazy from the birthing process itself. If you wait about 4 hours, you'll be able to decide if the breathing, pulse, etc are normal or not.


12:30 am: Back in the student room. The new baby definitely has a working set of lungs. I wrote as much of the Admission Note as I could without examining the baby, and will go back down after 2am to do the physical exam and use the information gained from it to finish the Admission Note.
I guess it's time for a quick nap until then....

8am, Wednesday: Went to bed at 3am. Another baby was born at 3:05am. What luck. Now it's time to present my patients from last night to the Pediatric team at "Morning Rounds"