Medical student here, ask me anything

25 / M (DX at 17)
190lbs / 5"8
T1D (Lantus & Apidra)

I seem to be experiencing symptoms of intermittent claudication although it's non consistent.
Some days I experience the calf pain / tightness, others I don't.

As far back as 12 years ago I can remember feeling pain or tightness in my shins after walking "X" distance / activity.

I am concerned about PAD and neuropathy but the symptoms seems too vague.

I have an appointment with my Endo and gp coming up. Will talk to them about that, ask for an evaluation.

Secondary: I seem to be experiencing symptoms of IBS, but it also comes and goes. No consistency. What trios me up about this is a previously diagnosed internal hemorrhoid which causes mild bleeding and evidence thereof when wiping my ass.
Google that and all you get is ass cancer...

Any ideas?

I've been having pelvic pain for the past two weeks, but now it's move to my stomach and it doesn't hurt as much in my pelvic. Also it feels like I need to pee but I don't. Nothing else wrong and no fever. Is it serious and should I be worried? And yes I went to the doctor but they couldn't address it because my appointment was for a physical and I couldn't double book or some stupid shit like that. I have to go back anyway for blood work. But should I be worried?

Are you male or female?
How old?

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OP here:
Unless you've severely fucked up your diabetes management, and have been eating fast food every day, you won't be having PAD. That's something old people get.

It's probaby shin splints. I'd go into more detail but you don't seem too concerned about this.

About your IBS thing. You can do an elimination diet or a FODMAP diet to rule in/out having IBS, it's a very rough diet to follow because you have to exclude sooo many foods. If you get better on FODMAP, you can slowly re-add foods to your diet until you start getting symptoms, then you'll know what your issue is.

It's probably still internal hemorrhoid. If it's extremely painful as you shit, it's an anal fissue. But You won't have cancer at your age either.

28 female
Continuously get swollen lymph nodes since I can remember. They pop up out of nowhere, are super big and painful and gone within a few days. I know once in a while is normal but I get them all the fuckin time. Most common area is jaw but I have gotten them in both armpits. I'm a smoker so I thought maybe that was the cause or something. Since I've been tested for basically everything. No idea what's causing it.

Male, 27

"feels like I need to pee but I don't". seems like a UTI. Any pain on peeing? any itching? Do you have constipation? Have your bowel habits changed recently/ going to the toilet more or less than usual?

Whats your urine stream like, is it hard to start urinating? Do you get dribbling at the end? Do you have any histories of having STI's?

Tits or get the fuck out

Last A1C was 9.1 mmol.
Higher than it should be, but not high enough to cause PAD this early eh?

As for the IBS thing, FODMAP is what I'm thinking as well.

I've also recently joined a gym, so hopefully overall condition will improve with excerise.

No pain when sitting, just more gas than usual and fresh, bright red blood on the paper. Sometimes diahreah, but no pain, and no weight loss or other classic symptoms or bowel cancer.

Thanks!

Solve my medical problem or gtfo

OP here.

When they come up, how long do they last before they go?
How long in between flare ups?
Have you noticed that they correlate with your periods/cycle?
Do you have a fever when it happens?
When they go, are they completely gone?
Do you have unexplained weight loss?

Things it can be:
infection.
Autoimmune disease.
Very unlikely to be cancer.

Solve my medical problem or gtfo

Early 20’s
Started 4 days ago after waking up
Constant chest pain on the left side, not terribly painful just really uncomfortable, sorta feels like something in there is being squeezed. Gotten better over time, has nearly gone away, laying down on my left side and moving my left arm make it worse.

They pop up randomly, no other symptoms at all. No fever. Nothing to do with period. Literally I'll be talking and feel sore in my jaw and I feel underneath and I'm like great another fuckin swollen lymph node. Sometimes they last like a week, never long enough to biopsy. But recently they have been popping up more often but leaving super quickly. Maybe a week or 2 ago I had one in my left pit. Then 4 days ago had one in my right pit and it went away after a day. Now I have one in my jaw since yesterday that is almost gone or at least the pain has gone away. It's so bizarre. I'm not sick. And I've had testing done. But it's definitely my body trying to fight something.

Firstly, congrats on going to the gym. Yeah if it happens in the front of your leg, with exercise, it's shin splints. Try doing exercises like riding bikes instead of running, or other exercises that don't use your shins, this is a band-aid fix, unless you want to spend money on a doctor/physio to treat the shin-splints if you can't self-educate on-line.

has it still been going on over the last 4 days? If you're coughing/fever etc. it's probably chest infection. If you smoke, then quite likely chest infection.

OP here.

Probably autoimmune disease. press firmly around your cheeks, and under your jaw, ( and basically everywhere else on your face) Any other pains?

It's probably not this, but can be an abscess somewhere in your mouth area.

Trips.
Once you get a bit older you'll change how you mentioned the age thing.

About 2 months ago a sent a real bad looking 28yo STEMI to a neighbouring hospital to be angio'd.

The consultant cardiologist there asked him if he wanted to pull out last second as he's too young to have ACS and it's probably pericarditis.

Anyway, he got stented for a STEMI.

You're right to use risk factors to narrow down and help you decide your immediate management but you throw all the risk factory stuff out the window if it turns out your initial impression was no good.

I have blotches on my feet randomly
22 M
I don't know
I don't think so
?
?
?
?
?
>too drunk to wright idk so meany times

Definitely constipation, but no pain or itching thankfully. I haven't been shitting anything solid since this started though. And my urine is a little bubbly but that's besides it. Should I just go to the doctor first thing tomorrow then? Can I still drink alcohol? Also no history of STIs and I haven't had sex in over a year and a half, so I'd be surprised if that's what going on

No fever no smoking no coughing, only happens on occasion now but the pain/discomfort isn’t nearly as bad as before. Forgot to mention bending over also makes it hurt

Also the constipation was occasional at first, but it's gotten a lot worse the past two days

Theres no other pains in my jaw no, I have other issues like frequent urination like constantly and dehydration.. but I've been tested for diabetes and literally everything. I'm not obese, I am fairly active. It's been going on for years and I have no idea if I did have an autoimmune disease what it would be. Thanks for your input op

OP here.

When was the last time you had a shit?

it's probably constipation.

Makes me think of large bowel obstruction. But it shouldn't be happening at your age, and the pain going near your stomach makes me think it isn't large bowel obstruction, because that pain should be in your pelvis still.

What do you mean by "urine is a little bubbly?"

I disagree. It's actually probably a chronic compartment syndrome. I have the same thing. Didn't realise I had it until one day an orthodox I was working with describe wanting a procedure done for his same condition.

Also I get them in my armpits too so I'm not sure if it would be an issue with the mouth or not, for the longest time I thought that I was diabetic because of all these issues but apparently I'm not.

Yeah anterior compartment syndrome can totally be the issue here.

Last time was earlier today, but nothing solid came out. The pain at first was squarely in the pelvic, right in the middle between my stomach and dick. But now the pain isn't as bad but it's spread between my pelvic and stomach. By bubbly I mean there's sometimes like bubbles or foam that form after I pee? Not sure if that makes sense. I think I'm just gonna go to the doctor in the morning now that I've actually typed all this out, because I feel kinda stupid. But does it sound like anything that could be pretty bad? I just want an idea of what to expect.

More likely to be compartment syndrome if you have weakness pointing your toe up ( towards your head) and loss of touch sensation or tingling in one leg compared to the second.

You aren’t even a MD yet and you’re posting advice? Faggot, an hero. GTFO

It's probably constipation user.

Criteria for diagnosing it is this:

Rome III diagnostic criteria for adults

At least two of the following symptoms must have occurred in the past 6 months over at least a 12 week period:

Passage of stool frequency < 3 times/week
Passage of hard or lumpy stool
Sensation of incomplete defecation
Manual maneuvering to empty the bowel
Straining during attempts to defecate
Sensation of anorectal obstruction

Treatment is

Begin with lifestyle changes: high-fiber diet (psyllium seed husk, wheat bran), increased fluid intake, and exercise.
If constipation continues: take osmotic laxatives

Not OP here. How's your general hygiene?
How do you get your insulin?

I personally wouldn't refer short lived painful nodes with no other symptoms for further investigation. If really pressured by the patient I might write a referral for the patient to follow up with their GP re: an autoimmune blood screen.

There's a lot of stuff in medicine that has no answer and doesn't cause you much ultimate harm. We're not machines made on an assembly line. Sometimes we come out a bit buggy and that's alright.

>404

Comment not found.

OP here.

This is good advice.

Trips again, nice!
I hope you pull out this Rome III spiel on a ward round. Would give all the other doc's a hearty chuckle and a fair hint of nostalgia for med school days.

Femanon, 20. For like the last 5 years I’ve had permanent hiccups. I hiccup once about every 30 minutes - an hour
Super obscure but do you know anything about this?

this

But if it's just that then why would I have pain in my pelvic, or is that part of it? I dunno, if it's just that then I'll be relieved. I do take mult vitiams but I don't exercise at all, and I have gained weight. I guess I'll just see what happens when i go to the doctor. Thanks for the advice user, good luck with your studies.

I'm not diabetic, and I have OCD so my hygiene is pristine haha, I would assume they're nothing but it used to be pretty spaced out and only in my neck. Then it got more frequent and now they're popping up everywhere in random spots. The neck ones swell huge like a bouncy ball. The arm pit ones are more like a marble. Extremely painful when they first show up then they're less painful and gone all together.

OP here.

No sorry, I don't. Could be vagus/phrenic nerve irritation but other than that, I don't have a clue what it could be.

What happened that caused it to start?

Yea this is a fairly rare condition I remember reading about, that affects women predominantly. The thing that causes this condition called roastyitis is the realization women are nothing more than worthless holes. The feeling of worthlessness after this realization manifests itself as hiccups.

Your armpit nodes and neck nodes are generally in different lymphatic drainage areas. IE a cancer or chronic infection is fairly unlikely to cause nodes in both these areas.

As mostly an ER doc (Aussie btw) this is unfortunately where I run out of knowledge and lose interest.

A biopsy isn't likely to bring you a huge amount of joy either as they're likely just to show reactive nodes.

Sorry man

140 lbs
33 male

Got a cold like a month ago. It passed by. After like a week, I got a sharp pain in my upper back tooth ; would hurt when I'd chew. Also noticed one of my nostrils squeaked and seemed blocked. The pain in the tooth subsided and transfered to the jaw. At this moment, I realized I had a small white spot on one of my tonsils. A week later, jaw pain dissapeared. Yesterday, started having a sore throat, noticed the white dot is still there after more than 7 days. Throat seems reddish. Tonsil on the side of the spot seems bigger. Got a runny / stuffy nose again.

Does it sound bacterial, viral or fungal to you?

Thanks!

That's okay, I appreciate it!

Women are just complicated beings and if it's something bad I'll find out eventually

You're giving a mixed picture here that unfortunately makes it hard for me to say whether it's bacterial or not.

The white spot is more likely bacterial cause
the stuffy nose is more likely viral cause.

Forgot to mention that the jaw / tooth pain was very likely sinusitis, because I would also have pain right beside my nose, where the parental (sp) sinus is, and feel headachy.

So, to clarify : cold > heal > sinusitis with white dot on tonsil > heal (except white dot) > sore throat / stuffy nose, white dot still there.

The white dot can be a tonsil stone, have you attempted to dislodge it?

No idea, I used to get like normal hiccups constantly. It was like every other day I would get the hiccups, then it just morphed into them being spread out throughout the day.

Oh okay thanks!

Whats your medical opinion on fasting? I'm trying to do intermittent fasting 20/4 that means I fast for 20 hours and eat whatever in those 4 hours remaining.

I'm a fat fuck trying to lose weight
> 24yo male
> 290 libs

How can you be sure it wasn't just a tonsillolith that the patient has noticed for the first time after paying special attention to the area?

Is a vital or bacterial infection a clinically useful distinction to the patient?

What differs in the treatment of a viral pharyngitis vs mild tonsillitis vs severe tonsillitis vs peritonsillar abcess?

>not trying to be snarky, trying to guide your thinking

Where in Toronto do you live?

Let’s meet up and fight and see if you can heal yourself back to life when I fuck you to death.

No I have not. it's really far back in my throat, and it's kind of inside the soft tissue ; looks a bit like an abscess,but it's very small (~2mm diameter). Don't think i'd be able to dislodge it. My tonsil on this side is a little more "bumpy" than on the other side. The white dot is on one of those bumps.

He’s not in class, he’s here to answer some questions you fucking faggot, stop trying to hurr durr I know more than a guy on Yea Forums him with retarded and pointless shit.

Go back to reading WebMD and spreading peanut butter on your dick for your dog.

>He doesn't know that Toronto notes are a popular set of very concise medical school notes published in Toronto for Canadian medical students but are commonly used by medical students all over the world.

I'm in my 4th year of being a doctor and I'm lurking for fun. Why you gotta be like this?

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Fasting is fine. I do intermittent fasting and studies show that fasting gives health benefits other than just losing weight.
The best diet is one that fits in with your lifestyle and one that you can manage to keep doing for a long time. With fasting like how you'd be doing, you'll be extremely hungry during the times you'd usually have lunch, due to insulin (and other things) that your body makes when it's expecting food, but that hunger craving will go.

If you're diabetic you'd need to speak to GP before you start a diet, otherwise, fasting will be fine, just stay hydrated and make sure you're getting your vitamins.

Why come when my straight friends and I suck and fuck eachother raw i pee white then red for a week?
>When did it start?
During/ after straight beat sesh
>How has it changed with time
Used to just pee white but now white and red sauce
Any associated symptoms?
Anus is completely prolapsed after most sessions, probably blew an o ring or two
Is it worse with any activity?
Yes it's worse if we jerk off with butts
Anything make it better/worse?
Less thick mushroms like small benis nigger
Anything run in the family?
My uncle is a pedophile he's awesome

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Great questions,

I did think about a tonsillolith, here I feel it is an important distinction to the patient because they might take antibiotics they've got laying about if they think it's bacterial.

Difference in management is very little, except for penicillin V in bacterial obviously. and analgesia.
Surgery for recurrent and chronic tonsillitis and extreme hypertrophy of the tonsils.
A history of peritonsillar abscess and tonsillitis that does not respond to antibiotic treatment would also be indications for surgery.

Viral vs bacterial would matter, at least to me, in the sense that if it's caused by something like strep, it could cause rare but serious complications. Whereas viral would pose no threat and clear up on it's own. Not sure what the implications of an abscess would be ; I hope they don't have to drain that shit.

Since it's been more than a week since I've noticed the white spot, and I'm getting sick for the third time in a month, I'm thinking it might be time to go to the clinic. I haven't seen a doctor in like 8 years.

Go make some money bruh. Instead of sitting knee deep in 300kgs of shit

The point I was trying to get at in that post is a mild bacterial pharyngitis and a viral pharyngitis are treated the same (with nothing). The useful answer for a patient is whether or not they need to go to a hospital for corticosteroid and observatio to minimise the risk of airway compromise in the case of a severe bacterial pharyngitis or for emergent surgical drainage of a peritonsillar abcess. Neither of these patient important actions can be decided by asking the patient about the white spots on their throat.

Asking about fever, dysphonia, and dysphagia is much more useful.
>Implying you can get this from.WebMD

Unless you have significant non-caucasian heritage, there is little need for antibiotics for a mild bacterial pharyngitis.

Certain populations are prone to post-strep complications. They need pills for mild cases.

For most other people the minimal reduction in duration of symptoms is not worth the risks of therapy.

I am a fat lardass (~300 lbs)... Had A1C or whatever test done and they said I'm pre-diabetic. How fucked am i? How long until i need insulin? Asking because I'm gonna kill myself when i develop full blown diabetes but i don't want to do it too early and hose myself out of good months/ years.

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This is good for me, I'm learning as I answer questions.

Yeah Indigenous = treat with ABx. How would you decide if tonsillitis is mild or not?

No fever, dysphonia or dysphagia. Tonsils are reddish but only slightly bigger. They seem nowhere near the point where they could cause obstruction.

I'm mostly concerned about the timespan of all these symptoms, and not their severity (symptoms are mild right now).

Money being kind of an issue, I was debating going to the clinic or not.

I guess I'll wait a few more days and see.

Thanks for your inputs guys.

Just because you're pre-diabetic, it doesn't mean you WILL develop diabetes. It's not too late to change.

If you exercise, and start restricting your caloric intake, you won't develop any diabetes at all. If you continue the way you are, you will develop diabetes.

Ive tried to lose weight a bunch of times. I went on strict 1500 cal a day of keto foods for a month and actually gained a couple of pounds. Not gonna happen. My question is at my current morbid obese weight, which I've been at for 2 years, about how long do i have before i develop full blown diabetes and then kill myself?

If money is an issue, you can just wait a week and see if your tonsillitis resolves, and visit then if not getting better

450Lbs
6' 5"

Feels like there is something on the bottom of my feet. Feet are swollen and discolored, redness and tightness above ankle. Some days it goes away and some days it comes back. Doesn't seem to matter if on feet or stay off.

Good on you for trying, sorry to be blunt but I don't think you were counting calories accurately. Make sure everything is logged. Your physician might prescribe you Metformin which will help you lose weight and help with the pre-diabetes issue.

got a photo?

Well it's all a spectrum right? So there's no cutoff but there's stuff that's definitely mild and stuff that's definitely severe.

>Definitely mild
Still eating and drinking with no drama. Grade 1 tonsils on view. Has been sick for more than 5 days on presentation. No fevers.

>Definitely severe
Recurrent episodes of tonsillitis. Sitting with a styrofoam cup that they're spitting saliva into. Has been sick for 48 hours with fever. I generally advocate for at an overnight admission on benpen IV (only because they can't swallow) and 8 hourly dex for anyone with a pair of grade 3 tonsils and fever.

Mild and severe are easy.
What you do with the moderate severities depends on your feeling for them as a person, what resources your area has, and what your boss thinks.

I used an app to count cals, maybe it fucked me. I'm an americunt who doesn't have health insurance, so I don't have a physician. However i did lose weight a few years ago by living off of cigarettes, Adderall, and smoking fentanyl gel. But when i had to stop doing those i gained it back.
Do you recommend a 9mm bullet or 12 gauge 00 buckshot for self-lobotomy? The 12 seems like overkill but the 9 might render one a vegital

Went to urgent care and the said maybe cellulitis, but I tried every antibotic accept Cipro and it did nothing.

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I recommend you do something for your suicidal ideation.

>Went to urgent care and the said maybe
Paying a "medical professional" to say "idk lol"
Whew lad.

Urgent care is like basically for minor stuff. When to hospital for blood test, everything good. No diabetes.

Not OP. Looks like fairly typical lipodermatosclerosis in an overweight person.

Essentially:
>Be fat
>Veins get not very good at returning blood
>???
>skin looks shit, eventually leather shins and ulcers

I'm not sure if losing weight will effectively treat this. I have never know a patient to get this and then actually be able to lose weight.

Sorry dude.

Just yanking your penis glad you're in good health

Does it give you any pain?

OP here,
This is probably what it is, if it isn't responding to antibiotics.

You a 22yo admin girl at the ED I used to work at had arm weakness out of nowhere and they found a brain tumour? It was excised and after about 2 weeks of extended pathology testing her (quite accomplished) surgeon told her that it was a likely neuroectodermal mass.

>Her surgeon essentially said "it's some kinda brain tumour
Sometimes we just don't know, man.

*Would you believe

One time years ago I was driving and suddenly felt a severe stabbing pain in my gut, severe enough that i pulled over and was quite distressed. But it soon passed and i went along my way. About an hour or two later I took a shit and there was a good amount of fresh blood in thw toilet bowl. I took a shower to clean up the mess and more blood shot out all over the tub/ floor. Went to the hospital and got fingered by a doctor and they said my rectum was fine and they don't know what happened

I would wager it was a diverticular bleed. The hypothesized mechanism is:
> Western diet and/or genetics causes small outpouchings on large bowel over time
> hard nugget of poor gets super stuck in this
> it erodes some tissue around pocket
> blood comes out as a small arteriole is affected
>???? maybe pain I dunno
> arteriole seals off and no further bleeds

But yeah no idea man.
>I would have put my finger in your butt too

This vs ischaemic collitis?

I was thinking sudden pain= embolus

As an addition, I'd have put my finger in his but too.

Yeah that was my other differential but I instinctively feel that as the tissue necrosed you should develop a fair good going peritonitis requiring a lot of antibiotics and maybe surgical washout and repair.

But I supposed it's not impossible that very small chunk of ischaemic colitis can just be wrapped up by your omentum and you don't die.

The body is magic man.

Is OP still around? Sorry for hijack your thread. I'm a bad man.

Yeah OP still here. Thanks for your advice regarding tonsillitis. Definitely helps having someone else here haha

Why do i get sensations, no pain at all just...sentations around my groin area. Sometimes it feels like it's my balls but after fondling them it's coming from behind or to the side of above.

Happens randomly but mostly when jacking it or having sex. Which i do a lot. Sex in the Morning jack off afternoon sex at night. My wife says I am draining my balls too much.

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