pulmonary artery hypertension

Pulmonary hypertension develops as a result of increased pulmonary artery pressure and vascular resistance. Primary pulmonary hypertension usually affects young women and is a disease of unknown etiology. Secondary pulmonary artery hypertension can be due to precapillary (eg, left-to-right shunt), capillary (eg, veno-occulsive disease), or postcapillary (eg, chronic lung disease) causes. The most common findings on chest radiograph are enlarged pulmonary arteries (arrow) that taper distally (peripheral pruning). A dilated right ventricle with a decreased retrosternal space may also be seen on lateral images.

Stories from the War(ds) 1

Consider me your own personal Ernie Pyle–except instead of writing to you from the frontlines of WWII it’s from the battlefront of a different war. 

SOMEWHERE IN THE HOSPITAL–May 3 2014

Let’s assume you know nothing about how hospitals work from the side of doctors–meaning let’s assume you’re me. So, I don’t want to deny you the experience of that first day walking onto the wards into the strangeness of it all for yourself, but I’ll try and show the picture. Just consider this your “spoilers, sweetie” warning. 

Hospitals are mazes. All the floors look roughly identical to the untrained eye: tile hallways, doors that only open with badges, carts of bland hospital food all in varying shades of white (bagels, mashed potatoes, vanilla pudding). Even the people start to look the same after a second: nurses with hands full of syringes, PTs with their support belts, residents in long coats always 8 items behind on their to do list, and then there’s the people who look like me. 

Med students. 

If you’ve never been in the hospital before I’ll give you the easy criteria to spot a med student. 

We’re the ones in short coats. We’re the ones with papers spilling out of our pockets: fat packets of patient notes, rounds summaries, pages and pages filled with lists of things our attendings told us to look up later, or flashcards of drugs we’ve forgotten since we took step 1. We’re the ones puppy dogging behind the people in the long coats–often one step behind and to the right of the people in the long coats who actually know what they’re doing. We actually have stethoscopes and pens–the attendings (the real doctors) they never do–they just steal ours. And if all else fails, you can probably recognize us by this constant expression of confusion, terror, and a tiny bit of excitement we’re wearing.

~~

I walk onto the wards and into the war zone on a Tuesday morning at 6:30 in the morning. The only introduction I’ve gotten from my resident the day before it is a patient’s MRN and instructions to pre-round and meet the team at 8 in the 5th floor work room. 

She’s left me this information but not even her name. 

Welcome to Internal Medicine. 

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anonymous asked:

Prompt: Gail & Holly before 4x12 Gail takes 2 viagra by accident. She's so ashamed by her mistake she won't go to the hospital. She stays at Hollys to keep an eye on her. she's gets so uncontrollably horny, she can't resist holly anymore ;)

A/N: I did some research on this to understand how Viagra (Ikeep spelling this ‘viagara’, like Niagara) works.  Learned some interesting things, mostimportantly, or most relevantly, is that Viagra causes smooth muscle relaxationand vasodilation, which allows for men to sustain an erection.  The effects of women taking the drug are unclear, but fuck the research, I’m writing this prompt as is.  

The drug has also found use in treating diabetes, pulmonary arterial hypertension, and altitude sickness. But the most important thing I learned is this: Israeli and Australian researchers discovered that 1 mg of the drug dissolved in a vase of water can extend the shelf life of cut flowers, making them stand up straight for up to a week beyond their natural lifespan. The drug also slows down plant ripening; tests were done strawberries, legumes, roses, carnations, broccoli, and other perishables.  

Lesson learned: Viagra gives flowers week long erections.  Now on to the story.  

Viagra (Part 1) (Part 2)

The sound of her phone vibrating against her coffee table alerted Holly to an incoming message.

Officer Awesome: Hypothetical question: what happens when a woman takes Viagra?

She looked at the text, surprised, but somehow not really.  This seemed to be the way with Gail Peck.  

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Pulmonary microvascular endothelial cells (PMVEC) cultured from Bmpr2R899X mice have defective cytoskeletal architecture, including lack of stress fibers (top), few and truncated microtubules (middle), and disorganized VE-cadherin (bottom).

Johnson et al. (2012) Cytoskeletal defects in Bmpr2-associated pulmonary arterial hypertension. American Journal of Physiology - Lung Cellular and Molecular Physiology, 302, L474-L484.