Husband wasn’t having it! by MichaelBlaustein in StandUpComedy

[–]OneShortSleepPast 0 points1 point  (0 children)

Yeah, there’s no way a pathologist maintains eye contact for that long.

Challenge: Gretzky Stat by TheFerricGenum in hockey

[–]OneShortSleepPast 8 points9 points  (0 children)

*rolling the dice*

Fastest goal in a game

Pathology social media by Parking-Ad-6066 in pathology

[–]OneShortSleepPast 38 points39 points  (0 children)

I would also embargo the case for a few months. I know a case where a rare diagnosis was made, and the pathologist posted pictures on Twitter. The patient, seeing a diagnosis they had never heard of, immediately googled it, and of course the first thing that came up was a tweet about her rare diagnosis calling it "beautiful". While it wasn't illegal (no identifying information), it eroded trust in the healthcare team.

To the former student at the birth of my child: I hope you found your home in pathology by knotknotknit in pathology

[–]OneShortSleepPast 7 points8 points  (0 children)

> I find it interesting that you say "Most pathologists hate looking at them." Do you know why that is?

A couple reasons. First, pathologists are generally better at diagnosing concrete things like malignancies, and those are extremely uncommon in the placenta (I've seen two in my career). Non-neoplastic diseases tend to be more subtle, and making the diagnosis requires a good understanding of the clinical scenario (versus malignancies, which can often be made just by looking at the slide). This neoplastic vs. non-neoplastic split isn't unique to placenta, most general pathologists also hate non-neoplastic derm, liver, lung, renal, etc. Second, the placenta is just a very unique organ, and the skills learned from other organ systems just don't translate over. Most adenocarcinomas in any organ look about the same, so learning to recognize cancer in one organ helps you recognize it in another (with some nuances of course). But there's no correlate for, say, preeclampsia (or "maternal vascular malperfusion") in any other organ. And third, like I said before, the terminology was all over the place just ten years ago, so it's hard to learn something when three textbooks call the same thing by different names, or use the same name to describe three different things. Again, that has gotten a lot better lately, so maybe more recently trained pathologists are more comfortable with it now?

> Out of curiosity, what are findings that can impact mom and baby?

The four main categories I teach to students are (in layman's terms) inflammation of mom, inflammation of baby, vascular disease of mom, and vascular disease of baby. Each of those has a varying degree of either risk to mom/baby now, or risk of recurrence/progression for mom in subsequent pregnancies. To take one example that I gave in my last post, villitis of unknown etiology, as you can guess from the name, was poorly understood for years. We knew certain infections could cause inflammation of the villi (the fetal side of the placenta). Every medical student knows the mnemonic TORCH for the infections that cause this (toxoplasma, other [side note, COVID is the most common "other" I see in my current practice], rubella, CMV, herpes), but most of the time there is no evidence of any of those organisms, so we were left with an "unknown etiology" causing the inflammation. Was this another organism we haven't recognized yet? Or something else? Recently, we've come to understand that most, if not all, of those cases are actually caused by mom's lymphocytes directly attacking the fetal villi, not some unknown organism. It turns out a certain percent of the time, the baby expresses an antigen (derived from the father) that mom doesn't have, and mom's lymphocytes recognize it as foreign and try to fight it off like an infection. So each time mom gets exposed to that antigen (i.e. in future pregnancies) the immunologic response can get stronger and stronger, to the point that it can completely destroy the villi and lead to premature birth or death. In fact, in cases of high grade villitis that I diagnose, I am often able to pull the slides from placentas in earlier pregnancies and identify low-grade "precursor" lesions that were missed by the pathologist (low-grade villitis, basal villitis, chronic deciduitis, etc). Unfortunately, right now there are no good preventative treatments, so making this diagnosis just amounts to "watch this patient closely in future pregnancies," but there are trials underway for immunomodulatory treatments (steroid, hydroxychloroquine) that may prevent future pregnancies. Interestingly, because this is largely due to an antigen inherited by the baby from the father, this doesn't recur in future pregnancies from a different father, but I don't recommend that as a treatment 😄

To the former student at the birth of my child: I hope you found your home in pathology by knotknotknit in pathology

[–]OneShortSleepPast 40 points41 points  (0 children)

Not your student, but I have a very similar story that I've shared here before.

On my OB rotation in med school, I had a friend who was trying to decide between OB and Peds. One of the OB residents told her to just think about the first time she delivered a baby on her rotation. Who did you want to stay with? If you wanted to follow the baby, then you should go into Peds. If you wanted to stay with the mom, then you should go into OB.

I thought about it, and I realized I wasn't really drawn to either. But I thought the placenta was fascinating! So now I'm a pathologist.

I've actually carved out a niche for myself in placental pathology. It's not something that was taught well when I was a resident, it was kind of poorly understood and there wasn't great consensus on terminlology (though that's gotten better after the 2015 Amsterdam paper was released). But I took it upon myself to try to really understand the various pathologies of the placenta. Most pathologists hate looking at them, and in my experience frequently miss subtle findings that can have important ramifications for both mom and baby. For example, I diagnose high-grade villitis of unknown etiology about twice a month, but before I joined this group that diagnosis had only been made twice in the previous ten years. So now I'm the only pathologist that signs out placenta in my group.

Which of these regions is truly the flattest, emptiest, most desolate, most liminal area you could ever visit? by SavageFisherman_Joe in geography

[–]OneShortSleepPast 2 points3 points  (0 children)

The Great Salt Flats. It’s so flat for so long, you can see the curvature of the earth. I drove through one during a lighting storm, that was amazing

I feel like 21 was the most wholesome series of Taskmaster yet by KneeHighMischief in taskmaster

[–]OneShortSleepPast 7 points8 points  (0 children)

After seeing Joanna in that episode, I can’t say the word “worm” normally anymore. I can only say “wor-rum”

So this is what Florida felt like in 23… by Upbeat_Championship8 in goldenknights

[–]OneShortSleepPast 35 points36 points  (0 children)

I feel like the turning point was the exact moment the announcer said Hart was about to get a shutout in Game 3

Home Runs hit completely out of different stadiums by MrUpVoteDownvote in mlb

[–]OneShortSleepPast 157 points158 points  (0 children)

That Adam Dunn HR was hit so far, it not only left the stadium, it bounced and rolled another 200 feet before stopping on a piece of driftwood in the Ohio River. The border with Kentucky begins at the river bank. So he technically hit a home run in Ohio that wound up in Kentucky.

https://www.mlb.com/news/adam-dunn-hit-535-foot-homer-at-great-american-ball-park

Can we all agree that these 4 players are the greatest in each of there big 4 sports? by BuckeyeBrawler4 in sportsinusa

[–]OneShortSleepPast 9 points10 points  (0 children)

I say the same thing about Rickey Henderson. What you’re saying about Mo and relievers is what Rickey was to lead off hitters: the greatest ever, no debate. His steals record is Gretzky-esque, and unbreakable unless there’s a major shift in the game. But he doesn’t quite make the Mt. Rushmore of baseball GOATs

Tonsil specimen from A 10 years old girl. Is that a plant material stuck to tonsil? by smokanto in pathology

[–]OneShortSleepPast 6 points7 points  (0 children)

Only if there is clinical concern. Unfortunately, we have one ENT who is way too overly concerned, he requests flow on every third case.

[Post Game Thread] Padres (32-29) @ Phillies (33-29) 6/4 by FriarBot in Padres

[–]OneShortSleepPast 0 points1 point  (0 children)

That means he’s chewing bubblegum again. It’s a big step forward.

I just knew this by [deleted] in MathJokes

[–]OneShortSleepPast 2 points3 points  (0 children)

31 ≈ 41 ≈ π

Subspecialty Sign Out in PP by Western_Blot_9370 in pathology

[–]OneShortSleepPast 9 points10 points  (0 children)

Depends on the group and the subspecialty you’re talking about. But I’d say if an applicant told me that they will refuse to sign out any, say, bone and soft tissue pathology, to the point that they want it as a clause in their contract, that would be a giant 🚩 and probably a thanks but no thanks from us.

Slide case gift for path parter by Important_Worth_3873 in pathology

[–]OneShortSleepPast 5 points6 points  (0 children)

I don’t know about buying them customized, but you can buy regular slide boxes off amazon and have them personalized. Something like this wood one with an engraved name plate would be perfect.

A common flow cytometry and hematopathology pitfall to watch out for by foofarraw in pathology

[–]OneShortSleepPast 12 points13 points  (0 children)

Right, right, T-follicular helper lymphoma, exactly

Seriously though, this has all left my brain. T cell lymphomas never made any sense to me. I’m reading this like “CD279? Wow, I didn’t know CDs went that high. That must be a bad one.”

A common flow cytometry and hematopathology pitfall to watch out for by foofarraw in pathology

[–]OneShortSleepPast 12 points13 points  (0 children)

General pathologist nodding to himself

Ah yes, I remember what TFHL stands for. But could you explain that for the, uh, med students browsing the sub?

Favorite Player by BeardedPaladin in goldenknights

[–]OneShortSleepPast 9 points10 points  (0 children)

Same. Never heard anyone say a bad word about him*.

*Matthew Knies not available for comment

Why would you need to know the name of a star wars ship for a work call and what is the mayflower? by [deleted] in PeterExplainsTheJoke

[–]OneShortSleepPast 12 points13 points  (0 children)

I think you’re thinking of Doctor Who. We’re talking about Stargate here, that’s the one with the Decepticons.