Two drops of mercury...

[LittleLebowski]

https://www.youtube.com/watch?v=NJ7M01jV058

[Nephrology]

I've seen these videos before. He does a pretty good job of breaking down clinical case presentations for laypeople. Zebras like mercury poisoning make for good material here for sure.

[Yung]

I should get my blood lead levels checked. Wonder if I can get that done at an urgent care, because I don't have a primary care provider.

https://pistol-forum.com/showthread.php?7726-Blood-Lead-Leval

[RoyGBiv]

I should get my blood lead levels checked. Wonder if I can get that done at an urgent care, because I don't have a primary care provider.

https://pistol-forum.com/showthread.php?7726-Blood-Lead-Leval

You can make your own appointment at any LabCorp.
https://www.labcorp.com/tests/007625/lead-whole-blood-adult

[5pins]

I got hooked on his videos about 5 months ago. In fact he just put one out on heatstroke.

[Bio]

This was in my field. We kept the article printed out in the lab on the wall as a reminder.

[Edster]

That was sad and scary.

[Shawn Dodson]

You can make your own appointment at any LabCorp.

Anywhere but LabCorp. They've fucked up two of my wife's lab tests, causing her extreme stress about her well-being. It cost over $300 for the doctor to see her again and order new tests. Unfortunately LabCorp is excused from any financial liability for their faulty test results.

[DDTSGM]

The firearms instructors had our lead levels checked every year. We went to the county health department. Unsure what the payment arrangement was, but they did the draws and took care of the testing.

[TGS]

That dude literally has a video of him reciting a medical dictionary from memory for 3 hours.

Reminds me of a pre-med student I took to the crisis center one time.

[entropy]

Holy crap.

[UNK]

I woked for 20 years in a facility that used raw lead as well as mercury among many other chemicals and radiation. Everyone hired had a baseline test. That was interesting because new hires had levels higher than mine. We had one guy who had to be taken out of his area every time we had a rebuild because his lead levels would get so high. Ive worked around it constantly and never tested high.
A good idea would to do a baseline and find out where you are.
Has anyone here with a baseline ever subsuquently tested high?

[BN]

I realize this is a different kind of mercury, but as kids, someone would drop and break a mercury thermometer and we would rush to coat coins in it and carry them around in our pockets. It made them nice and shiny. :(

[Bio]

I realize this is a different kind of mercury, but as kids, someone would drop and break a mercury thermometer and we would rush to coat coins in it and carry them around in our pockets. It made them nice and shiny. :(

Yeah. Way back people would actually drink the stuff. It's definitely not good for you, but in metallic form more of it passes through you compared to the organic form, so you're not killing yourself as quickly. The phrase "mad as a hatter" and the character of The Mad Hatter were based on reality. They would use mercury in the hat making process (I think to treat felt somehow, but I'm not sure), and over time, it would soak in enough to cause neurological effects, because of course the task was performed bare handed.

[Paul D]

For every one patient who had something exotic, I've had 999 who insist that they have something exotic but the overwhelming evidence shows that they are crazy. I still look for horses first and not zebras. Great case presentation though.

[the Schwartz]

While dimethyl mercury is pretty nasty stuff, heavier organo-metallic compounds are always bad news.

The worst of the lot is dimethyl cadmium (in which cadmium replaces mercury in the twin dimethyl molecular structure and Hg(CH3)2 becomes Cd(CH3)2) as it fumes at room temperature producing nearly undetectable vapors that are every bit as deadly as those produced by dimethyl mercury which, by the way, also fumes at room temperature. The above referenced highly-referenced 1997 death of Karen Wetterhahn, occurred when droplets of dimethyl mercury permeated one of her latex gloves. Truly a shame.

[Jim Watson]

We have a chlor-alkali plant here which used to have mercury cells for electrolysis of salt water into Chlorine and Sodium hydroxide. Seepage into the river and gradual methylation of the lost mercury called for warnings not to eat river fish, especially catfish.

They closed the chlor-alkali unit but kept making potassium hydroxide by the same electrolytic process on potassium chloride solution. Must have cells without mercury or mercury containment.

[Dr_Thanatos]

For every one patient who had something exotic, I've had 999 who insist that they have something exotic but the overwhelming evidence shows that they are crazy. I still look for horses first and not zebras. Great case presentation though.

Common things present uncommonly more often than uncommon things.

Unless you are studying for boards. Then it is ignore horse, consider zebra, rule out unicorn.

[Cory]

While dimethyl mercury is pretty nasty stuff, heavier organo-metallic compounds are always bad news.

The worst of the lot is dimethyl cadmium (in which cadmium replaces mercury in the twin dimethyl molecular structure and Hg(CH3)2 becomes Cd(CH3)2) as it fumes at room temperature producing nearly undetectable vapors that are every bit as deadly as those produced by dimethyl mercury which, by the way, also fumes at room temperature. The above referenced highly-referenced 1997 death of Karen Wetterhahn, occurred when droplets of dimethyl mercury permeated one of her latex gloves. Truly a shame.

I think it was dimethyl cadmium was used in a paint manufacturing place that my brother, and uncle worked for a bit. I think it was used to make some glow in the dark metallic paint or something.

My brother eventually got assigned to clean the containers that had the stuff after they were empty. They took some precautions but once didn't have the correct ppe. My brother left the job rather than clean without the proper safety equipment. He has never regretted the choice to my knowledge.

[the Schwartz]

I think it was dimethyl cadmium was used in a paint manufacturing place that my brother, and uncle worked for a bit. I think it was used to make some glow in the dark metallic paint or something.

My brother eventually got assigned to clean the containers that had the stuff after they were empty. They took some precautions but once didn't have the correct ppe. My brother left the job rather than clean without the proper safety equipment. He has never regretted the choice to my knowledge.

Most likely, what your brother would have been exposed to were the common pigmentary cadmium compounds, cadmium sulpho-selenide and cadmium zinc sulphide, that range from deep red to bright yellow. While not organo-metallics, they are nasty especially as finely divided particulates and your brother was exceptionally wise to walk off the job since his employer didn't supply the correct PPEs.

[Paul D]

Common things present uncommonly more often than uncommon things.

Unless you are studying for boards. Then it is ignore horse, consider zebra, rule out unicorn.

Maybe for path, but in cardiology it's usually atherosclerotic vascular disease, valvular disease or AFib. Don't get me wrong, I do think about zebras and unicorns. Think. In this day and age, I try to get a good history and go over available tests before I start burning through their copays and deductible. The weirdest/rarest cases that I've diagnosed was Whipple's disease with endocarditis in a 84 year old man (only 30 cases per year) and a guy who had both Hantavirus and a endocarditis from a bug that is indigenous only to Tahiti. He told me he cleaned out debris under his New Mexico cabin (including droppings) and he flew shortly after that to Tahiti for vacation. He returned to AZ after he started to have severe cough, fever and dyspnea. He died quickly after diagnosis unfortunately.

[Dr_Thanatos]

Maybe for path, but in cardiology it's usually atherosclerotic vascular disease, valvular disease or AFib. Don't get me wrong, I do think about zebras and unicorns. Think. In this day and age, I try to get a good history and go over available tests before I start burning through their copays and deductible. The weirdest/rarest cases that I've diagnosed was Whipple's disease with endocarditis in a 84 year old man (only 30 cases per year) and a guy who had both Hantavirus and a endocarditis from a bug that is indigenous only to Tahiti. He told me he cleaned out debris under his New Mexico cabin (including droppings) and he flew shortly after that to Tahiti for vacation. He returned to AZ after he started to have severe cough, fever and dyspnea. He died quickly after diagnosis unfortunately.

Cool case.

Pathology is a little bit weird with respect to it's board exam. We have a two day written test, one day for anatomic pathology (surgical pathology, cytology, renal pathology, neuropathology, Electron microscopy, Maybe one forensics question), one day for clinical pathology (Blood banking, hematology, microbiology, molecular, lab management, clinical chemistry, etc). The ABP's attitude is that you should know every possible detail about every possible disease and so there is no way they are going to show a common case. Hence, ignore horse, consider zebras and rule out unicorns. But that's only for boards. It really gets ridiculous. The reason pathologists are a running joke about know everything, is because it's on our test.

The rest of the career is spend on common things. Shockingly, in forensics, I also spend 50+% of my time on atherosclerotic cardiovascular disease, hypertensive heart disease, a good spattering of diabetes, chronic alcohol abuse and pulmonary thromboemboli. The other half of cases are drug overdoses, suicides, car wrecks and homicides. The fun cases are the zebras.

[Nephrology]

My most memorable zebra was catching pyoderma gangrenosum as a MS2. It was all downhill from there.

Speaking of zebras, I will probably never forgive the NBME for making me learn all those inborn errors of metabolism.