We started reproductive health in pathology, pharmacology, microbiology and clinical medicine this week. I've always been interested in reproductive health, so this by far has been my favorite set of lectures for the semester. I still think I'll end up in oncology and gynecological oncology is much more depressing than pediatric oncology, so I probably won't be a gynecological oncologist.
At any rate, this stuff is amazing. Every lecture has me at the edge of my seat. There are so many strange things that can arise from the reproductive system from a pathological perspective. At this point, we have just covered the female reproductive system, but part of the reason why it is so interesting is because there are germ cells, which retain their ability to differentiate into multiple cell lines or in plain English, they can become different types of cells like hair cells, teeth, skin, parts of the gut, etc. When these germ cells go wild, all heck breaks loose and some extremely disturbing masses can emerge. Obviously when talking about mix histology, the first thing that comes to mind is a teratoma. Teratomas can occur in adults or children and there are differences in these tumors. Generally teratomas are benign, but they can rarely have some malignant tissues within the neoplasm. These things are horrible looking, but thankfully, they do not act horribly (meaning that they are NOT likely to kill people). I didn't want to put anything to disgusting looking (and some of these teratomas are quite disturbing looking), but the following is an X-ray of a woman's pelvis with teeth in it. Those teeth are growing from a teratoma and I believe our professor said that this ended up being a benign neoplasm.
Sexually transmitted infections have been covered in microbiology. It never ceases to amaze me what these little bugs can do. In case you didn't know the the "in thing" is to call sexually transmitted bugs STIs (sexually transmitted infections) rather than STDs (sexually transmitted diseases) because some bugs will not cause symptoms of disease so a carrier does not have a "disease" per say, but he or she does have an infection and can keep spreading this infections around. I didn't realize before starting medical school that there are parasites that are sexually transmitted, Trichomonas vaginalis. In fact, these are the most common, curable STI in the WORLD. I'd have guessed something like chlamydia, a common bacteria. This is one subject that is best to study in books rather than get first hand knowledge and experience with! Here is a picture of that parasite, Trichomonas vaginalis, taken from my microbiology lecture.
Then the pharmacology: hormones. So interesting and so complex. For example, the differences in the types of birth control by both the dosing and the types of hormones--lots to keep straight. The steroids that athletes illegally use to bulk up--I can practically study by watching ESPN because there is so much steroid abuse in the athletic news. Manipulating hormones to treat prostrate and breast cancers. Pharmacology is not as intuitive for me, but still at least this is interesting.
As I already said, at this point in my education, I still want to go into pediatrics and hopefully I will get a fellowship in Hematology/Oncology. However, I've always had an interest in reproductive health but one of the reasons I doubt I'll actually go into OB is the malpractice insurance. I hate to agree with our former president GW Bush, but too many good doctors don't are not practicing obstetrics because of the malpractice. It is a really big consideration when thinking about going into something as stressful as OB/GYN.
I don't know what I would do if I ever found TEETH growing in my nether regions! That is SO disturbing, beyond disturbing!
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