Immunology

Our first two and a half weeks were a whirlwind of immunology and rheumatology. I was quite impressed; we covered the salient points of immunology in just a week. It's interesting learning this in a medical context; we learn some very specific details like NADPH oxidase because it plays a role in chronic granulomatous disease, yet we leave out other details like how RAG-1 and RAG-2 mediate VDJ recombination since the mechanism isn't important to physicians. When I took an immunology course at Stanford, we spent hours studying recombination signal sequences and hairpin loops and terminal deoxynucleotidyl transferase because the experiments were so elegant and the machinery so fascinating. I'm glad, though, that we focused more on clinical stuff as I knew very little about that. We read some journal articles too, which was good. Immunology is an interesting field because it has such a steep learning curve with figuring out the language and jargon, but once you begin feeling your way around, you realize how much and how little we know about it.

We also learned a few interesting rheumatologic diseases: SLE, OA, RA, gout, the spondyloarthropathies. We did all the vasculitis diseases in an hour which was sort of ridiculous. Rheumatology is interesting in many ways to me: it involves immunology gone awry, multiple organ systems, and diagnosis from history and physical. But unfortunately, joints simply don't fascinate me.

Our exam was yesterday, and it was all short answers. It reminded me a lot of undergrad tests. I wore my "It's not lupus" shirt, but unfortunately, one test question was most definitely lupus. Ah, well.