Thea Nikolaou/Dr. Solomon - Week 4

 This week I got to shadow Dr. Liechty and Dr. Pisapia in neuropathology for a few days. It was very interesting to see how they do frozen sections from tissue biopsies that require urgent diagnoses. The frozen sections are usually sent in from surgeons that need quick confirmation of their original diagnosis from a biopsy so they can proceed with the procedure. Frozen sections consist of two types of stained H&E stained slides: (1) a smear where a piece of tissue is squished and smeared onto the glass and (2) a piece of tissue rapidly frozen and thinly sliced. The smear offers cytological insight while the frozen section is informative of tissue architecture. I also got to see the neuropathologists perform brain cutting for two autopsies. It was really interesting to see how they slice the brain and assess for any visible damage. They also have a standard set of sections that are cut and prepared for microscopic evaluation plus some sections that are taken if the individual being autopsied was over 65 years old. Although both brains we looked at where relatively healthy without any remarkable findings, it was really interesting to learn the difference between a 70 year old vs a 95 year old brain in terms of size and atrophy. I attached a picture of the 95 year old axially cut brain and the cerebellum detached. 


On Friday I got to again spend some time at the Emergency Department. There were a lot of cases but most cases I got to see throughout the day were not severe injuries. One more severe case was a construction worker who came in after a fall because he lost sensation in his lower limbs. This patient was rushed for imaging. There were also a few cases of septic patients. Both of these patients were being treated for cancer as well but had recent infections that they had not fully recovered from. These patients were placed into actual rooms since they have compromised immunity due to their cancer treatments. Other than these few cases most other individuals were reporting pain in different areas of their body without cause or explanation. It seemed like fear is one of the most common reasons people choose to come in to the emergency room with this also being the reason that most of the patients are usually found to be okay after testing or to have minor conditions like muscle spasms, soreness, or Covid infections. 


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