July, 2011 | Master Of Medicine

Monthly Archives: July 2011

Walking down the memory lane, can you remember?

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Memory is an interesting subject. Since I started my MBBS course, I have experimented with a lot of things, share trading, web designing, reading online magazines etc. Trying to understand memory was one of my greatest passions. Though I understood a lot about how to remember, how to memorize sort of things, I myself didn’t apply a lot of those memory facts which I learned. As you may have understood, the gap between theory and practical application is very wide.

I have been maintaining a website puzzlehacker and a few blogs for quite some time. I tried to apply some of my ideas into my hacker puzzle, wrote about memory on my wordpress blog mindblogger .So what I am trying to deal with here, is memory and its applications in medical studies. Those who read blogs and research works maybe familiar with most of the discussed topics, but you may gain a few more points if you continue reading.

Creating memories which stick

Creating memories which stick , the motto of every advertizing agency. Don’t you remember some great advertisement’s on Doordarsan? Hamara bajaj, was a great advertisement with a good song, it was an advertisement which stood out among the crowd.  Creating memories which stick should be the aim of every student. Mixing the right quantity of emotions and dedication we can create  memories which stick.

Another trick employed by TV advertisers is to flash the advertisement repeatedly through out the day.  So this process of repetition embeds these images on our mind and imparts a feeling of familiarity, so when we go for shopping,we are most likely to pick the product of an advertiser who has spent more money and hard work on making their advertisements stick to our minds.

So revision is a word which no student should forget, forgetting to revise is as bad as forgetting to learn. If you ask me whether I follow these rules, then my answer is I am trying!

Some of the memory systems

Memory systems are used all over the world to help people remember. I will name a few of them so that you can check them out.

  1. The peg system of memory
  2. Method of loci
  3. Rhyming system
  4. Mnemonics

There are hundreds of subtopics under each of these sections, try to check them out.

I created this blog as a means to revise important topics before my MCQ exams. So most of the posts are done to revise them at a later date. I try to revise these topics in my free time, though I have been lazy in the last few weeks, I hope to catch up with the rest of the crowd in the coming months.

The importance of time decay

Haven’t you felt that you have an amazing ability to do a task at a later date, which you couldn’t do at a previous date? Does giving some time help us to do a difficult task much more easier? I have made a post on the topic:The simplest and best way to do a task which is difficult to perform

These are some of my blog posts at mindblogger:

The key to memory-3R’s

Mind mapping and learning

An earlier post How to learn medicine may come handy. Thanks to you guys, masterofmedicine is getting a lot of visitors these days, do leave some feedback which would help me to improve my writing and if you have got something worth posting don’t forget to mail me at martin.jobin@gmail.com.

Vertebral artery segments and branches

  1. Vertebral artery arises from the first part of Subclavian artery.
  2. Vertebral artery is the first and the largest part of Subclavian artery.

Divisions of vertebral artery

V1 segment - From origin to transverse process of C6 vertebra

V2 segment- Runs through foramen transversaria of upper six cervical vertebrae.

V3 Segment – Lies in the suboccipital triangle

V4 segment

  1. Extends from posterior atlanto occipital membrane to lower border of Pons.
  2. Traverses foramen magnum
  3. Pierces duramater, arachnoid mater and enters subarachnoid space.

Branches

Cervical branches- Spinal and muscular branches.

Intracranial branches

  1. PICA
  2. Medullary artery
  3. Anterior spinal artery
  4. Rarely Posterior spinal artery(Usually branch of PICA)

 

Common entrance for MBBS and PG,confusion prevails as the debate continues.

After a gap of several months, the news about medical common entrance exam has surfaced again.The decision has yet again come out a lot late than the expected date of announcement(June). And the government has to sort out several for and against arguments before continuing with the medical common entrance exam. The Tamilnadu and Karnataka governments have strongly opposed this proposal. The reasons may be different, because Tamilnadu has a unique reservation system and Karnataka has one of the largest number of private medical colleges.

The central government is in a difficult position, it has to implement the supreme court regarding the conduct of the common entrance exam in 2012 and also calm the dissenting voices arising from  the states. The national newspapers are reporting different versions of the issue. Some report only about common entrance exam for MBBS aspirants,where as a few national newspapers have applied it to the PG entrance exam also. There is no mention regarding the change of pattern of the PG exam. The PG aspirants are running out of time to prepare, the decision is not yet finalized and each expert has a different opinion.

The online option may be too optimistic to come true, but the pattern change may happen. The issue of CBSE conducting the MBBS entrance exam is also mentioned in many newspapers. But what about the PG exam, will it be conducted by the AIIMS exam section this year also? Many questions are still unanswered, read the conflicting reports in newspapers to understand chaos. There is no mention of any new developments in the Medical Council of India website. The never ending wait for clarity on the issue of conduct of common entrance exam continues. Let us wait wait and wait because we are left with no other option.

Read the reports run by different national papers below

From 2012, medical CET in English, Hindi-Indian express

The new board of Medical Council of India (MCI) and the Union Health Ministry have decided to start Common Entrance Examination (CET) for undergraduates and post-graduate medical courses from next year in two languages — English and Hindi.

Common entrance test for MBBS aspirants from next year- Times of India

The Union health ministry and the Medical Council of India (MCI) have reached a consensus to roll out CET for admission to all government, private medical colleges and deemed universities for MBBS course from the 2012-13 academic session

Karnataka govt’s ‘no’ to single CET for MBBS – DNA

The Karnataka government has opposed the Centre’s decision to conduct a national-level single common entrance test for medical undergraduate courses from next year.

Reacting to the decision at a meeting in New Delhi on Monday, state medical education minister SA Ramdas said, “I have already written to the Centre asking some questions on the issue. I am yet to receive a reply to them. So, we have decided not to agree with the idea of a single CET.”

A question still lingers, in the background will there be a NEET PG in 2012? Is anyone trying honestly,or are these debates a smokescreen to continue the same pattern next year? Patience pays, let us wait patiently.

Arterial pulse abnormalities

Pulsus Paradoxus

  1. Pulse volume decreases during inspiration and becomes normal in expiration.
  2. First described in costrictive pericarditis, but it is usually rare in this condition.

Typical of

  • Pericardial tamponade.
    Severe airway obstruction.
    SVC obstruction.

Pulsus Alternans

  1. Alternating small and large volume pulses.
  2. Seen in LVF

Reverse Pulsus paradoxus

  1. Rise in systolic BP>15mm during inspiration.
  2. Seen in:
  • Hypertrophic cardiomyopathy
  • Patients having LVF on Positive pressure ventilation.

Dicrotic Pulse

  1. Two palpable waves one each in systole and diastole
  2. Seen in conditions of  very low stroke volume.
  3. eg:Dilated cardiomyopathy.

Bisferiens pulse

  1. Two peaks, both in systole.
  2. Typical of AR(with or without AS)
  3. HOCM
  4. Best felt in peripheral arteries, radial or brachial.

Framingham Criteria for diagnosis of heart failure

Major Criteria

  1. Paroxysmal Nocturnal Dyspnoea
  2. Jugular Venous distension
  3. Rales
  4. Cardiomegaly
  5. Acute pulmonary edema
  6. S3 Gallop
  7. Positive hepatojugular reflex
  8. Rise in venous pressure>16cm H2O

Minor criteria

  1. Lower limb edema
  2. Cough at night
  3. Dyspnoea on exertion
  4. Pleural effusion
  5. Decrease in Vital capacity by 1/3rd of normal
  6. Tachycardia>120beats/min
  7. Weightloss 4.5Kg over 5 days

Systemic Inflammatory Response Syndrome

Systemic Inflammatory response syndrome abbreviated as SIRS, can be caused either by infection or can be due to non infectious causes.

SIRS is nonspecific and can be caused by ischemia, inflammation, trauma, infection, or a combination of several insults. SIRS is not always related to infection.

SIRS  is defined as the presence 2 or more of the following variables:

  • Fever of more than 38°C or less than 36°C
  • Heart rate of more than 90 beats per minute
  • Respiratory rate of more than 20 breaths per minute or a PaCO2 level of less than 32 mm Hg
  • Abnormal white blood cell count (>12,000/µL or < 4,000/µL or >10% bands)

 

Anti tumour Monoclonal antibodies

Monoclonal antibodies against tumour cells mainly act via antibody dependent cellular cytotoxicity.

They also act via complement mediated lysis and by induction of apoptosis.

Drugs

Rituximab – CD20 – Non Hodgkins Lymphoma

Ibritumomab -CD20 -NHL

Tositumomab- CD20- NHL

Ofatumumab -CD20 -NHL,CLL

Alemtuzumab- CD52- CLL

Gemtuzumab – CD33- AML

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