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Labels:
cardio,
medical videos,
paeds
Eisenmenger Syndrome
Over time, increased blood flow can damage the small blood vessels in
the lungs. This causes high blood pressure in the lungs. As a result,
the blood backs up and does not go to the lungs to pick up oxygen.
Instead, the blood goes from the right side to the left side of the
heart, allowing oxygen-poor blood to travel to the rest of the body.
Labels:
examination,
medical videos,
paeds
Primitive Reflexes
1) Foot placing reflex
2) Stepping reflex
3) Grasp/palmar reflex
4) Moro reflex
For further elaborations, please check HERE =)
2) Stepping reflex
3) Grasp/palmar reflex
4) Moro reflex
For further elaborations, please check HERE =)
Labels:
internalMed,
medical videos
Assess peripheral pulses Carry out an ECG Dipstick urine Bedside Blood Glucose Fundoscopy source :
CVS Examination
Introduction
Introduce yourself Explain what you would like to examine Gain consent Place patient at 45° with chest exposed Ask if patient has any pain anywhere before you begin!General Inspection
Bedside for treatments or adjuncts – GTN spray, O2, Tablets, Wheelchair, Warfarin Comfortable at rest? SOB Malar Flush Chest for scars & visible pulsations Legs for harvest site scars and peripheral oedema ..Hands
Temperature - poor peripheral vasculature Capillary refill – should be <2 seconds Colour – cyanosis Clubbing Splinter haemorrhages, Jane-way lesions, Oslers Nodes – infective endocarditis Palmar Erythema – hyperthyroidism, pregnancy, polycythaemia Nicotine Staining – smokerPulses
Radial Pulse – rate & rhythm Radial-Radial Delay – aortic coarctation Collapsing Pulse – aortic regurgitation BP – narrow pulse pressure = Aortic Stenosis | wide pulse pressure = Aortic Regurgitation Carotid – character & volume JVP – measure and also possibly carry out hepatojugular reflexFace
Eyes – conjunctival pallor, jaundice, corneal arcus, xanthelasma Mouth – central cyanosis, angular stomatitis Dental hygiene – infective endocarditisClose Inspection Of Chest
Scars - lateral thoracotomy (mitral valve), midline sternotomy (CABG), clavicular (pacemaker) Apex beat – visible in aortic regurgitation and thyrotoxicosis Chest wall deformities – pectus excavatum, pectus carniatumPalpation
Apex beat – 5th intercostal space, mid clavicular Heaves- left sternal edge – seen in left & right ventricular hypertrophy Thrills – Palpatable murmurs over aortic valve & apexAuscultation
Listen over 4 valves - ensure palpation of carotid pulse to determine first heart sound Roll onto left side & listen in mitral area – mitral stenosis Lean forward & listen over aortic area- aortic regurgitation Carotids - radiation of aortic stenosis murmurs & bruits Lung bases – pulmonary oedema Sacral Oedema & Pedal OedemaTo complete the examination
Thank Patient Wash hands Summarise Findings Say you wouldAssess peripheral pulses Carry out an ECG Dipstick urine Bedside Blood Glucose Fundoscopy source :
- Macleod
- http://geekymedics.com/osce/cardiovascular-examination-2/
Labels:
internalMed,
pictures
Spider Nevi
 |
| ecchymosis |
 |
| purpura |
 |
| petechiae |
 | |||||
| Spider Nevi |
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| Paraumbilical Hernia |
Labels:
misc,
tips
It is no secret that medical training is a long and time-consuming process frequently referred to as an exercise in delayed gratification. Indeed, completing college, 4 years of medical school, and at least 3 years of specialty training (in addition to any time off before starting medical school) takes a decade or longer.
Thinking about the time commitment can be overwhelming. The feelings can become especially acute when you see your nonmedical friends finding "real jobs," getting married, buying homes, or otherwise enjoying their lives.
The anxiety you might feel about figuring out your life can be particularly challenging if you're in your 20s and 30s -- the prime years of medical training for most of us.
I speak from experience: I am a medical resident in my late 20s and have yet to get married or buy a home. I have many friends outside of medicine who seem considerably farther ahead in their lives than I am. I admit that I have questioned my career decisions at times.
It's normal to have these feelings. Remember that you chose to become a physician, and the training process will be challenging and time-consuming. Regardless of what you do, medical school and residency is predefined and cannot be shortened.
Viewing these years as lost time before a "real job" is a mistake, however. You are taking important -- albeit occasionally grueling and certainly not financially rewarding -- steps in developing your career and learning the skills you need to excel as an independent clinician. Although training requires many sacrifices, it allows you to figure out your preferred path within the medical profession.
That said, there is no shame in taking the time to enjoy your life, and sometimes doing so is necessary. Make the sacrifices when they are required, but try to take some time for your friends, family, and yourself. Close your textbooks early or skip the latest journal articles if you need a break.
Medicine is just one part of your life, and it should not come at the expense of your personal well-being. You'll confront the same and additional new pressures when you become a physician: Finding ways to make time for yourself and others will help you succeed as a well-rounded and balanced professional.
Finally, I think it can be easy to develop a "grass is always greener" mentality when you see others having fun. Although your friends may never experience the distinct pleasure of being paged awake at 3 AM to clarify a sawdust allergy, they have their own career and life hurdles that can be equally daunting even if they do not appear to be on the surface.
Most important, remember that your medical training in the grand scheme of things is just a small part in the journey to an amazingly satisfying and rewarding career that you will ultimately have the ability to shape.
http://www.medscape.com/viewarticle/745834?src=mp&spon=25
Is Your 'Social Clock' Ticking Like Mine?
Question
Sometimes I feel like I'm missing out on my 20s: Everyone else seems to be living their lives and I'm still in school. Does this frustrate anyone else?It is no secret that medical training is a long and time-consuming process frequently referred to as an exercise in delayed gratification. Indeed, completing college, 4 years of medical school, and at least 3 years of specialty training (in addition to any time off before starting medical school) takes a decade or longer.
Thinking about the time commitment can be overwhelming. The feelings can become especially acute when you see your nonmedical friends finding "real jobs," getting married, buying homes, or otherwise enjoying their lives.
The anxiety you might feel about figuring out your life can be particularly challenging if you're in your 20s and 30s -- the prime years of medical training for most of us.
I speak from experience: I am a medical resident in my late 20s and have yet to get married or buy a home. I have many friends outside of medicine who seem considerably farther ahead in their lives than I am. I admit that I have questioned my career decisions at times.
It's normal to have these feelings. Remember that you chose to become a physician, and the training process will be challenging and time-consuming. Regardless of what you do, medical school and residency is predefined and cannot be shortened.
Viewing these years as lost time before a "real job" is a mistake, however. You are taking important -- albeit occasionally grueling and certainly not financially rewarding -- steps in developing your career and learning the skills you need to excel as an independent clinician. Although training requires many sacrifices, it allows you to figure out your preferred path within the medical profession.
That said, there is no shame in taking the time to enjoy your life, and sometimes doing so is necessary. Make the sacrifices when they are required, but try to take some time for your friends, family, and yourself. Close your textbooks early or skip the latest journal articles if you need a break.
Medicine is just one part of your life, and it should not come at the expense of your personal well-being. You'll confront the same and additional new pressures when you become a physician: Finding ways to make time for yourself and others will help you succeed as a well-rounded and balanced professional.
Finally, I think it can be easy to develop a "grass is always greener" mentality when you see others having fun. Although your friends may never experience the distinct pleasure of being paged awake at 3 AM to clarify a sawdust allergy, they have their own career and life hurdles that can be equally daunting even if they do not appear to be on the surface.
Most important, remember that your medical training in the grand scheme of things is just a small part in the journey to an amazingly satisfying and rewarding career that you will ultimately have the ability to shape.
http://www.medscape.com/viewarticle/745834?src=mp&spon=25
Why Pediatrics Is Priceless
===============
An extra blue scrub top is tucked away in the lower right cabinet of the nurse's station. Every so often, after being sprayed with bodily fluid, I have to make a midday swap of my work clothes. However, it's a small price to pay to be a part of children's lives; one day the baby who spits up on your shoulder will be the same kid who runs down the hall screaming your name and clings to your leg with the dexterity of a koala. What makes pediatrics so rewarding is the long-term relationships that you build with children and their families who every day make you feel like a small hero.
Practicing general pediatrics often feels like searching for a needle in a haystack. Hidden in a sea of upper respiratory infections, reflux, eczema, and diaper rashes is a cystic fibrosis diagnosis, for example, that the astute clinician must not overlook. There are enough challenging cases to keep you on your toes to make everyday clinic interesting, but they don't overwhelm you. As a result, you'll have plenty of time each day to build new relationships and foster old ones. These relationships create the backbone of a successful pediatrician's practice.
By knowing the histories of an individual family -- for instance, remembering the grandfather who has Crohn disease or the younger sibling who has a milk protein allergy -- a pediatrician has unique insight into each medical conundrum that presents itself, no matter how big or small. The trust and relationships that you develop allow you to take a personal and tailored approach to an ill-appearing child. That can save countless hours in an emergency department or avoid an unnecessary x-ray or blood test. Knowing that a mom is meticulous and reliable gives you an extra day of watchful waiting for a fever that an emergency department doctor might otherwise work up. This saves time, money, and anxiety.
A successful pediatrician should also be an excellent educator. The better job you do teaching your families -- that fever is a symptom and not a disease, that every cough does not need medication, and that in most cases diarrhea will go away with time -- the better doctor you will be. Using an evidence-based approach to simple problems will help prevent more complex ones; by avoiding the overuse of antibiotics for routine viral infections, you can curb the rise of antibiotic-resistant bacteria and the subsequent complications that they create.
Most pediatricians do not hold master of public health degrees, but we each play a vital role in preventive medicine to protect the individual and society as a whole. Immunizations are probably the single greatest advance of modern medicine. Diseases such as small pox, polio, measles, mumps, and rubella have been extinguished to the point that most modern pediatricians have seen few if any cases of these maladies. The world has benefited from the immense power of immunizations, and pediatricians stand at the front line in protecting children and the public at large.
Pediatrics is not everyone's cup of tea. You should have a high tolerance for shrieking, crying, and the errant stream of bodily fluid that will disrupt the occasional workday. Perhaps the most difficult aspect of caring for a child is working with the array of parental personalities. Both the pediatrician and the parent may have the best interest of the child at heart, but misinformation from old wives' tales, the Internet, and Aunt Bertha can confound clear communication and good intentions. This is where the art of medicine shines its brightest: Strategic word choice and good listening can go a long way to assuaging anxiety and making sure that children receive the best care possible.
Sometimes in the routine day-to-day of things, it is easy to forget that every visit counts; that each teaching moment may save an unnecessary test; and that each shot prevents a possible death. However. when you feel the familiar clutch of a child on your leg, you remember why you chose this job, and you gladly take your blue scrub home to be washed so that you're ready once again for whatever comes your way.
http://www.medscape.com/viewarticle/743742?src=mp&spon=25
Labels:
General
Question
I often panic before an exam because I am so worried about my performance. This makes it even harder to do well. What should I do?
Response from Sohil H. Patel, MD
Sohil H. Patel, MD, Intern, St. Vincent's Hospital, New York, NY
There is an obvious answer to this question: prepare well for the examination. But of course, it is hard to find anyone who would actually claim to be well prepared in the days before an exam. This is particularly true for exams that encompass a vast amount of information. No student knows every detail about the topic being tested. That is why it may always seem like you need more time to study, and why you never feel fully prepared.
The examinations themselves can generate anxiety as well, whether because of the time limits for finishing or perhaps because of an oral performance component. Of course, no two people handle stress in the same way, but here are some things that helped me.
The first step in destressing involves gaining some perspective. Having been in the clinical setting for a few years now, I have been exposed to life and death situations that legitimately stress people out. Given those experiences, I now find it hard to believe that I ever stressed out over my medical school examinations to the extent that I did.
In fact, I remember developing a different (and more healthy) attitude toward studying and exams after I started my clinical rotations, which made me realize just how insulating the pre-clinical years can be. So, if you are a first- or second-year medical student, shadowing a physician in the hospital might help put your exams in proper perspective.
Another way to gain perspective is to remember why you chose to attend medical school (hopefully, doing well on medical school examinations was not the reason). Studying really should be viewed as a means to a much larger goal than just passing a test. Exams should never be treated as ends in themselves. They are really just little check marks of approval on your way to becoming a physician -- nothing more.
Certain study techniques may also be effective in reducing your stress level. Cramming facts into your brain at random is not effective; if your mind goes blank during an exam, you won't have any broader framework on which to anchor your thoughts. Before memorizing details, I always tried to build a framework.
Take pulmonology, for example. Instead of learning pulmonary diseases at random, learn the basic categories of disease (eg, obstructive, restrictive), then learn the common features within each category, and finally, fill in the categories with particular diseases. This way, if the answer to an examination question is not immediately obvious, you have a systematic way of proceeding and narrowing your choices.
Another helpful method, particularly for oral exams involving standardized patients, is to develop routine practices. Before the exam, run through common scenarios or complaints you might encounter and think of the basic steps you should always take in those scenarios. Do this a few times so that, if a similar situation is encountered in the exam, your brain can run on auto-pilot as you follow through with your prepared steps.
Of course, there are many ways to address the stress itself, and what works for one person may not work for another.
For me, it seemed to help if I stuck with my workout schedule regardless of how close I was to an examination; this helped me set aside some time when I was not thinking about the exam. I also had the peculiar habit of taking a shower if I thought I was getting overly stressed out and I needed a break. But these methods vary for everyone. In general, it is probably a good policy to keep your life as close to normal as possible before an exam. This avoids giving the examination undue significance.
Finally, it is important to be confident. Medicine is not the single most complicated field of study, and most minds are similarly suited to learning it (unlike, perhaps, philosophy or some other fields that some people seem more inherently suited for than others). It means that there is a good correlation between how much effort a person puts into learning medicine and how well that person masters the subject.
It is less a matter of "getting it" and more a matter of "knowing it," and almost anyone can learn the material with a certain amount of effort. So, work hard and take confidence that your honest effort will pay off!
Link
How Do You Handle Pre-examination Stress?
Question
I often panic before an exam because I am so worried about my performance. This makes it even harder to do well. What should I do?
Response from Sohil H. Patel, MD
Sohil H. Patel, MD, Intern, St. Vincent's Hospital, New York, NY
There is an obvious answer to this question: prepare well for the examination. But of course, it is hard to find anyone who would actually claim to be well prepared in the days before an exam. This is particularly true for exams that encompass a vast amount of information. No student knows every detail about the topic being tested. That is why it may always seem like you need more time to study, and why you never feel fully prepared.
The examinations themselves can generate anxiety as well, whether because of the time limits for finishing or perhaps because of an oral performance component. Of course, no two people handle stress in the same way, but here are some things that helped me.
The first step in destressing involves gaining some perspective. Having been in the clinical setting for a few years now, I have been exposed to life and death situations that legitimately stress people out. Given those experiences, I now find it hard to believe that I ever stressed out over my medical school examinations to the extent that I did.
In fact, I remember developing a different (and more healthy) attitude toward studying and exams after I started my clinical rotations, which made me realize just how insulating the pre-clinical years can be. So, if you are a first- or second-year medical student, shadowing a physician in the hospital might help put your exams in proper perspective.
Another way to gain perspective is to remember why you chose to attend medical school (hopefully, doing well on medical school examinations was not the reason). Studying really should be viewed as a means to a much larger goal than just passing a test. Exams should never be treated as ends in themselves. They are really just little check marks of approval on your way to becoming a physician -- nothing more.
Certain study techniques may also be effective in reducing your stress level. Cramming facts into your brain at random is not effective; if your mind goes blank during an exam, you won't have any broader framework on which to anchor your thoughts. Before memorizing details, I always tried to build a framework.
Take pulmonology, for example. Instead of learning pulmonary diseases at random, learn the basic categories of disease (eg, obstructive, restrictive), then learn the common features within each category, and finally, fill in the categories with particular diseases. This way, if the answer to an examination question is not immediately obvious, you have a systematic way of proceeding and narrowing your choices.
Another helpful method, particularly for oral exams involving standardized patients, is to develop routine practices. Before the exam, run through common scenarios or complaints you might encounter and think of the basic steps you should always take in those scenarios. Do this a few times so that, if a similar situation is encountered in the exam, your brain can run on auto-pilot as you follow through with your prepared steps.
Of course, there are many ways to address the stress itself, and what works for one person may not work for another.
For me, it seemed to help if I stuck with my workout schedule regardless of how close I was to an examination; this helped me set aside some time when I was not thinking about the exam. I also had the peculiar habit of taking a shower if I thought I was getting overly stressed out and I needed a break. But these methods vary for everyone. In general, it is probably a good policy to keep your life as close to normal as possible before an exam. This avoids giving the examination undue significance.
Finally, it is important to be confident. Medicine is not the single most complicated field of study, and most minds are similarly suited to learning it (unlike, perhaps, philosophy or some other fields that some people seem more inherently suited for than others). It means that there is a good correlation between how much effort a person puts into learning medicine and how well that person masters the subject.
It is less a matter of "getting it" and more a matter of "knowing it," and almost anyone can learn the material with a certain amount of effort. So, work hard and take confidence that your honest effort will pay off!
Link
Labels:
General,
medicine
Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and suddenly, 24 hours in a day are not enough to get through the enormous volumes of information that we are expected to learn for every exam. It seems virtually impossible. We barely have time to eat or sleep.
Medical school is not the end of the world. Take it from us, 2 students who have been there, when we say that medical school is what you make of it. Do not let medicine define you; instead, you should tailor medicine to your lifestyle. Otherwise, you might become overwhelmed by the demands of your new life and lose the sense of why you chose medicine in the first place.
How do you survive medical school? From the beginning, time management must be a major priority. If you can manage your time successfully, you can still enjoy your life to a certain extent. Studying in med school is not the same as it was in college; this is a new world where you have to explore different techniques and find what works best for you. In medical school, it is all about studying smart, not studying hard. If you don't know this at the beginning, you will learn it the hard way.
Studying medicine is a long process and demands a great amount of discipline and sacrifice. But the reward is priceless. We hope that you chose medicine for the amazing field it is: the rich opportunities it provides for helping humans and the avenues it opens for making a difference in the world. The following are some of the most common pieces of advice we have collected:
Editor's note: This was adapted from a book manuscript in the publication process, How to Prepare for the Medical Boards – Secrets for Success on USMLE Step 1 & COMLEX Level 1, by Adeleke T. Adesina and Farook W. Taha.
http://www.medscape.com/viewarticle/736773?src=stfb
Tips for Surviving Medical School
Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and suddenly, 24 hours in a day are not enough to get through the enormous volumes of information that we are expected to learn for every exam. It seems virtually impossible. We barely have time to eat or sleep.
Medical school is not the end of the world. Take it from us, 2 students who have been there, when we say that medical school is what you make of it. Do not let medicine define you; instead, you should tailor medicine to your lifestyle. Otherwise, you might become overwhelmed by the demands of your new life and lose the sense of why you chose medicine in the first place.
How do you survive medical school? From the beginning, time management must be a major priority. If you can manage your time successfully, you can still enjoy your life to a certain extent. Studying in med school is not the same as it was in college; this is a new world where you have to explore different techniques and find what works best for you. In medical school, it is all about studying smart, not studying hard. If you don't know this at the beginning, you will learn it the hard way.
Studying medicine is a long process and demands a great amount of discipline and sacrifice. But the reward is priceless. We hope that you chose medicine for the amazing field it is: the rich opportunities it provides for helping humans and the avenues it opens for making a difference in the world. The following are some of the most common pieces of advice we have collected:
- Take care of yourself. You may face long-term negative consequences to your health if you adopt negative behaviors. Do not deprive yourself of healthy, fresh food. Do not ruin your health by eating fast food and avoiding exercise. Do not pull all-nighters and deprive your body and brain of sleep; the consequences are too severe for what may be only 15 minutes of productive studying. Your brain needs fresh food, water, fruits, and vegetables. Your body needs exercise and sleep.
- Do not compete with your classmates or compare your grades with others. We all had to be competitive to get into medical school. But once you are accepted, it becomes a level playing field. Although many students still compete with their classmates, it will not make them better physicians. Getting a 95% on your pathology exam does not mean you will be a great pathologist or clinician. As soon as you walk out of your first exam, look around, and you will see people obsessing about what the right answer was for Question 13. It is easy to spot them. They will come to you and ask you if you put "C" for Question 84. Seriously! Avoid everyone after the exam, and make friends with those who share your philosophy.
- Answer practice questions while you study. "Studying my notes 10 times is probably the best way to prepare for exams." Wrong! The only way to test your learning is to do practice questions. For example, after studying your Board Review Series physiology textbook, make sure you complete the questions at the end of each chapter. This will help solidify the concepts you just read. Studying the same thing repeatedly does not make you smarter, but getting a question wrong will teach you quite a bit. Professional educators will tell you that it is statistically proven that students who do more questions perform better on boards, and that the only time you should go back to the big books is when you consistently miss questions on a certain topic and the answer explanations are insufficient.
- Learn the big picture. You will likely start your first day in school delving into biochemistry, anatomy, physiology, or histology. From the start, instructors talk about columnar cells, impulse transmission, and glycolysis in fine detail. The next day, you are learning about brachial plexus and cardiac output. This is an enormous amount of information overload and students are often not prepared. As you memorize, learn the big picture
- Study with groups. "I am going to study on my own because I don't need anyone's help." Wrong! Medicine is all about teamwork and sharing information. You have to be able to cooperate with others. Even when you apply for residency, it is important to keep this concept in mind. The moment the residency directors feel you will not be a good team player or that you might have "issues" with your colleagues, your application goes in the shredder. Find a small group of people who share the same healthy habits as you, meaning they like to exercise, they do not like to discuss grades, and they have a positive attitude. Once you find the right group, arrange to meet weekly for several hours to ask each other questions about concepts you do not understand. Even better, ask each other questions on little details you think your friends might have understood. Arrange for a review session the night before the exam for last-minute tweaking of your knowledge.
- Take time to engage in stress-relieving activities. Everyone in your class is facing the same amount of stress, some people more than others. You might notice some students walk around with a frown, whereas others wear huge smiles. How is that possible if they are all facing the same pressure? Again, it is time management. If you have extra time, you are able to reduce stress. Spend time with friends, or do something on your own that makes you feel better. Activities like exercise, yoga, listening to calm music, talking to your parents or praying -- there is something out there that makes you feel better. Find it and do it. Do not let the stress affect your studies, relationships and, most importantly, health.
Editor's note: This was adapted from a book manuscript in the publication process, How to Prepare for the Medical Boards – Secrets for Success on USMLE Step 1 & COMLEX Level 1, by Adeleke T. Adesina and Farook W. Taha.
http://www.medscape.com/viewarticle/736773?src=stfb
Labels:
forensic
Rifled firearm weapons
1)Revolvers
A revolver is a repeating firearm that has a cylinder containing multiplechambers and at least one barrel for firing, with the modern revolver being invented by Samuel Colt
2)Automatic pistols
3)Rifles
A revolver is a repeating firearm that has a cylinder containing multiplechambers and at least one barrel for firing, with the modern revolver being invented by Samuel Colt
2)Automatic pistols
Labels:
General
This article may be not related to medicine. or maybe some of it :)
A top goal for many people is reading more books. And while it seems like an easy enough goal, it seems that it can be difficult with all of life's distractions.
Reading can be a pleasure like no other, especially when you discover a fantastic author or an imaginative new world. You can cuddle up with a good book on a weekend or rainy day, become life-long friends with a great character, lose yourself in the worlds created by books.
If reading more books is a goal of yours, there are some easy and simple things you can do to encourage a life-long reading habit. Follow these tips, and you'll soon have a list of books you've read that goes on forever.
20 Simple Ways to Become a Bookworm
This article may be not related to medicine. or maybe some of it :)
A top goal for many people is reading more books. And while it seems like an easy enough goal, it seems that it can be difficult with all of life's distractions.
Reading can be a pleasure like no other, especially when you discover a fantastic author or an imaginative new world. You can cuddle up with a good book on a weekend or rainy day, become life-long friends with a great character, lose yourself in the worlds created by books.
If reading more books is a goal of yours, there are some easy and simple things you can do to encourage a life-long reading habit. Follow these tips, and you'll soon have a list of books you've read that goes on forever.
- Make it a habit. If you can install a new habit to read at certain times of the day, no matter what, even if it's just for 10 minutes at a time, you'll end up reading a ton of books over the course of a year. For example, make it a habit to read with breakfast and lunch, when you use the bathroom, and when you go to bed. If you do 10 minutes at a time, you'll have 40 minutes a day, or nearly 5 hours a week. If you ride public transit, read while you're waiting and while you're on the bus or train. Make it a daily habit, and it will add up. This is the surest way to read more books.
- Keep a reading list. Either in a notebook, on a wiki, or some other document on your computer, keep a simple list of books you want to read. Add to it every time you hear of a good book, or read a good review. This running list will keep you motivated keep reading more.
- Keep a book log. Along those lines, also keep a log of all the books you read. If you want to be detailed, write the book title, author, the date you started and the date you completed it. Even more, you can write a short note about how you liked the book. If all of that's too much trouble, just keep a list of the books you read and maybe the date you finished them.
- Set a challenge. Make a challenge for yourself -- say one book a week, or 40 books in a year. Something achievable, but a challenge. Make it a public challenge, announcing it on your blog or to friends and family, and give everyone your weekly progress report. You'll push yourself to meet the challenge, and find ways to do it.
- Cut back on online reading. If you're reading a lot of stuff online, you probably don't have enough time to read books. If you cut your online reading by just 30 minutes (I'm not saying to ditch it completely), you'll have time to read for half an hour a day. That adds up.
- Join a book club. Most areas have some sort of book club -- look online, in your local newspaper, or at your local library for a book club near you. If you can't find one, organize one with friends, family and neighbors who are interested in books. A book club will get you motivated to read, and help you find recommendations for great books, and perhaps an easy way to swap good books with people in your area.
- Join an online forum. Along those lines, there are many online forums for book lovers -- just do a Google search. Join one, participate, list your favorite books and authors, read those of others, talk books. It's a lot of fun, and you'll get support to form your reading habit.
- Limit TV watching. If you watch hours of television every day, you won't be able to read many books. Cut your TV time in half (for example), to free up time for reading.
- Join Bookmooch. Try Bookmooch for a great way to swap books. List the books you're willing to mail to people, and then list the books you want. If someone requests a book, you mail it at your cost. If someone has a book you want, you get it mailed to you for free.
- Carry your book always. This is one of the most important tips if you want to read more books: anywhere you go, bring your book with you. If you leave the house, put your book in the car. That way, if you have any waiting time, you've got your book to keep you company.
- Find inspiration. Read blogs by book lovers. There are many. These book lovers will describe books in such as way as to make you want to read them. They'll talk about their favorite authors. It's inspiring, and it'll motivate you to read.
- Get great recommendations. Find others who love the books you love, and see what else they recommend. A great way to do that is through Library Thing, a service where you list the books you own, give them ratings and reviews, and get recommendations for other books.
- Read books you can't put down. While you may be ambitious and want to tackle all of the classics, if those go a little too slowly for you, put them down and come back to them later. Instead, find a real page-turner. It doesn't matter what kind of book it is, as long as it's a book you love to read and can't put down. For me, that's writers like Stephen King and John Grisham and Tom Clancy or Robert Ludlum or Sue Grafton. I'll stay up all night reading one of their books.
- Always have books to read. You should never finish a book and not have another book lined up. I like to have at least 5 lined up, so I don't have to worry about it. Have your lineup of books stacked to one side of your bookshelf, so you always know what's on deck.
- Read books that make you laugh. Humorous books are good books, in my opinion. They're fun, and they can poke fun at some of the things we normally take seriously. And they make you want to read them. Find a funny author and go with him. My favorites are Douglas Adams and Terry Pratchett and Mark Twain and David Sedaris.
- Connect with your passions. What do you love, and what do you love to do? If you read about it online, it's probably something you love to read about. Think about what those topics are, and find a good fiction novel about it. You're more likely to keep reading if you love the topic.
- Get into a series. Once I hit on a book I love, if it's part of a series, I try to read the whole series (if I can find all the books). Start to finish is best, but sometimes it doesn't matter. Series are a great way to keep reading
- Finish your book before starting another. One bad habit I broke a few years ago was starting one book, putting it down, and then starting another, thinking I'll read them both at the same time. It doesn't usually work. I often don't come back to the first book, and usually don't finish it. If you start a book and it's a dud, go ahead and abandon it. But if it's a keeper, try to finish it before moving on.
- Become a library lover. There's no better resource for book lovers than the local public library. It's full of great books, new and old, and it's free. It's free! Go there, and enjoy the time you spend there.
- Get to love used book stores. Second best, next to the library, are your local used bookstores There aren't a lot of them in my area (just one, actually, not counting a thrift shop), so it is one of my favorite places to go. I usually take a stack (or a box) of my old books, sell them, and use the credit to get a bunch of new ones.
Labels:
ENT,
pictures
From emel regarding ENT
THROAT SLIDES from DR. HAZEM
Briefing exam
Briefing exam
Pembahagian markah exam ENT
Written exam : 80 marks
Slides/station/OSPE : 40 marks
Oral : 20 marks
Research/ assignment : 5 marks (dr kate kire mcm percuma la)
Bentuk final exam
6 short questions, 5 marks each = 30 marks
2 problem solving, 10 marks each = 20 marks
30 MCQ's, 1 mark each = 30 marks
Total for written exam = 80 marks.
Website ENT department : www.orl-cairo.com
********************************
Important OSPE/slide.
*Mungkin lepas oral exam dlm hari yg sama.
*Note ni mungkin ade yg tak tepat sgt, memandangkan sy tak dapat bace slide kat depan tu. Just tulis ape yg sy dengar. So, kalau ade salah, sile betulkan ok.
Nose
- Purulent sinusitis
- Rigid endoscopic examination of nose
- Normal middle meatus
- Furunculosis of nasal >>> dangerous area : vestibule. (complication = cavernous sinus thrombosis)
- Deviated nasal septum (treatment) Symptomatic >>> septoplasty
- Septal haematoma.(complication = abscess and septal perforation) ttt = drainage
- Septal perforation. ttt = Graft/septal button
- Epistaxis >>> little area
- Inferior meatus
- Antrostomy of maxillary sinus (sinusitis)
- Orbital cellulitis. Complication = orbital abscess. ttt = systemic antibiotic and surgical (but in many cases, doesn't need surgical)
- Endoscopic enthmoidectomy
- orbital complication of maxillary and ethmoid sinusitis
- Foreign body in nose. In children = serious complication. ttt = removal in general anesthesia
- Oro-antral fistula
- cyst in maxillary sinus
- Fluid's level (kat x-ray rasenye)
- Unilateral nasal polyp. If firm = tumour.
- Cancer of maxilla. Characteristic >>> swelling, proptosis, teeth ache, pain in ptrego-maxillary area. ttt = surgical removal (maxillectomy)
Pharynx
- Adenoid hypertrophy
- cute tonsillitis
- Diphtheric and follicular tonsillitis
- Indication of tonsillectomy in diphtheric condition >>> not responsive to penicillin
- Pharyngeal and laryngeal diphtheria best treated >>> antibiotic and antiserum
- Infratonsillar cyst
- Chronic tonsillitis >>> NOT membranous (membrane present in acute only)
- Septic focus
- Oral monoliasis
- Indication of tonsillectomy (dr suruh chek buku sendiri) V.important.
- Quinsy. ttt = excision and drainage
- Parapharygeal abscess >>> occur after tonsillectomy and injury of pharygeal wall
- Bic's triad (chek balik name die) >>> lead to trismus
- parapharygeal swell
- Retropharygeal abscess >>> site
- cold abscess >>> pott's disease
- Dental infection >>> ludwig's angina
- Rhinolalia clausa
- Lingual thyroid. ttt = if it is the only one present, we need to remove it from mouth and plant it in sternomastoid muscle.
- Angiofibroma lead to epistaxis
- Nasopharygeal carcinoma >>> facial pain
- Trotter's triad (chek balik) >>> CHL, nasal regurge, nasal pain
- Pharygeal pouch
- achlalasia of esophagus (cardiac sphincter)
- Post-cricoid carcinoma. lead to severe dysphagia. ttt = total pharyngolaryngectomy.
Larynx
- Normal tube of larynx
- Vocal polyp
- singer's nodule
- bilateral abductor paralysis. its ttt.
- subglottic stenosis
- No microlarygeal surgery in congenital subglottic stenosis
- laryngeal web and its treatment (ttt)
- laryngomalacia
- Acute non-specific laryngitis more severe in children >>> dysphagia. Because = short and narrow
- leucoplakia. Causes = exessive smoking
- Cancer larynx, its stages and why. (ex; T1 = mobile cord)
- Thyroglossal cyst
- tracheostomy and its indication
- submandibullar tumour
- extensive parotid tomour
Liver Function Test
Liver function tests are used to detect liver damage or disease. Combinations of up to five tests are measured at the same time on a blood sample. These are selected from:
- Alanine aminotransferase (ALT) – an enzyme mainly found in the liver; the best test for detecting hepatitis
- Alkaline phosphatase (ALP) – an enzyme related to the bile ducts; often increased when they are blocked
- Aspartate aminotransferase (AST) – an enzyme found in the liver and a few other places, particularly the heart and other muscles in the body
- Total bilirubin – measures all the yellow bilirubin pigment in the blood. Another test, direct bilirubin, measures a form made in the liver and is often requested with total bilirubin in infants with jaundice.
- Albumin – measures the main protein made by the liver and tells how well the liver is making this protein
- Total protein - measures albumin and all other proteins in blood, including antibodies made to help fight off infections
When are these tests requested?
These tests are used when symptoms suspicious of a liver condition are noticed. These include: jaundice, dark urine and light-coloured bowel movements; nausea, vomiting and diarrhoea; loss of appetite; vomiting of blood; bloody or black bowel movements; swelling or pain in the belly; unusual weight change; or fatigue or loss of stamina. One or more of these tests may be requested when a person has been or may have been exposed to a hepatitis virus; has a family history of liver disease; has excessive alcohol intake; or is taking a drug that can cause liver damage.
http://www.labtestsonline.org.uk/understanding/analytes/liver_panel/glance.html
Medical Malpractice
A Medical Practitioner owes his patients a reasonable degree of medical skills, care and behavior so malpractice can be conveniently divided into two broad types :
- Medical negligence
- Professional misconduct
Examples of professional misconduct include :
- Practicing fraudulently
- Being habitually drunk, being dependent on or a habitual user of narcotics or other drugs with similar effects.
- Immoral conduct in the practice of the profession.
- Permitting or aiding an unlicensed person to perform activities without a license
- Refusing a client or patient's service because of creed, color or national origin.
- Practicing beyond the scope of the practice permitted by law.
- Being convicted of a crime or being the subject of disciplinary action in another jurisdiction
Core Attitudes
The core attitudes for ethics in the medical practice :
Cairo University 2010-2011
- Honesty, integrity and trustworthiness
- Critical self-appraisal (including recognition of limitations and errors)
- Empathy and compassion
- Respect of the patient as people
- Respect for the roles of other healthcare professionals in the care of the patient
- Responsibilities of the medical professional towards the local and global community
- Responsible and reliable
- Commitment to clinical competence and lifelong education.
Cairo University 2010-2011
Labels:
tips
10 Ways To Be A Good Medical School Student
Memotivasikan diri dengan membaca artikel yang membina.
1. Be An Excellent Manager of Your Own Time
Medical school will overwhelm you. In the four years it will take you to get your MD, you will be presented with more information that you must master than you might have thought possible, even if you did attend a rigorous pre-med program. Accordingly, the first tip to being a good medical student is to develop time-management skills.
2. Be Friends With More Experienced Medical Students
Making connections early in your med school career with students who have been around longer than you can be invaluable. You can learn from their mistakes instead of making them on your own.
3. Be Respectful of Your Own Health
During this overwhelming time, you will be taxing your physical and mental resources to stay on top of your studies. While it's important that you do well, of course, you must balance your quest for excellence with a commitment to maintaining your health.
4. Be Respectful of The Undertaking
Becoming a doctor is one of the most important things a person can do. Respect this undertaking, and understand that the other aspects of your life (anything non-med-school related) are going to have to take a back seat for a while. A long while.
5. Hit The Books Hard and Often
Get to love studying if you don't already. There's only one way to master the amount of information you need to when people's lives are in your hands, and that's to immerse yourself in it.
6.Play To Your Strengths, But Don't Be Limited To Them
Medical school is like any other kind of school in some ways -- it's a learning experience. Do engage in learning opportunities that will showcase your strengths, but also look for ways to grow, to build on areas where you might not be as strong.
7. Choose Your Specialization ASAP
The earlier you can decide about which area of medicine you'd like to practice, the earlier you can become an expert in this area.
8. Find Mentors In Your Field Of Choice
Before you decide on a specialization, talk to the experienced students you know about what they think. Talk to doctors currently practicing in the field that appeals to you. Talk to your instructors. Make professional connections with people who are already doing the kinds of things you want to be doing after you're out of school.
9. Write As Much As You Can
Med school may be too early to think about publishing your work, but if you are looking for prestige in your field, plan on publishing in the future. The best way to get publication worthy is to write what you can, perhaps by helping already publishing doctors prepare articles.
10. Take The Occasional Break
Good luck with this one!
Labels:
ENT,
medical videos,
pictures
Epistaxis treatment
Bawah ni dikongsikan video first aid to stop nose bleed,anterios&posterior nasal packing dan cauterization.
tapi ni tak tahu bahasa apa, tak faham apa je, tapi korang tengok la cara dia buat, iA nampak gambaran sikit-sikit...
tapi ni tak tahu bahasa apa, tak faham apa je, tapi korang tengok la cara dia buat, iA nampak gambaran sikit-sikit...
Labels:
ENT,
medical videos,
pictures
Takyah susah-susah XD
Website ni menghimpunkan segala macam gambar dan segala macam video ORL.
Meh hari-hari disiplinkan diri untuk lepak sini sambil cuci mata
Labels:
ENT,
pictures
Slide 19/1 (part 3/3)
 |
| GLOMUS TYMPANICUM: Picture of a left tympanic membrane with a pulsating red mass occupying the inferior portion of the middle ear space. The rest of the tympanic membrane is normal. |
 |
GLOMUS TYMPANICUM: Magnification of the above picture |
Labels:
ENT,
pictures
1) Perforations
Slide 19/1 (part 2/3)
1) Perforations
 |
| SUBTOTAL PERFORATION |
 |
| TRAUMATIC PERFORATION-irregularities of peroration's margin |
Types of perforations: From http://www.ent.com.hk/diagnosis/ear_diagnosis.html#2
Perforation at margin of the eardrum This is a perforation that occurs at the margin of the eardrum - where the eardrum and ear canal come together. In some cases, skin from the ear canal can grow through the perforation into the middle ear, forming a cholesteatoma. |  |
Central eardrum perforation A perforation can occur in any location on the eardrum. The size of the perforation varies from a small opening like the one shown, to a total (entire) eardrum perforation. |  |
Attic perforation of the eardrum This is a perforation in the superior part of the eardrum. This is sometimes referred to as an attic perforation. A perforation in this location may be associated with a deep retraction pocket or cholesteatoma into the mastoid. |  |
2) BARATRAUMA
Tentang Baratrauma yang diambil dari http://www.ent.com.hk/diagnosis/ear_diagnosis.html
During diving and flight elevation or landing, the pressure is changing To adapt to it, pressure of middle ear should be changed accordingly by opening up the eustachian tube. Besides swallowing or chewing action, sometimes Valsava maneuver may be needed.
| Barotrauma with Blood in Middle Ear Cavity |
However if the eustachian tube function is impaired or the change of depth or height level is too fast, pressure of middle ear cavity cannot be equalized and barotrauma may result. It may injury the ear drum resulting inperforation, middle ear cavity mucosa resulting in bleeding and fluid collection, even the inner ear through the round window causing severe sensorineural hearing loss.
Diagnosis and Treatment:
How to diagnose barotrauma?
- history of recent flight or diving would be hint for diagnosis.
- Otoscopic or microscopic examination of the eardrum would show blood or fluid inside the middle ear cavity. Sometimes perforation of ear drum may occur
- Pure tone audiogram is necessary as it usually shows conductive hearing loss. However if inner ear is involved, sensorineural hearing loss may be seen.
How to treat barotrauma?
- For ear drum perforation, observation is suggested. If it is not healed up after 3 months eventually, repair by surgical operation is recommended
- For blood or fluid in the middle ear, observation is suggested. But it can be drained by myringotomy if it is not subsided after a period of time.
If there is inner ear injury, conservative management such as bed rest and drugs is recommended. But if hearing deteriorates progressively, surgical exploration and operation would be suggested.
3) CHOLESTEATOMA
 |
| ATTIC CHOLEASTEATOMA |
4) MASTOID FISTULA
 |
| MASTOID FISTULA |
A fistula exposing the mastoid bone: Caused by a dangerous middle ear infection
6) HEMOTYMPANUM
HEMOTYMPANUM is taken from
 [Figure ID: F1] | Figure 1 Otoscopic images of bilateral spontaneous hemotympanum, after intake of anticoagulants. Upper: hemotympanum of the left ear; lower: hemotympamum of the right ear. |
 [Figure ID: F2] | Figure 2 CT scan of the mastoid demonstrating bilateral opacity of the tympanic cavity (white arrows). |
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