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.

Finally, and we cannot emphasize this enough, remember that we are joining a great profession. Be passionate about what you are learning! Medicine is a treasure and an art. As Henri Amiel said, "To me, the ideal doctor would be a man endowed with profound knowledge of life and of the soul, intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere presence."

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

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

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.

Taken from http://blog.liferemix.net/20-simple-ways-become-bookworm

From emel regarding ENT

THROAT SLIDES from DR. HAZEM

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

Medical Books

Medical Books for Free Download!

http://www.mediebooks.com/

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

Other tests that can be used to assess liver function include gamma-glutamyl transferase (GGT), 5'-nucleotidase, and coagulation screen, together with bilirubin and urobilinogen in urine

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