Saturday, April 21, 2018

Coronary circulation: Fun fact about blood flow to the myocardium

Hello everyone, here is a post busting a myth about coronary circulation.

Many of us have always thought that the heart itself receives blood during diastole which is only partially true. Here is the complete story.

Getting back to basics, let us revise a bit about the cardiac anatomy.

Tuesday, April 17, 2018

USMLEowesome: United States Clincal Experience (USCE), electives and obs...

United States Clinical Experience - An overview

Intended audience: Those who want to know more about USCE


What this video will cover:
Why do you need USCE?
Types of USCE
Deciding where to apply, which electives?
Paperwork required for electives (brief overview)
Strong letter (applicable for USCE and the match)
CV (brief overview)
Visa interview: Important! Do not mess it up!
If you are not accepted: Have back ups!
If you are accepted: Video for another time :)

Links from the video:

Types of USCE:
http://www.medicowesome.com/2016/03/a-short-post-on-how-to-apply-for.html
http://www.medicowesome.com/2016/04/dr-thinker-united-states-clinical.html
http://www.medicowesome.com/2017/06/my-elective-experience.html
http://electives.us/typesofusce.html

Paperwork:
http://www.medicowesome.com/2016/03/a-short-post-on-how-to-apply-for.html
http://electives.us/electiveapplication.html 

Read this before your visa interview: http://electives.us/usvisaandelectives.html

Link to the powerpoint:
https://drive.google.com/open?id=1aRH5u4Vk7RfHIKrBsDl0TjTMtuVmlVnW

That's all!

-IkaN

Sunday, April 15, 2018

USMLEowesome: Studying for the USMLE Step 1 exam

Hello!

The intended audience for this video is those who have decided to give the exam and are starting to study for it.

Friday, April 13, 2018

Facebook: Microbiology Candida.

So, this post is the answer to our previous question asked on medicowesome facebook page. Question was

#Medicowesome #Microbiology

A vitreous aspirate from a case of metastatic endopthalmitis on culture yields Gram-positive round to oval cells, 12-14 mm in size. The aspirate on Gram staining show the presence of pseudohyphae. Which of the following is the most likely aetiological agent?

1)  Aspergillus.
2)  Rhizopus.
3)  Candida.
4)  Fusarium.

Answer: Option 3) Candida.

Let's analyse the question and extract the information one by one.
So, we get two things from the question.
a) The causative organism has pseudohyphae and
b) It is stained by gram stains.

Among the given options, only Candida can form pseudohyphae. All other options are filamentous fungi forming true mycelia and Candia is the only fungi that are usually gram positive on smears.

Some awesome points that must be known on Candida infections.

1) Candida is unicellular organism belonging to yeast like fungus categories. All Candida species are commensals of humans. So, their mode of transmission is endogenous while most of the fungus have mode of transmission as inhalation.
2) They form pseudohyphae.
3) Candida albicans is different from other candida because :-
   a) It forms true hyphae or germ tubes when grown in serum.
   b) It forms thick walled large spores called chlamydospores.
   c) It is dimorphic. It means it grows as yeast at 37°C and as molds at 25°C.

4) Test to differentiate between C. Albicans and other Candida is called germ tube test or Reynolds Braude phenomenon.
-C. Albicans when placed at 37°C in human serum forms germ cell tubes within 2 hours.
5)Candida albicans is the most common cause of mucosal candidiasis.
6) Candidiasis is the most common systemic mycosis. It is also the most common fungal infection in neutropenic and immunocompetent patients.
7) It causes oral thrush, oesophageal candidasis, cerebral candidasis and pulmonary candidiasis.

Extra information:

Their is one test which I learned online and some people consider it as diagnosis of candida infections.

The Spittle Test:
When you get up in the morning, and before you brush your teeth, eat or drink anything, fill a glass with bottled water at room temperature.
Spit some saliva gently into the glass.
Come back every 20 minutes for the next hour and check for some of these signs.

1) Strings coming down through the water from the saliva at the top.
2) Cloudy saliva sitting at the bottom of the glass.
3) Opaque specks of saliva.

Also, in above question we deducted that the given pathogenic organism is gram stain so we get to learn about stains as well.
Normally, fungi are stained by PAS and methenamine silver but some fungi are stained by special stains like :-

Candida is stained by gram stain.
Cryptococcus is stained by mucicarmine, India ink.
Histoplasma is stained by Giemsa stain.

Thanks for reading!
Ojas Gite.

.

Schizophrenia: Types and Prognosis mnemonic

Schizophrenia: Types and Prognosis mnemonic.

So to begin with, Schizophrenia is a psychiatric disorder classified under psychosis.
Psychosis is a mental state involving loss of contact with reality, causing deterioration of normal social functioning. 

Features of psychosis are:
Loss of insight.
Marked disturbance in personality and behaviour.
Loss of contact with reality.
Impairment in judgement.
Presence of delusions and hallucinations.

A quick recap : Psychosis is classified as   -

• Organic e.g. Substance related psychosis, head trauma
• Major e.g. Schizophrenia, mood disorders
• Third psychosis e.g. delusional disorder, acute and transient psychotic disorders.

There are 7 types of schizophrenia and the mnemonic goes like
PHC (primary health centre) U R SO far

1. Paranoid: The commonest type and good prognosis. The onset is later in life 3-4th decade. Major symptoms are delusion of persecution and grandeur.

2. Hebephrenic: 2nd most common and the worst prognosis. Disorganisation of thought, speech, affect and personality is more prominent than other types. Also there is marked emotional impairment.

3. Catatonic: The best prognosis (especially reactive catatonia). Characterised by marked disturbance in motor activity. Further divided into 3 forms i.e. Excited, Stuporous, and one alternating between the two.

4. Undifferentiated: Where symptoms do not fit in any subtypes.

5. Residual: Chronic type where the positive symptoms vanish and patient is left with 'residual' negative symptoms

6. Simple: only negative symptoms from onset (no positive symptoms at all)

7. Others (f): 
Schizophrenia + mental retardation = Pfropf syndrome
Schizophrenia + self-mutilation = Van-Gogh syndrome

Now let us see what exactly we mean by positive and negative symptoms.
Positive symptoms are those psychotic symptoms not seen in normal individuals (of course, haa!) but are “actively expressed” in the patients (something is added extra and so called positive).

Negative symptoms are normally expected behaviours like emotions like feelings thoughts and drives that a normal person experiences are absent in the patient (Normal things are being taken away and so called negative).

That’s all for now,
Stay awesome!
Keep calm and keep studying!
-Ashish G. Gokhale

Thursday, April 12, 2018

USMLEowesome: Basics about the Step 1 exam

This video is for those who have no idea about the Step 1 exam.



Things I forgot to cover in this video:
You can not retake the exam, if you pass or fail, you score stays forever!
How the score is reported and what is a good score.

It'll be covered in the next video.

Download the slides from here:
https://drive.google.com/open?id=1cETyEFg4kJS8uXYTF8twPg22CLqPCfiE

That's all!
-IkaN

Being street-smart during interviews: Flights!

During the hectic interview season and when you wanna travel from the east coast to the west coast, you will need flights for sure :D

Below are some tips about tickets and flights:

1- buying tickets:

> It is almost always cheaper to buy tickets online, check: Expedia, Kayak, Google flights and Cheapoair websites and compare the prices.

> Check Southwest (recommended) website too, its flights won’t show in the websites mentioned above.
What is special about Southwest is that it allows you to have 2 checked bags (up to 23 kgs each) for free! Also, you can change your flight one-time without paying anything or pay the difference between the 2nd ticket but without losing the original one.
Southwest has some nice offers too and tickets sometimes go as low as 49$ :O

> There is an app called “Hopper” on smartphones, it gives you the prices of different flights and notify you if the prices go up or drop. It also shows you which days are more expensive and which are cheap.
It sometimes shows you a bit more expensive price than the websites mentioned above so you can use it to have a general idea about cheaper days then buy the ticket from the internet.

2- When to buy the ticket?

> In general, the earlier you buy the ticket, the cheaper it will be. Be careful, sometimes this doesn’t happen and you suddenly find that the price of a certain flight has dropped so keep looking.

> Some airlines may have some offers on Black Friday and Cyber Monday so stick to your laptop these 2 days and save some money :D

> Avoid buying tickets during the Christmas season. Prices become crazy skyhigh!

3- Which airlines to choose?

I will talk about the ones I tried only:
American Airlines and United: pretty much the same (at least in my experience), the price of any checked bag is not included in the ticket so you need to pay for it (25$ or 35$). They also charge you 100$ if you have an overweight bag ( >23 kgs / 50 pounds ).

They have a rule that you have to check your “checked bag” 30 and sometimes 45 minutes before your flight, so even if you arrive 30 minutes before your flight and you have a bag to check, you will miss the flight and automatically rescheduled to the next one.

Spirit: Although some people had bad experiences with it, it still has one of the cheapest ticket prices, but put in mind that you ll pay for everything in your flight including the water you drink. (Interestingly, my experience with them was so smooth though)

Other airlines include but are not limited to: Delta and Frontier.

Some important tips:

> If you travelling to a small city, don't fly there directly. Instead, book your flights to the city with a bigger airport (mostly the capital of each state) then take a bus from their to your desired destination. This can also be done to states that are near each other (Fly to a state near to your final destination then take a bus from that state). This may help in saving a lot of money but will need more time.

> Don't forget to check the weather forecast, snow storms result in many cancellations.

> For international travelers to US, if your airport doesn't allow you to board the plane except if you have a return ticket, you can simply buy a return ticket within 24 hrs of your departure flight and cancel it after your check in. This is better than buying a round-trip ticket or paying a fee to change the date of the return flight especially if you are not sure of this date.

===
Update: 6/2/2018...Thanks to Hyndavi:
copied:

I used Delta airlines for most of the part.
1. They allow you a free carry-on bag which is good for carrying interview stuff. Compare prices with other airlines adding the baggage cost and make a purchase.

2. In December and January, there might be a lot of delays and flight cancellations. Make sure you call them after your trip and ask for compensation. They usually credit in miles which you can use at later stage. There are incidences where I claimed even after a month. Email or lodge a complaint.They are pretty responsive. American airlines is good too.

3. Whenever there is a delay or cancellation request them for an immediate rescheduling. For interviews during December and January, try to take the earliest flights possible to avoid missing an interview.

4.Try to carry a snack whenever possible as food in the airports repeatedly can cause unwanted expenditure.

5. Never check-in a carryon bag because a luggage missing or any delay can affect your interview. Sometimes, they just collect if before boarding and give it back after landing, which is ok.

6. Regarding Southwest, if you cancel a ticket, you get a credit into your Southwest account which you can use at a later stage. .
========
Comment below for any other tips you feel may be helpful :D Happy flying everyone :)

-Murad

Wednesday, April 11, 2018

The USMLE journey cost

Hello!

This blog covers the finances of the journey.

I know you are reading this because you are wondering if you can afford it, if it is all worth it.

For knowledge, I believe, destiny creates a way. Remember, to NOT quit your dreams because of green pieces of paper.

Medicowesome dentistry study group on Whatsapp


Hello everybody!

Inspired by the medical students study group, we decided to create a dentistry Whatsapp study group for dental students and we are really excited!

This idea is by one of our dentistry authors, Anisha and she'll be handling the group.

What's the study group for?
A bunch of dental students from all over the world, discussing study related concepts!
You may share your experiences, what you studied today, ask interesting questions to help other people learn or simply revise, ask doubts about things you don't understand, answer other people or just tell a fact you learnt that fascinates you.
We learn something new on a daily basis <3

How do I sign up for the group?

USMLEowesome: Introduction

Hello!

What is USMLEowesome about?
A video series for those thinking or aiming for a residency in the United States.

Who is the intended audience?
Those who are new to the USMLE journey.

This video will also cover a little bit about me (IkaN) & an overview of the USMLE journey with my timeline.


Tuesday, April 10, 2018

How to use Anki Flashcards for studying

Hello!

Since many of you guys requested it - A video demonstration on how to use AnkiDroid for studying during premed and med school!



Monday, April 9, 2018

Sample CV for electives

Hello,

Since many of you guys have been asking for my CV for electives, I thought of uploading it for you to refer.

ECG changes seen in hyperkalemia and hypokalemia mnemonic

Here's a mnemonic by Shohrat Arazov!

When it seems out of your reach, should you try?

Here's an email I got from an awesomite who was extremely confused on whether or not to pursue something out of her reach (In this case, post graduate training in the US). Since it was an extremely personal email, I haven't posted the entire email here (just bits and pieces). Her email is in italics.

Sunday, April 8, 2018

Features of DNA replication: Semiconservative replication

Hello everyone!

Here is a feature of DNA replication that we don't think much about - the semiconservative replication!

Features of DNA replication: Unidirectionality and bidirectionality

Hello everyone!

DNA replication can be unidirectional or bidirectional, depending upon whether the replication from the point of origin proceeds only in one direction or proceeds in both the directions.

Medicowesome Anki flashcards

Hello everyone!

Here are the flashcards I used for step 2 CK and Step 3 -

Saturday, April 7, 2018

Some antibiotics in the US and their trade names

When you start your rotations, you'll hear many drug names that will sound new to you and since the drug names written in qbanks and books are the scientific ones, here is a brief list of some antibiotics and their trade names in the US:


Scientific name
Trade name
Cephalexin
Keflex
Ceftriaxone
Rocephin
Cefdinir
Omnicef
Cefadroxil
Duracef
Azithromycin
Zithromax
Ampicillin - Sulbactam
Unasyn
Piperacillin - Tazobactam
Zosyn ( also called Piptazo)
Levofloxacin
levaquin
Linezolid
Zyvox
Nitrofurantion
Macrobid
Dalfopristin - Quinupristin
Synercid


Comment below for more “commonly used” antibiotics (or drugs in general) that may be added to this table.


-Murad

Wednesday, April 4, 2018

Spanish learning tips for USMLErs

Speaking Spanish is a nice addition to your CV if you are planning to specialize in the US. Spanish is the 2nd most commonly spoken language in the US and some states especially southern ones like Texas and Florida have a huge Spanish-speaking population. Moreover, learning Spanish is fun :D

Here are some tips/methods that can help with that:

1- Language learning apps:

Memrise
www.memrise.com
One of the best apps out there, it works on any device. Just make a free account and practice a bit every day to find out that you learned several thousand words without knowing.
In addition to the main “deck” offered by the smartphone app, you can study many other decks just by going to the website on a laptop and search for the language you want. The only pitfall is that the main deck doesn’t teach you grammar so you have to find other decks or sources.

Duolingo
Another great app which is similar to Memrise. I haven’t used it but I have heard great reviews about it.

Spanish Verbs Lite
A nice smartphone app that has a selective set of verbs with their conjugation in all tenses.
===
2- Social apps for languages:

Tandem and Hellotalk

Consider these apps like a Facebook/Tinder but for languages.
You enter your language and choose the language you wanna learn. These apps will match you with people who speak the language you wanna learn and you will be speaking the language that they wanna learn. Nice platforms to make “language learning friends” especially that you write about your interests so you can befriend others who have the same ones.
===
3- Youtube channels:

Butterfly Spanish
https://www.youtube.com/user/ButterflySpanishola
ِA very useful channel to boost your Spanish. I ll leave you with what Anna wrote about her channel:
“Learn Spanish for free with Spanish lessons that cover grammar, pronunciation, vocabulary, tips & tricks, and cultural aspects. My Spanish lessons are for all Spanish levels and are based on my passion for Spanish culture, language, and teaching.

123dialogues
https://www.youtube.com/watch?v=JFINwW5qL1w&list=PLzRf-4Z5tJuQvis4oLgmkfG83Lrkjj_DA
A great channel which has many dialogues in both Spanish and English.

You can always search Youtube to find more stuff. This is one of the playlists when I searched for Medical Spanish:
https://www.youtube.com/watch?v=MyzgZbZnUik&list=PL5o-4-kgVLgivtGLZy6iTV-x6EqPSUDUI
===
4- Immersion:

Immerse yourself in Spanish. Use your Facebook in Spanish and maybe your smartphone too. You will automatically memorize words without even trying. You ll know that “me gusta, comentar and compartir” are the Spanish words for “like, comment and share”. After a while, you ll be amazed that you are picking more and more passively.
==
5- songs

Songs can stick in our minds in a magical way. Look for Spanish songs and read both the Spanish and English lyrics.
==
6- Friends

No matter how many progs and apps we use, nothing is like having a real conversation with a human being. The MATCH journey will let you meet people from Puerto Rico, Dominican Republic and many many others Spanish speaking countries. Practice with your friends and ask them to correct you.
==
7-Podcasts:

A treasure to learn languages. Many podcasts are there, among the best is: coffee break Spanish.
https://radiolingua.com/coffeebreakspanish/
Listen to the audio file, learn the accent, repeat. They also provide transcripts for the audio file in PDF form.
Coffee break podcasts are available for other languages including Italian and French.
==
8- Time Time Time

Specify a fixed period of your day to learn/talk in Spanish. This may be as short as 5 minutes up to a few hours. It may be when you wake up or before you sleep. Just develop a habit of learning new words and practicing your Spanish daily.



=>Updates<=
Some suggestions from the readers:

> Meetup
https://www.meetup.com/
As the name suggests, this is a website through which you can meet people.
Create a free account, then choose your interests and discover groups of people who share your interests and hang out with them. Language learning is among the things you can choose and especially in the US, you ll meet many people who wanna learn Spanish.

>" Spouse - induced"learning
Some friends stated that having a spouse is one of the biggest motives to learn a new language :D


Comment below if you know any more tips/programs/apps/books that can help in mastering EspaƱol  :)

-Murad

Neonatal Resuscitation Protocol

Here is a short (may be not very short) but concise flowchart on the neonatal resuscitation protocol by the American Academy of Pediatrics.




If I have forgotten to add any point, let me know.

Written by our Medicowesome Student Guest Author,
Devi Bavishi