New year

Here's something written by a friend as motivation for new year.

Thanks for letting me publish this, Raman! -IkaN

So many years have passed and you kept making resolutions every year, same ones year after year just to keep them for few  weeks or may be months.

But this year, it's time to stop making resolutions and start making decisions; decisions firm enough to make this year the absolute best year. 

And while doing so, promise yourself not to fall back on your old ways, and affirm yourself every morning that these decisions ate the ones that are going to help you make new rituals in order to change your life in a positive way forever. And additionally, after a span of some 5 or 10 years you will be looking back at 2015 with a sense of satisfaction and gratitude.

USMLE for Indian medical students

What is the best time to start preparing?
As soon as you have the slightest gut feeling that you might wanna go to the US. It's better to start preparing early and then change your mind than to start late.
I started in March of my third year. Ideally, you should start in your early second year.
It's never "too late" to start. I have a friend who started in internship and nailed the exam within a few months. Preparation time varies.

Preparing for the USMLE Step 1 exam

"How do I prepare for the USMLE Step 1 exam?" -The most requested post ever!

The essentials - Kaplan videos & notes (for basics) + Goljan book & audio + uWorld + First Aid is the general way to go for most IMG students.

Kaplan videos and notes: They are a good start. If you are time restricted, you may want to skip stuff, fast forward through it.

Anxiety and depression before exams

"How do you manage stress before an exam? I study a lot, but I stress too much and I usually forget everything before the exam. I have anxiety and depression because of this." -Asked on Tumblr

Sounds like you need to believe in yourself a little more. You study a lot. There is no reason for you to worry so much! 

You should start your day with positive thoughts. Affirm this to yourself every morning, "Today is a great day to study and be productive." Clap your hands while you do this. It'll flip your mood right around! Before exams, "I have studied enough and I will do well."

Trust yourself, you've got this. You are a medical student. Getting into medical school ain't easy, but you did it.  You can do this too. 

We have different reasons for getting stressed out -

When you get tired of studying

"Sometimes I get the feeling that my brain can't take more information. Can this be? What can I do when I have this feeling?" -Asked on Tumblr

Yes, it can be! We often get exhausted and feel like we can't take any more information.

In my experience, taking breaks is the best solution for this. I read a research a while back (Don't remember where!) that your performance deteriorates after 45-60 mins of studying depending upon your capacity. If you take a 5-15 min break, however, you do much better.

You can exercise, eat, mediate, dance, listen to music or an inspirational tape if you want in this mini tape. Closing your eyes and lying doing for a while is very relaxing.
Do not use your phone. Your phone has text all over and reading does exhaust you.

I usually get really distracted if I take mini breaks after studying for an hour and don't return to books for another hour. If you have the same problem, you can study for 2-3 hours straight and then take a longer break like a shower, have a long lunch break or a walk around the park.

Change

I spent a lot of time thinking over the name and the logo of the blog, before I even started!

It had to be related to the medical field with a tinge of young enthusiasm. It is a student's blog after all! After a  lot of pondering and questioning, the eureka moment happened. Which word makes us awe in amazement? Awesome! Medicowesome!

If you have a good idea, do it. You don't need to be perfect.

Why does hypophosphatemia cause an increased affinity for oxygen in the blood?

The mechanism for this is very fascinating.

Remember the reaction that generates 2,3-Bisphosphoglyceric acid (2,3-BPG)?

Submissions: Endocrinology notes

Here are some more!

Submissions: Fever with rash in childhood mnemonic

Mnemonic for fever with rash in childhood is, "MEEK SCREAMER"

Dealing with stress and studying before exams for medical students

"I am overwhelmed with exams. I have an anatomy exam coming up. I am slowly beginning to lose hope. Advice would be very much appreciated, thank you!" -Asked on Tumblr

Medicine does get overwhelming. Mostly because no matter how much you study, you will always feel under prepared. It's normal to feel this way.

But don't let it get to you. This part is important because if you feel hopeless, you won't work as much as you should and the guilt will feedback. You need to break the cycle and focus on what's in front of you. There is always hope.

Take a deep breath. Say this aloud - "I've got this. I can do this."

Exercise. Exercise gives you endorphins. Endorphins make you happy. Happy people kill exams!
(Do 20 jumps right now and then read further :D )

Laugh. It's a mature defense mechanism. You'll learn it in psychology. (Another reason for you to survive anatomy right now - so you can read new things next year!)

Acknowledge that you're stressed, laugh about it and be okay with it. Or pretend to be. Fake it till you make it. (PS: If you fake laughter, you'll end up laughing for real.)

Smile. Look at this smiley (:

It's smiling at you, please smile back!

Laughing and smiling alone is a HUGE stress buster.

Tissue plasminogen activator mnemonic

Greetings people!

Tissue plasminogen activator is an enzyme that catalyzes the conversion of plasminogen to plasmin, the enzyme responsible for clot breakdown.

It is used in the treatment of embolic or thrombotic stroke.
Contraindicated in hemorrhagic stroke and head trauma. The antidote for tPA in case of toxicity is epsilon aminocaproic acid.

Mnemonic is, "TPA"

T - Thrombotic and embolic stroke (Use)
P - Plasmin (Mechanism of action)
A - Aminocaproic acid (Antidote)

The dose mnemonic is, "TPA" again!

T for ten:
10% of dose given as bolus.

P mirrored looks like a 9:
0.9 mg/kg dose, maximum 90 mg.

A for an hour:
Rest of the dose is given as an infusion lasting for 60 minutes.

That's all!
-IkaN

Dominant hemisphere and handedness

Hello!
This is practical exam related concept.

In a patient with neurological symptoms, you'd like to know whether the person is left handed or right handed. Why?

Dominant hand is important in medicine because it helps us figure out the dominant hemisphere - especially, in patients with stroke.

People who are right handed have their left cerebral hemisphere dominant. 70% left handed people are left hemisphere dominant.

To figure out handedness, you can ask the person with which hand he writes. If illiterate - You can ask with which hand he prefers to eat, combs hair, etc.

Threading a needle is an excellent way to determine handedness because very frequently people tend to hold the thread in the dominant hand and hold the needle with the non dominant hand.

That's all!
I'm left cerebral hemisphere dominant. You?
-IkaN

Submissions: Microbiology notes

More submitted notes here! :)