Happy New Year

I wish all readers a happy new year.

Hopefully this blog will be much more successful in 2008. With unique posts in specific

categories.

Pathology Terms (part1)

Here are some basic pathology terms, definitions, and slides.


Infection:

An infection is the detrimental colonization of a host organism by a foreign species.

In an infection, the infecting organism seeks to utilize the host's resources to multiply (usually at the expense of the host). The infecting organism, or pathogen, interferes with the normal functioning of the host and can lead to chronic wounds, gangrene, loss of an infected limb, and even death.

The host's response to infection is inflammation ( read below ). Colloquially, a pathogen is usually considered a microscopic organism though the definition is broader, including feces, parasites, fungi, viruses, prions, and viroids. A symbiosis between parasite and host, whereby the relationship is beneficial for the former but detrimental to the latter, is characterised as parasitism.

The branch of medicine that focuses on infections and pathogens is infectious disease.

Inflammation:

is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a synonym for infection (people always confuse these two). Even in cases where inflammation is caused by infection it is incorrect to use the terms as synonyms: infection is caused by an exogenous pathogen, while inflammation is the response of the organism to the pathogen.

In the absence of inflammation, wounds and infections would never heal and progressive destruction of the tissue would compromise the survival of the organism. However, inflammation which runs unchecked can also lead to a host of diseases, such as hay fever, atherosclerosis, and rheumatoid arthritis. It is for this reason that inflammation is normally tightly regulated by the body.

Inflammation can be classified as either acute or chronic.

Necrosis:

is the name given to accidental death of cells and living tissue. Necrosis is less orderly than apoptosis, which is part of programmed cell death. In contrast to apoptosis, cleanup of cell debris by phagocytes of the immune system is generally more difficult, as the disorderly death generally does not send cell signals which tell nearby phagocytes to engulf the dying cell. This lack of signalling makes it harder for the immune system to locate and recycle dead cells which have died through necrosis than if the cell had undergone apoptosis.

The release of intracellular content after cellular membrane damage is the cause of inflammation in necrosis. There are many causes of necrosis including prolonged exposure to injury, infection, cancer, infarction, poisons, and inflammation. Severe damage to one essential system in the cell leads to secondary damage to other systems, a so-called "cascade of effects". Necrosis can arise from lack of proper care to a wound site.

Necrosis is accompanied by the release of special enzymes, that are stored by lysosomes, which are capable of digesting cell components or the entire cell itself. The injuries received by the cell may compromise the lysosome membrane, or may initiate an unorganized chain reaction which causes the release in enzymes.

Unlike apoptosis, cells that die by necrosis may release harmful chemicals that damage other cells. In biopsy, necrosis is halted by fixation or freezing.

Atrophy:

is the partial or complete wasting away of a part of the body. Causes of atrophy include poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself. Hormonal and nerve inputs that maintain an organ or body part are referred to as trophic.

Atrophy is a general physiological process of reabsorption and breakdown of tissues, involving apoptosis on a cellular level. When it occurs as a result of disease or loss of trophic support due to other disease, it is termed pathological atrophy, although it can be a part of normal body development and homeostasis as well.

Hypertrophy:

is the increase of the size of an organ or in a select area of the tissue. It should be distinguished from hyperplasia which occurs due to cell division increasing the number of cells while their size stays the same; hypertrophy occurs due to an increase in the size of cells, while the number stays the same.

Fibrosis:

is the formation or development of excess fibrous connective tissue in an organ or tissue as a reparative or reactive process, as opposed to a formation of fibrous tissue as a normal constituent of an organ or tissue.

Tuberculosis:


















is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. Tuberculosis most commonly attacks the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, bones, joints and even the skin.

Other mycobacteria such as Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, and Mycobacterium microti can also cause tuberculosis, but these species do not usually infect healthy adults.

Over one-third of the world's population has been exposed to the TB bacterium, and new infections occur at a rate of one per second. Not everyone infected develops the full-blown disease; asymptomatic, latent TB infection is most common. However, one in ten latent infections will progress to active TB disease, which, if left untreated, kills more than half of its victims.

In 2004, mortality and morbidity statistics included 14.6 million chronic active TB cases, 8.9 million new cases, and 1.6 million deaths, mostly in developing countries. In addition, a rising number of people in the developed world are contracting tuberculosis because their immune systems are compromised by immunosuppressive drugs, substance abuse, or HIV/AIDS. The rise in HIV infections and the neglect of TB control programs have enabled a resurgence of tuberculosis.

Sarcoidosis:

is an immune system disorder characterised by non-caseating granulomas (small inflammatory nodules) that most commonly arises in young adults. The cause of the disease is still unknown. Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes.

Symptoms can occasionally appear suddenly but usually appear gradually. The clinical course varies and ranges from asymptomatic disease that resolves spontaneously to a debilitating chronic condition that may lead to death.

Granuloma:

In medicine (anatomical pathology), a granuloma is a group of epithelioid macrophages surrounded by a lymphocyte cuff. Granulomas are small nodules that are seen in a variety of diseases such as Crohn's disease, tuberculosis, Leprosy, sarcoidosis, berylliosis and syphilis. It is also a feature of Wegener's granulomatosis and Churg-Strauss syndrome, two related autoimmune disorders.

An important aspect of granulomas is whether they are caseating or not. Caseation (literally: turning to cheese) is a form of necrosis at the centre of a granuloma and is a feature of the granulomas of tuberculosis.

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Sources:

Wikipedia.org

Google Images

The Fourth Annual Medical Weblog Awards!

The categories for this year's awards will be:

-Best Medical Weblog

-Best New Medical Weblog (established in 2007)

-Best Literary Medical Weblog

-Best Clinical Sciences Weblog

-Best Health Policies/Ethics Weblog

-Best Medical Technologies/Informatics Weblog

-Best Patient's Blog

Nominations are being accepted! Nominate HERE

An other article on smoking

This article is entirely from I Love My Heart medical blog. I already talked about this same topic, so I thought I can reinforce my opinion by adding this article.

Holy Smokes! You Gave Me a Heart Attack!

By: Bijoy Johnson

Every 33 seconds, a person dies of heart disease in America. And smokers have upto 400% greater chance of getting heart disease. The negative impact of smoking on health is so great that it is considered as the most significant preventable cause of disease and death in the United States.

Recipe for disaster - how smoking forms a substantial part of the equation for heart disease

Cigarette smoke contains nearly 4800 chemicals including nicotine. Nicotine adversely affects the heart and causes: Build up of fatty substances in the blood vessels, leading to their narrowing (atherosclerosis) Decreased amount of oxygen available to the heart and other organs. Increased blood pressure. Increased tendancy for blood clotting .Increased cholesterol level. All these increase the risk of heart disease. Decreased amount of oxygen makes it more difficult for the heart to function. Also with increased blood pressure, the heart has to do more work to pump the same amount of blood. In such a state, if a blood vessel supplying the heart gets blocked (due to vessel narrowing and increased tendancy to clot), it leads to death of that area of the heart, resulting in a heart attack.

The deadly cocktail

Smoking isn't the only risk factor for heart disease. Obesity, sedentary lifestyle, diabetes are also major risk factors. When smoking is coupled with the other risk factors, they form a deadly cocktail that is truly devastating for the heart.




What about passive smoking?

Cigarette smoking not only affects smokers, but also those who are frequently near smokers. Passive smoking (also known as second hand smoking) has also been associated with cardiovascular disease and death. The victims are mainly children of parents who smoke. Nearly 40,000 people die from heart disease caused by inhaling other people's smoke each year in America.

Read More

Medical Article: Medical Myth Buster!

Medical myths

Rachel C Vreeman, fellow in children’s health services research, Aaron E Carroll, assistant professor of paediatrics

Sometimes even doctors are duped, say Rachel C Vreeman and Aaron E Carroll

Physicians understand that practicing good medicine requires the constant acquisition of new knowledge, though they often assume their existing medical beliefs do not need re-examination. These medical myths are a light hearted reminder that we can be wrong and need to question what other falsehoods we unwittingly propagate as we practice medicine. We generated a list of common medical or medicine related beliefs espoused by physicians and the general public, based on statements we had heard endorsed on multiple occasions and thought were true or might be true. We selected seven for critical review:

• People should drink at least eight glasses of water a day ( I heard this one like a 100 times!!! )
  
• We use only 10% of our brains
  
• Shaving hair causes it to grow back faster, darker, or coarser
  
• Reading in dim light ruins your eyesight
  

We used Medline and Google to search for evidence to support or refute each of these claims. Because "proving a negative" can be challenging, we noted instances in which there was no evidence to support the claim.

People should drink at least eight glasses of water a day

The advice to drink at least eight glasses of water a day can be found throughout the popular press. One origin may be a 1945 recommendation that stated: A suitable allowance of water for adults is 2.5 litres daily in most instances. An ordinary standard for diverse persons is 1 millilitre for each calorie of food. Most of this quantity is contained in prepared foods. If the last, crucial sentence is ignored, the statement could be interpreted as instruction to drink eight glasses of water a day.

Another endorsement may have come from a prominent nutritionist, Frederick Stare, who once recommended, without references, the consumption "around 6 to 8 glasses per 24 hours," which could be "in the form of coffee, tea, milk, soft drinks, beer, etc." The complete lack of evidence supporting the recommendation to drink six to eight glasses of water a day is exhaustively catalogued in an invited review by Heinz Valtin in the American Journal of Physiology.

Furthermore, existing studies suggest that adequate fluid intake is usually met through typical daily consumption of juice, milk, and even caffeinated drinks. In contrast, drinking excess amounts of water can be dangerous, resulting in water intoxication, hyponatraemia, and even death.

We use only 10% of our brains

The belief that we use only 10% of our brains has persisted for over a century, despite dramatic advances in neuroscience. In another extensive expert literature review, Barry Beyerstein provides a detailed account of the origins of this myth and the evidence disputing it. Some sources attribute this claim to Albert Einstein, but no such reference or statement by Einstein has ever been recorded. This myth arose as early as 1907, propagated by multiple sources advocating the power of self improvement and tapping into each person’s unrealised latent abilities.

Evidence from studies of brain damage, brain imaging, localisation of function, microstructural analysis, and metabolic studies show that people use much more than 10% of their brains. Studies of patients with brain injury suggest that damage to almost any area of the brain has specific and lasting effects on mental, vegetative, and behavioural capabilities. Numerous types of brain imaging studies show that no area of the brain is completely silent or inactive. The many functions of the brain are highly localised, with different tasks allocated to different anatomical regions. Detailed probing of the brain has failed to identify the "non-functioning" 90%. Even micro-level localisation, isolating the response of single neurones, reveals no gaps or inactive areas. Metabolic studies, tracking differential rates of cellular metabolism within the brain, reveal no dormant areas.

Shaving hair causes it to grow back faster, darker, or coarser

Another common belief is that shaving hair off will cause it to grow back in a darker or coarser form or to grow back faster. It is often reinforced by popular media sources and perhaps by people contemplating the quick appearance of stubble on their own body.

Strong scientific evidence disproves these claims. As early as 1928, a clinical trial showed that shaving had no effect on hair growth. More recent studies confirm that shaving does not affect the thickness or rate of hair regrowth. In addition, shaving removes the dead portion of hair, not the living section lying below the skin’s surface, so it is unlikely to affect the rate or type of growth. Shaved hair lacks the finer taper seen at the ends of unshaven hair, giving an impression of coarseness. Similarly, the new hair has not yet been lightened by the sun or other chemical exposures, resulting in an appearance that seems darker than existing hair.

Reading in dim light ruins your eyesight

The fearful idea that reading in dim light could ruin one’s eyesight probably has its origins in the physiological experience of eye strain. Suboptimal lighting can create a sensation of having difficulty in focusing. It also decreases the rate of blinking and leads to discomfort from drying, particularly in conditions of voluntary squinting. The important counterpoint is that these effects do not persist.

The majority consensus in ophthalmology, as outlined in a collection of educational material for patients, is that reading in dim light does not damage your eyes. Although it can cause eye strain with multiple temporary negative effects, it is unlikely to cause a permanent change on the function or structure of the eyes. Even in patients with Sjögren’s syndrome (an autoimmune disease that features inflammation in certain glands of the body), decreased functional visual acuity associated with strained reading improves when they stop reading.

One review article on myopia concludes that increased use of one’s eyes, such as reading in dim light or holding books too close to the face, could result in impaired ocular growth and refractive error. The primary evidence cited was epidemiological evidence of the increased prevalence of myopia and the high incidence of myopia in people with more academic experience. The author notes that this hypothesis is just beginning to "gain scientific credence." In the past reading conditions involved even less light, relying on candles or lanterns, so increased rates of myopia over the past several centuries does not necessarily support that dim reading conditions are to blame. In contrast to that review, hundreds of online expert opinions conclude that reading in low light does not hurt your eyes.

Conclusions

Despite their popularity, all of these medical beliefs range from unproved to untrue. Although this was not a systematic review of either the breadth of medical myths or of all available evidence related to each myth, the search methods produced a large number of references. While some of these myths simply do not have evidence to confirm them, others have been studied and proved wrong.

Physicians would do well to understand the evidence supporting their medical decision making. They should at least recognise when their practice is based on tradition, anecdote, or art. While belief in the described myths is unlikely to cause harm, recommending medical treatment for which there is little evidence certainly can. Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge.

Contributors and sources

RCV and AEC are both health services researchers, whose research focuses on examining health policy and professional practices. They have both studied and reported widely on the most effective ways to improve children’s health. This article arose from discussions of how seldom physicians pause to examine the beliefs that they already hold as true. Both authors were responsible for the study concept and design, acquisition of data, and analysis and interpretation of data. RCV was responsible for the drafting of the manuscript and critical revision and is guarantor.

(READ MORE)

Nutrition: Junk Food County

Why many rural Americans can't get nutritious foods. The unhealthy truth about country living.


Recent studies show that many rural families are dependent on high-fat food from convenience stores like this one in South Carolina for too much of their diet

By Karen Springen | Newsweek Web Exclusive

Dec 11, 2007 | Updated: 5:56 p.m. ET Dec 11, 2007


Fannie Charles, 46, lives six miles from the nearest grocery store in rural Orangeburg County, S.C. She doesn't own a car, so she pushes a cart along the side of the highway. (There are no sidewalks.) It's difficult, since she weighs 240 pounds and suffers from asthma and type 2 diabetes. That's why she usually goes only once a month. About once a week she supplements her grocery-store purchases with pricier, less healthy food from the convenience store, just a mile and a half away...

This is the real world of eating and nutrition in the rural United States. Forget plucking an apple from a tree, or an egg from under a chicken. "The stereotype is everyone in rural America lives on a farm, which is far from the truth," says Jim Weill, president of the nonprofit Food Research and Action Center (FRAC). New research from the University of South Carolina's Arnold School of Public Health shows just how unhealthy the country life can be.

The study, which examined food-shopping options in Orangeburg County (1,106 square miles, population 91,500), found a dearth of supermarkets and grocery stores. Of the 77 stores that sold food in Orangeburg County in 2004, when the study was done, 57—nearly 75 percent—were convenience stores. Grocery stores, which stock far more fruits and vegetables than convenience stores, are often too far away, says University of South Carolina epidemiologist Angela Liese, lead author of the study, which appeared in last month's Journal of the American Dietetic Association. "Oftentimes a nutritionist will just say, 'Buy more fruits and vegetables,' when, in fact, the buying part is not simple."

Poverty poses a big barrier to good nutrition in rural areas. "Eating healthier is more expensive," says Jodi Bates, who operates the Compassion in Action food bank in Orangeburg County, where the median household income is just $30,000 and 22 percent of the residents fall below the poverty line. Last year food stamps went to 10.3 percent of rural Americans, versus 7.3 percent of urban ones, and 31 percent of rural grade-schoolers got a free or reduced lunch, compared to 25 percent of urban grade-schoolers... (read more)

Video: How to Keep from Getting Bored if the Internet Goes Down

Don't you hate it when your internet connection is down?! Here are some things that you can do when you are off-net: Organize your bookmarks, delete programs that you don't use, clean your computer, write your next blog post, run your maintenance programs, write down your user names and passwords to all your accounts-emails-forums-services-programs, etc.


http://youtube.com/watch?v=DRJEjWIOT14

The New BMW X6

This is my first non-medical post in this blog. BMW just today released this Ad. of the new X6, so i thought it would be nice to share it with you ;-)



http://youtube.com/watch?v=9SmaWAqOZmg

How To Get Fat without Really Trying

“Everything is bigger in America we’ve got the biggest cars, the biggest houses, the biggest companies, the biggest food, and finally, the biggest people! America has now become the fattest nation in the world. Congratulations! Nearly 100,000,000 Americans today are either over weight or obese. That is more than 60% of all US adults!” – Those are the words that Morgan Spurlock started his documentary “Super Size Me” with.

Super Size Me is an Academy Award-nominated 2004 documentary film. The film is closely linked to Eric Schlosser's Fast Food Nation, a book written somewhat earlier, that examines the impact of the fast food industry and the huge agribusiness companies on the health of the individual consumer.

Spurlock's film follows a 30-day time period (February 2003) during which he subsists entirely on food and items purchased exclusively from McDonald's, and the film documents this lifestyle's drastic effects on Spurlock's physical and psychological well-being and explores the fast food industry's corporate influence, including how it encourages poor nutrition for its own profit.

During the filming, Spurlock dined at McDonald's restaurants three times per day, sampling every item on the chain's menu at least once. He consumed an average of 5,000 calories (the equivalent of 9.26 Big Macs) per day during the experiment.

For a 4 minute glance at the film click here.

Another very interesting documentary I watched recently is “Obesity in America: How to Get Fat without Really Trying”.

“There are baby food desserts. Maybe that's where it starts and then when kids are 2 years old they gain the strength to turn on the television set and they see the constant stream of commercials," said Jacobson. "Then they go to school. And even in schools there are encouragements to eat junk food” For a glance at this documentary click here.

This documentary is really worth watching. It focuses on the commercial aspect of the problem and shows you how the food industry is deceiving us.

You can watch the entire documentary on Medical Videos! Under the label “Documentary” which you can find on the sidebar.

Medical Article: Food Safety FAQ 2

How can I clean my hands when water is not available, such as when traveling or picnicking away from home?
You can use disposable wipes or a hand gel sanitizer. You use the gel without water. The alcohol in the gel kills the germs on your hands. You can find disposable wipes and hand gel sanitizers in most supermarkets and drugstores.

How long can leftover food be left out of the refrigerator?
Hot foods should be refrigerated as soon as possible within two hours after cooking. But don't keep the food if it's been standing out for more than two hours. Don't taste test it, either. Even a small amount of contaminated food can cause illness. ( I don't know anyone that does so! )
Date leftovers so they can be used within a safe time. Generally, they remain safe when refrigerated for three to five days. If in doubt, throw it out, "It's not worth a food-borne illness for the small amount of food usually involved."

How can you figure out if the fish is fresh?
1-The fish's eyes should be clear and bulge a little.

2-Whole fish and fillets should have firm and shiny flesh. Dull flesh may mean the fish is old. Fresh whole fish also should have bright red gills free from slime.

3-If the flesh doesn't spring back when pressed, the fish isn't fresh.

4-There should be no darkening around the edges of the fish or brown or yellowish discoloration.

5-The fish should smell fresh and mild, not fishy or ammonia-like.

Is it safe to eat sushi, the Japanese raw fish specialty?
People in the at-risk groups should not eat raw or undercooked fish or shellfish. People with liver disorders or weakened immune systems are especially at risk for getting sick. Foods made with raw fish are more likely to contain parasites or Vibrio species than foods made from cooked fish. Always cook finfish until its muscle is opaque and flaky.

What do consumers need to know about juice safety?
When fruits and vegetables are made into fresh-squeezed juice, harmful bacteria that may be present can become part of the finished product. Most juice in the United States, 98 percent, is pasteurized to kill harmful bacteria.

The remaining two percent of juice sold is unpasteurized. Unpasteurized juice may contain harmful bacteria that make some people sick.

To help consumers identify unpasteurized juice and cider, the Food and Drug Administration is requiring a warning on these products.

Why is "WARNING" information needed now? Recent serious outbreaks of foodborne illness have been traced to the drinking of unpasteurized juices. The warning information is to help consumers decide whether to buy unpasteurized juice.

Unpasteurized Juice is normally found in the refrigerated sections of grocery or health food stores or at cider mills or farm markets. Unpasteurized juice should have warning information on the label or on a nearby sign.

Medical Article: Food Safety and Nutrition FAQ 1

FDA's Consumer Advice and Publications on Food Safety, Nutrition, and Cosmetics


Q-How sick can I get from eating contaminated food?
A-There are many variables. Your age, general health, and how much contaminated food you ate are all factors. The most common symptoms are diarrhea, nausea, vomiting, and abdominal pain, but you don't necessarily get all the symptoms. At-risk people can become very ill and can even die from food borne illness because their immune systems are less able to fight off the bacteria.

Q-Are some foods more likely to cause food borne illness than others?
A-Just about any food can become contaminated if handled improperly. However, foods rich in protein, such as meat, poultry, fish, and seafood, are frequently involved in foodborne illness outbreaks for 2 reasons:
1. Protein-rich foods tend to be of animal origin. Therefore, microorganisms of animal origin are frequently found in animal foods.
2. Animal foods are rich in protein that bacteria break down into amino acids, which are an important nutrient source to some bacteria.


Bacteria also need moisture in order to survive and reproduce. Thus, they thrive in foods with high moisture content. These include starchy, egg-rich foods and cream-based foods, such as potato or pasta salads, cream-based soups, and custard or cream pies.


Q-What are the symptoms of foodborne illness?
A-Symptoms

Common symptoms of foodborne illness include diarrhea, abdominal cramping, fever, headache, vomiting, severe exhaustion, and sometimes blood or pus in the stools. However, symptoms will vary according to the type of bacteria and by the amount of contaminants eaten.

In rare instances, symptoms may come on as early as a half hour after eating the contaminated food but they typically do not develop for several days or weeks. Symptoms of viral or parasitic illnesses may not appear for several weeks after exposure. Symptoms usually last only a day or two, but in some cases can persist a week to 10 days.

For most healthy people, foodborne illnesses are neither long-lasting nor life-threatening. However, they can be severe in the very young, the very old, and people with certain diseases and conditions.


For further reading, CLICK HERE

Conjoined Twins

Today I came across two amazing videos of twins, but not any twins, "conjoined twins". Before watching the videos lets have a quick look at what this conjunction really is:

Conjoined twins are identical twins whose bodies are joined in utero. It is a rare phenomenon; it is estimated to range from 1 in 50,000 births to 1 in 200,000 births, with a somewhat higher incidence in Southwest Asia and Africa.

Approximately half are stillborn, and a smaller fraction of pairs born alive have abnormalities incompatible with life. The overall survival rate for conjoined twins is approximately 25%. About 70% to 75% of conjoined twin pairs are female.


Two contradicting theories exist to explain the origins of conjoined twins. The older and most generally accepted theory is fission, in which the fertilized egg splits partially. The second theory is fusion, in which a fertilized egg completely separates, but stem cells (which search for similar cells) find like-stem cells on the other twin and fuse the twins together.

Perhaps the most famous pair of conjoined twins was Chang and Eng Bunker (1811–1874), Chinese brothers born in Siam, now Thailand. They traveled with P.T. Barnum's circus for many years and were billed as the Siamese Twins; due to their fame and the rarity of the condition, the term came to be used as a synonym for conjoined twins, although in recent years the term has fallen out of favor and is considered a pejorative term. Chang and Eng were joined by a band of flesh, cartilage, and their shared liver at the torso.

In modern times, they could have been separated easily.

The first video is a National Geographic video, its more like an introduction to the case.



The second video is of a pair of twins, Abby and Brittany Hensel, whom just recently turned 16. This video focuses more on the social effects of the case.



I find it really amazing how they manage to cope with their problem and get over it nicely.

Please share your thoughts and comments with us.

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Sources:
Wikipedia.com
National Geographic Videos
Youtube.com
For further reading click HERE.

video

How to Get a 99 on USMLE Step 1 Using Question Banks and FA only?

Sometime ago, I asked one of my friends whom got a 99 on USMLE Step 1 using question banks as her main studying source with a minimal amount of other materials, how she did that?

This is how it went:


"I'm sorry for coming out of nowhere and droping a question, but me and some others are struggling to find the best way to use USMLE Step 1 Q-Banks. On the other end, there are some amazing people using these Q-Banks as their main studying tool (not mentioning their great scores on the boards!).

Being a 99er whom used question banks as your main studying source, how did you use the Q-Banks? what was your approach? what was your technique? did you make notes? did you solve them over and over and over? did you read all the explanations or just those to the ones you got wrong?"


She replied:

"Hi XXXX, thanks for dropping by.

About using Q-banks (both Kaplan and USMLE World, not only UW for me), solving the questions is not the key issue here. I would do them quickly, (most time could not care about the score), but spend the majority of time in reading all the explanations, making notes.

From every Q, I learn a lot of stuff. Even the question itself will give me a lot of insights.

I review at least two times, more possibly three times for the Qbank. Then at last, I would do the marked Qs one more time, randomized, timed mode to test whether I have really mastered most of the concepts (the first time, subjects-wise). I gather at that time, I could get at least over 90 for each block of questions.

For USMLE Step 1, I just used the Q-banks and First Aid for Step 1, nothing else. But for USMLE Step 2, I would add Kaplan Lecture Notes to my study formula. But I would only go through Kaplan LN very quickly for two times, the most.

Every one has different approach to get a 99. Make sure your route will help you master most of the important concepts of all the subjects, and build up your skills in thinking and solving problems in a quick and right way.

Hope this will help you a little bit on your preparation. Good luck."



Later on, she added:

"One more thing to say. When reviewing the Qs and the explanations, I am thinking all the time, why I did that Q wrong, why I did that Q right; if the question stem changes a little bit, what will be the right answer; if the question asked something a little bit different, what will be the answer et all.

When making the notes, sometime I put similar things together. For example, under what condition, you prefer cesarean section for a pregnant woman; I just list different situations which need c-section in one page. So it is easy to compare and memorize.

If you don't feel this is a comfortable way to study, don't force yourself into it. Whatever works best for you, go with that. We want to study efficiently and effectively, with the specific way we enjoy."


Lets hope she gets another 99 on USMLE Step 2 CK ;-)

Update: May 28 2008

Here is another good piece of advice I read today. This time by Arlete from prep4usmle forums.

"For USMLE World, I did all the questions at once, to get rid of the ones I knew.

The ones I got right but wasn't very sure about the answer, I marked. So I got rid of around 57%.

Then I created new tests with the wrong and marked ones, tutor mode, and read all the answers.

I had a notebook where I wrote only one line of information I thought was important.

When I finished USMLE World (with 66%), I read First Aid for USMLE. When I finished First Aid (a few days before the test), I read my notebook." ... She got a 99 too.

Related posts:
How to get a 99 on USMLE Step 1? ---Collection

Science Faith video: ... Dr Francis Collins interview on CNN

A CNN interview with Dr. Francis Collins (Director of the National Human Genome Research Institute) on how he became a believer and how it is scientifically compatible.

From Wikipedia: Francis S. Collins (born April 14, 1950), M.D., Ph.D., is a physician-geneticist, noted for his landmark discoveries of disease genes, and his leadership of the Human Genome Project (HGP). He is director of the National Human Genome Research Institute (NHGRI).



Or click HERE.

http://youtube.com/watch?v=Ml0FqyFYfrU

USMLE Step 1: ... Exam Preparation Strategy

About a year ago I came across this excellent audio recording of a lecture by Dr. Daughtery (The Lecturer of Behavioral Science on Kaplan USMLE Step 1 DVDs).

Some of the topics the lecture included:

-Some Study Skills
-Clarifying doubts regarding USMLE Step 1 exam
-Couple of words on how the exam is graded
-General advice
-Test taking strategies

The only problem with the lecture is that the sound quality is very low.

Only (7527 KB)

Here is a link to it so you can download it

Let me know what you think.


----------------------------------------------------
Disclaimer:
I did not record this audio. I found it on the internet a long time ago.

Smoking: ... Lung Cancer

Lung cancer is a disease of uncontrolled cell growth in tissues of the lung. This growth may lead to metastasis, invasion of adjacent tissue and infiltration beyond the lungs. The vast majority of primary lung cancers are carcinomas of the lung, derived from epithelial cells.

Lung cancer, the most common cause of cancer-related death in men and the second most common in women, is responsible for 1.3 million deaths worldwide annually. The most common symptoms are shortness of breath, coughing (including coughing up blood), and weight loss.



A scanning electron micrograph provides a color depiction of a small cancerous tumor within a human lung. The tumor is covered in microscopic hairlike structures called microvilli, which enable absorption and secretion. Smoking and other tobacco use are responsible for nearly all cases of lung cancer.

Photograph by Moredun Animal Health Ltd/Science Photo Library

The main types of lung cancer are small cell lung carcinoma and non-small cell lung carcinoma. This distinction is important because the treatment varies; non-small cell lung carcinoma (NSCLC) is sometimes treated with surgery, while small cell lung carcinoma (SCLC) usually responds better to chemotherapy.

The most common cause of lung cancer is long term exposure to tobacco smoke. The occurrence of lung cancer in non-smokers, who account for fewer than 10% of cases, appears to be due to a combination of genetic factors, radon gas, asbestos, and air pollution, including second-hand smoke.


Lung cancer may be seen on chest x-ray and computed tomography (CT scan). The diagnosis is confirmed with a biopsy. This is usually performed via bronchoscopy or CT-guided biopsy.









Treatment and prognosis depend upon the histological type of cancer, the stage (degree of spread), and the patient's performance status. Possible treatments include surgery, chemotherapy, and radiotherapy.

With treatment, the five-year survival rate is 14%.

Please !

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Sources:

Photo #1 from NationalGeographic.com
Photo #2 from Wikipedia.com
Article from Wikipedia.com

Scientific Video: ... Birth of the Solar System

What does the "birth of the solar system" have to do with medicine? Come on, it has everything to do with it ;-)

Its a cool video, I'm sure you'll enjoy it.




A National Geographic video.

Med. Video: DNA Wrapping and Replication Animation

I found this amazing animation that visualizes the process of DNA wrapping and replication (the process of copying a double-stranded DNA molecule).

I hope you find it interesting too.

Burgers on the brain

Article from New Scientist vol 177 issue 2380. Date: 1 February 2003 Diane Martindale

Can you really get addicted to fast food? The evidence is piling up, and lawyers are rubbing their hands. Diane Martindale reports.

MIDDLE-AGED janitors rarely make their mark on science. But Caesar Barber looks like breaking the mould. Last July, Barber, a 56-year-old diabetic and double heart-attack victim from Brooklyn, sued McDonald's, Burger King, KFC and Wendy's, claiming that his illnesses were partly their fault. He had eaten in their restaurants for years, he said, without ever being told that the food was damaging his health.

Barber's class-action lawsuit was the first volley in a long-awaited legal
assault against the fast-food industry and its role in the obesity epidemic
that is swamping the US health-care system. Inspired by the success of Big Tobacco, the lawyers behind it believe they can force fast-food chains to meet their fair share of the enormous cost of caring for obesity. Pulling the strings is John Banzhaf, of George Washington
University Law School in Washington DC, who masterminded the Big Tobacco
crusade...

... New and potentially explosive findings on the biological
effects of fast food suggest that eating yourself into obesity isn't simply
down to a lack of self-control.

Some scientists are starting to believe that
bingeing on foods that are excessively high in fat and sugar can cause
changes to your brain and body that make it hard to say no.

A few even believe that the foods can trigger changes that are similar to full-blown
addiction. The research is still at a very early stage, but thanks to Caesar
Barber it is about to be thrust firmly into the limelight.

Now, if you are thinking : "What constitutes an addiction?"

Addictiveness has proved surprisingly hard to define, and there are several
different ways of judging whether a substance is addictive. One of the most
widely used is known as the DSM-IV criteria, devised by the American
Psychiatric Association. To be addictive, a substance has to meet at least
three of the following criteria:

* Taken in larger amounts or over a longer period than intended
* Persistent desire or unsuccessful efforts to cut down or control use
* A great deal of time spent seeking the substance out, using it or
recovering from its effects
* Important social, occupational or recreational activities given up or
reduced because of substance use
* Continued use despite knowledge of harmful consequences
* Increased tolerance with use
* Withdrawal symptoms

Some fat facts:

* More than 60 per cent of American adults and 13 per cent of children
and adolescents are classified as overweight or obese. The adult figure has
doubled since 1980; for children and adolescents it has trebled

* In 2000, the US healthcare system spent $61 billion on the diagnosis,
care and prevention of obesity

* Last year, Americans spent about $115 billion on fast food, more than
on higher education or personal computers or new cars

* Americans spend about half of their food budget on meals and drinks
consumed outside the home, and consume about a third of their daily energy
this way

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The Original post was written by Diane Martindale a science writer in Toronto.

I read the original article on OCA's website.