TSR Med Students' Society Part III

Does anyone have a good mnemonic for the bones of the foot?

Primary is really science heavy yeah.

I just like being able to actually understand why things work, helps me remember it more. I.e. everyone knows diabetics get neuropathies, but why...

Glucose > sorbitol in excess (by aldose reductase) which is osmotically active. This is broken down by sorbitol dehydrogenase by most tissues to fructose. Some tissue like schwann cells, lens, retina, kidneys don't have the dehydrogenase so they can't break it down, so you get osmotic damage in those cells!

Was a proper lightbulb moment for me!

I agree.

Never thought about it at the time, or through most of medical school, but I really regret not having a good grasp of the basic science, especially since I'm having to teach myself now.

Out of interest, how important is the basic science at your level?

We get teaching from doctors and at times it feels like they've forgotten a lot of the basic science and rely on their experience. I assumed if it serves them well, the basic science inherently becomes less important.

Still, it'd be nice to know if all the extra time I spend doing detail would be actually beneficial rather than just emphasising my nerdiness. The level of depth required for our exams isn't particularly extensive.

From what I can make out MRCS and the FRCA qualifications are very science-heavy. And the FRCA primary is pretty ****ing tough.

Ah OK. Interesting. I imagine a reasonable amount of the people in my year may potentially have issues with that then.

I imagine a reasonable amount of all medical students have potential issues with that then. My understanding is that medical education has moved away from basic sciences to make room for fluffy stuff like communication skills and sociology, whilst the college exams remain largely the same as before. I'm quite willing to be corrected on both of those points though...

Out of interest, how important is the basic science at your level?

You may well be right. I can't comment about other schools with much reliability, so it's difficult to compare.

I imagine a reasonable amount of all medical students have potential issues with that then. My understanding is that medical education has moved away from basic sciences to make room for fluffy stuff like communication skills and sociology, whilst the college exams remain largely the same as before. I'm quite willing to be corrected on both of those points though...

Essentially yes, but the membership exams do also have some fluffy stuff.

Ah, ok. IMO, fluffy stuff like communication is more intuitive and doesn't need the hours devoted to it at undergrad level, whereas basic science is by no means intuitive and has to be learnt. You're into Med Ed and stuff, aren't you? Why is basic science being slowly eroded from undergrad?

Hi guys, quick question, is stridor heard with a stethoscope? Or would that be inspiratory wheeze?

Not a great deal for practice.

But as Visesh says, the exams depend heavily on a good, broad knowledge of basic sciences. FRCA particularly covers anatomy, organic chemistry, biochemistry, pharmacology, physics, physiology, etc.

You can hear both, although you can usually hear true stridor from the end of the bed and they sound reasonably different.

Hi guys, quick question, is stridor heard with a stethoscope? Or would that be inspiratory wheeze?

Thanks Renal - How do they differ in sound?

I think I've got inspiratory wheeze over my left bronchus and a productive cough with purulent sputum lasting 7 days. One day history of a bleeding nostril, pleurisy and one episode of streaky sputum although I presume this is from my nostril.

Worth going to the GP?

Stridor can mean they're about the join the ranks of death - invariably large airways obstruction, the patient is desperate. Wheeze if its polyphonic may mean small airways obstruction.

EDIT: Ramblings, not health advice etc...