TSR Med Students' Society Part III

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Was in a seminar the other day where half the room - me included mistook a knee XR for a elbow...Consultant was a rabbit of negative euphoria. Though in our defense it was at a really wierd angle and completly buggered (Sabre Tib)..badtimes.

Reply 3581

Becca-Sarah

Original post by Wangers

I have to start on Urology in two weeks. Any tips? I know absolutely nothing...

Reply 3582

Renal

Original post by Wangers

Another report by the BBC - radio 4 this morning about a patient who had bad care, relative doing the distraught line. The thing is, it isn't balanced reporting because medics and nurses can't defend themselves on air. The NHS does fantastic work day in, day out, and its reports like that that do not help. Another biased, tunnel visioned view of the work that goes on everyday.

Five million 'episodes' a day, someone's going to **** up.

Reply 3583

Renal

Original post by Becca-Sarah

I have to start on Urology in two weeks. Any tips? I know absolutely nothing...

Big catheters will fit.

Reply 3584

Wangers

Original post by Becca-Sarah

I have to start on Urology in two weeks. Any tips? I know absolutely nothing...

Take the piss, dip it, worth knowing about Nephritic and Nephrotic. Always test for diabetes. (the hbA1c can now be used as a diagnostic). Remember that diabetes insipidis is a differential - lok for the plasma sodium. Oh and left testicular swelling, think of renal cell ca.

Reply 3585

Becca-Sarah

Original post by Wangers

Explain that last one to me, please?! The downside of systematic teaching is definitely that if you present me with a testicle, my mind is somewhat limited to disease that originates there...

Reply 3586

Wangers

Original post by Renal

Five million 'episodes' a day, someone's going to **** up.

Yes, but when you're in court for it at least you get to defend yourself. That radio 4 broadcast was a classic sop story, anyone who said anything against it, regardless of how true it might have been never would have stood a chance, the tears would peobably have flooded the studio. Poor care is poor care, but without all the information, we don't know if it is poor care or not. One of the examples thats constantly held up is patients not eating - an inspector might go in and just say - pt not eating, crap standards, end of story. Reported like that, it sounds terrible. But actually, there might be many multitudes of reasons why patients arn't eating - stroke ward for instance, where that might be a referral to pathology outpatients, or in AAU ?surgery, or when people feel ill, they don't want to eat - this as we both know is a well recognised phenomenon in advanced malignancy. The bloke that was put up, the chief exec of the hospital where that lady's mother died, poor sod never had a chance.

Yes, it is true that some care is crap - I work as a HCA, I can see that yes, some people do suffer because we can't get there quick enough - often in CoE wards where patients need badpans, if you're doing something else and you don't get there quick enough, problem. Now that is a dignity issue. Its not because the staff don't care, its because the staff do what they can, but there isn't enough to go around, particularly if you also have to keep an eye out for sicker or demented patients. Quite often the clean up operation takes two or three members of staff (because you need to turn pts), and getting that together is not easy on normal staffing levels. It is not entirely down to staffing levels, there are some inefficiencies in the system - for eample, everyone gets their sheets changed in the morning, everyday. How many of us do that at home? Does it really need to be done for unsoiled sheets?? The staffing issues aside - if the patient cannot cooperate you need minimum 2 staff for this, there is also the cost of laundry and associated costs.

There is very brilliant care going on day in, day out, but that isn't reportable - 'incidents avoided' are both difficult to calculate and frankly, do not sell papers or attract audiances. Then because the public do not work in hospitals, and so don't know of the many difficulties, and the many unsung triumphes everyday, they get a skewed image of the NHS. It makes it seem the NHS isn't working - that is profoundly not true. In the vast vast majority of cases, the NHS does brilliantly - but people do not appreciate how amazing that is. Our NHS is the envy of peoples around the world, hell we have health tourists coming here for treatment because it genuinely is second to none. Those reports taken out of context do more harm than good.

Reply 3587

Wangers

Original post by Wangers

Original post by Becca-Sarah

Explain that last one to me, please?! The downside of systematic teaching is definitely that if you present me with a testicle, my mind is somewhat limited to disease that originates there...

The right testicle venous drainage does to the IVC, on the left, it joins the renal vein. Therefore problems with the kidney can be reflected in the downstream anatomy, classically renal cell carcinoma - nasty bastard of a malignancy. Also watch for VHL, although it is very rare, gives itself away with high Hbs due to epo.

Reply 3588

Medicine Man

I'm probably being a bit thick here but with deep brain stimulation, do you stimulate or depress the subthalamic nucleus? It involves using a depolarising block which stimulates the STN, but surely stimulating the STN as the name of the procedure suggests means you're infact stimulating the GPi and thus inhibiting the ventral thalamus and subsequently the motor cortex from executing movements, which isn't what you want? Or have I completely got the wrong end of the stick? :p:

Can anyone explain it to me please?

Reply 3589

Elles

Rep for some local UCLH knowledge....

Spoiler

Reply 3590

Wangers

Original post by Elles

Rep for some local UCLH knowledge....

Spoiler

The hospital entrances are on Euston Road and theres a back entrance off Gower street around the back of the medical school - Cruciform (big red cross shaped building)

Euston square is very close - you cross the road and walk around a corner to get to the Euston Rd entrance, Warren St is slightly further away, a few minutes max, you walk up university St past the Cruciform, circle slightly to go through the back entrance. Both of these are within 5 minutes, easily. Russel SQ is in the other direction and so about 10-15 minutes away, which is pointless, I would in that case get off at Euston proper and cross the road, pass the Welcomme through a small square where the Quakers Friends House is, then you turn right walking straight and should see one of the entrances, if you get lost, head toward the massive unmissable red building, the back entrance is around the corner.

Don't go into the lower building that looks like the back entrance - that is the Elizabeth Garrett Anderson (maternity wing) - you can get through to the main hospital through it, but it requires basement navigation which is easy to get lost in if you don't know where you're going, and you need access badges to get through the door. There is no normal throughfare as far as I know. - The UCLH back entrance is a circle revolving door the EGA is a normal door. Simples.

Yes, I'm based at UCH, I usually go through Warren St coming from Kentish Town, but Euston station dosn't make much difference, you'd still be there within about 5 minutes.

Reply 3591

Elles

Original post by Wangers

The hospital entrances are...

Thank you!

May or may not have access badges when I need to go there... :ninjagirl:

(edited 12 years ago)

Reply 3592

Wangers

Original post by Elles

Thank you!

May or may not have access badges when I need to go there... :ninjagirl:

I see

Be warned, canteens not great though - limited space and no staff bit, although the views out from the tower are fantastic.

Reply 3593

Philosoraptor

Original post by Wangers

I see

Be warned, canteens not great though - limited space and no staff bit, although the views out from the tower are fantastic.

What BSc are you going to be doing? I hope you chose well

Reply 3594

Wangers

Original post by Elles

Thank you!

May or may not have access badges when I need to go there... :ninjagirl:

oh sorry from Euston you go through quaker house first and then past the welcomme and the union should be to your left theres usually a crowd in the morning heading for that direction. If you come from Warren St then exit turn right , walk up to where the subway is, then cross the road and keep going up, that takes you to the cruciform.