TSR Med Students&#x27; Society Part III

Original post by lekky

Woop well done :biggrin:

Thanks! Of course I haven't found out if I've passed all of my assessments yet, but I'm feeling positive!

Reply 8243

lekky

Original post by John Locke

edit just realised the question apologies!

surely its just the haem from haemolysed erythrocytes? or am i missing something?

^ twas my thought also

Reply 8244

Beska

21

Original post by lekky

Have you yet to discover the beauty that is tortora?

In 1st year it was pretty much my bible. Now I use it to read through everything and make notes so I understand it before going somewhere else to read the subject again to make my proper notes as it is a bit dodge and for this year lacking in detail in places. It's fantastic though - explains things simply, clearly and in a logical order. I always start there & would be lost without it.

I use Boron's and Levick's Cardiovascular Physiology, also have Berne & Levy. How is tortora for cardio stuff?

Reply 8245

_Andrew_

11

Original post by John Locke

edit just realised the question apologies!

surely its just the haem from haemolysed erythrocytes? or am i missing something?

Hmm - I was always under the understanding that, only congugated bilirubin was capable of darkening the colour of the urine. Having said that, I've been cramming for about 12 hours solid now, so I'm probably msissing something obvious :confused:

Reply 8246

SMed

11

Original post by RollerBall

I swear my brain is dying. I can't seem to learn anything anymore. The lecturer will say a sentence with a keyword in it and 20 seconds later I can't remember the key word but feel like I should like its all cloudy or something. I used to find stuff easy to take in now I'm struggling to even remember basic facts.

I should probably get more sleep.

Original post by crazylemon

I have this.
I was unable to recall the GCS earlier. I had a mental block at what M5 score meant
Early night tonight I feel.

Original post by Kinkerz

You're not the only one. I definitely feel like my capacity to take in new things has declined over the last two years. My suspicion is that it does have a lot to do with sleep...

My knowledge of that feel... bro, I don't even :frown:

Reply 8247

John Locke

12

Original post by Beska

I use Boron's and Levick's Cardiovascular Physiology, also have Berne & Levy. How is tortora for cardio stuff?

you're using the best books IMO. I'm going to, controversially perhaps, go against lekky here and say tortora is not very good at any physiology and intentionally oversimplifies (in fairness due to it's target audience).

Reply 8248

Becca-Sarah

Original post by Beska

I use Boron's and Levick's Cardiovascular Physiology, also have Berne & Levy. How is tortora for cardio stuff?

levicks is what yhje engineres yse. vanders frw

Reply 8249

lekky

Original post by John Locke

you're using the best books IMO. I'm going to, controversially perhaps, go against lekky here and say tortora is not very good at any physiology and intentionally oversimplifies (in fairness due to it's target audience).

That's the whole point though surely. If you're struggling with the books you're using start with tortora, read the chapter through, then go on to Vanders/Levicks and they'll make much more sense. if you read my post I did say it's not good to just use tortora, I don't make any of my notes from there, but is a great starting point if you're struggling with topics as beska seems to be. But everyone has different methods, its just what works for me, get the basics sound in my head before then going on to properly learn it and it sticks in my head whether I want it to or not :tongue:

(edited 12 years ago)

Reply 8250

Original post by lekky

Have you yet to discover the beauty that is tortora?

In 1st year it was pretty much my bible. Now I use it to read through everything and make notes so I understand it before going somewhere else to read the subject again to make my proper notes as it is a bit dodge and for this year lacking in detail in places. It's fantastic though - explains things simply, clearly and in a logical order. I always start there & would be lost without it.

OHCM is my first and only medicine bible, the only other books I bought were greys, mcminns and wheaters

Reply 8251

digitalis

Original post by rainbowbex

OHCM is my first and only medicine bible, the only other books I bought were greys, mcminns and wheaters

You will go far!

Reply 8252

lekky

Original post by crazylemon

Is someone drunk?

I have vanders. it sits collecting dust...

Feel free to donate it to me :wink:

Reply 8253

Wangers

16

Original post by _Andrew_

Why do you get brown urine in G6PD, I didn't think that happened with un-congugated bilirubin?

AFAIK Crash course:

Bilirubin comes in 2 forms - when initially produced from haem breakdown, it is unconjugated and floats around in blood - therefore high unconjugated bilirubin is one possible indicator of acute haemolysis.

There are 2 main ways out of the body, urine and excreta. UC Bilirubin is insoluble - therefore it dosn't go in urine. This is a problem because it floats around in blood and starts affecting acid base. the gut is a major conjugation factory as is the liver, conjugated bilirubin can go out in the urine. This is also why hepatic failure gives clinical jaundice - because the UC bilirubin sticks around and is clinically detectable at around 35 whatever the units are.

Acute haemolysis would give unconjugated bilirubin which is insoluble. The source is a deficiency in GPD, which means the RBC can't run ?NADPH, which means it can't keep ions in the right places, osmotic effects therefore destroy it.

Once Bilirubin is conjugated it can go one of two ways

conjugated bilirubin -> Urobiliogen -> in urine
conjugated Bilirubin -> Steabililogen in the excreta

My guess would be that in the acute case, the liver is overwhelmed, and so you get a backlog of all 3 with some urobilinogen in the urine which would colour it.

Side point -

If the conjugated bilirubin can't get out, then you get high levels with no uribilinogen in the urine - This happens in complete obstructive jaundice, which is why you get dark urine, pale stools - because it can't go through the gut.

This is also why in ?Gilbert's you can do a urine dip (should show positive urobilinogen).

Reply 8254

Phryx

Original post by rainbowbex

OHCM is my first and only medicine bible, the only other books I bought were greys, mcminns and wheaters

You have the exact same books as me! Never actually used greys though.

Reply 8255

Original post by digitalis

You will go far!

haha thanks, I was using the 7th mini edition, upgraded to 8th last week. Think I'm in love..

Reply 8256