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    (Original post by Beska)
    Why does nowhere describe the effects of high/low sodium/potassium/calcium on the heart clearly. And why does everywhere give different explanations.
    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.
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    Why do you get brown urine in G6PD, I didn't think that happened with un-congugated bilirubin?
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    (Original post by _Andrew_)
    Why do you get brown urine in G6PD, I didn't think that happened with un-congugated bilirubin?
    edit just realised the question apologies!

    surely its just the haem from haemolysed erythrocytes? or am i missing something?
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    (Original post by lekky)
    Woop well done
    Thanks! Of course I haven't found out if I've passed all of my assessments yet, but I'm feeling positive!
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    (Original post by John Locke)
    edit just realised the question apologies!

    surely its just the haem from haemolysed erythrocytes? or am i missing something?
    But that would be unconjugated which I thought could not be passed by the kidneys?
    Bah I really should read up on this...
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    (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
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    (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?
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    (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:
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    (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
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    (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).
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    (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
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    (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
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    (Original post by Becca-Sarah)
    levicks is what yhje engineres yse. vanders frw
    Is someone drunk?

    I have vanders. it sits collecting dust...
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    (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
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    (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!
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    (Original post by crazylemon)
    Is someone drunk?

    I have vanders. it sits collecting dust...
    Feel free to donate it to me
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    (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).
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    (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.
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    (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..
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    (Original post by Phryx)
    You have the exact same books as me! Never actually used greys though.
    Used the latter three in first and second year and haven't touched them yet this year (in fact grays is currently propping up my second monitor) I imagine I will be picking it up again because my third rotation has a musculoskeletal component and some anatomy knowledge is required!
 
 
 
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