Sunday, April 9, 2017

Bakit Nga Ba Tinutubo ang Pasyente? (Indications for Intubation for the Layperson)

By: Viktoria Ines Matibag, MD

Siguro naman nakakita na kayo ng mga pasyenteng nakatubo sa mga drama. Maraming maling konsepto na tinuturo katulad na lamang ng: 1) Nagtutubo lamang ang pasyente kapag wala nang pulso, 2) hindi nakakapag salita ang may tubo dahil nga nasa daluyan ito ng hangin, 3) hindi makakahinga ang pasyente kapag may tubo.

Translation> Don't mistake medical drama series in TV for the real thing. Often times, there are specific important details that is missed out in TV that if you missed it out in real life could result to patients getting harmed. These are the common misconceptions about Intubation: 1) We only intubate patient if they are already dead or has no pulse 2) The patient can't express himself if a patient is intubated 3) The patient can't breathe if he/she is intubated because a TUBE is inserted down his THROAT!

Sunday, June 29, 2014

Hanging by a Thread: Tips on Reviewing for the Physician's Licensure Exam

As much as I wanted to update this blog as often I can, unfortunately I cannot. I am currently reviewing for the August 2014 Medical Board Exam and it's officially about 60+ days to go... so I would like to personally apologize and at the same time thank everyone who are avidly checking the site and using the site...

As a stress buster in a way, I'll be updating the site and at the same time providing you with insights on my experience reviewing for the boards. As you all know, reviewing can cause burnout fastet than any training there is... as advised by my peers I came up with these time needed tips in conquering the Physician's Licensure Exam.

Tip #1: Read a little, Master a lot.

One common feedback I get from those who conduct reviews and those who took the boards and PASSED! is you don't have to read every book in medschool cover to cover. I mean if you haven't done that during medschool, it's certainly not advisable to do it during review where TIME is literally GOLD and should be spent wisely. The key is RECALL and it's certainly reasonable advise, I mean what's the use of having read Harper's, Guyton, Schwartz or even Solis if you can't even recall the answer during your exams? There's a study out there conducted to find out what's the most effective way to recall something you read and they found out that REPEATITION is the key. They say you more likely to remember something if you read it twice, thrice or even 4x. So read those review handouts as often as you can.

Tip #2: Read, Read and Read.

Tip #3: Treat leisure time as REWARD not as INCENTIVES.

I can't understand this at first but upon explanation, I totally get the point. You ever have moments where you are suppose to finish something but you take a look at your laptop, your tablet or your tv and you say, ok "I will finish what I'm suppose to finish after this episode or after playing Clash of Clans or Candy Crush." (Sounds familiar?) Eventually after the night is through, you end up not finishing what you are suppose to do or worse, you have not even started. This is where the tip comes in, treating your leisure time as reward simply means, you can have your leisure time AFTER finishing what you're supposed to do. Meaning, "I can watch this episode of Game of Thrones if I finish reading 10 pages of my handouts, as a REWARD".

Tip #4: Read, read and read.

Tip #5: Exercise

Someone can easily fall into the trap of neglecting your health and your body when your routine is: Sleep-Eat-Read-Eat-Read-Eat-Read-Sleep. Burnout and stress can easily creap in once you don't take time to stretch, smell the flowers and shake your butt alittle. Exercise   releases endorphins that makes you feel good and at the same time facilitates easy retention when you read. So do take time to exercise.

Tip #6: Read, read and read.

Tip #7: Sleep!!!

No matter what anyone says, take time to sleep. Sleep gives your body a chance to rejuvenate and at the same time gifes your brain cells a breathing room to convert what you read into memory. One can easily read whole day and not sleep thinking that sleeping is a waste of time but studies show that a person who have ample sleep can recall mire compared to those who have little or no sleep at all.

Wednesday, August 14, 2013

Choosing a Specialty

My favorite part of my job is teaching. There, I’ve said it. Yeah, it’s cool picking apart diseases and mix-n-matching treatment regimens for the optimal balance of cure and side effect. I love hand-holding people through concepts that are far beyond their educational level and helping patients and families make impossible decisions with uncertain data.

But give me a new third-year medical student who’s been dropped in the middle of the hospital for her First Real Rotation Ever, and I am just in heaven. I love teaching med students.

One of the things I love the most is helping them figure out what flavor of doctor they want to be. Third year is all about sampling it all, and experiencing what actually happens in the various medical specialties. You rotate through Surgery. You rotate through Internal Medicine. You rotate through Family Practice. You rotate through Anaesthesia. You rotate through Psychiatry. In fourth year, you’re supposed to be narrowing it down to your most likely options for residency.

Friday, August 9, 2013

Tips on Excelling on Rotations

I know that my performance on clinical rotations is important for how I will be assessed. How can I distinguish myself?
Response from Sheila M. Bigelow, DO

Resident Physician -- Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio
Clinical rotations can be very challenging. For the first time, you're expected to follow patients, present on rounds, show your medical knowledge, and work well in a team environment with people who are new to you, knowing that you'll be moving on before long. Not only are you expected to meet the basic requirements, you are expected to do well enough to earn an honors grade or a strong letter of recommendation from the attending.
Fortunately, there are some "must know" tricks that can help you distinguish yourself and help get the grade or letter that you want.

Thinking of Quitting


Medical school and residency can be tough physically, mentally, and socially. What's the best way to get through those tough times when all I want to do is quit?

Response from Sheila M. Bigelow, DO
Resident Physician - Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio

Depression in Medical Students

Medical school and residency are some of the biggest challenges of our careers. Along with the good, exciting times come the hard, rough times. Long hours, little sleep, and a high-stress environment all create the perfect storm. These feelings can fall anywhere in the spectrum from burnout and depression to suicidal thoughts and suicide attempts.

Deep Tendon Reflex

In a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body lies in a dorsal root ganglion innervates the muscle or Golgi tendon organ associated with the muscles; the efferent neuron is an alpha motoneuron in the anterior horn of the cord. The cerebral cortex and a number of brainstem nuclei exert influence over the sensory input of the muscle spindles by means of the gamma motoneurons that are located in the anterior horn; these neurons supply a set of muscle fibers that control the length of the muscle spindle itself.

Hyporeflexia is an absent or diminished response to tapping. It usually indicates a disease that involves one or more of the components of the two-neuron reflex arc itself.

Hyperreflexia refers to hyperactive or repeating (clonic) reflexes. These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.

By convention the deep tendon reflexes are graded as follows:

Tuesday, February 7, 2012

Ins and Outs of Being an Intern


How will things change as I transition from medical student to intern?

Response from Graham Walker, MD
Chief Resident, St. Luke's-Roosevelt Hospital Center, New York, New York

As an intern, you are the primary patient data collector. It's probably the most important part of the team. Welcome to the role.

Your first days as an intern may seem like just another medical school rotation; you're still writing notes, but what you write matters much more now. Your team will rely on you to know your patients and their numbers inside out, so if you say the creatinine is trending down, it better be.
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