Get an overview of basic microbiology and the concepts involved, including the bacterial growth curve and classifying organisms based on morphologies. This lecture describes blood, urine and skin/soft tissue cultures, focusing on the types of media, sample collection processes, culture procedures, as well as speciation and susceptibility testing.
over 5 years ago
As the days are slowly getting longer, and spring looms in the near future, it can only be the deep inhale of the medical student ready to embrace the months of revision that lies ahead. Books are dusted off the shelves and Gray's anatomy wrenched open with an immense sigh of distain. But which book should we be pulling off the shelves? If you're anything like me then you're a medical book hoarder. Now let me "Google define" this geeky lexis lingo - a person who collects medical books (lots of medical books) and believes by having the book they will automatically do better!... I wish with a deep sigh! So when I do actually open the page of one, as they are usually thrown across the bed-room floor always closed, it is important to know which one really is the best to choose?!? These are all the crazy thoughts of the medical book hoarder, however, there is some sanity amongst the madness. That is to say, when you find a really good medical book and get into the topic you start to learn stuff thick and fast, and before you know it you’ll be drawing out neuronal pathways and cardiac myocyte action potentials. Yet, the trick is not picking up the shiniest and most expensive book, oh no, otherwise we would all be walking around with the 130 something pounds gray’s anatomy atlas. The trick is to pick a book that speaks to you, and one in which you can get your head around – It’s as if the books each have their own personality. Here are a list of books that I would highly recommend: Tortora – Principles of anatomy and physiology Tortora is a fantastic book for year 1 medical students, it is the only book I found that truly bridges the gap between A levels and medical students without going off on a ridiculous and confusing tangent. While it lacks subtle detail, it is impressive in how simplified it can make topics appear, and really helps build a foundation to anatomy and physiology knowledge The whole book is easy to follow and numerous pretty pictures and diagrams, which make learning a whole lot easier. Tortora scores a whopping 8/10 by the medical book hoarder Sherwood – From cells to systems Sherwood is the marmite of the medical book field, you either love this book or your hate it. For me, Sherwood used to be my bible in year two. It goes into intricate physiological detail in every area of the body. It has great explanations and really pushes your learning to a greater level than tortora in year one. The book doesn’t just regurgitate facts it really explores concepts. However: I cannot be bias, and I must say that I know a number of people who hate this book in every sense of the word. A lot of people think there is too much block text without distractions such as pictures or tables. They think the text is very waffly, not getting straight to the point and sometimes discusses very advanced concepts that do not appear relevant The truth be told, if you want to study from Sherwood you need to a very good attention span and be prepared to put in the long-hours of work so it’s not for everyone. Nonetheless, if you manage to put the effort in, you will reap the rewards! Sherwood scores a fair 5-6/10 by the medical book hoarder Moore & Dalley – Clinical anatomy At first glance Moore & Dalley can be an absolute mindfield with an array of pastel colours that all amalgamate into one! It’s also full of table after table of muscle and blood vessels with complicated diagrams mixed throughout. This is not a medical book for the faint hearted, and if your foundation of anatomy is a little shakey you’ll fall further down the rabbit hole than Alice ever did. That being said, for those who have mastered the simplistic anatomy of tortora and spent hours pondering anatomy flash cards, this may be the book for you. Moore & Dalley does not skimp on the detail and thus if you’re willing to learn the ins and out of the muscles of the neck then look no further. Its sections are actually broken down nicely into superficial and deep structures and then into muscles, vessels, nerves and lymph, with big sections on organs. This is a book for any budding surgeon! Moore & Dalley scores a 6/10 by the medical book hoarder Macleod’s clinical examination Clinical examination is something that involves practical skills and seeing patients, using your hands to manipulate the body in ways you never realised you could. Many people will argue that the day of the examination book is over, and it’s all about learning while on the job and leaving the theory on the book shelf. I would like to oppose this theory, with claims that a little understanding of theory can hugely improve your clinical practice. Macleod’s takes you through basic history and examination skills within each of the main specialties, discussing examination sequences and giving detailed explanations surrounding examination findings. It is a book that you can truly relate to what you have seen or what you will see on the wards. My personal opinion is that preparation is the key, and macleod’s is the ultimate book to give you that added confidence become you tackle clinical medicine on the wards Macleod’s clinical examination scores a 7/10 by the medical book hoarder Oxford textbook of clinical pathology When it comes to learning pathology there are a whole host of medical books on the market from underwood to robbins. Each book has its own price range and delves into varying degrees of complexity. Robbins is expensive and a complex of mix of cellular biology and pathophysiological mechanisms. Underwood is cheap, but lacking in certain areas and quite difficult to understand certain topics. The Oxford textbook of clinical pathology trumps them all. The book is fantastic for any second year or third year attempting to learn pathology and classify disease. It is the only book that I have found that neatly categories diseases in a way in which you can follow, helping you to understand complications of certain diseases, while providing you with an insight into pathology. After reading this book you’ll be sure to be able to classify all the glomerulonephritis’s while having at least some hang of the pink and purples of the histological slide. Oxford textbook of clinical pathology scores a 8/10 by the medical book hoarder Medical Pharmacology at glance Pharmacology is the arch nemesis of the Peninsula student (well maybe if we discount anatomy!!), hours of time is spent avoiding the topic followed immediately by hours of complaining we are never taught any of it. Truth be told, we are taught pharmacology, it just comes in drips and drabs. By the time we’ve learnt the whole of the clotting cascade and the intrinsic mechanisms of the P450 pathway, were back on to ICE’ing the hell out of patients and forget what we learned in less than a day. Medical pharmacology at a glance however, is the saviour of the day. I am not usually a fan of the at a glance books. I find that they are just a book of facts in a completely random order that don’t really help unless you’re an expert in the subject. The pharmacology version is different: It goes into just the right amount of detail without throwing you off the cliff with discussion about bioavailability and complex half-life curves relating to titration and renal function. This book has the essential drugs, it has the essential facts, and it is the essential length, meaning you don’t have to spend ours reading just to learn a few facts! In my opinion, this is one of those books that deserves the mantel piece! Medical Pharmacology at a glance scores a whopping 9/10 by the medical book hoarder. Anatomy colouring book This is the last book in our discussion, but by far the greatest. After the passing comments about this book by my housemates, limited to the sluggish boy description of “it’s terrible” or “its S**t”, I feel I need to hold my own and defend this books corner. If your description of a good book is one which is engaging, interesting, fun, interaction, and actually useful to your medical learning then this book has it all. While it may be a colouring book and allows your autistic side to run wild, the book actually covers a lot of in depth anatomy with some superb pictures that would rival any of the big anatomical textbooks. There is knowledge I have gained from this book that I still reel off during the question time onslaught of surgery. Without a doubt my one piece of advice to all 1st and 2nd years would be BUY THIS BOOK and you will not regret it! Anatomy colouring book scores a tremendous 10/10 by the medical book hoarder Let the inner GEEK run free and get buying:)!!
over 8 years ago
In this Chest X-Ray we can identify a left sided pneumothorax - there is absence of lung markings in the periphery and we can also see a shadow which outlines the edge of the lung. A pneumothorax is caused when air enters the potential space between the viceral and parietal pleura and causes the lung to collapse down under the pressure of it's elsatic recoil. In this case it is likely that the pneumothorax has been caused by trauma as we can see air in the soft tissues on the left side (surgical emphysema - clinically feels like bubble wrap). A pneumothorax can be a life threatening condition. The patient presents in respiratory distress with decreased expansion on the affected side. There will be hyperresonance to percussion on that side but absent breath sounds. The emergency treatment is decompression with a large bore cannula in the 2nd intercostal space mid-clavicular line followed by insertion a chest drain in the 5th intercostal space mid-axilllary line
almost 12 years ago
This image is part of our online anatomy trainer. We are happy to share it with the meducation community. Stop worrying about learning anatomy and start doing it the efficient way. Sign up at [www.kenhub.com](https://www.kenhub.com "www.kenhub.com") to pass your next anatomy exam with ease.
over 8 years ago
This video will help you understand the components of the brachial plexus and the problems that arise when one or several of the nerves to the upper limb are...
over 6 years ago
This 3D medical animation shows a blood clot forming in a lower leg vein, creating a deep vein thrombosis, or DVT. When the thrombus breaks free of the valve, it is called an embolus, and travels toward the heart and lungs. The animation ends by showing the embolus lodging in the lung tissue forming a life-threatening pulmonary embolism (PE).
over 11 years ago
Cranial Nerve 1- Olfaction This patient has difficulty identifying the smells presented. Loss of smell is anosmia. The most common cause is a cold (as in this patient) or nasal allergies. Other causes include trauma or a meningioma affecting the olfactory tracts. Anosmia is also seen in Kallman syndrome because of agenesis of the olfactory bulbs. Cranial Nerve 2- Visual acuity This patientâs visual acuity is being tested with a Rosenbaum chart. First the left eye is tested, then the right eye. He is tested with his glasses on so this represents corrected visual acuity. He has 20/70 vision in the left eye and 20/40 in the right. His decreased visual acuity is from optic nerve damage. Cranial Nerve II- Visual field The patient's visual fields are being tested with gross confrontation. A right sided visual field deficit for both eyes is shown. This is a right hemianopia from a lesion behind the optic chiasm involving the left optic tract, radiation or striate cortex. Cranial Nerve II- Fundoscopy The first photograph is of a fundus showing papilledema. The findings of papilledema include 1. Loss of venous pulsation 2. Swelling of the optic nerve head so there is loss of the disc margin 3. Venous engorgement 4. Disc hyperemi 5. Loss of the physiologic cup an 6. Flame shaped hemorrhages. This photograph shows all the signs except the hemorrhages and loss of venous pulsations. The second photograph shows optic atrophy, which is pallor of the optic disc resulting form damage to the optic nerve from pressure, ischemia, or demyelination. Images Courtesy Dr. Kathleen Digre, University of Uta Cranial Nerves 2 & 3- Pupillary Light Refle The swinging flashlight test is used to show a relative afferent pupillary defect or a Marcus Gunn pupil of the left eye. The left eye has perceived less light stimulus (a defect in the sensory or afferent pathway) then the opposite eye so the pupil dilates with the same light stimulus that caused constriction when the normal eye was stimulated. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Inspection & Ocular Alignmen This patient with ocular myasthenia gravis has bilateral ptosis, left greater than right. There is also ocular misalignment because of weakness of the eye muscles especially of the left eye. Note the reflection of the light source doesn't fall on the same location of each eyeball. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Versions • The first patient shown has incomplete abduction of her left eye from a 6th nerve palsy. • The second patient has a left 3rd nerve palsy resulting in ptosis, dilated pupil, limited adduction, elevation, and depression of the left eye. Second Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Duction Each eye is examined with the other covered (this is called ductions). The patient is unable to adduct either the left or the right eye. If you watch closely you can see nystagmus upon abduction of each eye. When both eyes are tested together (testing versions) you can see the bilateral adduction defect with nystagmus of the abducting eye. This is bilateral internuclear ophthalmoplegia often caused by a demyelinating lesion effecting the MLF bilaterally. The adduction defect occurs because there is disruption of the MLF (internuclear) connections between the abducens nucleus and the lower motor neurons in the oculomotor nucleus that innervate the medial rectus muscle. Saccades Smooth Pursui The patient shown has progressive supranuclear palsy. As part of this disease there is disruption of fixation by square wave jerks and impairment of smooth pursuit movements. Saccadic eye movements are also impaired. Although not shown in this video, vertical saccadic eye movements are usually the initial deficit in this disorder. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Utah Optokinetic Nystagmu This patient has poor optokinetic nystagmus when the tape is moved to the right or left. The patient lacks the input from the parietal-occipital gaze centers to initiate smooth pursuit movements therefore her visual tracking of the objects on the tape is inconsistent and erratic. Patients who have a lesion of the parietal-occipital gaze center will have absent optokinetic nystagmus when the tape is moved toward the side of the lesion. Vestibulo-ocular refle The vestibulo-ocular reflex should be present in a comatose patient with intact brainstem function. This is called intact "Doll’s eyes" because in the old fashion dolls the eyes were weighted with lead so when the head was turned one way the eyes turned in the opposite direction. Absent "Doll’s eyes" or vestibulo-ocular reflex indicates brainstem dysfunction at the midbrain-pontine level. Vergenc Light-near dissociation occurs when the pupils don't react to light but constrict with convergence as part of the near reflex. This is what happens in the Argyll-Robertson pupil (usually seen with neurosyphilis) where there is a pretectal lesion affecting the retinomesencephalic afferents controlling the light reflex but sparing the occipitomesencephalic pathways for the near reflex. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerve 5- Sensor There is a sensory deficit for both light touch and pain on the left side of the face for all divisions of the 5th nerve. Note that the deficit is first recognized just to the left of the midline and not exactly at the midline. Patients with psychogenic sensory loss often identify the sensory change as beginning right at the midline. Cranial Nerves 5 & 7 - Corneal refle A patient with an absent corneal reflex either has a CN 5 sensory deficit or a CN 7 motor deficit. The corneal reflex is particularly helpful in assessing brainstem function in the unconscious patient. An absent corneal reflex in this setting would indicate brainstem dysfunction. Cranial Nerve 5- Motor • The first patient shown has weakness of the pterygoids and the jaw deviates towards the side of the weakness. • The second patient shown has a positive jaw jerk which indicates an upper motor lesion affecting the 5th cranial nerve. First Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 7- Motor • The first patient has weakness of all the muscles of facial expression on the right side of the face indicating a lesion of the facial nucleus or the peripheral 7th nerve. • The second patient has weakness of the lower half of his left face including the orbicularis oculi muscle but sparing the forehead. This is consistent with a central 7th or upper motor neuron lesion. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 7- Sensory, Tast The patient has difficulty correctly identifying taste on the right side of the tongue indicating a lesion of the sensory limb of the 7th nerve. Cranial Nerve 8- Auditory Acuity, Weber & Rinne Test This patient has decreased hearing acuity of the right ear. The Weber test lateralizes to the right ear and bone conduction is greater than air conduction on the right. He has a conductive hearing loss. Cranial Nerve 8- Vestibula Patients with vestibular disease typically complain of vertigo – the illusion of a spinning movement. Nystagmus is the principle finding in vestibular disease. It is horizontal and torsional with the slow phase of the nystagmus toward the abnormal side in peripheral vestibular nerve disease. Visual fixation can suppress the nystagmus. In central causes of vertigo (located in the brainstem) the nystagmus can be horizontal, upbeat, downbeat, or torsional and is not suppressed by visual fixation. Cranial Nerve 9 & 10- Moto When the patient says "ah" there is excessive nasal air escape. The palate elevates more on the left side and the uvula deviates toward the left side because the right side is weak. This patient has a deficit of the right 9th & 10th cranial nerves. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 9 & 10- Sensory and Motor: Gag Refle Using a tongue blade, the left side of the patient's palate is touched which results in a gag reflex with the left side of the palate elevating more then the right and the uvula deviating to the left consistent with a right CN 9 & 10 deficit. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 11- Moto When the patient contracts the muscles of the neck the left sternocleidomastoid muscle is easily seen but the right is absent. Looking at the back of the patient, the left trapezius muscle is outlined and present but the right is atrophic and hard to identify. These findings indicate a lesion of the right 11th cranial nerve. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 12- Moto Notice the atrophy and fasciculation of the right side of this patient's tongue. The tongue deviates to the right as well because of weakness of the right intrinsic tongue muscles. These findings are present because of a lesion of the right 12th cranial nerve.
over 10 years ago