Physiology practical

So, we go to the lab in the morning at 8.30 without breakfast. And wait there till about 9. I went without a watch and there was no clock like in anatomy hall, so don't know the exact timings.
The group is divided into 3. One group starts with hematology, one goes down for human experiments, while my group starts with clinical physiology.

I get the questions
"Palpate and auscultate axillary and posterior lung fields"
"Examine the sensory system of the subject"
The examiner conveniently lets me skip demonstrating 90% of tests.

Then, I go down to do the perimeter experiment. Easy viva: parts of the instrument, what is blindspot.

Running back to the hematology lab I have the most important segment of the  day in practical side.
Major experiment: Absolute eosinophil count
Minor experiment: Bleeding time, clotting time
Chart: Jugular venous pressure
Problem/case: Hemiplegia

Confronted with all of them simultaneously, I did a small dance :D

Finished off the minor experiment while trying to focus the old worn out Neubar's chamber. And that let me take the viva for that experiment (which included the charts and problems) along with the first set of people who'd been doing hematology from beginning.
Bleeding time method: I answered Duke's method. (What I did was, putting 6 points of decreasing size :D)
Clotting time method: Ans: Slide and nail method :P
What is that thread you're pulling out? Fibrin!
Ok, what stabilizes fibrin? Clotting factors.
Which one? Von Willebrend.
No? No idea.
Factor 13? Stuart Power. ?
No? IDK.
Ok.

So, jugular venous pressure.
What is the normal right atrial pressure? (I said 14 mmHg, must be even lower)
When is it higher than that? (I said right ventricular hypertrophy and tricuspid valve stenosis)

And this case history, what does it suggest? lesion in the lower part of internal capsule (after crossing has occurred) [copied directly from memory :P]
{I've a vague idea that the facial nerve is also injured, and that the symptoms are that of Bell's palsy}
So when she asks what if the lesion had occurred before crossing, I say partial closing and drooping of eyelids. She asks what happens to eyes, I say IDK :D

Then, I'm left with just the eosinophil count. And I'm still unable to see any lines on the chamber. I wait for people of first set to leave and snatch a newer Neubar's chamber. Should say this one was perfect! All the lines right on my face. Thus I begin the battle. Drains blood, loads the chamber, focuses. Nothing on the slide. New blood, again loading, same result. Finally I think of the number of eosinophil cells, and understand that it would be too diluted. And trade secret idea, I take more of blood, and less of dilution factor. Only to end up with 550 cells/cu mm which's slightly high. But that's not because there were so many cells, it was because I counted every black spot as a cell. Before submission I strike down the numbers to make it 275 cells. Still the examiner couldn't find out any :P
Anyhow, when is eosinophil more in number? eosinophilia: allergy, parasitic infection.
When is eosinopenia? depression of bone marrow
what stain does it take up? eosin.
color? pink. no ma'am blue. I mean pink. Basophils take up blue.
What are the granules? Histamine, serotonin. NO, they're basophilic granules. Don't know.
Fine or coarse granules? Gothilla.
Ok, fine.

Then! viva. after lunch break (but no lunch taken)
First examiner. CNS
Descending tracts? Cortico spinal...
Origin of it? Somatosensory cortex.
Where is it? Precentral gyrus.
Where is that? anterior to central gyrus. Brodmann's area 4.
Ok, what is postcentral's number? 3,1,2
8 is? conjugate movements of eye in frontal lobe
[some other number]? I don't know.
Wernicke's area importance? Ma'am, seat of intelligence, all language comprehension everything.
Aphasia? 3 types - wernicke's, broca's, global.
Ok.

Second examiner: endocrine.
Anterior pituitary hormones? FSH, LH, ACTH, TSH, Growth Hormone..
Ha! GH. Functions? Promotes growth.
Through? IGF.
Expansion? Insulin like growth factor
also called? somatomedin c
ok, why are african pigmies short? because of deficiency of somatomedins :P
tell me cause of dwarfism. GH axis deficiency, Thyroid axis deficiency.
Then? [thinking...]
Insulin, right? Yeah ma'am.
Ok, is insulin anabolic or catabolic. catabolic. No, anabolic. protein sparing.
Fine, male sex hormones? testosterone....
Klinefelter's, Turner's? I answer.

Examiner 3.
This viva was over in 30 seconds, and I remember answering the respiratory centres, and what deglutition is. That's all :P Ha, she asked nephron also

Examiner 4: CVS.
Normal pulse rate: 72/min
What maintains that? sympathetic, parasympathetic
autonomic. Then? Then what sir?...[thinking]...
Don't know BP? Pressure exerted by flowing blood on the artery walls.
Maintenance?? short term, intermediate term, long term
long term? renal
renal what? renin angiotensin.
ha. what is sarcomere? Functional unit of muscle fibre.
Define it! the smallest unit, consisting of actin band, myosin
just define sarcomere. functional unit of muscle.
heard of z lines? ha sir, between 2 z-lines.
hmm. what is the difference between sarcomere in cardiac muscle and skeletal muscle?
Or tell me, anatomy of cardiac muscle. branching, anastomizing, central nucleus. intercalated discs.
what is syncitium? cells acting together.
hmm. fine.

And I leave to have food.

1 comment:

pasindu krisantha said...

although i am not from your collage . i still can remember how was the my 1st year .
actually nice blog post i read it completely

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