Once you get a hang of it though (the feeling doesn’t last long), it’s actually pretty cool. During my first year of med school, I was honestly amazed at the notes I had taken over a 2 month period. The content was equivalent to the biology notes I took in my first year of A Levels, meaning that I had essentially learned in 2 months, the content which was equivalent to 1 year.
And I actually understood stuff. It blew my mind.
I might have to explain how things work in my school. We function on a modular system and we work not subject by subject, but system by system. I’m currently studying the respiratory system and that involves all of the pathology of the respiratory system, all of the microbiology causing respiratory diseases and all of the drugs you give in respiratory disorders, whether it’s for the microbes or for asthma.
There’s a lot of overlap. There are sections in my microbiology book that are repeated in my pathology book, but if it’s a more microbiology subject (like ’causes of bacterial throat infections’), then it’ll be studied from microbiology rather than pathology.
Although it could be studied from pathology too.
The point is, in my school, there’s a lot of content and it overlaps with other subjects a lot. You could pick up a microbe- let’s go for Streptococcus pyogenes. Streptococcus basically means a chain of cocci, where cocci refers to round bacteria. Pyogenes on the other hand refers to pyogenic, which is the involvement or relation to the formation of pus.
Studying about the microbe itself comes under microbiology, where we discuss pathogenesis (how the bacteria brings about disease), transmission (how the bacteria spreads and reaches humans), epidemiology (where is this bacteria more commonly found) and diagnosing (how can we detect the bacteria in a human) apart from the bacteria’s own characteristics like if it’s gram positive or gram negative, if it has exotoxins or endotoxins.
What is the disease in question? That comes under pathology. One of the most common disease/condition that result from Streptococcus pyogenes is what we call ‘strep throat’. The correct medical term would be streptococcal pharyngitis, but we’ll let that slide for now (it means inflammation of the pharynx aka throat, in case you’re interested).
Strep throat presents with (you guessed it), a sore throat that looks red on examination. There will be a fever too, because the bacteria is going to settle there and cause inflammation. Last but not least, the lymph nodes will enlarge too, particularly the ones in the neck, to accommodate for the body’s response to a foreign invader.
Some important concepts about general pathology can be grasped from this example.
Inflammation. Inflammation is the response of the body to any sort of injury, whether it chemical or physical or microbial- whatever really. Here’s an example. All of us, in some time in our lives, have definitely touched a pot that was too hot. You jerk your hand back (there’s the withdraw reflex) and oh no, you’ve got a slight burn on your finger. You’ll notice a couple of things that are characteristic of inflammation like
– the area is a little red. There’s congestion.
– the area is a little bumped up. It’s swollen.
– it’s a lot warmer than your other fingers. There’s heat.
– it hurts a LOT if you touch that area. There’s pain.
– you can’t use that finger for a while. There’s a loss of function.
These 5 observations are the hallmarks of inflammation. Look for them next time you accidentally hurt yourself or get hit really hard by a soccer ball.
Lymph node enlargement. Lymph nodes can be compared to… well. Police checkpoints? They’re basically these little tiny things that filter the lymph draining into them and each lymph node drains a different area. If there’s something weird getting filtered by the lymph nodes, the immune cells sleeping in the lymph nodes will wake up and start multiplying really fast to bring out an army to fix things. That’s why the lymph nodes get big enough for you to feel them. If you find lymph nodes to be enlarged, there are three main causes
– either the lymph node is reacting to something, like inflammation as we discussed above.
– or some cancer cells have been filtered into the lymph nodes and have started growing there (cancer from somewhere else)
– or there is a lymphoma, which is the cancer of the lymphocytes sleeping in the lymph nodes (cancer from the lymph node)
There are also later complications involved in the disease, like rheumatic fever, scarlet fever, glomerulonephritis but we won’t discuss those.
Now that we’re done with pathology, it’s time to figure out what kind of drugs to give to a patient with Streptococcus pharyngitis. Since it’s cause by a bacteria, the obvious answer would be to give it antibiotics and first on that list is penicillin. If the patient is allergic to penicillin, the second choice would be macrolides, like erythromycin.
How these drugs do what they do also falls under pharmacology, as well as their side effects, their contraindications and their mode of inactivation and removal from the body. And doses. Oh I hate doses, all those numbers and calculations…
Are you feeling overwhelmed? Yeah, that’s how I feel all the time. Just an onslaught of information swarming over you and you’re just trying to do your best to survive. But how do you survive?
Here’s what I’ve started doing.
Initially, I used to take all my notes by hand. It’s great, it keeps me awake and I like working with pens and pretty colors. Unfortunately, when I would be done making notes for microbiology, pathology would knock the door with all of it’s facts and I would sit and stare at my perfect notes in despair. How do I fit the new information in? Do I make separate notes? Will the overlapping information make things hard for me? Do I really want to go through all of that again?
I didn’t want to make new notes or cram more details into my original notes. I needed a new plan and ladies and gentlemen, it took me forever to reach this point and you may laugh at me, but here is the solution. Typed notes.
Typed notes are amazing. You just open up a word document for the entire topic (I’ll be sharing an example) and keep adding things to it! I hate writing paragraphs and blocks of text though so I decided to go for a table format. Here are my latest notes.
I picked up the entire topic of pneumonia. First I discussed the general features of pneumonia from a pathology point of view, as well as the types of pneumonia before breaking it down to explain organism by organism. This whole division of topics was done using the notes in First Aid (very concise book, by the way, but absolutely no detail anywhere).
Most of notes itself are in the form of a table. You’ll notice three columns of information: pathogenesis (which is essentially microbiology), clinical presentation (which is essentially pathology) and diagnosis/cure (which is a mix of microbiology and pharmacology).
Making these notes took a while (maybe three days? one hour a day. so three hours). I’ve also added in “influenza” after pneumonia and will be adding some general stuff there too before wrapping everything up into a neat PDF (that one is a prototype) and getting it printed. Voila, over 30 pages of solid text converted into 4 or 5 sides of a paper. And no hassle of “oh no, where do I fit this new information in?” because you won’t print it until the entire topic is actually done!
Genius, I know. I’m so glad I figured this method out. I’m halfway through third year (kinda) and I just figured this out, I’ll definitely be using this for the rest of the year. The use of my notebook for notes has decreased drastically (some days, it never comes out of my bag) and the amount of stapled paper documents I’m carrying has increased.
Wait I forgot another great perk. You’ll never lose your notes. You’ll always have the virtual copy around to print again if you lose your notes. You can even share your virtual notes. It’s great, honestly. Once I’m done with my current pneumonia/influenza notes, I’ll share the completed document if you’re interested in taking a look!
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