Thieme Test Prep Series

5
Physiology

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Thieme
Delhi • Stuttgart • New York • Rio de Janeiro
 AETCOM Super-16 Questions

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guidelines, and technological advancements. They attend
AETCOM 1.1 What does it mean to be a doctor
medical conferences, participate in continuing medical educa-
tion programs, and engage in lifelong learning to provide the
Q.1. Explain the role of a physician in a healthcare best care possible.

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system.
8. Team leader
(Or Discuss the various roles of a doctor.)
Doctors collaborate with various healthcare professionals,
Ans. Doctors have various roles beyond their main duty of diag- including nurses, pharmacists, therapists, and other specialists,

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nosing and treating patients. Here are some of the key roles and to provide coordinated and comprehensive care to patients.
responsibilities of doctors: They work as part of a multidisciplinary team, exchanging
1. Medical practitioner information, consulting, and collaborating to achieve optimal
Doctors are primarily responsible for diagnosing and treating patient outcomes.

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illnesses, injuries, and various medical conditions. They use 9. Preventive care provider
their medical knowledge and expertise to provide direct patient
Doctors place importance on preventive care. They emphasize
care and manage their overall health.
the significance of regular check-ups, vaccinations, and screen-

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2. Educator ings to detect and prevent diseases before they progress or
Doctors play a crucial role in educating patients about their become more severe. They educate patients about maintaining
medical conditions, treatment options, and preventive meas- a healthy lifestyle and reducing risk factors.
ures. They explain complex medical concepts in a way that 10. Emotional support
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patients can understand, empowering them to make informed
decisions about their health. In addition to providing medical care, doctors often act as
emotional support for their patients. They build relation-
3. Researcher ships based on trust, empathy, and understanding, comforting
Many doctors participate in medical research to advance patients, and offering support during challenging and stressful
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medical knowledge and find innovative ways to treat diseases. times.

They design and conduct clinical trials, analyze data, and
contribute to scientific publications to improve healthcare Q.2. Any doctor can treat but only a good doctor
practices and discover new treatments. can “truly heal.” Justify.
4. Patient’s advocate (Or True healing extends beyond medical therapy.
Doctors advocate for their patients, ensuring that they receive Justify.)
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appropriate medical care, resources, and support. They commu-

Ans. Any doctor can provide medical treatment by diagnosing
nicate patients’ needs and concerns to other healthcare profes-
and prescribing medications or by following procedures to alle-
sionals, insurance providers, and policymakers, advocating for
viate symptoms or cure diseases. However, healing extends
fair and equitable access to healthcare services.
beyond merely addressing physical ailments; it involves
5. Administrator providing comprehensive care that considers the patient’s
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Doctors often assume administrative roles, especially in emotional, mental, and social well-being. Key points:
larger healthcare institutions. They manage healthcare teams, 1. A good doctor not only possesses medical expertise but
supervise medical staff, develop protocols and policies, and also has a compassionate and empathetic approach toward
ensure smooth operations in clinics, hospitals, or healthcare the patients.
organizations.
They build a strong doctor–patient relationship based on trust,
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6. Decision-maker active listening, and understanding. This enables them to truly

understand the root causes of the illness, identify underlying
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Doctors are frequently faced with challenging decisions, often

involving the lives and well-being of their patients. They factors, and develop personalized treatment plans.
analyze medical data, interpret test results, and make critical
2. A good doctor recognizes the importance of holistic
decisions regarding treatment plans, surgeries, and referrals to
healing.
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specialists.
They acknowledge the interconnectedness of physical and
7. Continuous learner mental health, and consider the impact of a patient’s lifestyle,
The field of medicine is constantly evolving, and doctors must environment, and emotional state on the well-being of the
stay up to date with the latest medical research, treatment patient. They take the time to educate patients about healthier

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AETCOM Super-16 Questions

habits, preventive measures, and self-care techniques that can 7. Problem-solving and decision-making abilities
lead to long-term healing and improved overall health. Physicians frequently encounter complex medical cases that

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3. A good doctor understands patient’s mind. require critical thinking, problem-solving skills, and swift deci-
sion-making. They must be able to analyze multiple factors,
They know that true healing involves addressing the patient’s
consider potential risks and benefits, and make decisions that

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fears, anxieties, and emotional distress that can arise from the
are evidence-based and in the best interest of the patient.
illness. They provide emotional support, listen attentively, and
offer reassurance, helping patients navigate difficult emotions 8. Teamwork and collaboration
and empowering them to actively participate in their own A good physician should be able to work effectively within a
healing process. healthcare team. This includes collaborating and communi-

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cating with other healthcare professionals, such as nurses,
Q.3. Discuss the professional qualities of a good specialists, and therapists, to provide comprehensive and
physician. coordinated care for patients. Effective teamwork is crucial for

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Ans. Professional qualities of a good physician include: optimal patient outcomes.

1. Medical knowledge and expertise 9. Resilience and adaptability

A good physician should have a strong foundation of medical Medicine can be a demanding profession, and physicians often
knowledge and stay updated with the latest advancements face high levels of stress and long working hours. It is impor-

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in the field. They should have a thorough understanding of tant for a physician to be resilient, able to cope with stress, and
diseases, treatment options, diagnostic procedures, and medical adapt to changing situations or unexpected challenges. They
research. should be able to maintain a calm and composed demeanor,
ensuring patient safety and quality of care even in difficult

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2. Diagnostic skills circumstances.
A good physician should possess excellent diagnostic skills to
10. Commitment to continuous learning
accurately identify and assess a patient’s condition or illness.
This involves gathering relevant information, performing phys- Medicine is a constantly evolving field, and a good physician
should have a lifelong commitment to learn and improve his or
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ical examinations, ordering appropriate tests, and interpreting
the results correctly. her knowledge and skills. They should be open to new research,
advancements, and technologies, and be willing to stay updated
3. Communication skills through continuing medical education and professional devel-
Effective communication is a crucial quality for a physician. opment activities.
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They should be able to communicate clearly and compas-

sionately with patients, addressing their concerns, explaining Q.4. Explain the importance of lifelong learning for
information regarding their diagnosis, treatment options, and physicians.
prognosis in a way that is easily understandable. Good listening
(Or For a doctor, “Learning never stops.” Explain.)
skills are equally important for understanding patients’ symp-
toms and concerns. Ans. Lifelong learning is crucial for doctors due to several
reasons:
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4. Empathy and compassion

Compassion is an essential quality as it helps develop a strong 1. Expanding medical knowledge
doctor–patient relationship. A good physician should be empa- Medical science is constantly evolving with new discoveries,
thetic toward patients’ physical and emotional pain, showing technologies, and treatments emerging regularly. Staying
genuine care and concern for their well-being. This can greatly updated with the latest research and advancements is essential
contribute to a patient’s trust and comfort in receiving medical for doctors to provide the best possible care to their patients.
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care. Lifelong learning ensures that doctors are well-informed about

current medical practices and can integrate new knowledge
5. Dexterity and coordination into their clinical decision-making.
Physicians often need to perform physical examinations, proce-
dures, or surgeries that require manual dexterity. They must 2. Maintaining professional competence
possess the precision to perform these tasks with accuracy and Medical knowledge and skills can become outdated over time
minimal discomfort to the patient. Good hand–eye coordina- if not regularly refreshed. Lifelong learning helps doctors main-
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tion is particularly important in surgical specialties. tain their professional competence by continuously improving
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their knowledge base, clinical skills, and diagnostic abilities. It

6. Ethical and professional behavior allows them to adapt to changing medical standards and guide-
A good physician should maintain high ethical standards and lines, ensuring that they can deliver the highest standard of care
professional behavior. This includes respecting patient confi- throughout their careers.
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dentiality, providing unbiased care to all individuals, and acting

in the patient’s best interest. Physicians should abide by the 3. Enhancing patient safety
principles of medical ethics, such as beneficence (acting in the Medical errors can have serious consequences on patient safety.
patient’s best interest), non-maleficence (do no harm), and Lifelong learning helps doctors identify and address any gaps
justice (fairness in treatment and resource allocation). in their knowledge or practices, minimizing the risk of errors.

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AETCOM Super-16 Questions

Through ongoing education and professional development, explore new ideas, analyze medical data, and challenge existing
doctors can stay up to date with best practices, evidence-based treatment practices.
medicine, and new treatment modalities, ultimately improving

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6. Mentorship
patient outcomes and reducing potential harm.
Seeking guidance from experienced physicians and mentors can

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4. Adapting to societal changes significantly impact a doctor’s professional growth. Mentors
The healthcare landscape is constantly evolving, influenced by provide valuable insights, share their experiences, and offer
societal, cultural, and technological changes. Lifelong learning career advice, helping doctors broaden their perspectives and
equips doctors with the skills to adapt to these changes and navigate through their medical careers.
meet the evolving needs of their patients. For example, learning

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about emerging diseases, population health management, 7. Self-directed learning
telemedicine, or electronic health records allows doctors to Taking personal initiatives to study medical topics of interest
provide efficient and patient-centered care in changing health- or pursuing advanced degrees (such as Master’s programs or
PhDs) allows doctors to delve deeper into specific areas and

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care environments.
develop expertise. Self-directed learning involves reading
5. Fostering professional growth and innovation textbooks, attending specialized courses, or engaging in inde-
Lifelong learning not only helps in acquiring knowledge but also pendent research.
encourages professional growth and innovation among doctors.
8. Quality improvement initiatives

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By attending conferences, participating in research activities, or
pursuing advanced degrees, doctors can contribute to medical Doctors can participate in quality improvement activities
advancements, development of new treatment approaches, and within their practice settings, such as adopting new proto-
be pioneers in their respective fields. cols, implementing evidence-based practices, or monitoring

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outcomes. This helps in enhancing patient care, reducing errors,
Q.5. Enlist the various ways by which doctors can and implementing best practices.
practice lifelong learning. 9. Reflective practice
Ans. Doctors can practice lifelong learning through various Reflecting on patient cases, clinical experiences, and personal
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methods, including: practice allows doctors to identify areas for improvement and
enhance their skills. Regularly reviewing and analyzing one’s
1. Continuing medical education (CME)
own practice helps in self-assessment and promotes self-
Participating in CME programs allows doctors to earn credits directed learning.
and stay updated with the latest medical knowledge and
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advancements. CME activities can include attending confer- 10. Peer review and feedback
ences, workshops, seminars, or online courses that focus on Engaging in peer review processes, receiving constructive feed-
various medical specialties or specific topics of interest. back from colleagues, or participating in clinical audits can help
doctors identify areas for improvement and stimulate ongoing
2. Medical journals and publications
learning.
Subscribing to reputable medical journals and publications
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provides doctors with access to the latest research findings,

clinical guidelines, and case studies. Regularly reading medical AETCOM 1.2 What does it mean to be a patient
literature helps doctors stay informed about recent develop-
ments in their fields. Q.6. What do you understand by patient autonomy?
3. Online resources and e-learning Ans. Patient autonomy refers to an individual’s right and ability
to make decisions concerning one’s own health and treatment
The internet offers a wealth of educational resources, including
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without undue influence or pressure from doctors.

online courses, webinars, podcasts, and medical forums.
Doctors can take advantage of these resources to enhance their Key points:
knowledge, learn about new treatment approaches, and partici- • Patient autonomy recognizes that each person has the
pate in discussions with other professionals. right to have control over one’s own body and healthcare
decisions.
4. Collaborative learning
• It emphasizes the importance of informed consent, where
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Engaging in multidisciplinary discussions and case conferences

patients have the right to receive all the necessary infor-
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with colleagues helps doctors exchange experiences, share

mation about their medical condition, available treatment
knowledge, and learn from each other. Collaborative learning
options, potential risks, benefits, and alternatives, allowing
can take place through professional networks, medical socie-
them to make autonomous decisions.
ties, or hospital-based meetings.
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• Respecting patient autonomy means acknowledging and

5. Research and participation in clinical trials valuing a patient’s ability to make choices, even if the deci-
Conducting research or participating in clinical trials allows sions may differ from what the healthcare providers believe
doctors to contribute to medical knowledge and gain practical to be in the best interest of the patient. Medical profession-
experience. Research involvement provides opportunities to als are responsible for providing patients with the necessary

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AETCOM Super-16 Questions

information, ensuring their understanding, and supporting if they have received substandard care. This involves reporting
them in making informed decisions that align with their to higher authorities or utilizing institutional mechanisms for
values, beliefs, and goals. resolving disputes.

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• However, patient autonomy is not absolute and may be
limited in certain situations. For example, if a patient lacks AETCOM 1.3 Doctor–patient relationship

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decision-making capacity due to a mental illness, severe
cognitive impairment, or is a minor, the autonomy of the Q.8. What are the prerequisites to build a good
patient may be restricted, and alternative decision-making
processes may be employed, such as involving a legally doctor–patient relationship?

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authorized representative. (Or Write a short note on doctor–patient
relationship.)
Q.7. Explain the various rights of patients.
Ans. Building a good doctor–patient relationship is important

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Ans. Patients have various rights that are recognized and for effective healthcare delivery. It helps build trust, enhances
protected in the healthcare setting. These rights include: communication, and ensures a more collaborative approach to
1. Right to information treatment. Here are some prerequisites to build a good doctor–
patient relationship:
Patients have the right to receive accurate and understandable

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information about their medical condition, proposed treat- 1. Good communication skills
ments, risks, benefits, and alternatives. This includes access to Doctors should have excellent communication skills to effec-
their medical records and the right to ask questions and seek tively convey medical information, listen to patients’ concerns,
clarification. and respond empathetically. This involves both verbal and

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2. Right to consent nonverbal communication skills.
Patients have the right to give informed consent before any 2. Empathy and compassion
medical intervention or treatment. Healthcare providers should
Doctors should demonstrate empathy and compassion toward
explain the purpose, potential risks, benefits, and alternatives
nif their patients, showing genuine care and concern for their well-
of the proposed treatment, allowing patients to make autono-
being. This helps patients feel more comfortable, understood,
mous decisions.
and supported during their medical journey.
3. Right to confidentiality
3. Respect and trust
Patients have the right to have their medical information kept
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Building mutual respect and trust is crucial for a strong

confidential. Healthcare providers are obligated to protect
doctor–patient relationship. Doctors should respect patients’
patient privacy and should only disclose patient informa-
autonomy, opinions, and decisions while providing unbiased
tion with the explicit consent of the patient or in exceptional
medical advice. Patients, on the other hand, should trust their
circumstances mandated by law.
doctors’ expertise and follow their guidance.
4. Right to privacy and dignity
4. Active listening
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Patients have the right to be treated with respect, dignity, and

Doctors should actively listen to patients, giving them their full
confidentiality. This includes maintaining privacy during exam-
attention, and allowing them to express their concerns, symp-
inations, procedures, and discussions on their condition.
toms, and experiences without interruption. Active listening
5. Right to access healthcare helps doctors gather accurate information and understand
Patients have the right to timely and equitable access to health- patients’ needs better.
care services, regardless of their gender, age, race, ethnicity,
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5. Time management
socioeconomic status, or any other factor.
Doctors should allocate sufficient time for patient visits,
6. Right to second opinion allowing for thorough discussions, explanations, and addressing
Patients have the right to seek a second opinion from another concerns. Adequate time management shows that doctors
healthcare professional to confirm or explore alternative diag- value their patients’ time and this fosters a more satisfactory
noses or treatment options. This empowers patients to make relationship.
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well-informed decisions about their care.

6. Cultural sensitivity
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7. Right to refuse treatment Doctors should be culturally sensitive and aware of diverse
Patients have the right to refuse any medical treatment or inter- backgrounds, traditions, and beliefs. This understanding helps
vention, even if it is recommended by healthcare providers. them provide personalized care, accommodate cultural prefer-
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This right is especially important when it comes to procedures ences, and avoid potential misunderstandings.
that are not immediately life-threatening.
7. Professionalism and ethical behavior
8. Right to complaint and redress Doctors should maintain professionalism and adhere to ethical
Patients have the right to voice their grievances, file complaints, guidelines. This includes respecting patient confidentiality,
and seek redress if they feel their rights have been violated or providing unbiased care, and avoiding conflicts of interest.

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AETCOM Super-16 Questions

8. Continued education and expertise Q.10. What is written consent? Why is it important
Doctors should stay updated with the latest medical knowledge, in clinical setting?

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research, and treatment options. Continued education ensures
(or Discuss the importance and process of informed
doctors can provide accurate information and comprehensive
care to their patients. written consent.)

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Ans. Obtaining written informed consent from patients is a
Q.9. What is clinical empathy? Explain its impor- crucial ethical and legal requirement in healthcare. It plays a
tance in doctor–patient relationship. vital role in respecting patient autonomy, promoting shared
decision-making, and ensuring patient safety.
(Or Explain the role of empathy in patient care.)

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Ans. Clinical empathy refers to the ability of healthcare profes- Importance of written informed consent
sionals to understand and share the emotions and experiences
of their patients. It goes beyond sympathy or pity, as it involves 1. Respecting patient autonomy

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truly putting oneself in the patient’s shoes, understanding the Informed consent respects a patient’s right to make decisions
perspective of the patient, and responding with compassion and about his or her own healthcare. It empowers patients to
understanding. Clinical empathy is very important because: actively participate in their treatment plans, understand the
risks and benefits, and make informed choices based on their
1. It builds trust and rapport values and preferences.

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When healthcare providers demonstrate empathy, patients feel
2. Enhancing shared decision-making
more comfortable, validated, and supported. It establishes a
trusting relationship, which aids in open and honest communi- The process of obtaining informed consent involves a mean-
ingful dialogue between healthcare providers and patients. It

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cation, leading to more accurate diagnoses, informed decision-
making, and better treatment outcomes. facilitates discussions about treatment options, risks, benefits,
and alternatives, enabling patients to actively engage in the
2. It enhances patient satisfaction decision-making process.
Patients who perceive their healthcare providers as empathetic
3. Protecting patient rights
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are more likely to report higher levels of satisfaction with their
overall care. Empathy makes patients feel valued and heard, Written informed consent acts as a legal document that protects
which contributes to their sense of well-being and increases patients’ rights and serves as evidence that they have been
adequately informed about their healthcare choices. It protects
patient satisfaction.
both patients and healthcare providers by ensuring account-
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3. It improves patient outcomes ability and transparency in the provision of care.

Studies have shown that empathetic healthcare providers posi- 4. Improving patient safety
tively impact patient outcomes. Patients who feel understood
Prioritizing informed consent helps mitigate potential risks and
and cared for by their providers are more likely to adhere to
complications associated with medical procedures or treat-
treatment plans, follow medical advice, and actively participate
ments. By ensuring that patients are fully aware of the potential
in their own healthcare.
risks, benefits, and alternatives, the decision-making process
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4. It provides psychological and emotional support can be more informed and reduce the potential for adverse
outcomes.
Clinical empathy acknowledges the emotional and psycholog-
ical impact of illness on patients. It helps healthcare providers Process of Obtaining Written Informed Consent
recognize and address patients’ emotional distress, fears, and
anxieties. This support can significantly improve patients’ well- 1. Providing vital information
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being and quality of life. Healthcare providers must provide patients with clear, accu-
5. It promotes shared decision-making rate, and understandable information about their diagnosis,
proposed treatment, potential risks and benefits, alternatives,
Empathy plays a crucial role in shared decision-making, where
and the consequences of not proceeding with the treatment.
patients and healthcare providers collaboratively discuss treat-
The information should be tailored to the patient’s specific
ment options, risks, benefits, and personal preferences. When
needs and delivered in a manner the patient can comprehend.
healthcare providers understand and validate their patients’
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perspectives, it allows for a more patient-centered approach to 2. Patient understanding

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healthcare decisions. It is essential to assess and ensure that patients have under-
stood the information provided. Clear communication, using
6. It reduces healthcare disparities
layman’s terms, visual aids, or interpreters, if necessary, can
An empathetic approach is essential in providing cultur- assist in facilitating understanding.
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ally sensitive care, acknowledging the unique experiences

and needs of diverse patients. Understanding and respecting 3. Answering questions
patients’ cultural backgrounds and beliefs reduce healthcare Patients should be given ample opportunity to ask questions
disparities and improve health equity. related to their healthcare options. Healthcare providers must

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AETCOM Super-16 Questions

address all concerns and provide satisfactory responses to help differential and to ensure it is not exploited or abused.
patients make informed decisions. Physicians should aim to foster a collaborative and egalitarian
approach, enabling patients to actively participate in their

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4. Voluntary consent healthcare decision-making process.
The patient’s consent must be completely voluntary, without

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any coercion or undue influence from healthcare providers or 6. Personal space and touch
external factors. Patients should feel free to accept or decline Physicians should be mindful of personal space and appropriate
a treatment option without fear of judgment or consequences. physical contact with their patients. Touch should be limited
to necessary procedures or examinations, and consent should
5. Documentation always be obtained before initiating any physical contact.

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Once patients have been adequately informed and have given
consent, the process should be documented in writing. This 7. Financial implications
typically involves a consent form signed by the patient or an Physicians should be transparent about the financial implica-
authorized representative, indicating that they understand the tions of treatments or interventions and should not exploit a

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information provided and agree to the proposed treatment. patient’s vulnerability or financial situation for personal gain.

6. Ongoing consent 8. Recognize personal limitations

Informed consent is not a one-time event. It may need to be Physicians should be aware of their own limitations and seek
appropriate consultation or referral when necessary. It is essen-

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revisited and reestablished if there are changes to the treat-
ment plan or new information becomes available. Healthcare tial to acknowledge when a patient’s needs or circumstances
providers should continuously engage in open communication fall outside of one’s area of expertise and involve other health-
to ensure patients remain informed and involved in their care. care professionals as required.

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Q.11. Discuss boundaries in the doctor–patient AETCOM 1.4 Foundations of communication—I
relationship.
Ans. Establishing clear and appropriate boundaries in the Q.12. Define communication with regards to
nif
doctor–patient relationship is essential for maintaining profes- healthcare setup. Enlist the various types of
sionalism, trust, and respect. The various boundaries that need
communication encountered in a hospital setting.
to be drawn between doctors and their patients pertain to the
following aspects: Ans. Healthcare communication refers to the process of
exchanging information between healthcare providers, patients,
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1. Professionalism and other stakeholders involved in the delivery of healthcare

Healthcare professionals should maintain a professional services. It involves both verbal and nonverbal communica-
demeanor at all times when interacting with patients. This tion methods, such as spoken and written language, as well as
includes maintaining appropriate physical and emotional gestures, body language, and technology-assisted communica-
boundaries and refraining from engaging in any behavior that tion. Effective healthcare communication is crucial in ensuring
could be perceived as crossing those boundaries. high-quality patient care, promoting patient safety, and estab-
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lishing trust and rapport between healthcare providers and

2. Confidentiality patients.
Physicians have a duty to protect patient confidentiality and
must maintain utmost discretion regarding patient informa- Types of healthcare communication
tion. Sharing patient information without proper consent or a
justifiable legal reason is a breach of trust and privacy. 1. Patient education
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Healthcare communication involves providing patients with

3. Clear communication clear and understandable information about their medical
Effective communication is the foundation of a healthy doctor– conditions, treatment options, and medication instructions.
patient relationship. Physicians should strive to communicate This allows patients to make informed decisions about their
clearly, honestly, and in a respectful manner, ensuring patients healthcare and actively participate in their treatment.
have a comprehensive understanding of their medical condi-
tion, treatment options, and any associated risks or benefits. 2. Interprofessional collaboration
:

Effective communication is essential for facilitating collabora-

4. Personal relationships
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tion and coordination among different healthcare professionals,

Physicians should avoid dual relationships with their patients such as physicians, nurses, pharmacists, and therapists. Clear
that could compromise the objectivity, trust, or confidentiality communication helps ensure that all team members are aligned
of the relationship. This includes refraining from engaging in on treatment plans, patient goals, and any necessary adjust-
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personal or social relationships with current patients, as it can ments in care.

blur boundaries and lead to conflicts of interest.
3. Informed consent
5. Power dynamics Healthcare communication includes obtaining informed
Doctors possess expert knowledge and authority within the consent from patients before any medical procedures or
healthcare setting. It is crucial to be mindful of this power treatments. This involves providing patients with detailed

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AETCOM Super-16 Questions

information about the intervention, potential risks and bene- 4. Misinterpretation and misunderstanding
fits, alternatives, and allowing them to ask questions or express Patients and doctors may interpret information differently due
concerns.

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to various factors, including cultural, language, or educational
differences. Misunderstanding can lead to incorrect diagnosis,
4. Patient safety
treatment, or patient compliance.

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Clear and accurate communication is vital in preventing
medical errors and adverse events. Healthcare providers must 5. Lack of empathy
exchange information about patient’s conditions, medications, Doctors may unintentionally appear detached or show a lack
allergies, and relevant medical history to ensure safe and coor- of empathy toward patients’ emotions and concerns. This can
dinated care. negatively impact the doctor–patient relationship and patient

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satisfaction.
5. Emotional support
Effective healthcare communication involves showing empathy, 6. Nonverbal communication
compassion, and providing emotional support to patients and

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Nonverbal cues, including body language, facial expressions,
their families during challenging times. This includes active and tone of voice, can significantly affect communication.
listening, responding sensitively to patient concerns, and Misinterpretation or mixed signals can lead to misunderstand-
acknowledging their emotions. ings or decreased patient trust.
6. Cultural sensitivity 7. Incomplete or inadequate explanation

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Communication in healthcare must be culturally sensitive, Doctors may provide insufficient or incomplete explanations
considering the diverse backgrounds and beliefs of patients. about diagnoses, treatment options, or risks, leaving patients
Healthcare providers should be mindful of cultural prac- feeling uncertain or confused.

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tices, religious beliefs, and language barriers that may impact
communication and adapt their approach accordingly. 8. Cultural insensitivity
Healthcare professionals may overlook or not fully appreciate
7. Health promotion cultural differences, leading to misunderstandings, miscommu-
Healthcare communication is also aimed at promoting health nication, and ultimately, compromised patient care.
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and preventing diseases. It involves educating patients on
healthy lifestyle choices, disease prevention strategies, and the 9. Language barriers
importance of regular screenings and vaccinations. Language barriers between doctors and patients who speak
different languages can impede effective communication,
8. Telemedicine and technology affecting the accuracy of medical histories, diagnoses, and
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With the growth of telemedicine and digital health, effective treatment plans.
communication also extends to technology-assisted platforms.
Providers must adapt their communication skills to virtual 10. Bias and stereotyping
interactions, ensuring clear documentation, and maintaining Both conscious and unconscious biases can impact doctor–
patient privacy and confidentiality. patient communication, leading to unequal treatment, compro-
mised trust, and patient dissatisfaction.
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Q.13. Mention the various errors in a doctor–

patient communication. Q.14. Explain the various barriers encountered that
can affect communication in a healthcare setup.
Ans. Several communication errors can occur during doctor–
patient communication. It is important to identify them to Ans. There are several barriers that can affect healthcare
improve the quality of healthcare communication and patient communication. These barriers can arise from various factors
outcomes. Here are some common errors: and can hinder the effective exchange of information between
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healthcare providers and patients. It is essential for healthcare

1. Lack of active listening providers to be aware of these barriers and make efforts to
Healthcare providers may fail to actively listen to patients, overcome them. The various barriers are:
interrupting or not fully attending to their concerns or ques-
tions. This can result in incomplete or inaccurate understanding 1. Language and cultural differences
of the patient’s condition or needs. Language barriers can make communication difficult in health-
:

care settings, especially when patients and healthcare providers

2. Information overload
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do not speak the same language fluently. Additionally, differ-

Doctors sometimes overwhelm patients with complex medical ences in cultural backgrounds, beliefs, and practices can affect
jargon or a large amount of information, making it difficult for understanding and create miscommunication.
patients to comprehend and retain important details about
2. Health literacy
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their condition or treatment.

Limited health literacy refers to an individual’s ability to under-
3. Limited time stand and use health-related information effectively. Low
Time constraints during appointments may lead to rushed and health literacy makes it challenging for patients to comprehend
abbreviated conversations, leaving patients feeling unheard healthcare information, follow instructions, and actively partic-
and impacting the thoroughness of communication. ipate in their own care.

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AETCOM Super-16 Questions

3. Emotional barriers 1. Building a relationship

Patients may experience fear, anxiety, or stress when discussing Establishing a rapport and trust with the patient is crucial

5
their health issues, which can hinder effective communication. for effective communication. This involves demonstrating
Similarly, doctors may have their own emotional barriers that empathy, respect, and creating an environment where the
can affect their ability to listen empathetically or provide clear patient feels comfortable sharing their concerns and asking

02
information. questions.
4. Time constraints 2. Understanding the patient’s perspective
Limited time during healthcare appointments can create a Gaining insight into the patient’s unique experiences, beliefs,
barrier to effective communication. Healthcare providers may values, and preferences is essential for delivering patient-

/2
feel rushed, leading to incomplete explanations or inadequate centered care. Healthcare providers need to show genuine
patient education. Likewise, patients may not feel comfortable interest in understanding the patient’s perspective and actively
discussing all of their concerns or asking necessary questions listen to the concerns and expectations of the patient.

03
due to the time pressure.
3. Sharing information
5. Power dynamics
Clear and accurate information exchange is vital. Healthcare
The inherent power imbalance in the doctor–patient relation- providers should provide relevant information about the
ship can inhibit open and honest communication. Patients patient’s condition, diagnosis, treatment options, and prog-

5/
may feel intimidated or afraid to ask questions or express their nosis. They should also ensure the information is delivered in
concerns, while healthcare providers may unintentionally a manner that patients can understand and encourage them to
dominate the conversation. ask questions for clarification.

,1
6. Technical jargon 4. Eliciting the patient’s perspective
The use of complex medical terminology or technical jargon by Healthcare providers need to actively seek input from patients
healthcare providers can confuse and intimidate patients. This regarding their concerns, expectations, and goals. Open-ended
can result in a lack of understanding of diagnoses, treatment questions can help elicit patients’ perspective and encourage
options, and instructions.
nif
them to express their thoughts and feelings.
7. Lack of trust 5. Reaching a mutual understanding
Trust is fundamental in healthcare communication. Patients Achieving a shared understanding between the healthcare
need to trust their healthcare providers to share accurate infor-
provider and the patient is important. It involves clarifying any
Ha

mation and make informed decisions. Any breaches of trust,

misconceptions, confirming understanding, and ensuring that
previous negative experiences, or lack of empathy can also
both parties are on the same page regarding the patient’s health
hinder effective communication.
and treatment.
8. Physical barriers
6. Making decisions
Physical barriers, such as noisy environments or lack of privacy,
Collaborative decision-making is a key element of patient-
can make communication difficult. These barriers can affect
centered care. Healthcare providers should involve patients
rim

a patient’s ability to hear and understand information or feel

in the decision-making process, presenting treatment options,
comfortable discussing personal and sensitive issues.
benefits, risks, and potential outcomes while considering the
9. Technology-related barriers patient’s values and preferences.
The increasing use of technology in healthcare, such as elec- 7. Supporting self-management
tronic health records or telemedicine, can create communi-
Empowering patients to actively participate in their own care
Sa

cation challenges. Technical issues, lack of familiarity with

technology, or limited access to digital platforms can impact is essential. Healthcare providers should provide education,
effective communication. resources, and support to help patients manage their health and
make informed decisions.
10. Bias and discrimination
8. Managing emotions
Preexisting biases, stereotypes, or discrimination can nega-
tively impact healthcare communication. This can lead to Emotions play a significant role in healthcare communication.
:

unequal treatment, diminished trust, and reluctance to disclose Healthcare providers should be aware of and sensitive to the
er

critical information. emotional needs of patients and their families. They should
provide support, empathy, and reassurance throughout the
Q.15. Discuss the various elements of Kalamazoo healthcare journey.
Consensus Statement. 9. Enabling patient and family support
Us

Ans. Kalamazoo Consensus Statement aims to define and Recognizing the role of family and support networks is impor-
enhance effective communication in healthcare. The statement tant in healthcare communication. Understanding and involving
outlines the following 10 essential elements of communication the patient’s family or designated support person can enhance
that contribute to successful patient-centered care: communication, decision-making, and overall patient care.

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AETCOM Super-16 Questions

10. Continuity and coordination 3. Agree

Effective communication should be continuous and coordinated The healthcare provider collaborates with the patient to set

5
across various healthcare settings and providers. It includes realistic goals and develop a mutually agreed-upon plan for
clear handoffs, timely sharing of information, and collaboration behavior change. This step involves engaging the patient in a
to ensure seamless, patient-centered care. discussion and taking the patient’s preferences and values into

02
account. The patient’s preferences and objectives are consid-
Q.16. What are the 5 A’s of behavior change model ered essential to instill a sense of motivation for change.
of doctor–patient relationship? 4. Assist
Ans. The 5 A model recognizes the importance of a patient- The healthcare provider supports and assists the patient in

/2
centered approach so as to improve doctor–patient relation- making the desired behavior change. This may involve providing
ship. The 5 A’s stand for Assess, Advise, Agree, Assist, and resources, educational materials, practical strategies, or refer-
Arrange. Here is a brief explanation of each component: rals to other healthcare professionals or support services. The

03
provider may also help the patient identify potential barriers
1. Assess
and develop coping mechanisms.
The healthcare provider assesses the patient’s current health
status, behavior, and readiness to change. This involves gath- 5. Arrange
ering relevant information, such as medical history, lifestyle The healthcare provider ensures appropriate follow-up and

5/
habits, and any specific challenges or barriers the patient may ongoing support to facilitate sustained behavior change. This
be facing. step involves scheduling follow-up appointments, monitoring
progress, and providing continued guidance, encouragement,
2. Advise
and reinforcement. The provider helps the patient navigate any

,1
The healthcare provider provides personalized advice and challenges, adjust the plan as needed, and maintain motivation
information to patients about the specific behavior they need to toward the goals.
change. This advice is based on the patient’s individual context
and the health issue at hand. The provider may explain the
potential risks of the behavior and the benefits of change.
nif
Ha
rim
: Sa
er
Us

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 Medical Student FAQs

5
02
Q.1. How do I remember information easily and for Remember, while rote memorization may be necessary
for certain aspects of medicine, understanding and critical
longer periods?
thinking are equally important. Focus on understanding
concepts rather than solely relying on memorization.

/2
Ans.

1. Use mnemonic devices: Mnemonics are memory aids that

help you remember complex information by associating it with Q.2. How can I score better in exams?

03
something more easily retrievable. Create acronyms, rhymes, or Ans.
visual images that represent key facts or concepts.
1. Understand the exam format: Familiarize yourself with
2. Make use of flashcards: Create flashcards for key terms, defi- the structure and requirements of the exam. Know the type of
nitions, or important details. Write the question or concept on questions (multiple choice, short answer, essay) that will be

5/
one side and the answer on the other. Regularly review these asked and allocate your study time accordingly.
flashcards to reinforce your memory.
2. Review course materials regularly: Instead of waiting until
3. Repetition and spaced practice: Review and repeat informa- the last minute, consistently review and revise your class notes,

,1
tion regularly to reinforce your memory. Instead of cramming textbooks, and supplementary materials throughout the course.
all at once, space out your study sessions to retain informa- Regular revision helps reinforce your understanding and reten-
tion more effectively. Review material at regular intervals, tion of the content.
increasing the time between each review.
3. Organize your study time: Create a study schedule that
4. Active recall: Instead of simply re-reading notes or textbooks,
nif
allows adequate time for each subject or topic. Break down your
actively recall information without looking at your materials. study sessions into smaller, manageable chunks, and allocate
Test yourself by trying to remember key facts, diagnoses, or time for both reviewing and practicing exam-style questions.
treatment options. This process strengthens your memory and
highlights areas where you need to focus more. 4. Seek clarification: If you have any doubts or confu-
Ha

sion about specific topics, don’t hesitate to reach out to your

5. Use visualization techniques: Create a mental image or professors, teaching assistants, or classmates for clarification.
visual representation of the information you need to memorize. Understanding the concepts thoroughly will help you tackle
The more vivid and detailed the image, the better it will help related questions in exams more effectively.
you recall information.
5. Practice previous exam papers: Familiarize yourself with
6. Teach someone else: Explaining a concept or teaching the exam format by practicing previous papers or sample ques-
rim

someone else helps reinforce your understanding and memory tions. This will help you understand the style of questions asked
of the material. Study in groups and take turns teaching each and get an idea of the time management required during the
other or try to explain complex topics to a friend or family actual exam.
member.
6. Focus on key concepts: Identify the core concepts and prin-
7. Break information into manageable chunks: Divide ciples within each subject that are most likely to be tested. Pay
large amounts of information into smaller, more manageable extra attention to these areas and ensure you have a strong
Sa

sections or categories. This makes it easier to memorize and understanding of them.

recall the material.
7. Practice active learning techniques: Instead of passively
8. Practice active learning: Engage in active learning strategies reading or listening, engage in active learning strategies such
that involve writing, drawing, and problem-solving. Summarize as summarizing, explaining concepts to others, creating mind
concepts in your own words, create concept maps, or solve maps, or teaching the material to a study partner. These tech-
:

practice questions that require applying knowledge. niques enhance understanding and memory retention.
er

9. Use mnemonic tools like the method of loci: Create a 8. Develop effective note-taking methods: Develop a note-
mental map of a familiar place (e.g., your house) and associate taking system that works best for you, such as using headings,
specific information with various locations in that place. As you bullet points, diagrams, and highlighting key information. This
mentally walk through the locations, you can recall the associ- will make it easier to review and recall information during
Us

ated information. exams.

10. Stay focused and avoid distractions: Minimize distractions 9. Time management during exams: Read all the questions
during your study sessions to enhance concentration and reten- carefully before starting and allocate time for each question
tion. Find a quiet, well-lit space, turn off notifications on your based on its weightage. Answer questions that you are confi-
devices, and practice mindful studying. dent about first, and then move on to more challenging ones.

11
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Medical Student FAQs

Make sure to leave time for reviewing your answers before 1. Preparation: Ensure you are well-prepared for the exam by
submitting. studying and reviewing the material thoroughly. Being confi-
dent in your knowledge and understanding can help reduce

5
10. Take care of yourself: Prioritize self-care and well-being anxiety.
to optimize your focus and concentration during exams. Get

02
enough sleep, maintain a balanced diet, exercise regularly, and 2. Time management: Start studying early and avoid last-
take short breaks during study sessions to avoid burnout. minute cramming. Effective time management can alleviate
stress and give you a sense of control.
Remember, scoring well in theory exams is not just about
memorizing facts, but also about demonstrating your 3. Practice relaxation techniques: Deep breathing exercises,

/2
understanding of the subject matter. Invest time in building meditation, or progressive muscle relaxation can help calm
a strong foundation of knowledge, practicing critical your nerves before and during the exam. You can find guided
thinking, and developing effective exam strategies. meditation or relaxation apps/videos online to assist you.

03
4. Positive self-talk: Replace negative thoughts with positive
Q.3. What is the best way to attempt theory paper? affirmations. Remind yourself of your capabilities and focus on
your past successes.
Ans. There are several strategies you can employ to attempt a
theory paper more effectively: 5. Visualize success: Create a mental image of yourself
performing well in the exam. Visualizing success can help boost

5/
1. Read all the instructions carefully and thoroughly. your confidence and alleviate anxiety.
2. It is always better to attempt answers in serial order. 6. Breaks and self-care: Take regular breaks during study

,1
3. Try to complete answer at one place only instead of breaking sessions to rest and recharge. Prioritize self-care by engaging in
activities you enjoy, such as exercise, hobbies, or spending time
it into several parts spread across different pages in an answer
with loved ones.
sheet.
7. Avoid unhealthy coping mechanisms: Avoid excessive
4. Highlight key points with highlighter or by underlining.
caffeine intake, as it can increase anxiety. Additionally, try to
nif
5. Avoid cutting and overwriting as much as possible. steer clear of procrastination, and instead, develop a consistent
study routine.
6. Draw more diagrams and flowcharts instead of writing long
paragraphs. 8. Seek support: Talk to someone you trust, such as a friend,
Ha

family member, or teacher, about your anxiety. They may be

7. Once you have completed your paper, proofread it carefully able to offer guidance, reassurance, or helpful study tips.
for errors in grammar, punctuation, and spelling.
9. Stay positive: Remember that exam performance does not
8. Avoid making appeals to the examiner in the answer sheet. define your worth or intelligence. Focus on doing your best
rather than seeking perfection.
Q.4. I become very nervous during exams. What to
If your nervousness significantly affects your everyday life
do?
rim

or becomes overwhelming, consider seeking professional

Ans. Here are some strategies you can try to help manage nerv- support from a counselor or therapist who can provide
ousness during exams: additional coping strategies and guidance.
: Sa
er
Us

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Trivia

Trivia

5
02
Blood and Immunity • In India the most prevalent blood type is B+ while AB− is
the rarest. In a lighter vein, it has been said that Indians
• Jaggery, which is also known as “Gur” in local parlance, is are mostly hard-wired to be optimistic (Be-positive!). It
made from slow heating of sugarcane juice in an open iron has been reported that almost 100% of Chinese population

/2
vessel. It is intriguing to note that sugarcane juice has very is Rh+!
low iron content but its product jaggery is rich in iron; this • Antigen is actually an acronym for Anti(body) Gen(erator).
is because the iron from the cooking vessel reacts and mixes The term originated during old times when it was thought

03
with the jaggery during the heating process. that only antigens were capable of triggering an immune
• Thalassemia derived its name from the Greek word thalassa attack in the form of antibody formation, since at that time
which means “sea,” because it was first discovered in islands T cell mediated immunity was unknown. However, now
around the Mediterranean Sea. β Thalassemia is a common it is known that antibody formation is not the only way of
immune response and that T cells are also involved. But still

5/
blood disorder in India. Punjab has maximum number of
cases affected with this disorder. the term has been retained due to its popularity and wide-
spread usage!
• HbD Punjab: It is so named because of its higher prevalence
among Indo-Pakistani Punjabi population. Hemoglobin

,1
Nerve Muscle Physiology
D-Punjab was first discovered in the early 1950s in a mixed
British and American family of Indian origin from the Los • There are around 300,000 vesicles in one neuronal termi-
Angeles area; hence, it is also sometimes called “D Los nal and each vesicle contains around 10,000 molecules of
Angeles.” However, it was later also found in Italy, Turkey, neurotransmitter.
nif
Austria, etc. It developed as a response to the selective pres- • Each myofibril contains around 1500 myosin and 3000
sures of malaria in these regions. actin filaments.
• The two-pathway model of blood coagulation was given • Di-isopropyl-fluoro-phosphate (an irreversible acetylcho-
by Dr MacFarlene in 1964. linesterase inhibitor) is a nerve gas poison that was used
Ha

• Clotting factor numeral VI is currently blank (unassigned). by Syrian government, Germans (Nazis), and terrorists for
However, it was previously known as ACCELERIN. But it was biological warfare. This agent can inactivate the enzyme
later discovered that accelerin is not an independent clot- for up to several weeks, following which there is strong,
ting factor but actually the activated form of factor V, i.e., uninterrupted Ach action leading to painful muscle spasms
proaccelerin. Hence, its separate nomenclature was abol- (especially in laryngeal muscles) which frequently results in
ished and numeral VI was left unassigned to avoid change in death due to asphyxia.
rim

nomenclature of other factors! • Titin: largest protein.

• Clotting factors IX, X, and XI are named after the patients
in which they were discovered, i.e., IX→ Mr Stephen Cardiovascular System
Christmas; X→ Mr Rufus Stuart (American) and Ms Audrey
• SA node is “Pacemaker of heart” because it generates car-
Prower (British); XI→ John Hageman. diac impulse while AV node is also known as “Gatekeeper
Sa

• Platelet phospholipid, Fletcher factor, and Fitzgerald of heart” as it regulates the number of impulses going from
factor were kept out of numerological classification since atria to ventricles!
they were discovered quite later than the other factors and • ECG in Heart Blocks Poem
by that time it had already been decided by the International
When R is away from P, patient has FIRST DEGREE;
Committee on Thrombosis & Hemostasis (ICTH) that the If PR interval keeps prolonging and “drops” attack, patient
total number of numerals will be restricted to XIII only. will get WENCKEBACH;
:

• Hemophilia is also known as ROYAL DISEASE since the If some P’s don’t pass through, you can say it’s MOBITZ II;
er

members of royal families suffered from it, i.e., heirs of And when P’s & Qs “Don’t agree,” it surely is THIRD DEGREE!
Queen Victoria of England and Czar Nicholas II of Russia. • Nucleus ambiguus is so named because it lacks a distinct
• Rh: The term “Rh” was originally an abbreviation of “Rhesus anatomical margin and is thus difficult to be identified in the
factor.” It was discovered by Karl Landsteiner and Alexander medullary sections (Ambiguous = Unclear).
Us

S. Wiener who believed it to be similar to an antigen found • Origin of the term essential hypertension (HTN): In the
in rhesus monkey RBCs. It was subsequently found that past, physicians would evaluate HTN patients for some
human antigen is different from rhesus monkey antigen, but secondary (systemic) cause. All those patients in whom no
the term was retained. known cause could be isolated were labelled as “essentially

13
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Trivia

normal” to indicate absence of secondary cause for HTN. This

Neurophysiology
term over a period of time got modified to essential HTN.

5
• Fainting is frequently reported in medical students stand- • Anandamide, an endocannabinoid neurotransmitter
ing for prolonged hours in operation theater during observa- involved in supraspinal analgesia, derives its name from
tion of surgeries. This is thought to be due to a combination Sanskrit word “Anand,” which means Pleasure.

02
of vasovagal and orthostatic (due to prolonged standing) • Two-point discrimination is the basis of Braille script. It
causes. is well known that blind people “read” by using a special
• Choosing PQRST alphabets for naming ECG waves: Initial script known as “braille.” Braille is a tactile writing system in
ECG tracings consisted of two waves that were named A and which each of the characters of the alphabet of any language

/2
B; later some more waves were also recorded. Ultimately is assigned a pattern of raised bumps/dots that are embossed
Einthoven decided to choose PQRST (middle alphabets) due on a special paper. The visually impaired reader feels these
to two reasons: patterns with the fingertips and thus decodes what has been
written, thus enabling him/her to read. This technique is

03
– To avoid confusion of corrected ECG tracings from ini-
based on the ability of the human brain to detect two-point
tial, uncorrected tracings (in which alphabets A, B, and
discrimination, which is highly precise at fingertips due to
C were used).
high density of tactile receptors in this part. Braille was cre-
– To create a provision for assigning additional alphabets ated circa 1824 by a French scientist Louis Braille, who had

5/
to newer ECG waves (before P and after T) that might be lost his vision at the age of 15 due to a childhood accident.
discovered in future, e.g., U wave.
• H-reflex was the first medical experiment to be done on
the International Space Station (ISS). It was noted that after
Respiration about 5 days in space, the H-reflex of astronauts diminished

,1
• Oxygen consumption of the whole body is 250 mL/min. The significantly. It was assumed to be due to marked reduction
order of O2 consumption of various body organs is liver (51 in spinal cord motor neuronal excitability in the absence of
mL/min) > skeletal muscle (50 mL/min) > brain (46 mL/min) gravitational forces. Once the astronauts returned to Earth,
> heart (30 mL/min) > kidneys (18 mL/min). it took up to 10 days for H-reflex to become normal.
nif
• J Receptors were discovered by an Indian scientist Dr Autar • It was actually the observation of Jacksonian seizure that
Singh Paintal who went on to become the first Indian to be led the scientists to explore the possibility of existence of an
elected as Fellow of the Royal Society, London. orderly representation of the whole body within the motor
cortex, an idea that later gave birth to the concept of motor
• Head’s paradoxical response: Henry Head interrupted his
homonculus!
Ha

medical studies to do research with Dr. Ewald Hering (dis-

coverer of Hering-Breur reflexes). Head’s reflex response • The Ice Bucket Challenge, sometimes called the ALS
was paradoxical to findings of Dr Hering, hence the name. (Amyotrophic Lateral Sclerosis) is an activity involving the
dumping of a bucket of ice and water over a person’s head,
• Iron lungs: At the peak of polio outbreaks of the 1940s and
either by his/her own self or by someone else. In 2014, many
1950s, rows of iron lungs filled hospital wards, helping chil-
videos of this challenge went viral on social media to raise
dren, and some adults, with bulbar polio and bulbospinal
awareness about ALS and to raise funds for ALS foundation.
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polio. A polio patient with a paralyzed diaphragm would

typically spend 2 weeks inside an iron lung while recover- • Syndeham’s chorea is also known as “St Vitus dance.” This
ing. These have now largely been replaced by mechanical is in reference to Saint Vitus, a Christian saint who was exe-
ventilators. cuted by Roman emperors in AD 303. He is considered as a
patron saint of dancers, with the eponym given as a homage
• Folklore behind Ondine’s curse phenomenon: As per a
to the maniac dancing that used to take place in olden times
German folktale, Ondine was a young and beautiful water
Sa

in front of his statue during the feast of Saint Vitus.

nymph who lived in a forest. There was a man named
Polemon who loved a princess named Bertha. Once Polemon • Discovery of muramyl peptide—the sleep toxin: In the
saw Ondine and immediately fell in love and soon proposed early 20th century, French psychologist Henri Piéron
marriage to her, to which she agreed. However, when the hypothesized that prolonged wakefulness causes the build-
king of water nymphs got to know about Ondine’s marriage, up of a “sleep toxin” that is subsequently broken down
he told her that Ondine would lose her youth and beauty during sleep. To test his hypothesis, Piéron walked dogs
:

soon after marriage with a mortal human. But Ondine did through Paris at night to prevent them from sleeping. He
then injected their cerebrospinal fluid into the brains of
er

not change her mind. On their wedding day, Polemon made

a vow to his wife Ondine that “his every waking breath other dogs. He found that these other dogs then slept longer
would be his testimony of his love [for Ondine].” However, and more deeply than usual.
gradually Ondine became old and ugly and one day Polemon • Pavlov’s classical conditioning experiments: It all began
Us

left her and went back to his first love Princess Bertha. This when Dr Pavlov was studying digestion in dogs. He had
made Ondine very angry, and she cursed him that since developed a procedure whereby he could collect saliva
she had accepted his wedding pledge, hence from now on of dogs in an external measurable container in response
“he would live as long as he would remember to breathe, to feeding through a tube whose one end was inserted in
and that every breath would remind him of her! Should he the dogs’ mouth and other end was dipped in the jar. Dr
forget to breathe (or sleep), he would die!” Pavlov noticed that in addition to ↑ salivation in response to
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Trivia

feeding, the dogs also started drooling when they heard the for Facebook because of his medical condition. He said, “Blue
footsteps of his assistants who gave food to dogs and when is the richest color for me! I can see all of blue!” Some other
they (dogs) saw white lab coats which his assistants used to personalities with red-green color blindness are Mr Bill

5
wear. This made him wonder why dogs were showing this Clinton (Ex-US president) and John Dalton (Scientist). In fact,
unusual behavior and decided to study it in more detail. That color blindness is also called Daltonism!

02
is what led him to conduct the famous conditioning experi- • Tetrachromacy: It is a rare condition in which there are four
ments on dogs! cone systems instead of the normal three. These people can
• It has been estimated that the storage capacity of human see 10 times more colors than normal people. This condition
brain is around 2.5 petabytes!!! (i.e., one million gigabytes). is unique as it affects only females!

/2
• There was one person by the name of Steven Wiltshire • Stapes is the smallest bone in human body.
who is known as human camera for his amazing memory. • Ventriloquism: Many of us are probably aware about this
When he was 11, he drew a perfect arial view of London special ability of some entertainers who can make inanimate
after taking a single helicopter ride!

03
objects (like dolls, puppets etc.) talk. This act of “throwing
• Anterograde amnesia has been a subject theme of many one’s voice” or making it appear as if voice is coming from
movies such as 50 First Dates, Memento, and Ghajini. somewhere else is called ventriloquism. The ventriloquist
• Hygrosensation: It refers to the “feeling of water” touching fools the audience into thinking that he or she is quiet, and
skin. No receptor has been found. it is actually the dummy that is talking. This is because the

5/
artist learns to create sounds with lips closed while synchro-
• Stressed is Desserts spelt backwards: No wonder people nizing the body and lip movements of the dummies to the
tend to have more sweet cravings when stressed. words being spoken. Thus, a trained ventriloquist can trick

,1
• Feeding center is rage center and satiety center is calmness the sound localization ability of the audience’s brains.
center. People tend to get enraged when extremely hungry. • A nose perfumer is a chemist with an extremely keen
• Vibration sense is the first to be lost in neuropathy. sense of smell and is employed by perfumeries all over the
world to create new fragrances. These professionals’ smell
Special Senses sensitivity is innate and cannot be learned. They can repro-
nif
duce, blend, recall, and differentiate between various natu-
• Logic behind choosing the color scheme of traffic lights ral floral, spicy, and/or woody aromatic chemicals and can
– Red color is universally recognized as the color to denote create new and exclusive fragrances based on their artistic
danger. This is because it has the longest wavelength. imagination!
Ha

Thus, it can be viewed from a considerable distance • Taste areas do not exist on tongue. All kinds of tastes can be
away. Hence, it was considered apt for signaling STOP. appreciated on all parts of tongue.
– Yellow/Orange color is next to red in terms of wave-
length and can also be spotted from some distance away. Gastrointestinal System and Nutrition
Thus, it is a color to signal “CAUTION/WAIT.” This is also
the reason why school buses are painted yellow/orange • Pepsin and Pepsi-Cola: The famous carbonated cola drink
or even the tape used by police to secure a crime area. Pepsi was initially sold in pharmacies as a fountain drink
rim

that was delicious (due to cola flavor) and also aided in

– Green color is the next in wavelength to yellow and digestion (due to presence of pepsin enzyme). In fact, the
orange. Also, the word GO is easily associated with green. presence of pepsin and cola nuts in the recipe earned this
• Animals with supernatural vision: Nature has imparted beverage the name Pepsi-Cola. However, as its popularity
certain animals with the supernatural ability to detect even soared, the company gradually modified the original for-
those electromagnetic radiations which we humans cannot mula and removed pepsin, but retained the cola flavor.
Sa

detect. For example, butterflies and bees can detect ultravio- • It has been estimated that the inner surface area of a
let light, while certain varieties of snakes (python, viper, rat- mucosal cylinder, the size of small intestine, would be
tlesnake), fishes (salmon, goldfish, and piranha), and frogs around 3300 cm2. The valvulae would increase it to 10,000
(bullfrogs) can detect infrared rays! cm2, the villi would further increase it to 100,000 cm2, and
• About 99% of the color blind people have red-green color the microvilli would enhance this number to up to 2 million
blindness, the variant being deuteranomaly. cm2!
:

• To help color blind people to recognize traffic lights, in some • The term vitamin was derived from “vitamine,” a compound
er

western countries the traffic light colors have different word coined by the Polish biochemist Casimir Funk in 1912
shapes, e.g., in Canada, the traffic lights are designed such from vital and amine, meaning amine of life, because he
that red color is square shaped, yellow is diamond shaped, isolated a complex of micronutrients essential to life, all of
Us

and green is circle shaped. In Britain, there is a slightly dif- which he presumed to be amines. This was true of thiamine,
ferent set of colors to denote traffic light symbols, e.g., “Stop” but after it was found that other such micronutrients were
is blood red (instead of mild red), “Wait” is yellow (instead not amines, the word was shortened to vitamin in English.
of orange), and “Go” is blue (instead of green). • All vitamins were discovered (identified) between 1913
• Mark Zuckerburg, the CEO of Facebook, has red-green color and 1948. Before 1935, the only source of vitamins was from
blindness. He admitted to choosing blue as his theme color food. If intake of vitamins was lacking, the result was vitamin
15
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Trivia

deficiency and consequent deficiency diseases. Then, com- many unsuccessful attempts had been made on his life. This
mercially produced tablets of yeast-extract vitamin B com- made Hauser famous throughout Europe, with hundreds
plex and semisynthetic vitamin C became available. of books, magazine articles, films, and even plays written

5
• The reason for skipping the alphabets F through J while about him for the next 25 years! Thus started a conspiracy
naming of vitamins directly from E to K is that the vita- theory that Hauser was actually the Prince of Baden who

02
mins that were assigned alphabets F through J were either had been switched with a dead baby at birth and impris-
reclassified over time, discarded as false leads, or renamed oned for nefarious reasons. After all, many said, why would
because of their relationship to vitamin B, which came to be the boy have been so mistreated, and why would several
known as vitamin-complex. assassins try to kill a teenage boy, if his existence wasn’t a
threat to someone powerful. However, others refuted this

/2
• Scurvy is nonexistent nowadays. However, it was prevalent
theory and merely believed him to be a mentally sick person
in the early 13th and 14th centuries, especially among sail-
who wanted his share of name and fame. This was because
ors because they were out for many months altogether for
Hauser could never produce any witness of his attacks nor
their voyages and their provisions did not include lemons/

03
gave a credible description of any of his assailants. Hauser
citrus fruits. Vasco de Gama’s voyage provided the first writ-
died under mysterious circumstances, being stabbed one
ten record of scurvy since 100 of his crew members out of
day in a public park. At Hauser’s direction, after the attack
160 died due to scurvy. Scurvy was extremely common in
a small purse was found with a note that he claimed his
the Middle Ages especially among sailors who made pro-
attacker gave to him that, amazingly, mentioned his assail-

5/
longed sea voyages, since their diets usually lacked vitamin
ant’s hometown. Why an assassin would intentionally give
C. It was the major cause of mortality in sailors. In 1747, Dr
his victim a handwritten note that would later be discov-
James Lind, a naval surgeon aboard the HMS Salisbury, an
ered and partially identify him strains credulity. Even more
American Battleship, did a lot of work on finding the cause of

,1
damning for Hauser’s tale is that it had snowed that day and
death among soldiers and established that vitamin C was an
only a single set of footprints was found in the snow (the
effective cure to curb scurvy-related deaths. The Merchant
second set of footprints was missing). It is widely believed
Shipping Act of 1867 required all ships of the Royal Navy
and Merchant Navy to provide a daily lime ration to sailors that Hauser was an imposter who had stabbed himself
to prevent scurvy. This led to coining the term “limey” for (probably for attention) and had simply injured himself
nif
British sailors. more grievously than he had intended.

• Outbreaks of beri beri substantially rose in the late 1800s • Mrs Indira Gandhi, ex-PM of India, who had a typical tuft of
due to increased trend of consuming polished (white) rice. white hair on her forehead, suffered from piebaldism!
• Although the Islets of Langerhans were first discovered in
Ha

Endocrinology 1869 by a German medical student Dr. Paul Langerhans, yet

it was only in the 1920s that insulin was first isolated from
• Secretin was the first hormone to be discovered in 1902 by these islets by Dr. Frederick G. Banting (an orthopedician)
Dr William Bayliss and Dr Ernest Starling. In fact, the discov- and Dr. Charles Best (a first-year medical student).
ery of this special chemical messenger led Dr Starling to coin
the term Hormone in 1905! • Kisspeptin: The origin behind this rather unique name for
this hormone is that the gene coding for Kisspeptin was
rim

• The current Guinness World Records holder for the world’s discovered in a research lab in Hershey town, Pennsylvania,
tallest person is Mr. Sultan Kosi of Turkey while the shortest US. This town is famous for Hershey’s chocolates, especially
man is Mr. Chandra Bahadur Dangi of Nepal! their product Hersheys Kisses. Thus, the gene coding for
• A recent study has found that people with Laron dwarf- this hormone was named Kiss-1 while its ligand was named
ism are innately immune to cancer and diabetes. The exact Kisspeptin. There is also a scientific basis for this name since
reason for this is unknown but is somehow probably linked the “SS” in the name indicates “Suppressor Sequence” of the
Sa

to their genetic defect. gene which plays a role in prevention of tumor metasta-
• Kasper Hauser syndrome: It is a clinical condition char- ses. This is also the reason why Kisspeptin is also known as
acterized by constitutional delay in growth due to chronic Metastin (i.e., inhibitor of tumor metastases).
neglect. This condition has an interesting backstory: In • Pineal gland: It is considered to be the place where “soul”
May 1828, a teenager was found wandering a public square of a person resides. Some others also consider it as vestigial
in Germany. The boy wore tattered clothing, seemed con- remnant of “Third eye” that used to be located at the back of
:

fused, and was unable to read or write anything other than head in some lower animals.
er

his name, “Kaspar Hauser.” He carried a letter addressed

to the chief of the local cavalry regiment to induct the boy Integrative Physiology
into service. The letter was written by a laborer who had
found and raised this abandoned boy but could no longer • It has been recently discovered that garlic contains chemi-
Us

keep him. The boy didn’t know who he was (other than cals (alliin, allicin, allyl cysteine, etc.) that act as antioxi-
his name) or where he had come from. He claimed that he dants either by inhibiting the formation of superoxide or by
had spent his entire life in a darkened cell and was given scavenging hydroxyl radicals. Similarly, another chemical
only bread and water. He had been set free by an unknown gingerol (in ginger) has been found to have free radical scav-
stranger. A baffling thing about this boy was his claim that enging action.

16
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