Dr. Rajendran's Institute of Medical Education (RIME)
PG MEDICAL ENTRANCE EXAM 2024 MCQs
GENERAL (INTERNAL) MEDICINE
FOR MEDICAL STUDENTS (PGs AND UGs)
Bad conversation habits you must break for healthy communication - 10 05 24
1. Inability to listen to others
A conversation is a two-way process where there is an exchange of ideas and beliefs. Therefore, it is integral that you are paying attention when the other person is speaking.
2. Lack of trust in people and transparency
It is very important to try to trust the other person while communicating with them. A lack of trust can often have you wonder if the other person has your best interests at heart. “It may also lead to suspicion, jealousy as well as other harmful thoughts that are not conducive to a healthy conversation”.
3. Being ready with a response
It is important to listen and understand what a person’s saying without forming our views and opinions. “Very often, just to sound smart, we are quick to share our verdict of a person’s situation, and this can often make them feel taken off guard. They may even retreat and not share the rest of their problem”.
4. Interrupting the other person
Breaking into a person’s train of thought, in order to speak our point of view, is a rather rude way to conducting a conversation. This can have an impact on the trust and respect in a relationship”. It is very important to pause for a minute or two after a person has finished talking, in order to continue the conversation with your side of the story.
5. Not pausing while speaking
We have so much to say that we often don’t give time for the other person to respond to what we are saying. “A conversation is more about engaging with the other person, rather than just saying what we feel. So, it is very important that we talk at a speed where the other person can understand what we are saying and also has a chance to intervene and respond”.
6. Trying to always be right
"I told you" is a phase that must be avoided in a conversation. This phase can more than often lead to the other person being totally put off and ending the conversation. It doesn’t always have to be about the winning argument. It is very important to offer constructive advice only when asked. The other person must have space to be heard in a conversation”.
7. Reacting instantly
It is imperative that one listens in a conversation, and then gives our reply. You must concentrate on not only listening, but also understanding what the other person is saying, where he or she is coming from, their state of mind; and then come up with your response. Reacting instantly to a statement never brings any good.
8. Ignoring the other person’s reaction
There might be time when the other person might not be reacting in the way we think he or she should. They might be taking an offense to what you are saying, or maybe what you are saying is making them uncomfortable or even sad. You must be able to notice these cues of the person. Your replies should be according to how a person is reacting, one should talk accordingly”.
9. Lying your way through a conversation
We might catch ourselves giving advice about things that we have no idea about. Admitting to not knowing something is very important. If you don’t know something, say that you don’t. This does not make you small, but at least you are able to answer right.
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NEET EXAM 2024 - HEAT ILLNESS (8)
Must know points
Hyperthermia is defined as elevation of core body temperature above the normal diurnal range of 36 to 37.5°C due to failure of thermoregulation. Hyperthermia is not synonymous with fever, which is induced by cytokine activation during inflammation and regulated at the level of the hypothalamus. A temperature above 40.5°C (or 105°F) is severe hyperthermia.
The most important causes of severe hyperthermia (greater than 40.5°C or 105°F) caused by a failure of thermoregulation are heat stroke, neuroleptic malignant syndrome, and malignant hyperthermia.
Exertional heat illness (EHI) is among the leading causes of death in young athletes and others who exert themselves in the heat (eg, construction workers, firefighters, soldiers); there is a disturbing trend of increasing incidence. EHI is an ever-present danger when athletes or workers perform intense exercise in the heat.
Important risk factors include high ambient temperature and humidity, lack of acclimatization, dehydration, and poor physical fitness. A number of drugs and supplements, including alcohol and stimulants, increase the risk of EHI.
Exertional heat stroke (EHS) is the most dangerous type. Elevated core body temperature (above 105°F, 40.5°C) associated with altered mental status following exertion in high heat and humidity is consistent with a diagnosis of EHS.
EHS is a multisystem, life-threatening illness characterized by CNS dysfunction (encephalopathy) and additional organ and tissue damage (eg, acute kidney injury, liver injury, rhabdomyolysis) in association with high body temperatures.
The two main diagnostic criteria are a core (eg, rectal) temperature above 40°C and CNS dysfunction.
CNS dysfunction can manifest as disorientation, headache, irritability, emotional instability, confusion, altered consciousness, coma, or seizure.
The severity of a heat illness may not be apparent during the initial presentation. Morbidity and mortality are directly related to the duration of core temperature elevation.
First evaluate and secure the airway, breathing, and circulation. Measurements of vital signs, including a rectal temperature, fingerstick glucose, and serum sodium concentration, should be obtained quickly.
Do not use alternative methods to determine body temperature (eg, oral, tympanic, axillary, temporal, forehead sticker). If a rectal thermistor or rectal thermometer is not available, cool the patient with a severe heat illness until they begin to shiver.
"Cool-first, transport second". Rapid cooling is critical. Cold water immersion therapy is highly effective.
In circumstances when ice water immersion is not feasible, (eg, compromised airway, seizure), apply ice packs to the neck, axillae, and inguinal regions (areas adjacent to large blood vessels). Simultaneously spray moderately warm water over the patient's body and using fans to blow air over the moist skin (ie, evaporative cooling). The goal temperature is 101 to 102°F or 38.3 to 38.9°C.
Exertional heat injury is similar to EHS, but the patient's central nervous system is not affected.
Heat exhaustion and heat syncope is characterized by the inability to maintain adequate cardiac output (usually manifested as physical collapse during exercise) due to strenuous physical activity and environmental heat stress. Elevations in body temperature are less extreme than with EHS, and the central nervous system is not affected. Treatment includes moving the patient to a cool environment, with additional cooling methods used as needed, rehydration (usually with oral fluids), and careful monitoring.
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