 What is up guys? Karma Medic here and welcome back to another dose. If you're new to the channel, then hi, my name is Nasser and I'm now a fourth year medical student studying at Kings College London and welcome back. Welcome back to my vlogs. I feel like it's been a long time since I've picked up the camera and talked to a camera. You know, last time was the last video that I put up. Oh yeah, a productive med school study vlog. That was me on my peripheral placement, finishing off my opposite gyneurotation and then studying for my upcoming final written exams that I've already written. They're done and out of the way, which I'm very happy about. It's honestly been quite an intense studying period. I think I showed you guys the timetables that I was using to prepare for that written exam. Yeah, hopefully the amount of messiness can display to you just how much studying we had to do. And then as soon as this was finished, we had no break at all. And we've had to start studying for our upcoming oski exam, the practical exams here in medical school. So I had to come up with a brand new timetable, which I'm working my way through. And believe it or not, we are two days out from the oski. So basically, guys, it's been nonstop studying for over two months now, something like that day in and day out, preparing for either written exams or these practical oski exams. Later today, I'm actually going into campus to the clinical skills room to actually hold and feel and use some of this equipment that I might have to use after tomorrow. Oh man, the exam is way too close. Anyways, that's med school for you. That's a problem for future me. Okay, this is it. Rachel and I walking to our feels like our death bed. Today, me has quite enough to deal with alone. So let's get started working on those. But before we do that, I do have some good news. Christmas has come early this year. And we've got a lot of packages to open. So let's get into that tons of boxes. Honestly, don't know which ones to start with. I'm just gonna go for the first one. We'll move from there. Video production on the channel is about to skyrocket. All right, probably the biggest and most exciting purchase, the Sony a7c. Wow, it's incredibly light as well. That is fantastic. This is going to be a lot more easy to take around with me. So this over here is called a slider. So this is a power bank. I'll take it. All right, I'll show you guys this in a second. Something else I'm very, very excited about. I call myself the new GoPro Hero 9. Now a lot of you guys won't know this, but my entire YouTube video making journey started with a GoPro, the GoPro Hero 2, I think it was. Let me go grab it. I still have it right over here. It's the GoPro Hero 4. And I use this to make my first couple of videos that I ever uploaded onto YouTube. As you guys can see, it's it's old. It's battered. It's definitely been through its paces. This is the wow, that's a huge box Sigma 2470 f 2.8 lens. Cool. I've managed to make a huge mess as per usual when I do these unboxing videos. You guys will be seeing all of these in future future videos. So stay tuned, subscribe, et cetera, et cetera. And yeah, let's get back to the vlog. I think it's time to actually get started now. Let me briefly clean up my surrounding study area because everybody knows clean study environment makes for a cleaner study mind. This book has basically been my like North Star, my guiding light or whatever when it comes to oscure preparation and oscure studying for upcoming exams. But the medical school has also given us some guidance, some instruction on sort of possible things that might come up. So I'm going to show that to you on my screen right now. So I think you guys have all become pretty familiar by now with my conditions list. So this is where I keep track of all the conditions that I need to know about in medical school. You know, if we open each one of these, it has its own set of notes color coded according to different things. But studying for oscure for the practical exams is a completely different game. And so I've had to create a new thing. So under oscure here, it's called the purple book checklist. And basically what I have is the five different domains that we can have in our upcoming oscure exams. So we have communication stations. So talking to anxious parents or explaining different diseases or conditions to people who have recently been diagnosed, or maybe someone's really upset about something, you have to deal with an angry patient. That's what comes up in comms communication. Then we have exams. So these would be things like full neurological exams, abdominal exams, cardio, rest, you know, you name it procedures. These are things like clinical skills, for example, taking blood, measuring blood glucose, taking observations, so respiratory heart rate, blood pressure. Those are all the simple ones. But then you have things like urinary catheterization, doing an ABG. There's a lot. Then we have histories. This is sort of the bread and butter of medicine, you know, patient comes into the GP or into the hospital, and you have to take a history from them. You have to find out what's brought them there, what's wrong, take all their relevant history, past medical history, social history, drug history, blah, blah, blah, blah. So that's the histories one. And then finally, prescribing. This is a good one about like a week or two ago, you know, me and all my friends were like, yeah, prescribing, like how hard can that be, you know, you just look at the drug chart, you fill in the drugs, make sure you write everything in the right place, and you're good to go. But it turns out it's way harder than that. All right. So this is an example of a drug chart. This is not a real drug chart. It's an example. And it looks like this, and you have to fill out all kinds of different information. I've scribbled all over it right now because I was just practicing and trying to learn and remember things. Anyways, that was a quick tangent. Now that I've rambled on and we're like a hundred minutes into this video, let's raise the desk. Let's get into studying mode and just bang out a couple hours of this. What are we starting with here? We have review basic life support and I'm new back. All right, let's get started. Quick interruption. When you take a patient history, okay, there's a lot, there's a lot of things you need to do. There's a lot of things you need to remember. But there's certain things that if you forget sort of are really, really bad, or if you forget them, then you'll just be missing a bunch of information that could be very helpful in identifying what the actual problem is. Okay. So one of the things you should never, ever, ever, ever miss is asking a patient about allergies because obviously if an allergy is not documented at the notes and then you give them something they're allergic to, it's going to be catastrophic. Some other things that are really helpful in a history are asking the patient's ideas, concerns and expectations. Okay, so Kings as a medical school has drilled this into our brains as ice, ideas, concerns and expectations. So anyways, there's a bunch of these things and I've written them down as sort of my holy grail list on the like random contents page of this book, sort of like five or six things that you need to need to need to ask. And that I sometimes forget, which I shouldn't. That's what I'm going to go over now and review and make sure that I have grained in my brain. So I can't can't forget them. Moderate severe pain. Okay, for an adult, 30 milligrams every four to six hours. Okay, we're giving this is breakthrough pain relief 30 milligrams PRN so as needed but for a maximum of four to six hours per day. So that would All right guys, so I'm mid studying and we've started to make good progress on our to do list. So we've ticked off quite a few things over here and there's still more to go but we've got the whole day just making random notes over here currently going through blood transfusion charts. But basically, there's this app that I'm using, which is really helping me keep track of time and it's helping me stay motivated and focused for the time that I'm actually studying. And I just got a notification from it and I think it's really great. So I want to show you. All right, so this is the app over here called flow. Let me zoom in so you guys can see that a little bit better. So flow is basically just a very simple little timer that runs in the background and you can move it wherever you want. And you can set how many flows you want to do in a day. So I currently have one, two, three, four, five, six, seven, eight, which amounts to eight hours of studying. And you can pause the timer, you can start the timer, you can give it a little name, reset it. And basically you can hide it if you don't want it, you can bring it back if you do and you can just put it anywhere on the screen. So it sort of helps me be more intentional with my time. And I like that you can see sort of the progress of what you've done so far and how much is left in the rest of the day. The app looks like this on the app store. So if you guys want to check it out, search flow and look for that. Also need to say that extra saucy AKA that medic, he's been on my podcast. If you watch the karma cast, he's the one who told me about the app. So check him out as well. Links in the description down below. All right, quick little detour back to prescribing blood products back to work. Guys, guess what else is happening today? I'm being abandoned, being abandoned by Noor. She's going to Jordan to see our parents. This is her room right now. Hello. How's it going? Going good? Almost unpacking. Almost. You're going to get to see Simpson as well. Do I haven't seen Simpson in three years? Three years. If you guys haven't seen my Jordan vlog, I was there a couple months ago to be fair. I was there in December. You guys can watch that up over here. I had a great, great time there and I'm sure Noor's going to have lots of fun as well. Make sure you send me pictures. Okay. Plenty of what's up videos of Simpson. All the what's up videos of Simpson. All right. I'm going to study a bit more and then I'll see you for lunch. I'm about to do my first team activity today, which is going to be prescribing practice with Kenji, Georgina and maybe one other friend, Kobe. Basically what we do is we go through this book that we have here. We choose a scenario. So let's say sepsis, meningitis, acute asthma, acute COPD, something like that. We read through the scenario and then we practice prescribing all the medications that person would need. I do that on my iPad, but I'm an absolute genius and I decided to hit the update button literally two minutes before this call. So now I need to let this thing update. So hopefully as soon as that's done, I'm going to hop on the call and we can start that. All right. It's time guys. I cheated for an extra 10 seconds there. So much writing man. Variation. Like in what you think you can do. So once only this time, I did goodness alone and hippodropin bromide. Dose and route. So goodness alone, if the hippodropin, I did 500 micrograms nebs. Yep. Same. That's all I did. Because for me, like the regular, the only thing I put was delt, iron, oxygen for this one. Okay. Wait, before, before we move on to that, I also put magnesium sulfate on once only. Should we break for lunch and then regroup at around 2pm? Sounds good. Does that sound good? All right. Homies, catch you in a bit. Okay. So that is our prescribing station done for the day. As you guys can see, it's really confusing. There's a lot to remember. It's very easy to make mistakes. So practice, practice, practice is what we need to do. As you guys can see from this nice little flow timer on my screen, I've got five minutes left for the last four minute session, which is perfect because I studied from nine to one, four flow blocks. What I'm going to do is I'm going to go say bye to Noor, which is about to go to Jordan and abandon me, leave me alone in this house. I wasn't expecting that. Don't leave me. No. Change your mind. See you later, man. See you later, man. How about fun, bro? Thank you. Bye, Noor. Have lots of fun. Bye. All right. And that's it. I'm on my lonesome. All right. It's fine. I've got my own exams to prepare for my own stresses to deal with. Let's go make some lunch. Let's sit down and have a chat while I eat this lunch. First things first, let me show you what we've made. We have had my face. We've got cut up potatoes in a lemon and butter sauce with sugar snap peas, normal peas, and then crispy honey glazed chicken thighs. You might have looked at that bowl and thought to yourself, Hey, Nasser, why is the chicken burnt to all s***? Well, the answer to that is Noor burnt the chicken in the oven. So don't blame me. Classic angry motorists ruining my audio. All right, guys. So check it out. I'm literally two days away from doing the final exams in my fourth year of medical school, after which I will be a final year medical student. I need to like, I need to listen to that a couple of times out loud. I'm almost a final year medical student. That is absolutely incredible and amazing and exciting. Oh man, it's just crazy to think about like how long this process takes and all the different things you've done over the years to get to this point, all the challenges and hurdles, all the lucky breaks, all the effort, help you've gotten from other people, everything sort of comes together for the one moment when you graduate and you're finally a doctor. Pretty crazy. All right, anyways, we're meeting again in 45 minutes to continue with oski practice. So I'm going to wolf down this food while watching something on the TV and then call Alex here and we'll get back to it. So I'll see you guys in a bit. All right, we interrupt this vlog for a brief word from Amazon. Oh, this isn't even what I was expecting. Wow, I've gotten a bunch of stuff. This is a nice handheld microphone so I can go interview people on the street and on campus, which I think would be a very fun series of video ideas to do. So stay tuned for that. I've got a lot of exciting things coming there. And then this is a water handle for the GoPro that I got as well. So I can take it in the sea and not lose it. Almost made it in one trip. We had three casualties. So close. Quick side note, if you haven't read Homo sapiens and Homo deus by this guy, Yuval Noah Harari, you should definitely give it a shout. It's honestly mind blowing. And I posted this on my Instagram page that I've never spent so much time thinking about a book outside of when actually reading the book as I have with these two. It poses some really good existential questions. And I feel like it makes you rethink a lot of your beliefs, reasoning, logic, upbringing. So yeah, it's a really good read. Would highly recommend it. Fellows, we have a busy, busy day. My goodness. I feel like I've been running around this whole time. All right, we are about to start oski practice session number two for the day. We're going to go through some histories with Kenji and Georgina channel favorites. And then I'm actually heading to campus for some clinical skills practice, but there's too much going on right now. You guys have seen this before. If you haven't seen this, check out my previous oski vlog. You'll find it's linked somewhere over here. But without further ado, let's turn on the screen recording and get this bad boy started. There's our good friend G. G money. Oh wait, is it doing the voice thing again? Oh, and she left. This is the book we're using to go through histories over here. So there's like hundreds and hundreds of histories in this thing. And we just sort of tell each other what we want. So let's say a pediatric history, opt in guiding history, you know, whatever it is. And then somebody else reads the like mark scheme for it and prepares the history. And then we do the pretend scenario. And yeah, that's just what we've been doing back and forth and see for a while now. But yeah, Georgina just bailed from my zoom call. So let's give her a second to join back and see what's going on. Hi there. Good afternoon. My name is Nasser Karmann. I'm one of the doctors here in A&E. Could I please start by confirming your name and your age? Yeah. So it's Mr. Gopala Kaur and I'm 31. Okay. Lovely to meet you, Mr. Kaur. Can you tell me what's going on? What's brought you in today? Yeah. So for the last about a week or so, I've been having this, you know, really kind of bad shortness of breath and also quite bad cough as well. Okay. Can you tell me a little bit more about the cough? Yeah, it's just really been constant cough, particularly when I exert myself. Particularly when you exert yourself? Okay. Does anything come up when you cough? Kind of on two occasions. I didn't cough up a bit of blood. Otherwise, no. So a bit of fresh blood on two occasions. And this has been going on for about a week. Does anything make it better or worse? My two differentials for this patient would be lung cancer and tuberculosis. My reasoning for lung cancer is his extensive smoking history and his recent episodes of hemoptysis. I bet you guys thought we were going to be home all day for this vlog. No, no, no. We're going out. We've got to practice our clinical skills on campus because I don't want to be fumbling around with any equipment that I might have to use after tomorrow in the exam. The easiest way to show that you don't have confidence or that you don't know what you're doing is fumbling around with equipment. So I want to make sure that doesn't happen tomorrow. You'll also notice I'm in a t-shirt, which you probably haven't seen me in a t-shirt for like months here on the channel. Weather's finally gone and sunny. We're going out to the parks enjoying ourselves in the sun. I can go out without like three layers on me, which is also fantastic. And yeah, life is just good, man. Life is good once I finish this exam. I can't wait. Have a nice little ice cream truck. Campus here, obviously a library. If you guys have been watching this channel for a while, you might remember this room. It's been a hot minute since I've been in here. I think second year. Let's settle down and figure out what we want to do. All right guys, just kidding. I got kicked out of that room because apparently someone else has booked it and I'm actually upstairs. So let's go there. That's us. That is me in second year. That photo was taken by the one and only Aaron. You guys don't know him from my Instagram. Cool. So we're going to settle down in here. All right. So like I said, I'm going to be doing some very basic clinical skills just to sort of get a feel for everything again. So it feels like a lifetime ago that I've done certain things like take a manual blood pressure. So let's see what we can find here. We've got some syringes, a tourniquet, that special tying method. Let's get some of those. There we go. Urine analysis is what I was looking for. So we've also got models here to do vaginal exams and genital exams for males. But I'm going to blur those out because YouTube is going to demonetize me, but I've done a decent amount of practice with those. So I don't think I'm going to do any today. We've got some saline, some tweezers, we're setting up a sterile field. We've got a couple of breasts here. I think I'll do a breast exam as well and some subcutaneous and IM injections there. Nice. They've got some urine specimens as well. We can take a look at and examine. So we're going to inspect our sample, which appears to be fairly dark yellow. And if we shake it about, we can see actually a clump in there or a couple of clumps. It doesn't appear foamy. It's going to give it a good smell. Okay. I don't smell anything pungent or abnormal. I'm going to get our strip. I'm going to dip it inside to cover the entire surface of it. Now I'm going to take out and I let it rest 45 seconds, I believe. And then we can interpret the results and leukocytes at 90 to 120 seconds. Fine. Aurobulinogen, which I would say is negative. Second one is for glucose, which is definitely positive ketones that looks at least a little bit positive. Okay. So I'm already thinking of diabetic ketosis because we have positive glucose and we have positive ketones, blood negative, happy to see that, pH five. Okay. So that's the topic as well. Protein, negative. So no protein, no leukocytes, negative. All right. So we've gone through your analysis now and I'm pretty confident with that. The next thing that I want to do is show you guys this interesting trick for tying a 20k. You tie it as if you're going to do your shoelaces, but then leave a little strip behind, pass it through, but you leave yourself this little tip here. There we go. Nice and tight and easy. So we're just going to pretend there's a carnival here. Kind of like this. So we put one of these on each wing of the carnival. All right. So another skill that I think they could ask us to do is to put on a pair of sterile gloves. So now we need to only touch the inside areas of the glove. I can go in like this and very careful not to touch the inside area. Even though it's a mess, this is all sterile. So I can touch anything here now. So that gives me an easier time when putting on the second glove. A mixture of cotton, sweaty room and small gloves is no good. And I'm ready to go. I did find a manual blood pressure cuff, but I've known to do it on obviously. So I think I'm just going to do it to myself or try and do it to myself. See if that would work. I've obviously forgotten my stethoscope because I'm a genius, but let's see if I can do this. Ideally what I would do is I would place my stethoscope here and inflate the blood pressure cuff until I stopped hearing my pulse. So also you can actually cheat. You can look at the single momometer here and you can see that the dial is coming down smoothly. It's not ticking. Do you guys see that? So once this reaches around 120, you should see it start to tick. See that ticking there? That ticking means my pulse is back. So that tells you the systolic pressure and then it will keep ticking until it goes down to my diastolic pressure, which is at about 80 or should be 80 if I'm normal and healthy. Tick, tick, tick. You should do a stethoscope obviously, but I don't have one right now. I'm going to do a brief breast exam just to practice the motions. Feel one nodule there. Okay, I'll come back to that in a bit. Obviously here we have the skin dimpling and I can feel another nodule. Let's put the breast on the side of my other hand and follow it down to the auxiliary tail here and here. All right, so I'd like to read it to the two modules that I found. So one is here at about 11 o'clock in the upper inner quadrant of the breast. The second mass is at about two o'clock in the upper outer quadrant of the left breast. I can see that it is not tethered to the skin. It is in fact tethered to the underlying muscle. All right, and I think that is everything that I wanted to do today. I'm happy I came. Just going to pack up, head downstairs, and I'll see you there. I don't know why I got so thirsty doing that. Please don't be stuck. Please don't be stuck. Nice. Look at how beautiful campus is. There's so many people. Guys, what the hell has happened to my hair? This has to be a joke. I mean, thankfully I'm getting your hair cut tomorrow, but that is kind of absurd. Stay there. Man, campus is just looking so nice. I remember when we'd used to come here, like all this would be filled with people eating their food, bathing in the sun. I miss being on campus. I wish more of medical school was based around this campus, but once you start clinical placements and you start going further out to different hospitals, you just lose all of this. One day, everything will go back to normal and we'll be able to enjoy these scenes again. All right, guys, so I think that's it. I think I'm done studying for the day. I'm going to head home, hit a gym, and then probably go hang out with my friends, maybe watch a movie, have some dinner together or something like that, just to relax a little bit, de-stress, decompress from a long day of studying, and yeah, just get in a calm zone before the exam starts in two days. That mental is so important to keep myself calm and relaxed. Otherwise, I'm going to freak out, stress out, and yeah, bad things happen when you're stressed before exams, so need to keep a cool mind and a cool head. See you guys in a bit. All right, guys, I've been thinking about it on the way home. I can't decide if I should go for a run or if I should go to the gym. I'm just infinitely conflicted. I feel like a run would get more stress out of me. Gym will be pretty good. I don't know. I'm thinking this one through. I've actually come up with a genius idea. If it works, I'm going to be very, very happy. I need a couple of things, this, this, and this. Check it out, check it out, and then for the magic, let's go. Check out this super cool thing. So you turn it on. GoPro, start recording. How insane is that? GoPro, stop recording. It's like immediate. That's insane. That's absolutely insane. All right, anyways, I'm going to put on some running clothes and we're going to go on a run. One last for water. How cool is this? Honestly, what a great idea. I hope it works and the footage comes out okay. I don't know if anyone else is like this, but my left ear struggles so much with earphones and headphones. Whereas my right ear has absolutely no problem. It'll never fall out no matter how much I shake my head or run, but my left ear gives me a bit of trouble. Let's get going. Jesus, I almost run over a pigeon. It was a bit of a shorter run, but a good time, good time, good pace. I'm happy with that. I'm going to go hop in the shower, cool off, get some food, and check in with you after that. Peace. Bye-bye. Lovely catch-up with mum. I ordered food and I've just taken the first two bites and it is so spicy and hot. I'm kind of dying over here. I'm hoping I'll make it for the rest of the meal. When I say my mouth is on fire, all right, it was rated as very hot on the menu. So let's just get that out there before I see all the white boy can't handle spice jokes, but I'm coming back with milk. All right, milk. Do your thing. Protect me from this spice. I'm not going to lie. That meal and run has taken out of me. I am ready to sleep, but I just remembered something. Kenji, Georgina and I said we would each take a common prescribing station and sort of type up the most important things to know for that station or like an easy mnemonic to help remember or something. And I'm yet to do mine. So at 9, 11 p.m., I'm going to quickly bang this out, add to the group, be a good team member, and I'm going to call it for the day. This shouldn't take too long, maybe like 10, 15 minutes of focused work. So let's get it done and then we'll show. Check in with you after. Actually, you know what? You guys can watch me do it. That'll be an extra dose of motivation to keep me focused and energized. Do you guys want the wide? Or do you guys want the zoom? Let me know in the comments down below, but you're getting wide for now. I'm procrastinating. All right, I'll see you guys in a bit. It's officially it. I'm actually done working for the day. That's it. That's it. That's it. Goodbye. All right, that is it guys. This vlog is coming to an end right here. Oh, my cat was falling. I'll catch you. As I was saying, this vlog is going to come to an end right over here. I really hope you guys enjoyed watching. It was a very busy day. I genuinely felt like I was running all over the place. I am going to go to my friend's house and play some video games, chill and chat and just hang out and have some fun to relax for the rest of the evening. And then tomorrow is the last day. I'm traveling to my peripheral placement, where I'm going to be staying for a couple of days while being examined for these oskies, and then I'm going to be final year medical student, which is dope. I absolutely can't wait for that. Oh, let's go. Let's go. Let's go. Let's go. If you enjoyed the video, please don't forget to leave a like on it and subscribe to my channel to see more content from me in the future. I'll catch you in the next one. Peace. All right. We interrupt this vlog for a brief word from Amazon.