Live for the moments you can't put into words...

Hi my name is Nycki. I believe in love at first sight and unconditional love.

[sunsetquotes]

Life is short, break the rules, forgive quickly, kiss slowly, love truly, laugh uncontrollably, and never regret anything that made you smile. Twenty years from now you will be more disappointed by the things you didn’t do than by the ones you did. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.

Unknown (via sunsetquotes)

[studyquill]

Notetaking

Sound Note - take notes while you record audio

Evernote - notetaking that syncs across platforms

Paper 53 - minimal notetaking that syncs

Microsoft OneNote - collaboration and syncing, best for Office users

Google Keep - jot things down, best for Google suite users

Notability - take notes and annotate PDFs

Mindly - create mind maps

Day One - a digital journal

Flash Cards

Quizlet - the quintessential flash card app

StudyBlue - another commonly used app

Cram - best for its “cram mode”

Eidetic - uses spaced repetition for effective memorization

Planner 

My Study Life - schedules, tasks, reminders, and more

StudyCal - keeps track of tasks, exams, and grades

24me - automated reminders and event planning

iStudiez - schedule and prioritized task list

Google Calendar - a calendar, best for Google users

Glass Planner - a calendar and to do list with incredible functionality

To Do List

Clear - organized to-do and reminders

MinimaList - simple to-do and focus timer

Trello - collaborative project organizer

Todoist - clean and functional task manager

Default notes app on your phone

Time Management

Forest - plant trees by staying focused

Pomotodo - pomodoro timer with to-do list

Timeglass - custom timers

Tide - pomodoro with white noise

Alarmy - forces you out of bed 

Pillow - smart alarm that tracks sleep cycles

Productivity

Workflow - automate tasks

Habitica - turn your habits into an RPG

Continuo - simple, colorful activity tracking

Freedom - block distracting apps

Free Learning

Coursera - free MOOCs

TED - listen to Ted Talks

Duolingo - language learning

Memrise - spaced repetition language vocabulary

Khan Academy - free video lessons

Ambient Noise

8tracks - curated playlists

Spotify - online music streaming

Coffitivity - cafe ambience

Noisli - background sound generator

Rain Rain - rain sounds

Binaural - binaural beats

Health

Rockin Ramen - recipes based on ramen

MealBoard - meal planning

Lifesum - healthy eating

Stop Breath And Think - mindfulness meditation

Pacifica - mental health management

Sworkit - personalized video workouts

Waterlogged - hydration tracker

Reference

WolframAlpha - Google on steroids

Oxford Dictionary - all of English at your fingertips

RefMe - citation generator

PhotoMath - solve math problems by taking a photo

Mathway - step by step math help

Desmos - free graphing calculator

Wikipedia - not the best source, but it’s handy

Miscellaneous 

Companion - stay safe when walking alone

Mint - money management

Toshl - finance manager

Tiny Scanner - scan documents

[studypsy]

great!!

[books-n-quotes]

“If we wait until we’re ready, we’ll be waiting for the rest of our lives.”

— Lemony Snicket, The Ersatz Elevator

[books-n-quotes]

“I’m beginning to think that maybe it’s not just how much you love someone. Maybe what matters is who you are when you’re with them.”

— Anne Tyler, The Accidental Tourist

[books-n-quotes]

“And sometimes I have kept my feelings to myself, because I could find no language to describe them in.”

— Jane Austen, Sense and Sensibility

[ipositivequotes]

“I lost myself trying to please everyone else. Now I’m losing everyone while I’m finding myself.”

— (via purplebuddhaquotes)

[michellepsychologist]

Mental Health Support

“Mental Illness Recovery Series” book contains 100 true life stories of people all around the world battling daily with their mental disorders . It’s an inspirational book, that gives rise to the silenced 🤫 truth of mental illness and the exhausting, but noble journey of recovery.


📖📍🌎 Where to buy it :) = http://awakesociety.com/mental-illness-recovery-book/ 🌎📍📖

Mental disorders found in the book:

🔻Depressive disorders

🔹Anxiety disorders

🔺Bipolar & related disorders

🔸OCD & related disorders

🔻Eating disorders

🔹Schizophrenia spectrum & psychotic disorders

🔺Conduct disorders

🔸Dissociative disorders

🔻Neurodevelopmental disorders

🔹Personality disorders

Thank you 🗯
‼️ 🚫 STOP THE STIGMA 🚫‼️

[ipositivequotes]

“Be with someone who is proud of you, someone you can laugh with, someone who listens to you, understands you, who treats you well and makes you a priority.”

— Brigitte Nicole (via purplebuddhaquotes)

[janedoemd]

ECG: quick and dirty

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career. 

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough. 

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number. 

3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.

4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II. 

up in lead I, up in lead II: normal axis

up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)

down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)

5. did someone say HYPERTROPHY?

look at V1

is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.

is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.

  6. P-waves

look at lead II

is it wide? left atrial enlargement.

is it tall? right atrial enlargement.

7. PR interval

should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].

long PR interval means there’s some sort of block at the AV node. 

1st deg block. PR interval is long. everything else is normal. cool. 

2nd deg block

type I: PR interval progressively gets long. eventually a dropped QRS.

type II: PR interval is constant, but randomly dropped QRS. 

3rd deg block “complete block”

there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg. 

8. QRS complex

narrow or wide? 

narrow: good. signal coming from somewhere above ventricles. 

wide: think BBB (bundle branch block)

LOOK AT V1 ONLY.

if the last deflection of QRS is DOWN, then it’s a left BBB

if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap. 

9. ST segment

always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval). 

elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes. 

look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:

posterior up, anterior down

anterior up, inferior down

inferior up, lateral down

lateral up, septal down.  

LBBB can look like STEMI. How to tell?

disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)

concordant changes is abnormal. 

massive discordance is abnormal. (STEMI is greater than 5mm)

this isn’t that important. Moving on. 

Inferior STEMI. Could right ventricle be involved? 

DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.

order a 15 lead

is STE in lead III > lead II? likely RV involvement

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

10. T waves

is it inverted? indicates recent ischemic changes. 

11. Q waves

is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs). 

I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart. 

  Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.

[doctorkintsugi]

Nice summary!

[creamhy]

15 things to remember:

1.   that thing you did that was kind of embarrassing and weird, everyone else forgot about that already

2.   you look fine today, if you can’t notice something on your face standing 6 feet from a mirror then nobody else will either.

3.   social lives can go through cycles sometimes, if you feel like your friends are all ignoring you for no reason they’re probably just busy with other things.

4.   if you can’t stop thinking about someone or something, read a book, paint your nails or watch a movie. it won’t solve any serious problems but you will feel better.

5.   listen with the intent to understand, not the intent to reply.

6.   if you want something, go get it. 

7.   drink lots of water, eat lots of fruit, exercise more, go outside, get enough sleep and think positive thoughts.

8.   if you don’t ask, the answer will always be no.

9.   throw away the idea of a perfect tomorrow and live in the moment.

10.  stop comparing yourself to others.

11.  a beautiful day begins with a beautiful mindset. It’s a privilege to simply be alive and healthy. Start acting like life is a blessing.

12.  act the way you’d like to be and soon you’ll be the way you’d like to act.

13.  you will change. You’re not the same person you were three years ago. you’re not even the same person you were three minutes ago and that’s okay. especially if you don’t like the person you were three minutes ago.

14.  you don’t have to open the curtains if you don’t want to.

15.  being happy is the most important thing.

[estudyr]

thank you 😭😭

[fyp-psychology]

Eight Ways to Remember Anything by Alex Lickerman M.D.

Reference: Research-based strategies to boost your memory and keep it strong via psychology today

[thenamesjocelyn]

[jatel0-deactivated20150421]

For The Masses:

http://gen.lib.rus.ec

http://textbooknova.com

http://en.bookfi.org/

http://www.gutenberg.org

http://ebookee.org

http://www.manybooks.net

http://www.giuciao.com

http://www.feedurbrain.com

http://oll.libertyfund.org/index.php?option=com_content&task=view&id=380

http://www.alleng.ru/ 

http://www.eknigu.com/ 

http://ishare.iask.sina.com.cn/

http://2020ok.com/

http://www.freebookspot.es/Default.aspx

http://www.freeetextbooks.com/

http://onebigtorrent.org/

http://www.downeu.me/ebook/

http://forums.mvgroup.org

http://theaudiobookbay.com/

More Here

[keomoto-deactivated20141214]

no one coulda reblogged this a month ago when i spent 500

[kreativegeenius]

momentsbymarcus

[trappunzelll]

Look at KB coming through

[kimreesesdaughter]

Every time you see this, reblog it. There is always someone in college that will see this.

[mypsychology]

For more posts like these, go to @mypsychology​

[janedoemd]

ECG: quick and dirty

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career. 

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough. 

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number. 

3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.

4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II. 

up in lead I, up in lead II: normal axis

up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)

down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)

5. did someone say HYPERTROPHY?

look at V1

is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.

is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.

  6. P-waves

look at lead II

is it wide? left atrial enlargement.

is it tall? right atrial enlargement.

7. PR interval

should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].

long PR interval means there’s some sort of block at the AV node. 

1st deg block. PR interval is long. everything else is normal. cool. 

2nd deg block

type I: PR interval progressively gets long. eventually a dropped QRS.

type II: PR interval is constant, but randomly dropped QRS. 

3rd deg block “complete block”

there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg. 

8. QRS complex

narrow or wide? 

narrow: good. signal coming from somewhere above ventricles. 

wide: think BBB (bundle branch block)

LOOK AT V1 ONLY.

if the last deflection of QRS is DOWN, then it’s a left BBB

if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap. 

9. ST segment

always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval). 

elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes. 

look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:

posterior up, anterior down

anterior up, inferior down

inferior up, lateral down

lateral up, septal down.  

LBBB can look like STEMI. How to tell?

disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)

concordant changes is abnormal. 

massive discordance is abnormal. (STEMI is greater than 5mm)

this isn’t that important. Moving on. 

Inferior STEMI. Could right ventricle be involved? 

DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.

order a 15 lead

is STE in lead III > lead II? likely RV involvement

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

10. T waves

is it inverted? indicates recent ischemic changes. 

11. Q waves

is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs). 

I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart. 

  Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.

[erratic-emedicine]

This diagram shows how the mechanics of the heart co-ordinate with the heart sounds and the ECG (EKG).

By keeping this diagram in mind, it can make identifying murmurs much easier, by taking the pulse whilst auscultating.  

The pulse represents the maximum arterial pressure, which as you can see in the diagram occurs in between heart sounds 1 and 2. Once you have identified which heart sound is which, you can more easily identify systole, and diastole, and describe with greater accuracy the nature of a murmur if present. 

[erratic-emedicine]

Murmur Murmur

Here’s some causes of murmur patterns:

Ejection Systolic Murmurs

AorticStenosis - Ejection systolic murmur, radiates to carotids (In Aortic Sclerosis, there is no carotid radiation)

Pulmonary Stenosis  - Ejection systolic murmur which radiates to back/left scapula (may obscure second heart sound)

Atrial Septal Defect - sounds like pulmonary stenosis

Hypertrophic Cardiomyopathy - Harsh Ejection systolic murmur, palpable

Pansystolic Murmurs

Mitral Regurgitation - Best heard at apex, radiates to axilla

Tricuspid Regurgitation - Best heard at left lower sternal edge (tricuspid region) 

Ventricular Septal Defect - Best heard at left sternal edge

Early Diastolic Murmurs

Aortic Regurgitation - best heart at left sternal edge, in expiration, with patient leaning forward

(Rarely) Pulmonary Regurgitation

Mid-Diastolic Murmurs

Usually Mitral Stenosis - Best heard with Bell of stethescope at apex, with patient rolled to left

Rarely Tricuspid stenosis - sounds simliar to Mitral Stenosis

Continuous Murmur - referred to as a ‘machinery murmur’, although I don’t think anyone knows what machine it sounds like.

Patent Ductus Arteriosus - rare in adults. Best heard over upper left sternal border, radiates to back/left scapula

[timbllr]

via weheartit

[hplyrikz]

I can relate to this