Application of blooms taxonomy of verbs to evaluate the cognitive domain in undergraduate medical physiology question papers: a critique.

Background: Over the years medical education has evolved in the system of education, teaching and evaluation. It is the evaluation system that has the most insightful impact on learning. This study aimed to assess the use of taxonomy of verbs in medical physiology question papers as a tool for written examination for summative evaluation of I year medical students. Methods: Retrospective analysis of I MBBS undergraduate question papers of revised scheme Rajiv Gandhi University of health sciences, Bangalore from the year 2006- 2014 was done. Questions were analyzed individually for the use of taxonomy of verbs in each question, marks allotted for each, and type of cognition analyzed from each question. The data was classified using a modification of Bloom’s hierarchy of cognitive learning (level I, II, III). Results: Majority (45%) of the questions in the papers had no use of verbs. There was variability in the distribution of marks on various chapters of Physiology across the years. Comprehension and knowledge component of the cognitive domain were maximally assessed in the written examination. Conclusions: Examination and evaluation though a source of anxiety for the undergraduate medical students, it is essential to stimulate their cognitive skills by teaching and enhance the evaluation of mental and reasoning skills. It could be more facilitated by proper framing of questions by adequate usage of verbs.

Anti-tubercular treatment in patients with hepatitis.

Sixty seven patients with coexistent tuberculosis and hepatitis were given a 3 drug regimen of streptomycin (SM), isonicotinic acid hydrazide (INH) and ethambutol (ETB) and observed for a period of 15 days. Total bilirubin as well as SGPT were repeated weekly and these showed a significant drop in a majority of patients when observed over this period. No patient developed any signs of fulminant hepatic failure. We conclude that a regimen of SM, INH and ETB can be given to patients who suffer from combined pathologies of pulmonary tuberculosis and active hepatitis without incurring the danger of increasing hepatocellular dysfunction/damage.

Renal cell carcinoma: presenting with congestive hepatosplenomegaly and rare haematological complications.

We report here a case of right-sided renal cell carcinoma who presented with hypertension and multi-organ metastases. Haematological manifestations noted were erythrocytosis, thrombocytosis and leukaemoid reaction. Of these leukemoid reaction and thrombocytosis are very rare. The patient had hepatosplenomegaly which was found to be congestive in origin due to the pressure of the tumour on the hepatic vein and the inferior vena cava. These rare features make it an unusual case.

Interhemispheric empyema. An unusual form of subdural empyema.

A 16 year old male was admitted with a clinical picture suggesting an intracranial pyogenic infection. He also has focal convulsions and left abducens palsy. CT scan showed a subdural empyema with interhemispheric extension. Since the patient was improving clinically, neurosurgical intervention was deferred. Spontaneous interhemispheric empyema is an uncommon condition. In our case conservative management was curative in what is considered a neurosurgical emergency.