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REMEMBERING REAMS...

As we traverse the scholastic ladder from Kindergarten to
college, we tax our memories with an ever-increasing deluge
of information. How we perform during the exam depends
largely on our ability to remember facts, figures, definitions
and diagrams. While rote learning involves a mechanical
regurgitation of facts; answering analytical questions, solving
problems or presenting a cogent argument also depends on our
ability to recall specific information. How can students hone
their memories so that they perform optimally in exams?
Psychologists have long-studied this human faculty and,
students can mine their mental libraries more effectively by
following certain principles.
Foremost, memorising should never be a substitute for
understanding. In fact, the more deeply you understand
content, the more likely you are to remember it. When we read
material in a shallow fashion — merely saying the words aloud
without really processing the meaning behind them — our
memory of that content is likely to fade away rather quickly.
However, if we engage with the material more actively, then
the imprint it leaves on our minds will be stronger. For
example, in an experiment, subjects were asked to read a set
of words on the screen. Half the subjects were told to check if
the words contained either an A or Q, while the other half
were asked to judge whether a word triggered pleasant or
unpleasant thoughts. The subjects in the latter group
remembered twice as many words as those in the former.
Key methods
Thus, asking questions as we read, making connections with
what we have learned earlier, organising information
meaningfully by making tables, rephrasing content in our own
words and drawing diagrams when appropriate are some of the
ways by which we can interact with content more deeply,
thereby increasing our chances of recalling the information.
Cognitive psychologist Daniel Willingham argues that the
human mind is receptive to understanding and remembering
stories; hence, we may take advantage of this proclivity to aid
our memories. For content that lends itself to a story format,
like a history lesson, reorganise the information using a story
structure. Even science lessons, reframed as stories, are better
recalled.
While delving into meaning is integral to learning, we have to
sometimes memorise information by rote. For example, even
after understanding the logic behind formulae, it is most
efficient for us to memorise them to solve problems. Likewise,
we may have to remember a list of facts like the causes leading
up to a battle. Here, we can use mnemonics or memory
strategies like creating anagrams, where every letter of the
word stands for one fact that we have to remember. You may
be creative in devising acronyms, even coining your own
words. Another ancient yet popular technique used by
professional mnemonists is called “Method of Loci.” Suppose,
you have to remember the names of the Presidents of India in
order. Imagine walking through a very familiar place like your
own house. Start at the entrance and imagine placing a picture
of Dr. Rajendra Prasad there. If you don’t know what he
looked like, create a visual mnemonic for his name. So you can
imagine placing ‘prasad’ from a temple at the entrance of your
house to help trigger the name. Next, you can imagine the
mythic Radha and Lord Krishna sitting in the hallway to trigger
the name of Dr. Radhakrishnan. As you mentally move through
the house, continue placing presidents in different locations in
your mind’s eye. Then, when you have to recall the list, all you
have to do is walk through your house!
How often and far apart should you review information? While
individuals differ in the number of revisions they need, spaced
repetition is a technique advocated by cognitive psychologists
where you gradually increase the interval before reviewing
information. Thus, after committing a set of formulae to
memory, you may review them the next day, then after two
days and then after a week. You can pace and space your
studying by alternating between subjects instead of studying
and reviewing the same subject at one go.
As students, we try to remember academic information so that
we can do well in tests. However, research indicates that
testing itself promotes recall. When students take a test, they
remember the content better at a later point as opposed to
those who simply restudy the material. Psychologist, Henry
Roediger and colleagues, who have researched the “testing
effect”, write that “Testing is a powerful means of improving
learning, not just assessing it.” Thus, if you periodically test
yourself while studying, you are more likely to recall
information on the actual test. Adequate sleep is also essential
as sleep actually helps us consolidate information in memory.
(The author is Director, PRAYATNA

Lab Values

                Lab value

                                         (Ref. Harrison 18^th ed.)

            

1.   Hematology and Coagulation

	Analyte	Specimen	SI Units	Conventional Units              Round-off
Differential blood count		Relative counts:
·         Neutrophils			0.40–0.70	40–70%
·         Bands			0.0–0.05	0–5%
·         Lymphocytes			0.20–0.50	20–50%
·         Monocytes			0.04–0.08	4–8%
·         Eosinophils			0.0–0.6	0–6%
·         Basophils			0.0–0.02	0–2%
Absolute counts:
·         Neutrophils			1.42–6.34x109/L	1420–6340/mm3
·         Bands			0–0.45x109/L	0–450/mm3
·         Lymphocytes			0.71–4.53x109/L	710–4530/mm3
·         Monocytes			0.14–0.72x109/L	140–720/mm3
·         Eosinophils			0–0.54x109/L	0–540/mm3
·         Basophils WB			0–0.18x109/L	0–180/mm3
Erythrocyte count		WB
·         Adult males			4.30–5.60x1012/L	4.30–5.60x106/mm3
·         Adult females			4.00–5.20x1012/L	4.00–5.20x106/mm3
Erythrocyte life span		WB
·         Normal survival			120 days	120 days
Erythrocyte sedimentation rate		WB
·         Females			0–20 mm/h	0–20 mm/h
·         Males			0–15 mm/h	0–15 mm/h
Hematocrit		WB
·         Adult males			0.388–0.464	38.8–46.4
·         Adult females			0.354–0.444	35.4–44.4
Hemoglobin
·         Plasma		P	6–50 mg/L	0.6–5.0 mg/dL
·         Whole blood:		WB
·         Adult males			133–162 g/L	13.3–16.2 g/dL
·         Adult females			120–158 g/L	12.0–15.8 g/dL
Leukocytes
·         Alkaline phosphatase (LAP)		WB	0.2–1.6 kat/L	13–100 /L
·         Count (WBC)          Erythrocytes		WB	3.54–9.06x109/L	3.54–9.06x103/mm3
·         Mean corpuscular hemoglobin (MCH)		WB	26.7–31.9 pg/cell	27–32  pg/cell
·         Mean corpuscular hemoglobin concentration (MCHC)		WB	323–359 g/L	32–36 g/dL
·         Mean corpuscular hemoglobin of reticulocytes (CH)		WB	24–36 pg	24–36 pg
·         Mean corpuscular volume (MCV)		WB	79–93.3 fL	79–93 m3
·         Mean platelet volume (MPV)		WB	9.00–12.95 fL	9.00–12.95
Partial thromboplastin time, activated(aPTT)		P	26.3–39.4 s	26.3–39.4 s
Platelet count		WB	165–415x109/L	150–400x10 ^3/mm3
Prothrombin time(PT)		P	12.7–15.4 s	12.7–15.4 s
Red cell distribution width		WB	<0.145	<14.5%
Reticulocyte count		WB
·         Adult males			0.008–0.023 red cells	0.8–2.3% red cells
·         Adult females			0.008–0.020 red cells	0.8–2.0% red cells
Thrombin time		P	15.3–18.5 s	15.3–18.5 s

*(Abbreviations: P, plasma; RC, red cells; S, serum; WB, whole blood)

Table 2 Clinical Chemistry and Immunology

Analyte	Specimen*	SI Units	Conventional Units
Alanine aminotransferase (ALT, SGPT)	S	0.12–0.70 kat/L	7–41 U/L
Albumin	S	40–50 g/L	4.0–5.0 mg/dL
Anion gap	S	7–16 mmol/L	7–16 mmol/L
Arterial blood gases ·         [HCO3–] ·         PCO2 ·         pH ·         PO2	WB	22–30 mmol/L 4.3–6.0 kPa 7.35–7.45 9.6–13.8 kPa	22–30 meq/L 32–45 mmHg 7.35–7.45 72–104 mmHg
Aspartate aminotransferase (AST, SGOT)	S	0.20–0.65 kat/L	12–38 U/L
Bilirubin ·         Total ·         Direct ·         Indirect	S	5.1–22 mol/L 1.7–6.8 mol/L 3.4–15.2 mol/L	0.3–1.3 mg/dL 0.1–0.4 mg/dL 0.2–0.9 mg/dL
Calcium	S	2.2–2.6 mmol/L	8.7–10.2 mg/dL
Calcium, ionized	WB	1.12–1.32 mmol/L	4.5–5.3 mg/dL
C-reactive protein	S	<10 mg/L	<10 mg/L
Creatinine ·         Female ·         Male	S	44–80 mol/L 53>106mol/L	0.5–0.9 mg/dL 0.6–1.2 mg/dL
Erythropoietin	S	4–27 U/L	4–27 U/L
Fatty acids, free (nonesterified)	P	0.1–0.6 mmol/L	2.8–16.8 mg/dL
Ferritin ·         Female ·         Male	S	10–150 g/L 29 248g/L	10–150 ng/mL 29–248 ng/mL
Glucose ·         Glucose (fasting) ·         Normal ·         Increased risk for diabetes ·         Diabetes mellitus	WB P	3.6–5.3 mmol/L 4.2–5.6 mmol/L 5.6–6.9 mmol/L Fasting >7.0 mmol/L A 2-hour level of >11.1 mmol/L during an oral glucose tolerance test A random glucose level of >11.1 mmol/L in patients with symptoms of hyperglycemia	65–95 mg/dL 75–100 mg/dL 100–125 mg/dL Fasting >126 mg/dL A 2-hour level of >200 mg/dL during an oral glucose tolerance test A random glucose level of >200 mg/dL in patients with symptoms of hyperglycemia
Insulin	S, P	14.35–143.5 pmol/L	2–20 U/mL
Iron	S	7–25 mol/L	41–141 g/dL
·         Iron-binding capacity	S	45–73 mol/L	251–406 g/dL
·         Iron-binding capacity saturation	S	0.16–0.35	16–35%
Lactate dehydrogenase	S	2.0–3.8 kat/L	115–221 U/L
Oxygen saturation (sea level) ·         Arterial ·         Venous, arm	WB	Fraction: 0.94–1.0 0.60–0.85	Percent: 94–100% 60–85%
Phosphatase, alkaline	S	0.56–1.63 kat/L	33–96 U/L
Potassium	S	3.5–5.0 mmol/L	3.5–5.0 meq/L
Protein fractions: 1.        Albumin 2.        Globulin 3.        Alpha1 4.        Alpha2 5.        Beta 6.        Gamma	S	35–55 g/L 20–35 g/L 2–4 g/L 5–9 g/L 6–11 g/L 7–17 g/L	3.5–5.5 g/dL (50–60%) 2.0–3.5 g/dL (40–50%) 0.2–0.4 g/dL (4.2–7.2%) 0.5–0.9 g/dL (6.8–12%) 0.6–1.1 g/dL (9.3–15%) 0.7–1.7 g/dL (13–23%)
Protein, total	S	67–86 g/L	6.7–8.6 g/dL
Sodium	S	136–146 mmol/L	136–146 meq/L
Thyroid-stimulating hormone	S	0.34–4.25 mIU/L	0.34–4.25 IU/mL
Thyroxine, free (fT4)	S	9.0–16 pmol/L	0.7–1.24 ng/dL
Thyroxine, total (T4)	S	70–151 nmol/L	5.4–11.7 g/dL
Urea nitrogen	S	2.5–7.1 mmol/L	7–20 mg/dL
Uric acid ·         Females ·         Males	S	0.15–0.33 mmol/L 0.18–0.41 mmol/L	2.5–5.6 mg/dL 3.1–7.0 mg/dL

Table 5 Classification of LDL, Total, and HDL Cholesterol

LDL Cholesterol <70 mg/dL Therapeutic option for very high risk patients <100 mg/dL Optimal 100–129 mg/dL Near optimal/above optimal 130–159 mg/dL Borderline high 160–189 mg/dL High 190 mg/dL Very high Total Cholesterol <200 mg/dL Desirable 200–239 mg/dL Borderline high 240 mg/dL High HDL Cholesterol <40 mg/dL Low 60 mg/dL High

Cerebrospinal Fluid

Reference Range Constituent SI Units Conventional Units Osmolarity 292–297 mmol/kg water 292–297 mOsm/L Electrolytes Sodium 137–145 mmol/L 137–145 meq/L Potassium 2.7–3.9 mmol/L 2.7–3.9 meq/L Chloride 116–122 mmol/L 116–122 meq/L pH 7.31–7.34 Glucose 2.22–3.89 mmol/L 40–70 mg/dL Lactate 1–2 mmol/L 10–20 mg/dL Total protein: Lumbar 0.15–0.5 g/L 15–50 mg/dL Albumin 0.066–0.442 g/L 6.6–44.2 mg/dL CSF pressure 50–180 mmH2O CSF volume (adult) 150 mL Red blood cells 0 0 Leukocytes Total 0–5 mononuclear cells per L Differential Lymphocytes 60–70% Monocytes 30–50% Neutrophils None

Urine Analysis and Renal Function Tests
Ammonia	30–50 mmol/d	30–50 meq/d
Creatinine	8.8–14 mmol/d	1.0–1.6 g/d
Glomerular filtration rate	>60 mL/min/1.73 m2 For African Americans multiply the result by 1.21	>60 mL/min/1.73 m2 For African Americans multiply the result by 1.21
Glucose (glucose oxidase method)	0.3–1.7 mmol/d	50–300 mg/d
Ketone (acetone)	Negative	Negative
Microalbumin –Normal –Microalbuminuria –Clinical albuminuria	0.0–0.03 g/d 0.03–0.30 g/d >0.3 g/d	0–30 mg/d 30–300 mg/d >300 mg/d
Osmolality	500–800 mOsmol/kg water	500–800 mOsmol/kg water
pH	5.0–9.0	5.0–9.0
Phosphate (phosphorus) (varies with intake)	12.9–42.0 mmol/d	400–1300 mg/d
Potassium (varies with intake)	25–100 mmol/d	25–100 meq/d
Protein	<0.15 g/d	<150 mg/d
Sediment –Red blood cells –White blood cells –Bacteria –Crystals –Bladder cells –Squamous cells –Tubular cells –Broad casts –Epithelial cell casts –Granular casts –Hyaline casts –Red blood cell casts –Waxy casts –White cell casts	0–2/high-power field 0–2/high-power field None None None None None None None None 0–5/low-power field None None None
Sodium (varies with intake)	100–260 mmol/d	100–260 meq/d
Urea nitrogen	214–607 mmol/d	6–17 g/d
Uric acid (normal diet)	1.49–4.76 mmol/d	250–800 mg/d