Grey Matter Pathways

Dr Nishen Gokal

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We take a deep dive into study technique and answering technique. This channel is designed for candidates preparing for postgraduate fellowship exams. The principles are easily extrapolated to any exam. Paving pathways between the finite short term memory and the infinite long term memory.

10 HR AGO

CO2 Transport

In this episode we explain the multifaceted role of haemoglobin in the physiological movement of carbon dioxide through the bloodstream. We highlight how this protein facilitates the formation of bicarbonate by acting as a buffer for hydrogen ions and enables the creation of carbamino compounds by binding directly to the gas. Central to the discussion is the Haldane effect, which describes how the oxygenation state of blood influences its total carbon dioxide capacity. By contrasting gas exchange at the tissues and the lungs, the sources demonstrate how changes in chemical affinity ensure efficient respiratory waste removal. Furthermore, we provide evaluative feedback on common academic errors, emphasizing the need for quantitative precision and clear biochemical equations in medical examinations. This comprehensive overview serves as both a scientific guide and a pedagogical tool for understanding respiratory acid-base balance.

17 min
30 JAN

An Approach to SBA Questions

Dr Nishen Gokal outlines effective techniques for students to improve their performance on multiple-choice examinations. The primary focus is on active comprehension, such as rephrasing confusing prompts and mastering "direction words" like "analyze" or "infer" to ensure instructions are followed precisely. Students are encouraged to formulate independent answers before viewing the provided options to avoid being misled by deceptive choices. Furthermore, the text emphasizes strategic time management and the use of deductive reasoning to eliminate improbable answers when guessing is necessary. By implementing these systematic approaches, learners can build the confidence and skills required to navigate complex testing formats successfully.

12 min
28 JAN

Using Hendry’s Law to Explain the Role of Haemoglobin

This educational material focuses on the application of Henry’s Law to human physiology, specifically regarding how oxygen is transported in the blood. The text explains that while gas solubility is proportional to partial pressure at a stable temperature, the amount of oxygen dissolved in plasma is insufficient to meet the body's metabolic demands. Through step-by-step mathematical calculations, the source demonstrates that dissolved oxygen only provides about 15 ml/min, which falls far short of the required 200 ml/min at rest. Consequently, the documents emphasize that haemoglobin is vital because it significantly increases the blood's oxygen-carrying capacity. Student feedback within the text highlights the necessity of using the oxygen content equation and quantitative data to fully explain these biological concepts in an exam setting.

18 min
18 JAN

Wests Zones and the Framing Statement

This document provides a guide for students on mastering the "framing statement" technique to improve performance on high-stakes examinations. The episode emphasizes using a single introductory sentence to contextualize complex physiological topics, such as West’s zones of the lung and pulmonary blood flow, within the broader scope of respiratory physiology. Detailed clinical explanations are provided for Zones 1 through 4, outlining how gravity and pressure variations between the alveoli, arteries, and veins affect ventilation and perfusion. Furthermore, the resource offers practical feedback on common student errors, recommending the use of labeled diagrams and mechanistic analogies like the Starling resistor. By applying these methods to various concepts like surfactant and the alveolar gas equation, candidates can demonstrate a sophisticated grasp of how posture and lung volume impact human physiology.

15 min
29/12/2025

Diffusion and an Approach to Graphs

This educational resource provides a comprehensive guide to respiratory physiology and the interpretation of medical graphs for clinical examinations. The material focuses heavily on the mechanics of gas exchange, explaining how the movement of molecules is either diffusion-limited, as seen with carbon monoxide, or perfusion-limited, like nitrous oxide. Through the application of Fick’s Law, the text details how factors such as exercise, alveolar hypoxia, and physical abnormalities can disrupt the pressure gradients and transit times necessary for proper oxygenation. Beyond physiological concepts, the sources offer a structured framework for graphical analysis, teaching students to identify dependent and independent variables while assessing the significance of slopes and curves. To reinforce these lessons, the document includes candidate feedback and specific examples involving ventilatory responses to changing carbon dioxide and oxygen levels. This holistic approach ensures that students can both memorize key biological facts and apply critical thinking to unfamiliar data sets in an exam setting.

12 min
19/12/2025

Dead Space, Trigger Phrases and Derivations

This educational resource focuses on physiological respiratory monitoring, specifically highlighting the Bohr equation for calculating dead space. It details how to mathematically derive the formula by measuring carbon dioxide balance and using clinical surrogates like end-tidal and arterial CO2. Beyond specific formulas, the text advocates for a long-term study strategy that prioritizes understanding physical principles over simple rote memorization. By using annotated diagrams and "trigger phrases" for definitions, the source aims to help medical students internalize complex concepts like compliance and the alveolar gas equation. Ultimately, the material serves as both a specialized medical tutorial and a guide for mastering professional examination techniques.

14 min
08/12/2025

The Stream of Concepts

I use the chapter in respiratory physiology on the mechanics of pulmonary ventilation to demonstrate a study technique I call “the stream of concepts”. A powerful tool used by candidates who have been successful in the recent CMSA FCA Part 1 exam. The provided text is an academic resource that focuses on the mechanics of pulmonary ventilation, particularly through the analysis of the pressure-volume (PV) curve of the lung. The source includes an examination of student performance on related questions, highlighting common errors such as insufficient precision when identifying dependent and independent variables, and omissions regarding the role of surfactant at high lung volumes. The material then introduces a study technique called the "stream of concepts," which emphasizes understanding individual concepts like lung compliance and elastance, and the logical connections between them. Various diagrams, equations for static and dynamic compliance, and a detailed graphical analysis approach are presented to aid in the comprehension of complex physiological principles, such as hysteresis and the passive nature of normal expiration.

13 min
27/11/2025

The Hidden Narrative: Adaptation for Gaseous Exchange

The provided materials outline a specific study technique known as the "hidden narrative," which is designed to improve long-term memory by arranging dry facts into a cohesive, memorable story structure. This pedagogical concept is immediately applied to an example concerning respiratory physiology, specifically the structural features of the lung that facilitate effective gaseous exchange. The scientific explanation is framed around Fick's law of diffusion, demonstrating how the lung optimizes variables like surface area, membrane thickness, and pressure gradient to maximize gas transfer efficiency. Specific anatomical details, such as the expansive alveolar surface area (up to 100 m2) and the extremely thin blood-gas barrier (0.3 micrometers) are provided as evidence of these adaptations. The diagram further illustrates how narrow alveolar capillaries force red blood cells into single-file passage, ensuring full oxygen saturation before leaving the exchange interface. Comprehensive feedback emphasizes that successful answers require both an understanding of Fick's law and the accurate recall of precise physiological data points.

11 min

We take a deep dive into study technique and answering technique. This channel is designed for candidates preparing for postgraduate fellowship exams. The principles are easily extrapolated to any exam. Paving pathways between the finite short term memory and the infinite long term memory.

Creator

Dr Nishen Gokal
Years Active

2025 - 2026
Episodes

14
Rating

Clean
Copyright

© Dr Nishen Gokal
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Grey Matter Pathways