Anatomy

AETCOM Questions and answers

SR. SUBTOPIC COMPETENCY

NO. NAME DESCRIPTION NUMBER
XIV AETCOM
CORE/ Y
1 Write dos and don’ts of doctor-patient verbal communication.

2 Boundaries of the doctor-patient relationship

3 “Cadaver as our first teacher” Justify

4 Write a note on importance of handling of biological tissues.

5 Need for biomedical waste management

Enumerate drum/bag colors used with the types of biomedical waste to be

6 disposed in them.

Write note on things you will do & not do in dissection hall, to show your
7 respect for cadaver.

Enumerate different locations in medical colleges and hospitals where

8. biomedical waste disposal knowledge is important
Q1. Write do and don`t of doctor patient communication
Do`s
1. Treat patients as individuals and respect their dignity.
1. A Doctor must be polite and considerate.
2. A Doctor must treat patients as individuals and respect their dignity and privacy.
3. A Doctor must treat patients fairly and with respect whatever their life choices and
beliefs.
4. A Doctor must work in partnership with patients, sharing with them the information they
will need to make decisions about their care, including:
a) their condition, its likely progression and the options for treatment, including
associated risks and uncertainties
b) the progress of their care, and role and responsibilities of doctor in the team
c) who is responsible for each aspect of patient care, and how information is shared
within teams and among those who will be providing their care
d) any other information patients need if they are asked to agree to be involved in
teaching or research.
5. A Doctor must treat information about patients as confidential, including even after
patient’s death.
6. A Doctor must support patients in caring for themselves to empower them to improve and
maintain their health. This may, for example, include:
a. advising patients on the effects of their life choices and lifestyle ontheir health and
well-being
b. Supporting patients to make lifestyle changes where appropriate.
7. A Doctor must explain to patients that if they have a conscientious objection to a
particular procedure they have right to see another doctor. A Doctor then should make
sure they have enough information to exercise that right. In providing this information
one must not imply or express disapproval of the patient’s lifestyle, choices or beliefs. If
it is not practical for a patient to arrange to see another doctor, one must make sure that
arrangements are made for another suitably qualified colleague to take over your role.
8. A Doctor must be open and honest with patients if things go wrong. If a patient under
your care has suffered harm or distress, you should:
a. put matters right (if that is possible)
b. offer an apology
c. explain fully and promptly what has happened and the likely short-term and long-
term effects.
9. A Doctor must consider and respond to the needs of disabled patients and should make
reasonable adjustments to one’s practice so they can receive care to meet their needs.
10. A Doctor must respond promptly, fully and honestly to complaints and apologise when
appropriate. You must not allow a patient’s complaint to adversely affect the care or
treatment you provide or arrange.

Things that can be avoided

1. A Doctor must not use one’s professional position to pursue a sexual or improper
emotional relationship with a patient or someone close to them.
 2. A Doctor must not express one’s personal beliefs (including political, religious and moral
beliefs) to patients in ways that exploit their vulnerability or are likely to cause them
distress.
3. A Doctor must not deny treatment to patients because their medical condition may put
you at risk. If a patient poses a risk to your health or safety, you should take all available
steps to minimize the risk before providing treatment or making other suitable alternative
arrangements for providing treatment.
4. A Doctor must not unfairly discriminate against patients or colleagues by allowing one’s
personal views to affect the professional relationships or the treatment one provides or
arranges.

DO
Doctor • Engage in general conversation
to help the patient feel at ease
• Ask open ended questions
• Maintain eye contact
• Listen to the patient
• Empathize with patient
• Take consent from patient for
examination
• Use simple words to describe
the disease to the patient
• Schedule follow ups
appropriate time
• Take down notes of the consult
Patient • Give the complete history
• Follow advice given by doctor
• Adhere to the prescribed
treatment
• Adhere to the follow up
schedule
DON’T
• Don’t interrupt the patient
• Don’t look at your phone while
talking to patient
• Don’t use medical jargon
• Don’t dismiss the patient’s
concerns
• Don’t speak ill of your colleague in
front of the patient
at
• Don’t hide information regarding
the symptoms, drugs ingesting or
addictions
• Don’t google your symptoms
Q2. Boundaries of Doctor patient relationship
➢ Doctor patient relationship relies on trust, honesty, communication skill and partnership.
➢ Trust and mutual consent helps in proper diagnosis and belief in healthcare management and
outcome. It should not be breeched by crossing boundaries by sexual advances such as improper
talk, behavior and considering social and cultural behavior.
➢ To maintain trust, proper consent must be taken after explaining professional conduct and
procedure in advance in local language which can be understood by patient.
➢ Weak segment of the society should be dealt with care such as child, old person, race, patient of
opposite sex and mentally challenged or disabled person.
➢ Honesty of both doctor and patient plays important role.
➢ Doctor must listen to patients complains and concerns till end. He should maintain his
knowledge and skills updated to become competent in delivering healthcare efficiently.
➢ Doctor should prescribe investigations and treatment judicially and in benefit of patient.
➢ Doctor should be honest to patient about adverse outcome and explain it to patient.
➢ Patients should not hide any relevant information from doctor that will help in improving
healthcare.
➢ Patient should carry out investigation and take treatment as prescribed and inform doctor about
difficulty in managing with treatment.
➢ Communication skills during adverse reactions or critically ill or terminally ill patient plays
important role. While explaining doctor must be empathetic.
➢ Most important, Patient is partner in his treatment and healthcare. Patients’ autonomy should be
respected. Treatment modalities must be explained and one should make sure that option is
chosen by patient.
➢ Counseling should be non-directive and parenting should be avoided. Care should be taken to
respect autonomy of patient with no harm principle must be followed both at individual and
societal level.
Q 3. “Cadaver as our first teacher” Justify
Dissection is a time-tested method of medical education all over world. Dissection of cadavers
lays down a strong foundation for medical knowledge and clinical practice.
Real dissection was being replaced by virtual e-learning with computer-simulated models in the
teaching of gross anatomy in some colleges world wide due to scarcity of cadavers to dissect. But now
again institutions are understanding importance of actual dissection.
This is because dissection is one of the first things which medical students have to face in
anatomy and just like any other teacher the cadaver they encounter here teaches them many things along
with Anatomy.
Students may initially perceive this as an unnerving sight which disturbs their notion that being
a doctor means handling live patients. But as they spend more and more time in dissection hall they start
understanding its importance.

What do students learn in dissection hall from dissection of cadavers -

• Starting the dissection with cadaveric oath & lecture on body and organ donation – teaches
respect and gratitude. Importance of showing reverence towards cadaver inculcates humility,
caring attitude, sympathy which will be later useful while dealing with patients.
• Cadavers teach the students the complex relationships of anatomical structures and give the feel
of the tissues.
• Dissection also helps to instill a spirit of team-work, patience, respecting each other’s opinion.
• Dissecting as team allows development of communication skills, leadership qualities.
 • Lecture on importance of and ways of biomedical waste disposal - teaches about biomedical
waste management which is very important for today’s doctor.
• Even after completing post graduate education, doctors keep on coming to the dissection hall to
practice fine surgical skills and refresh their knowledge before operating on the patient. Getting
dissection exposure in first year is just 1st step in long journey of becoming doctor.
• Cadavers can be compared to a complex road map in which there is no active traffic. The
students can learn anatomy without actually hurting anyone. This gives them a safe environment
to learn complex human body.
• Many colleges conduct donor honor ceremony at the end of the dissection. This teaches students
to be grateful to the cadaver even when it is of no further use and to respect the dignity of human
being who voluntarily submitted their body for the purpose of medical education.
• The disciplined and respectful environment of the dissection hall also is a beginning of the
development of a disciplined life as a medical graduate.

Q 4. Write a note on importance of knowledge of handling of biological tissues.

Biomedical waste is defined as any waste, which is generated during the diagnosis, treatment or
immunisation of human beings or animals, or in research activities pertaining thereto, or in the
production or testing of biologicals.
Handling and disposal of this waste is a concern, as many medical wastes are classified
as infectious or biohazardous and could potentially lead to the spread of infectious disease. The most
common danger for humans is the infection which also affects other living organisms in the region.
Daily exposure to the waste leads to accumulation of harmful substances or microbes in the person's
body.
Biomedical waste handled incorrectly may pose risk of an injury and exposure via contact with
medical waste for doctors, nurses, and other non medical workers. Further, there are opportunities for
the general public to come into contact medical waste, such as needles used illicitly outside healthcare
settings, or biomedical waste generated via home health care.
Improper disposal can lead to many diseases in animals as well as humans. For example,
animals, such as cows may consume the infected waste and eventually, these infections can be
transported to humans who consume their meat or milk. Similarly biomedical waste discharged in sea
could then be consumed by ocean life creatures and eventually reach humans who consume them.
Human exposure to such toxins can stunt human growth development and cause birth defects.
The syringe tide environmental disaster of 1987–1988 raised awareness about medical waste as
medical syringes washed ashore in Connecticut, New Jersey, and New York. The syringes endangered
marine species and posed a threat to humans who visited the beach. The crises spurred scientists and
lawmakers to create mechanisms, policies, and laws so that health care providers would process their
bio-waste in an environmentally friendly way.
Improper management of health care waste can have both direct and indirect health
consequences for health personnel, community members and on the environment.
The high volume of plastic use in the medical field also poses a dangerous threat to the
environment.. In addition to the serious health implications of releasing harmful toxins in the
environment from medical waste deposits, introducing this volume of single-use plastics can catalyze
the compounding health detriments caused by macro and microplastics.
Post incineration process, toxic ash residue is produced and is often disposed at landfills. These
landfills are not protected by any barrier and the residue has the potential of reaching underground
water that is often exposed to human use. The combustion of plastic material releases toxic gases that
escapes and joins breathable air. Human and animal exposure to such gases can cause long term
breathing and health issues.
Air pollution caused by the incinerators depletes the ozone layer, causes crop, trees and forest
damage, and increases climate change.
Thus as future doctors it is important for medical students to have knowledge about biomedical
waste handling.

Q5. Need for Biomedical Waste Management:

• Any waste generated in diagnosis, treatment or immunization of human beings or animals or in
research activities is said to be biomedical waste.
• Biomedical waste management is of utmost importance in today’s world which is facing
emerging and remerging infections every day.
• Biomedical waste poses a great threat as most of the waste is hazardous. When this infectious
waste mixes with general wastes, it ends up contaminating all it.
• It is a potential health hazard to healthcare workers, public, flora and fauna of the area.
• This waste includes sharps like syringes, blades, etc. that can injure a person.
• Also, insects, rodents and worms are attracted to this waste and can act as vectors for various
diseases like typhoid, cholera, etc.
• The amount of biomedical waste generated per bed per day is approximately 2 kilograms.
Therefore, it is necessary to separate out wastes that can be recycled after disinfection to reduce
the burden put on our environment.
• Biomedical waste types include:
1) Biological waste
2) Radiation waste
3) Chemical waste
4) Pharmaceuticals
5) Sharps, etc.
Separation and treatment of each must be done as all of them present a different threat.

• The principle of Biomedical Waste Management is to reduce, segregate, disinfect, store,

transport and dispose the waste.
• At the hospital level, it is vital that healthcare personnel are educated about segregation of waste.
• Separate colour-coded dustbins should be available is every hospital at the necessary locations.

Q 6. Enumerate drum/bag colors used with the types of biomedical waste to be disposed in them.
Color coding for biomedical waste disposal – 4 colors are used – yellow, red, white, blue
Either containers or non chlorinated plastic bags
Yellow containers/ bags –
a. Human Anatomical Waste: Human tissues, organs, body parts and fetus below the viability period,
b. Animal Anatomical Waste : Experimental animal carcasses, body parts, organs, tissues, including
the waste generated from animals used in experiments or testing in veterinary hospitals or colleges
or animal houses
c. Soiled Waste: Items contaminated with blood, body fluids like dressings, plaster casts, cotton
swabs and bags containing residual or discarded blood and blood components
d. Expired or Discarded Medicines: Pharmaceutical waste like antibiotics, cytotoxic drugs including
all items contaminated with cytotoxic drugs along with glass or plastic ampoules, vials etc.
e. Chemical Waste: Chemicals used in production of biological and used or discarded disinfectants
f. Chemical Liquid Waste : Liquid waste generated due to use of chemicals in production of
biological and used or discarded disinfectants, Silver X-ray film developing liquid, discarded
Formalin, infected secretions, aspirated body fluids, liquid from laboratories and floor washings,
cleaning, house-keeping and disinfecting activities
g. Discarded linen, mattresses, beddings contaminated with blood or body fluid.
h. Microbiology, Biotechnology and other clinical laboratory waste: Blood bags, Laboratory
cultures, stocks or specimens of microorganisms, live or attenuated vaccines, human and animal cell
cultures used in research, industrial laboratories, production of biological, residual toxins, dishes and
devices used for cultures
Red containers/ bags –
Contaminated Waste (Recyclable): Wastes generated from disposable items such as tubing,
bottles, intravenous tubes and sets, catheters, urine bags, syringes (without needles and fixed
needle syringes) and vaccutainers with their needles and gloves
White containers –
Waste sharps including Metals: Needles, syringes with fixed needles, needles from needle tip
cutter or burner, scalpels, blades, or any other contaminated sharp object that may cause puncture and
cuts. This includes both used, discarded and contaminated metal sharps
Blue containers –
a. Glassware: Broken or discarded and contaminated glass including medicine vials and ampoules
except those contaminated with cytotoxic wastes.
b. Metallic Body Implants

Q 7. Write note on things you will do & not do in dissection hall to show your respect for cadaver.
Dos
a. Wear gloves, clean apron, keep your bags in racks
b. Tie long hair, cut nails
c. Talk with respect about cadaver and parts while dissecting
d. Keep the private parts of cadaver covered
e. Throw waste from cadaver in the tray provided and in appropriate waste disposal container at the
end of the day
f. Keep your scalpel and any sharp instruments on the table when not in use
g. Keep your hands away from mouth and nose
h. Wash your hands after dissection
i. Maintain discipline and cleanliness in the dissection hall
Don’ts
a. Do not eat or drink in the dissection hall
b. Do not Use mobile, Talk loudly
c. Do not leave your table or the dissection hall without prior permission
d. Do not throw the body waste from cadaver or your gloves anywhere other than indicated
containers
e. Do not make fun or talk bad about any aspect of any cadaver
Q8. Enumerate different location in medical college and hospitals where biomedical waste disposal
knowledge is important
Ans. Different locations include:
1. Anatomy Dissection Hall
2. Haematology Lab Physiology
3. Biochemistry Lab
4. Pathology Lab
5. Microbiology Lab
6. Surgical OTs
7. Labour room
8. Wards/ Nurses Station
9. OPD
10. Blood Bank
11. Research Lab
12. Forensic Lab
13. ICU
14. Hostel
15. Canteen
16. Washrooms