Why is independence often considered the cornerstone of the auditing profession? Why were independence issues a primary concern of Congress when they developed the Sarbanes-Oxley Act? Due professional care is to be exercised in the performance of the audit and the preparation of the report.
July 25, at 7: I am a medical student, though, and the primary focus of our scientific learning is in PBLs Problem-Based Learning groups. These are at the start and end of every week, and go for three hours, and they are, frankly, enjoyable to the point of exhilaration, at least for me.
I did not do as well in first-year. But I was the sort of person, and I still am, who examines and amends their learning methods constantly.
This is something of a neurosis for me, actually, driven in part by fear, i. So I amended my approach to learning. I used Pushing Electrons. I recorded lectures and played them in the car, on the way to and from Uni. This type of abstract thinking is similar, in a way, to learning about something like limits or differentiation, although the mathematics is probably more abstract and challenging than the organic chemistry in many ways.
Once I realised the creativity involved in chemistry, and particularly in organic chemistry, I was hooked. I was always better at English than mathematics in high school: I had low mathematical ability, low confidence, and a general desire to avoid mathematics.
At Uni, my first-year teacher was an inspiring and very, very engaging teacher and that allowed me to re-evaluate the way I thought of numbers and stats and mathematics.
Organic chemistry is a creative art. We use all that information in the PBL scenarios, and we have 2 of these scenarios per week. They require lots of work but they are immensely fun.
Sometimes it will be quite clear — e. The low MCHC count tells us that we have a high level of hypochromic microcytic RBCs, and we can confirm this by viewing a peripheral blood smear, which will show a number of small RBCs with a lack of substantial colour.
The smear will also show smaller entitites called reticulocytes, these are immature RBCs. We can use these, and another measure called RDW RBC distribution width to determine the type of microcytic anemia, i. Is it caused by protein globin deficiency? Both inhibiting Hb production Is it caused by a combination of other factors, or single other factors?
IDA typically shows decreased RI. Normal or elevated RI is consistent with haemoglobinopathies inhibited globin production, so inability to form the haeme protein subunits in Hb.
That way is to check serum ferritin levels: Ferritin is a protein that transports iron in the plasma and is a marker for iron storage in the body: In the presenting complaint I mentioned, we have normal ferritin.
This is caused by mutation in the HBB gene on chromosome If both alleles are affected ie the mutant form of HBB is homozygous then they have the more severe form of the disease, thalassemia major.
In both cases, reduced beta globin means less HbA is generated; a deficiency of HbA results in microcytic anaemia and lack of proper RBC functioning: The patient is at risk of haemochromotosis due to iron buildup from these transfusions, but the risk can be mitigated somewhat with the use of iron chelating agents.
But I hope you get a bit of a taste as to what it is like, in medical school anyway, with respect to learning human biology in the preclinical aspect: I enjoy it immensely.
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