Saturday, September 23, 2017

Bacterial exotoxins that work via overactivating Adenylate Cyclase, a mnemonic

There are many bugs which have many exotoxins

to memorize those that have an exotoxin which work through overactivating Adenylate Cyclase therefore increasing cyclic AMP (+ cAMP) => just remember the letters of the word: CAMP

=> the bugs are:
Cholera (Vibrio Cholera)
Anthrax(Bacillus Anthracis)
Moctezuma's revenge ( a fancy name of heat labile entertotoxigenic E.coli, ETEC)
Pertussis (Bordetella Pertussis)

-Murad

Chromosomes affected in syndromes that sound similar, a mnemonic

Hello everyone!

Wilson's disease, Williams syndrome and Wilm's tumor are confusing since they all start with "Wil". This is how I remember them and differentiate which chromosome number is affected in which disease. 

Wilson's disease: (for Dr. House fans)
Remember Dr. House, Wilson and Thirteen?

So that's how I remember that in Wilson's disease chromosome 13 is affected. 

William syndrome:
If you read the 2nd part of the word William, it is: I AM. When you re-arrange it: I AM WILL. 

Remember Will Smith and his famous movie - Seven Pounds? 

William syndrome => chromosome 7 affected. 


Wilm's tumor:
Just write the I and L as 11 so it is W11m's => Chromosome 11 is affected.

-Murad

Trinucleotide repeats mnemonics

In Friedreich Ataxia, patients have problems in their gait => GAAAAAAAAAAAit :D
so the trinucleotide repeat is: GAA

In Fragile X syndrome, patients have problems in their testicles (large testes among other things) so they  "Can't Get it Going" :P  => the trinucleotide repeat is: CGG

-Murad

Friday, September 22, 2017

Renal stones and pH of urine mnemonic

Hello!

Here's a post on the association between renal stones and pH of urine.

Which stones form in acidic urine?

Mnemonic: It's pretty simple, stones which have "weak acids" as a component.

Uric ACID
Calcium oxalate (Oxalic ACID)
Cysteine (Which is an Amino ACID)

PS: This is just a mnemonic.

Which stones form in alkaline urine?

Calcium Phosphate
Magnesium Ammonium Phosphate

That's all!

-IkaN

Thursday, September 21, 2017

SERM for vulvovaginal atrophy mnemonic

Which of the following is a selective estrogen receptor modulator (SERM) that is prescribed mainly for treatment of genitourinary syndrome of menopause (vulvovaginal atrophy)?

A.) Bazedoxifene
B.) Raloxifene
C.) Phentermine
D.) Lasofoxifene
E.) Ospemifene

Atherosclerosis location mnemonic

Atherosclerosis location mnemonic

"A Cholesterol Plaque In Circles"

Most commonly involved vessels in decreasing order is:

Abdominal Aorta (especially around ostia - openings of major branches)
Coronary Artery
Popliteal Artery
Internal Carotid (especially at carotid sinus)

- Submitted by Murad

Tuesday, September 19, 2017

Ocular toxoplasmosis and HIV

Here are some fun facts about Ocular Toxoplasmosis and HIV!

Ocular toxoplasmosis usually causes a retinal lesion with inflammation, giving the classical "headlight in the fog"  appearance.

Headlight is the lesion and the fog is due to the inflammation (WBCs).

HIV being an immunodeficient condition, there are lesser number of WBCs and hence there's no fog - Just the headlight.

The drug of choice for treatment of ocular toxoplasmosis is pyrimethamine.

However, it is contraindicated in pregnancy and HIV due to the risk of megaloblastic anemia and neural tube defects, respectively.

In pregnancy, spiramycin is preferred.

In HIV, the preferred drugs are clindamycin, azithromycin or quinolones.

- Written by Dr²

Sunday, September 10, 2017

Enucleation, Evisceration & Exenteration

In this post, we will look at the definition, indications and some few details regarding these 3 ophthalmologic surgeries. 

Saturday, September 9, 2017

Cytochrome P450 3A4



Hello everyone!

Today lets discuss the Cytochrome P450 3A4
It is the microsomal enzyme involved in metabolism of xenobiotics. Maximum number of drugs are metabolised by CYP 3A4 in our body.

Here’s how you  remember the substrates and the inducers of the enzyme:

“In emergency Straightaway give a CPR and ACT SaNely

The inducers are:
S: St John Wort
CPR: Carbamazepine, Phenytoin, Phenobarbitone, Rifampicin


The substrates are:
ACT SaNely

A-Amiodarone
A-ACT drugs(Anti Histamines) 
*A-Astemizole
 *C-Cisapride
*T-Terfenadine
C- Cyclosporine
T- Tacrolimus
S- Statins
N-Navirs (protease inhibitors)




And how do we remember the inhibitors?

Shout “Fire in the Hole!”
Fluconazole   Ketoconazole
and Ritonavir and Erythromycin
Also you can have some grapefruit juice to chill out! Grapefruit juice is also a Inhibitor of CYP3A4.

That’s all
Thank you,
Chaitanya Inge

Tuesday, September 5, 2017

Drug interaction

Hello :)

Definition:-
Modification of response  to one drug by another drug or non drug (like food ,beverages like alcohol,smoking) when they are administered simultaneously or in quick succession  .


Factors for drug interactions:-
1.Multiple drugs for same disease.
2.Multiple prescribers.
3.Multiple diseases.
4.Poor patient compliance .
5. Drug factors like it is not palatable or too many in frequency .
6.Multiple unknown action of drugs.
7. Most imp is patients age .

Effects of drug interaction:-
1.Quantitative i.e Increase  or decrease the response intensity.
2. Qualitative:- abnormal /different type of response.

Mechanism of drug interaction :-
A.Pharmacokinetic interactions include,
 1.Absorption (either complex formation ,pH change ,or alteration in motility of GIT.)

2. Distribution:- (displacement from plasma protein binding site + inhibition of metabolism /or excretion)

3. Metabolism:- ( induction of enzymes or inhibition of enzymes or hepatic blood flow)

4.Excretion:- ( alteration in urine pH, Competition for active secretion ,renal blood flow)

B. Pharmacodynamic drug interactions include,
1.Antagonism
2. Summation
3.synergism

C.Drug interaction before administration:-
Either mixing before administration.
Or, exposure to light in some cases. (Like sodium nitroprusside).


-Upasana Y.

Blood retinal Barrier

Hello :)

There are two blood retinal Barrier (BRB) :-

1. Outer blood retinal Barrier - Formed by tight junction of retinal pigmented epithelium.

2. Inner blood Retinal Barrier - Formed by Muller cells and pericytes surrounding the lining of microvasculature.

That's all for today.
-Upasana Y. :)

Sunday, August 27, 2017

Immunology question

Hola awesomites!!

So, this is answer of our previous question. Lets have a look into it.

Q1)Which of the following features is not shared between T cells and B cells
a)Antigen specific Receptors
b)Class 1 MHC expression
c)Positive selection during development
d)All of the above

Answer is
C) Positive selection during development

Explanation:

Positive selection:
Site is thymic cortex.
-T cells having affinity for MHC molecules are selected since T cells having affinity for MHC molecules can interect with APC  and one who don't have recognisation is killed

Negative selection:
Site:Thymic medulla
Selected T cells are sent to medulla,where there affinity for self antigens are tested.If the have affinity they are programmed to death.

Incase of B cells,if they recognize self antigens they do not undergo death instead there receptors are changed by the process called as "Receptor editing" .If receptor editing dose not take place,then apoptosis takes place.This is negative selection of immature B cells. B cells negative selection occurs in the bone marrow

Both T-cell and B-cell have TCRs and BCRs respectively.
Class I MHC is expressed on both T cells and B cells..

Stay awesome:)

~Ojas

Saturday, August 26, 2017

Opioids analgesics classification + NEET notes

Hello awesomites so here is my " Single page notes" on opioid analgesics.
Lets begin.

Let us know the difference between opiates and opioids. 

Chemicals derived from opium or related to morphine chemically are called opiates.
And those having morphine like structures, irrespective of chemical action are called as opioids.
Opioid analgesics are classified as follow

1) Natural opium alkaloids

     - Morphine, Codeine.
 Morphine
 A) Acts on Mu(Causes dependency-Euphoria) , kappa(Dysphoria - Psychomimetic) and delta receptors as agonist. Hence used as supraspinal and Spinal analgesic.
 B) Treatment of poisoning: Naloxone 0.4-0.8 mg i.v. repeatedly for 2-3 minutes.
 C) Can be administered through oral, rectal, i.m, i.v, intrathecal, epidural routes. Used as preanaesthetic medications
 D) Useful in MI and acute pulmonary edema(Both by i.v. route)
 E) Contraindicated in head injury, hypothyroidism patient, pregnancy.

Codeine.
 A) Partial agonist at mu receptor.
 B) 1/10th analgesic of morphine and less efficacious.

2)Semi-syntheic opioids :

Diacetyl morphine(Heroine), Pholcodine, Ethylmorphine.

Heroine:Three time more potent than morphine.

Codeine, pholcodeine, dextromethopran and noscapine are cough suppresants.
Dextromethopran is devoid of constipating action.

3) Synthetic opioids:

-Pethidine(Meperidine):
 A) To control shivering after anesthesia
 B) Used during labour as analgesic
 C) Safer in asthma.
 D) Pethidine and pentazosin both are anticholinergics. Hence they causes tachycardia. Perhaps, they are contraindicated in MI but useful in biliary colic

-Fentanyl:

 A) Causes truncal rigidity due action on mu receptor.
 B) Can be given as transdermal patch and as well as buccal transmucosal

-Methadone 

 A) Agonist action on mu receptor + blocks NMDA reuptake of monoamines and hence useful in neuropathic and cancer pain (Not controlled by morphine)
 B) Can be given by oral, rectal, i.v, s.c, routes.
 C) Long plasma half-life hence less dependency and tolerance. Therefore used as maintenance therapy in opioid dependency

-Dextropropoxyphene
 A) At high doses it causes seizures.

-Tramadol

 A) It is a weak mu receptor agonist and decrease reuptake of NA and 5-HT hence used as analgesia. This is abolished by Ondasteron.

By ojas 

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