Monday, August 29, 2016
Sunday, August 28, 2016
What is phimosis and paraphimosis?
Phimosis is constriction of the preputial orifice. In phimosis, the foreskin can not be retracted.
In paraphimosis, the foreskin can not be reduced back on the glans. It may cause a painful glans swelling going on to proceed to a gangrene.
I always mix up the two, so mnemonic!
Another mnemonic - Call Paramedics if paraphimosis because it's a surgical emergency.
This one was submitted by SG on our study group, "PAra is PAinful."
Say you have a hemodynamically unstable patient with a gunshot wound or blunt trauma to the RUQ.
Why shouldn't you simply suture and close deep liver lacerations?
Because of the risk of hemobilia and abscess formation.
Here's what a surgeon must do:
Saturday, August 27, 2016
Thursday, August 25, 2016
Wednesday, August 24, 2016
Monday, August 22, 2016
Sunday, August 21, 2016
Why do ferritin levels increase in Rheumatoid arthritis?
It is an acute phase protein.
The levels increase in serum as well as in synovial fluid. The rise is more in synovial fluid because of local production of ferritin in the inflamed joint.
Ferritin levels show a positive correlation with ESR, CRP, platelet count, and DAS score.
And a negative correlation with hematocrit levels.
Is there a difference of levels in inactive and active disease?
Yes, the levels are lower in inactive RA patients because of iron deficiency.
Synovial ferritin production in active RA leads to increase of ferritin in active disease.
Gold standards for diagnosis of iron deficiency in RA?
1. Bone marrow iron stain
2. Serum transferrin receptor analysis
What leads to high ferritin levels in SLE?
Ferritin synthesis is induced by interleukins IL-1, IL-6 and Tumor Necrosis Factor (TNF) alpha in hepatocytes. In SLE, there is defect in IL-1 production while IL-6 and TNF-alpha levels are increased. So, the high levels of ferritin are due to IL-6 and TNF-alpha. (IL-1 does not play a major role in the synthesis of ferritin)
The ferritin levels are correlated with ANA titre, anti-dsDNA titre, and SLEDAI score.
(No significant correlation with acute phase parameters and negative correlation with complement levels)
Saturday, August 20, 2016
Which nephrotic syndrome is associated with Hodgkins lymphoma?
Lymphoma usually causes membranous nephropathy.
But Hodgkins is a weirdo which minimal change disease.
Mnemonic: Kids get MCD usually, so "Hodgkid"
Mnemonic by DJ AweSpear sent to us in our study group. Thanks!
Most common cause of nephrotic syndrome in adults.
Associated with clots - DVT, renal vein thrombosis and PE are common.
Nephrotic syndrome associated with malignancy.
It's membranous glomerulonephritis! :D
Difference between fall of fever by crisis and fall of fever by lysis ?
In fall of fever by crisis, there's sudden decrease in temperature (Mostly due to treatment).
In fall of fever by lysis, reduction in temperature occurs gradually.
Typhoid fever falls by lysis.
(Step ladder pattern!)
Dengue fever falls by crisis.
Thursday, August 18, 2016
This post is from the authors diary.