Saturday, December 30, 2017

Ocular Therapeutics (DYES)

Hello Awesomites! :D

Today I will discuss here

DYES:-

USES OF FLUORESCEIN DYE
-This dye stain damaged corneal epithelium bright green best seen under cobalt blue and ultraviolet light.
1. To detect breach in continuity of corneal epithelium.
2. Contact lens fitting.
3. Applanation tonometer.
4. Test for leaking wound (Seidel test)
5. Patency of nasolacrimal duct.
6. Fluorescein angiography.
7. Diagnosis of lacrimal fistula.
8. Treatment of pediculosis (Fluorescein dye strips, which are used in the diagnosis of corneal abrasions, may be used in combination with white petrolatum. The strips are applied to the eyelashes for 3 nights)
9. Differential stain along with Rose bengal.

Pattern of stain:-
- interpalpebral staining of cornea & conjuctiva is common in aqueous tear deficiency
-superior Conjuctival Staining in superior limbic keratoconjuctivitis
-Inferior corneal &conjuctival staining in blepheritis & exposure keratitis.


USES OF ROSE BENGAL:-
-Stain the devitalized corneal and conjuctival epithelium. The drawback with rose bengal is it stings.
-Seen under white light /red free light. (Red-free light is absorbed by the RPE, creating increased contrast)

1. CORNEA -Staining corneal ulcer,erosion and abrasion.
2. LID- Meibomian gland dysfunction.
3. CONJUCTIVA- Conjuctival staining and evaluation of ocular surface disorder.

I hope it helped.
More is coming up in this section.

-Upasana Y. :)


Friday, December 29, 2017

Nasotracheal intubation

Hello!

This post is about the indications and contraindications of nasotracheal intubation.

Indications:
1) Oral surgery
2) Fracture mandible
3) Inadequate mouth opening
4) Tube to be kept for longer time
5) Awake fibre-optic intubation

Contraindications:
1) Fracture of base of skull (may directly enter inside skull)
2) CSF rhinorrhea (increases infection - meningitis)
3) Nasal mass (do not allow tube to pass)
4) Adenoids
5) Coagulopathy
6) Decreased movement of endotracheal tube
7) Nasal mucosal damage.

Thanks for reading.

Madhuri Reddy

Malignant hyperthermia

Malignant hyperthermia is a syndrome of rapidly rising temperature.

It occurs due to abnormality of Ryanodine receptors which cause release of large amount of calcium from sarcoplasm reticulum leading to sustained muscular contraction.

It is triggered by:
1) Succinylcholine (50%) - most common
2) ether
3) methoxyflurane
4) halothane
5) enflurane
6) isoflurane
7) Desflurane
8) sevoflurane

Clinical features:
1) Masseter muscle spasm - most initial sign
2) Rise in end tidal CO2
3) Tachycardia
4) Respiratory/ metabolic acidosis
5) Hyperkalemia
6) Pulmonary edema
7) Cerebral edema
8) Myoglobinuria
9) Renal failure
10) Rise in temperature - late sign

Treatment:
1) Stop all anesthetic agents (because one of it is a triggering factor).
2) Hyperventilate with 100% O2.
3) Inj.Dantrolene - 2 mg/kg  intravenously every 5 minutes to a maximum dose of 10 mg/kg.
Dantrolene can be continued for next 48 hours.
4) Sodabicarb to correct metabolic acidosis.
5) Cooling of body.
6) Other symptomatic treatment.

To detect malignant hyperthermia:
BEST DIAGNOSTIC TEST -> Halothane Caffeine muscle contraction test.
BEST SCREENING TEST -> Creatinine kinase test.

Thanks for reading.

Madhuri Reddy

Wednesday, December 20, 2017

Step 3 NBME Form 4 Answer key

Hey, here is the answer key.
For download link, email medicowesome@gmail.com and I will send you the offline download link.

Lemme know if I accidentally typed some wrong!


Friday, December 15, 2017

Foreign body aspiration - Flexible or rigid bronchoscopy?

Foreign body aspiration (FBA) - Which bronchoscopy should you do? Flexible or rigid?

#TLDR:
Life threatening - Rigid bronchoscopy
Diagnosis not clear - Flexible bronchoscopy

Children - Rigid bronchoscopy
Adults - Flexible bronchoscopy

Mnemonic: childRen thReatening - Rigid bronchoscopy

So first ask - is this a life threatening FBA? Yes - Rigid bronchoscopy (after airway stabilization of course)

Then ask - Is the diagnosis clear? No - Flexible bronchoscopy

If the diagnosis is clear and the FBA is not life threatening - See the age.

If it is a child - Rigid bronchoscopy
If it is an adult - Flexible bronchoscopy

Here's a looooong copy paste explanation from UpToDate:

Wednesday, December 13, 2017

Varenicline mnemonic

Hello!

A short post on Varenicline :)

Mirtazapine mnemonic

Hello!

Here's a short post on the atypical antidepressant, Mirtazapine! It's an alpha 2 antagonist that increases release of NE (norepinephrine) and 5-HT (serotonin)

Mirtazapine causes sedation (desirable in depressed patients with insomnia)

Mnemonic: MirtaZZZZapine
Zzz for 😴 sleep

Mirtazapine increases appetite, causes weight gain (desirable in elderly or anorexic patients)

Mnemonic:
M - Mirtazapine makes you motu
(Motu in Hindi / Urdu is fat)

-IkaN

Sunday, December 10, 2017

USMLE Step 3 CCS: Fracture of the hip / femur

Hello!
Here are orders for the hypothetical case - let me know if I missed out on something! :)

Tuberculosis: Eponymous pathologies picmonic


Hey guys!!

So TB, huh? As if the complicated diagnostic and treatment modalities aren't enough, we also have to remember some characteristic pathological entities, especially the eponymous ones like Ghon, Rancke, Assmann, Rich, Simond, Simon, Weigert, Puhl, Rasmussen and I am sure there are more. Lucky for us, we have a pimonic for this.



Thank you Subasini for this wonderful illustration! Inspired! :*

Pulmonary Embolism Picmonic


Hey guys!!

Pulmonary embolism is a diagnosis of exclusion. I am sure this illustration will help you to make a diagnosis of PE after you have ruled out the other differentials.



Thank you Subasini for this wonderful illustration! Inspired! :*

Algrove Syndrome Picmonic


Hey guys!

This picture will help you get a visual recollection of Algrove syndrome.



Thank you Subasini for this wonderful illustration! Inspired! :*


Saturday, December 9, 2017

Bacterial Protein Synthesis Inhibitors


Hey guys

Here are two pics to help you all to better understand the mechanism of action of bacterial protein sysnthesis inhibitors: antibacterials.



Thank you Jailene for contributing to the blog! :)



Friday, December 8, 2017

USMLE Step 3 CCS: Rape

Hello!

These are my CCS steps for a case of rape. Lemme know if I missed out on anything!

Consent
Rape evidence kit

Complete physical examination

CBC
BMP
Vaginal fluid analysis
Vaginal, cervical, rectal cultures
BHCG
UA
Urine culture
HIV test, P24 antigen
VDRL
HbSAg
Gonococcal tests
Chlamydial tests

Emergency contraception (ulipristal / levonogestrol)
Ceftriaxone
Azithromycin
Metronidazole
Tenofovoir + emtricitabine + raltegravir
HBIG (if unvaccinated)

Psych consult
Drug screen
Colposcopy (for injuries)

That's all!
-IkaN

USMLE Step 3 CCS: Kawasaki disease

Hello, these are my hypothetical orders for KD.
Let me know if I missed something out!

Physical examination (PE)

CBC
BMP
ESR
CRP
Blood culture (to rule out infection)
Urinanlysis (to rule out infection)
Urine culture (to rule out infection)
CXR (to rule out infection)

LFT
ASO
Strep pharyngitis culture
EKG
Echocardiogram

IVIG
Aspirin

That's all!
-IkaN

Save, near miss and preventable adverse effect mnemonic

Hey!

These are for USMLE ethics.

Poor prognostic factors for schizophrenia mnemonic

Hello!

This is a mnemonic for some (not all) prognostic factors for schizophrenia.

Likelihood ratio mnemonic

Hello! :)

The likelihood ratio of a positive test result (LR+) is sensitivity divided by 1- specificity.

The likelihood ratio of a negative test result (LR-) is 1- sensitivity divided by specificity.

How I remember the formulae for LR+ and LR-

Mnemonic on viral structures

Hey guys!! Long time!

As the title suggests this post will help you remember the different viral structures in a way that is fun and easier.

Tuesday, December 5, 2017

Puerperal sepsis

PUERPERAL SEPSIS

Puerperal sepsis is any bacterial infection of the genital tract which occurs after the birth of a baby. It is usually more than 24 hours after delivery before the symptoms and signs appear.

Some of the most common bacteria are:
Streptococci
Staphylococci
Escherichia coli (E.coli)
Clostridium tetani
Clostridium welchii
Chlamydia
Gonococci

SYMPTOMS AND SIGNS 
Fever (temperature of 38°C or more)  Chills and general malaise
Lower abdominal pain
Tender uterus
Subinvolution of the uterus
Purulent, foul-smelling lochia.
Slight vaginal bleeding
Shock.

RISK FACTORS
Some women are more vulnerable to puerperal sepsis, including anaemia and/or malnourished, protracted labour, prolonged rupture of the membranes, frequent vaginal examinations, a traumatic delivery, caesarean section and retained placental fragments, PPH, diabetes all predispose to puerperal infection.

SITES
The most common site of infection in puerperal sepsis is the placental site.
Other sites of infection are abdominal and perineal wounds following surgery and lacerations of the genital tract, e.g. cervix, vagina and perineum.

Following delivery, puerperal sepsis may be localized in the perineum, vagina, cervix or uterus.
Infection of the uterus can spread rapidly if due to virulent organisms, or if the mother’s resistance is impaired.
It can extend beyond the uterus to involve the fallopian tubes and ovaries, to the pelvic cellular tissue causing parametritis , to the pelvic peritoneum, causing peritonitis , and into the blood stream causing septicaemia

DIFFERENTIAL DIAGNOSIS
Fever  in the puerperium can also be caused by:  urinary tract infection (acute pyelonephritis)  wound infection (e.g. scar of caesarean section)  mastitis or breast abscess  thrombo-embolic disorders, e.g. thrombophlebitis or deep vein thrombosis  respiratory tract infections.

-Md Mobarak Hussain (Maahii)

Adrenaline : Dosage

Dose of Adrenaline :

Anaphylaxis :- 0.5mg 1:1000 IM

Anaphylactic Shock :-  1mg 1:10000 IV

Cardiac Arrest :-  1:10000 IV

CPR :-  1:10000 IV/IO, if not accessible 1:1000 ET

With LA :- 1:200000 SC

-Md Mobarak Hussain (Maahii)

Sunday, December 3, 2017

Flap Valve Mechanism of Inguinal Canal

Hello Everyone!

     Today lets understand the Flap Valve mechanism of Inguinal Canal:




That's all,
Thank you!
Chaitanya Inge

Cryoprecipitate constituents mnemonic

Hello!

This is a post on the constituents of Cryoprecipitate :)

Thursday, November 30, 2017

Guidelines for treatment of drug-susceptible tuberculosis 2017 UPDATE

Hello Awesomites :D

This is to inform you the updated guidelines.
I was overwhelmed with the data in the book. I tried to simplify it.

1.The name given to this scheme is "99 DOTS"
99 means that 99% benefits should reach to all the people who are enrolled under this programme.

2.INTRODUCTION OF FDC (fixed dose combination)
 (Please make a correction in the following diagram :- ETHAMBUTOL=275mg)

3. FROM THRICE WEEKLY TO "DAILY DOSING"
4.Information technology is incorporated to monitor the adherence of patient to treatment regimen.
5.REGIMEN :-
6. DOSE OF THESE DRUGS :-
7. IMPLEMENTATION :-
by toll free no. 

I hope it helped. 
(Edit1:- 99DOTS

-Upasana Y. :)







Wednesday, November 29, 2017

USMLE Step 3 CCS: Asthma exacerbation

Orders to remember!

Pulse oximetery (every 1-2 hours to access response)
Oxygen
Physical examination
Albuterol nebulizer
Intravenous methylprednisone
Peak flow (every 1-2 hours to access response)
EKG (is this cardiac?)
CXR (to find out cause of asthma excerbation - infection)
CBC (to find out cause of asthma excerbation - infection)
BMP

Other stuff:
Cardiac monitor
Head elevation
Ipratropium for severe exacerbations
ABG
Admit
NSS 0.9%
NPO
Discharge on oral prednisone for 5-7 days

Uptodate:
- Use inhaled short-acting beta agonists early and frequently, and consider concomitant use of ipratropium for severe exacerbations
- Start systemic glucocorticoids if there is not an immediate and marked response to the inhaled short-acting beta agonists
- Make frequent (every one to two hours) objective assessments of the response to therapy until definite, sustained improvement is documented

-IkaN

Wednesday, November 22, 2017

Mapelson circuits in anaesthesia mnemonic

Hey!

So I've faced a lot of problems trying to remember the various Mapelson semiopen circuits for inhalational anaesthesia and sadly they have been asked in exams so I tried to identify them using these simple points.

Firstly, remember, the circuits are semi open so part of the gases will be exhaled and part of them will be re inhaled.

Basic parts of any circuit are
-an inlet for fresh gases
-an outlet valve for exhalation
-the patient end
-the distal end usually with a bag to control rise and fall of the chest.



1) Mapelson A
The only circuit where fresh gases come in from the distal end. The exhaling valve is near the patient. It is suitable for spontaneous ventilation so rate of flow of gases = minute volume.

2) Mapelson B
Remember, B for both. So both inlet and outlet are together at the patient end. Otherwise it's the same as A.

3) Mapelson type C
C for closed and C for corrugationless. It's a closed circuit and the only one which has no corrugations.

4) Mapelson D
It is the exact opposite of A. Inlet for fresh gases is near the pt, outlet is far away. It is suitable for controlled ventilation.

5)Mapelson E
This is a valveless circuit and also has no bag (the only one without a bag). Since the arrangement is in the form of a T, it is also called Ayre's T piece.

6) Mapelson F
It is the same as E, valveless, but it has a bag to control the rise and fall of chest. It is mainly used in infants and neonates.

Summary:
Fresh gases distally ➡A
Inlet outlet both together➡B
No corrugation➡C
Opposite of A➡D
No exhaling valve ➡ E and F
No bag ➡ E
Same as E but with bag ➡F

Submitted by Aditi

Sunday, November 12, 2017

DD of white membrane over tonsil

DD of white membrane over tonsil -
" MALA VIT DC"

M- Membranous tonsillitis
A - Aphthous ulcers
L -  Leukocytosis
A -  Agranulocytosis

V - Vincent Angina
I   - Infectious mononucleosis
T  - Traumatic ulcers

D- Diphtheria
C - Candidia infection

Thank you :)
  
~Pratheek Prabhu

Friday, November 10, 2017

Sunday, November 5, 2017

Steroid Hormone synthesis pathway (Clinical aspect)

Hello Awesomites :D

I was reviewing the corticosteroid synthesis pathway and its applied.
Let us begin. :))
Adrenal gland consist of two parts :-
1. MEDULLA
2.CORTEX
Adrenal dysfunction includes hyperfunction / hypofunction of medulla and cortex.
1. MEDULLA

A) HYPERFUNCTION - pheochromocytoma
                                        -Neuroblastoma
2.CORTEX

A)HYPERFUNCTION -Conn's disease
                                      -Cushing's syndrome (Primary tumors)
                                                                          (excess ACTH -pituitary hypersecretion,ECTOPIC)
B)HYPOFUNCTION -ACTH deficiency (Iatrogenic , pituitary insufficiency)

C)CONGENITAL ADRENAL HYPERPLASIA (from partial enzyme deficiencies due to mutation in genes)

Clinical features of CAH :-

1.DUE TO DECREASED ALDOSTERONE :-
-Sodium wasting (hyponatremia+dehydration+shock)
 (early presentation)
-increased potassium
-acidosis
2.DUE TO DECREASED CORTISOL:-
-Hypoglycemia
-increased ACTH
3.DUE TO INCREASED TESTOSTERONE :-
In female , virlization.
In male, No symptom, increased size and pigmentation of penis.

Q. What is the difference between 21-hydroxylase deficiency and 11beta hydroxylase deficiency ?
Ans. In 21-hydroxylase deficiency, hypotension occurs due to salt wasting.
Accumulation of 11-deoxycorticosterone as a result of 11 beta hydroxylase deficiency leads to "HYPERTENSION".

Q.Most common form of CAH is due to mutation or deletion of which gene?
Ans. CYP21A resulting in 21-HYDROXYLASE DEFICIENCY .

Q.Which Enzyme deficiency showing virlization in females?
Ans. -21 hydroxylase
        -3beta HSD
       -11 Beta hydroxylase.

Q. Two hypertensive form of CAH.
Ans. 11beta hydroxylase and 17hydroxylase deficiency.

Other points :
- Females with 17-hydroxylase deficiency appear phenotypically female at birth but do not develop breasts and mensturate in adolescent because of INADEQUATE ESTRADIOL PRODUCTION(17 hydroPregnenolone is also a precursor of estrogen). They may present with hypertension.
-CAH is a type of enzyme deficiency. So it can be partial or complete .There is a severity spectrum.
More severe form shows salt wasting.
Milder form shows "NON CLASSICAL TYPE of CAH".

Diagnosis:-

  • 17hydropregnenolone with or without ACTH test
  • CYP21A2 panel,sequencing,deletion
  • Carrier screening test (Preconception test)
  • Karyotyping ( In case of ambiguity of sex)
  • Hormones and electrolytes
Treatment:-
  • Counsel the parents.
  • Protect from Adrenal insufficiency ( Give mineralocorticoid and glucocorticoid)
  • Avoid salt wasting crisis during illness,stress,etc. ( Increase dose of glucocorticoid,Give IV fluids and sodium and dextrose)
  • Surgery ,sex assignment.
(Note :- There are two more variants of CAH 1. Lipoid CAH 
2.POR deficiency ( P450 oxidoreductase enzyme deficiency) - also involved in both sterol and steroid synthesis pathway).


Study hard.
-Upasana Y. :)

Friday, November 3, 2017

Sequels of corneal ulcer perforation

Sequels of corneal ulcer perforation :
"SILICA PAPA"

S- Subluxation of lens
I -  Iris prolapse
L-  Leucoma
I -  Intraocular haemorrhage
C- Corneal fistula
A-  Adherent Leucoma

P- Phthisis bulbi
A- Anterior synechiae
P- Purulent infection
A- Anterior Staphyloma

Thank you :)

~Pratheek Prabhu

Complications of corneal ulcer

Complications of corneal ulcer - "DEPICT"

D- Descemetocele
E- Ectatic cicatrix ( Keratectasia )
P- Perforation
I - Inflammatory glaucoma 
C- Corneal scarring
T-  Toxic iridocyclitis

Thank you :)

~ Pratheek Prabhu

DD of neonatal cloudy cornea

Differential diagnosis of neonatal cloudy cornea - "STUMPED"

S-Sclerocornea
T-Tear in Descemet's membrane
U-Ulcer
M-Metabolic condition
P-Posterior corneal defect
E- Endothelial dystrophy
D-Dermoid

Thank you :)

~Pratheek Prabhu

Thursday, November 2, 2017

MELD score mnemonic

Hello everyone!

Model for End-Stage Liver Disease (MELD) The Model for End-Stage Liver Disease (MELD) is a reliable measure of mortality risk in patients with end-stage liver disease. It is used as a disease severity index to help prioritize allocation of organs for transplant.

MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. Sodium was recently added to improve predictive value.

Wednesday, November 1, 2017

Desmosomes and its disorders

Hello friends,
This post is about the importance of desmosomes in various dermatological conditions.

Basics:
Desmosomes are present in stratum spinosum of epidermis.  They are calcium channel dependent adhesion molecules (cadherins)  and hence form intercellular connections.

Desmosomes are seen all through the epidermis, but are obvious as spines in spinous layer.

They have many constituents. Important transmembranous  parts are:
•Desmoglein (DSG)
•Desmocollin (DSC).

Now we will focus on Desmoglein (DSG) .
•DSG-3 is present mainly in basal layer of epidermis and strongly seen in mucosae.
•DSG-1 is present in superficial epidermis and is not seen in mucosae.

Clinical importance:
* If DSG-3 is damaged --->
   early, severe mucosal involvement.
   Lower level of damage to epidermis.
* If DSG-1 is damaged --->
    No mucosal involvement.
    Superficial epidermal damage.

° If IgG antibody is formed against DSG-3, then the resulting disease is known as Pemphigus vulgaris.
° If IgG antibody is formed against DSG-1, then the resulting disease is known as Pemphigus foliaceous.

A mnemonic to remember DSG-3 for basal layer and mucosal involvement :

Thanks for reading
Madhuri.

Sunday, October 29, 2017

Neonatal Resuscitation Tray

Hello :D

The tray consist of the following :-
1.Long cuff surgical gloves.
2.Stethoscope
3.Mucous extractor/ suction apparatus - (yankauer suction tube)
4.Suction catheter (6,8,10 Fr= French)
5. Facemask  size 0 and 1
6. Self inflating bag with reservoir , flow inflating bag or T-peice device
7. Laryngoscope with STRAIGHT BLADE (0 and 1 size)  (keep spare bulb and batteries)
8. Endotracheal tube (2,2.5,3,3.5,4 mm ID=internal diameter)
9. Stylet
10. Nasogastric tube (6,8 Fr= French)
11. Disposable syringes ( 1,2 and 10 ml)
12. IV cannula
13. Adhesive tapes and scissors
14. Umblical vessel catheters
15. Pediatric reflex Hammer
16. Drugs (Rarely indicated)
 -Adrenaline (1:10,000)
-Naloxone
-Sodium bicarbonate
-Calcium gluconate (not a routine resuscitation drug)
-Potassium chloride (I have seen in my tray!)

So What is in your tray ? :P
Go and find out it in your NICU.
Do share it below in the comment section.

-Upasana Y. :)



Thursday, October 26, 2017

Swine flu categories

Hello!

Here's a post on the categories of Patients with Swine flu.
The categories are A, B1, B2 & C.

Category A:

Mild fever plus Cough, Sore throat, Headache, Body ache, Diarrhoea, Vomitting.

Action in Category A:

No Testing for H1N1
No Temiflu
Only daily observation for symptoms

Category B1:

Category A symptoms plus high grade fever, severe sore throat.

Action in Category B1:

No Testing for H1N1
Tab Temiflu as per dose
Home isolation
Avoid public places

Category B2:

Category A symptoms plus high risk conditions such as
Child< 5 yrs
Age > 65 yrs
Pregnancy
Chronic disease
Diabetes
On long term treatment with steroids

Action in category B2:

Tab Temiflu as per dose
Home Isolation
No H1N1 Testing

Category C:

Category B symptoms plus
Chest pain
Breathlessness
Blood in cough
Blue nails
Worsening of underlying disease

Action in category C:

Tab Temiflu as per dose
H1N1 Testing
Hospitalization isolation

~Pratheek Prabhu

Sunday, October 22, 2017

Electrocardiogram


File:Ecg.png - Wikimedia Commons

P wave

  • Positive wave
  • Shape is up rounded deflection
  • Cause: Depolarisation of atrial musculature.
  • Duration: 0.1 sec
  • Intensity: 0.1-0.12 mV
  • Represents functional activity of atria.


Clinical Aspects:
  1. Mitral stenosis: left atrium is hypertrophied and P wave is larger and prolonged.
  2. Tricuspid stenosis: Right atrium is hypertrophied and P wave is taller but there is no change (normal) duration.
  3. Atrial fibrillation: P wave disappears and is replaced by fine irregular oscillations.
  4. Ectopic Pacemaker: (reverse) The impulses are sent from AV node to SA node.

QRS COMPLEX

  • Q wave is often absent.
  • Cause: Ventricular Depolarisation.
  • Duration: 0.08 sec ( less than P wave)
  • Intensity: 0.1 mV to 0.2 mV ( amplitude is more)
  • R wave is 1 mV
  • S wave is 0.4 mV
  • Total Intensity is 1.5 mV to 1.6 mV

Clinical Aspects
  1. Deep Q wave: more than 0.2 mV. This is seen Myocardial Infarction.
  2. Tall R wave: more than 0.1 mV. This is seen in ventricular hypertrophy.
  3. Low Voltage QRS Complex:  This is related to hormones and pericardial fluid. Hypothyroidism and Pericardial fluid around the heart.
  4. QRS COMPLEX: Prolonged in bundle branch block.

T wave

  • Cause: Ventricular Repolarization.
  • It’s positive wave because the direction of Ventricular repolarization is opposite to depolarization.
  • Duration: 0.27
  • Intensity: 0.3 mV

Clinical Aspects

  1. Flattened T wave: old age.
  2. Height increases: during exercise.
  3. Inverted T wave: this is seen in myocardial infarction.
  4. Tall and peaked T wave:  Hyperkalaemia.

U wave
  • Positive round wave
  • Repolarization of papillary muscled
  • Duration: 0.08 sec
  • Intensity: 0.2 mV
  • Rarely seen
  • Prominent in hypokalaemia.

P R interval

  • Onset of P wave to onset of QRS complex (PQ interval)
  • Represents AV conduction time.
  • Duration: 0.12 to 0.21 sec

Clinical Aspects

  1. Prolonged PR interval: AV conduction block.

J Point

  • The meeting point of QRS complex with ST segment.
  • It represents the end of Depolarisation and beginning of repolarization.
  • At this point, no current flows around heart.


I hope this helped you :))  Have a good day!

Saturday, October 21, 2017

Lesions of visual pathway

Visual pathway starting from retina consists of optic nerve , optic chiasma , optic tracts , lateral geniculate bodies , optic radiations and the visual cortex .
Courtesy :- Comprehensive Ophthalmology 6th edition ; AK Khurana ; Pg.314


Sl . no
Site of lesion
Type of lesion
1
Optic nerve
Complete blindness on ipsilateral side
2
Anterior Chiasma
Junctional scotoma
3
Central chiasma
Bitemporal hemianopia
4
Lateral chiasma
Binasal hemianopia
5
Optic tracts / LBG
Incongruous homonymous hemianopia
6
Part of optic radiations in temporal lobe
Superior quadrant hemianopia (pie in sky )
7
Part of optic radiations in parietal lobe
Inferior quadrant hemianopia (pie on floor )
8
Optic radiations
Complete homonymous hemianopia
9
Visual cortex sparing macula
Congruous homonymous hemianopia
10
Visual cortex , only macula
Congruous homonymous macular defect
11
Bilateral Visual cortex , only macula
Bilateral homonymous macular defect


`~ Pratheek Prabhu
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