Multiple Endocrine Neoplasia

MEN are autosomal dominant syndromes.

They are classified as-

1. MEN 1 ( Wermer syndrome)
Pituitary, pancreas & Parathyroid adenomas.

2. MEN 2
a) 2A (Sipple syndrome)
Hyperparathyroidism, medullary carcinoma of the thyroid and pheochromocytoma.
b) 2B
Medullary carcinoma of the thyroid, pheochromocytoma, and mucosal ganglioneuromatosis.

Related post: MEN syndrome mnemonic

Step 2 CK: Types of incontinence mnemonic

Here's a short post on types of incontinence. It is important to know for step 2 CK as well as step 2 CS!

Local anaesthetics - What's in a name?

Personally I am very bad at remembering weird names. I feel like I am being bullied, horribly tortured for the sins I have committed whenever I have to deal with learning names.

Anyways chuck remembering stupid names, we will be smart and figure out a way to remember them..without trying too hard. Like using Google maps to reach a place through shortcuts :D

So Aminoesters and aminoamides are the two types of local anaesthetic in use.

You just need to remember that the esters has only one letter "I" and the amides has two letter "I"

Also that the esters can be effectively neutralised by the cholinesterase in plasma, that's pretty nice cause these substances are known to cause allergic reactions.

Just for the sake of naming.
The highly unstable esters are..
Procaine
Chlorprocaine
Tetracaine
Benzocaine
Cocaine

And again just for the sake of completing this post-
Lidocaine
Mepivacaine
Prilocaine
Bupivacaine
Etidocaine
Ropivacaine

They are dreadful I agree..but "I" will save the day :D

Laughing gas aka Nitrous oxide

Some random facts about nitrous oxide

1. Discovered by preistly

2. Cylinder colour blue

3. Stored as a liquid ( critical temp 36.5 C )

4. Aka laughing gas

5. Not metabolised in the body

6. In anaesthesia it acts as a carrier to other agents..used in conc of 33%O2 + 66%N20 + 1% inhalational agent

7. For every one mole of nitrogen removed, 35 moles of N2O enters..that means compliant spaces in our body take in more gas with increased in pressure..therefore nitrous oxide is constraindicated in these situations.

  Pneumothorax
  Pneumoperitoneum
  Tympanaplasty
  Posterior fossa surgeries ( high risk of air embolism)
  Intestinal obstruction
  Microlaryngeal surgeries ( N2O diffuses through the tube cuff and double or triple the volume of the cuff leading to laryngospasm)

8. Side effects - it can lead
   Bone marrow aplasia
   Sub acute degeneration of spinal cord
  Megaloblastic anaemia
( It inactivates B12 if used for more than 6 hrs in a surgery )

- happy studying
Sakkan :)

 

Mnemonic for foramen of cranial nerves

Here are awesome notes drawn by Mini on foramina for passage of cranial nerves:

Mnemonic for foramen of cranial nerves

Edward syndrome notes and mnemonic

Hello!

So here's how Yeshwanth remembers the features of Edwards syndrome.. He thinks of Accelerate from Ben 10!

Here are his notes:

Gout and pseudogout mnemonic

Hello!

Remember N for Gout:
N for Na urate crystals
N for Negative refringent crystals on polarised microscopy
N for Needle shaped crystals

Patau syndrome notes

These were submitted by Yeswanth Gopisetti

Montegia and galezzia fractures mnemonic

Hello everyone! 

In today's post, I'll be sharing a mnemonic on Monteggia and Galezzia fractures! 

U for ulna in Monteggia  

R for radius in Galezzia 

Also, U in Monteggia is at the Upper end of ulna. 

R in Galezzia is at the lower end of radius. 

Another mnemonic is M for Monteggia, M for the medial bone, which is ulna! 

Submitted by DoctorWizard 

Ketamine- A new antidepressant!

Hello!

Remember those conventional classes of drugs used for treating major depressive disorders?? Well, now I have a better one. Ketamine!
Haha yea trust me... this commonly used anaesthetic, analgesic, hallucinogenic drug has got its place in another class of drugs- The anti-depressants. :D

#AnswerTime: Female with weakness of lower limbs

Okay so answer tim! 

I posted a quiz time question here: http://www.medicowesome.com/2016/07/quiztime.html?m=0

Here's the solution to it. 

Sorry this got so late, I've had exams -.-

The IMNCI problem - Solved. (Mnemonic)

Hi everyone !
So I was just studying Pediatrics and sometimes they expect us to remember how to fill the IMNCI form 😭 #SoCruel.
So here's a mnemonic I made for the headers :

For a child below 2 months -->
Bl*w Job TDM

So
Bl*w= Bacterial infection
Job= Jaundice
T=Temperature (hypothermia)
D= Diarrhea
M= Malnutrition

__________________________________
For a child above 2 months -->
3 Di*ks in FEMAles Is Fun

So 3 D*cks are  :
Danger signs
Diarrhea
Dypnea /difficult breathing /cough.

FEMAles  :
  F = Fever
  E = Ear problem
  M = Malnutrition
  A = Anemia

Is = Immunization

Fun = Feeding .

Hope you find this one helpful.
Will continue with the GI hormone series once exams are done.  :p
Bye.

Solitarius and ambiguus

Vagal nuclei was a hated subject to me..so bad that I would turn the page if I ever came across it.

This thing helps keep my facts straight when it comes to these horrid nuclei.. hopefully it will help you too.

Ambiguous in a literal meaning is to outshine everyone else. There are many ways to do that. The most everlasting impression you leave is how you interact to people..what to say and when to say.

That's what nucleus ambiguous helps you to achieve..these are the neurons controlling the palate, pharynx and larynx. Hence, the controller of speech :)

its the vagus, the glossopharyngeal and spinal accessory that share this nucleus

Nucleus Solitarius is for taste sensation and for the supply of carotid and aortic body chemoreceptos
Hence, it's the facial, glossopharyngeal and vagus nerve that share this particular nucleus

Psst- let me know of your way to remember this. Our ideas may be solitary..but let's make it ambiguous together :D

Sticks like a gum

I am generally against the idea of using mnemonics.. but this particular one is a life saver for me.. though stupid :D

Think of a chewing GUM, think of the times when it was stuck to your fingers..and you struggled to get rid of it.

That's how valgum..when things stick to each other.

No more worries as to what is genu valgum and genu varus.

Additional mnemonic by Subbiah: After K is L, by alphabetical order. Hence Knock knees is vaLgum.

Antibodies to stop Heart disease!

Hello everyone!

Cardiovascular disease is one of the most leading causes of death in the world today, with major risk factors not merely high cholesterol and high blood pressure but also the actual lesions being directly responsible for the disease- Atherosclerotic plaques.
Antibodies that help the immune system remove dead and dying cells have been shown to reduce atherosclerosis. 
Read further to know the "how" of that.. :D

Why use glycine in TURP?

TURP is the current standard surgical procedure for BPH. The various irrigation fluids are

NaCl- since there is use of cautery in TURP.. NaCl can be hazardous to the surgeon as well as the patient

Distilled water- while resection of prostate tissue, there is exposure of the underlying vessels..which leads to rapid absorption of the irrigating fluid. Distilled water is highly hypotonic.. which can cause widespread hemolysis.

Glycine- currently the most preferred agent. The commonly used conc is 1.5% glycine with an osmolality of 230mosmoles(plasma 285-290mosmole) At this conc the hypotonicity is balanced with the toxicity of glycine. Though it can still cause volume overload with dilutional hyponatremia..it is not as severe as with distilled water.

Dilution hyponatremia Is a dreaded complication of TURP. The management includes I.V NaCl solution (0.9% & 3%), fluid restriction and furosemide.

Other less known solutions are- Glucose , mannitol and urea
A costly but comparatively safer option is cytal( sorbitol+mannitol)..but due to cost restriction..it's not that common.

#QuizTime: Female with weakness of lower limbs

#Quiz time

A 25 year old female who is a marathoner presented to the OPD with weakness of her lower limbs. She said she isn't able to practice as her legs feel very tired. This started with her foot , about a week back, And now her entire leg feels weak.
History is otherwise insignificant , but there is a history of mild fever with a very light maculopapular rash about 4 weeks back, within a span of 3 weeks after she returned from a Running Contest in Brazil.

GI Hormones: Cholecystokinin Pancreozymin

Hi everyone ! So this is the 3rd post in  the series of the hormones of the GIT.
Last post we discussed about the Zollinger Ellison syndrome as a result of  Gastrin.  This post we look at the 2nd member of the gastrin family. Cholecystokinin PZ
Hope you like it. ::)

⛔Cholecystokinin Pancreo-Zymin ⛔

◾Produced by : I cells in mucosa of Upper SI.

◾Physiology of secretion :
○ Acts vis CCK A receptor. (Gastrin acts via CCK-B if you recollect)
○Pre-Pro-CCK fragmented into many parts.
○Multiple AA in each for, but same 5 AA at Carboxy terminal
○Also found in distal ileum and colon + Cerebral Cortex.

◾Functions : lots.

○Gall bladder motility (contraction - kinesis)
○Stimulates pancreatic enzyme secretion ; augments secretin's actions
○Trophic action on pancreas
○Inhibits gastric emptying
○Causes contraction of pyloric sphincter -->preventing duodenal content aspiration.
○CNS --> role in regulation of satiety/food intake, Anxiety.

________________________________________

So if you notice, this does way more things than its brother Gastrin. Now it might get a little tedious to remember. So think of it this way :
Cholecysto-kinin Pancreo-Zymin. So first part of the name is cholecysto = Gall bladder. Kinin=motility. So 1. GB motility. Next is Pancreozymin. So acting on the zymogen granules in pancreas to bring about 2. enzyme secretion. Now along with causing enzyme stimulation it'll also tell the pancreas to grow up , hence exerting a 3. trophic action. So far so good?
Now for all of this gall and pancreatic fluid to reach the intestines , the barrier of the Oddi sphincter needs to be passed. So it'll 4.relax this sphincter causing the secretions to flow freely into the gut.
This causes a lot of fluid to be present in the duodenum. Since this is in proximity to the pylorus, the pyloric sphincter will  have to be shut to prevent aspiration of alkaline duodenal stuff into the stomach, hence 5.pyloric sphincter constricts.
Finally, since it's modulating so much of the digestion , it's got receptors in the CNS that 6.stimulate/depress hunger based on the CCK levels (like more CCK indicates more food being gulped down)
I have no idea about the anxiety part. So we're gonna have to go with it. Lol.

◾Regulation :

○Factors that increase -->
□Luminal  : fatty acids (>10Carbon atoms) -as lipase from pancreas acts on lipids and gall fluid contains fat digestive bile acids + AA.
□Other : CCK-Releasing peptide (intestinal mucosa) + Monitor factor (pancreatic)
+ feedback b/w degradation and secretioPZ

◾Applications
○ CCK in the injectable form can be used as a diagnostic aid to check Gall bladder motility

○ CCK Antagonists -->
□Proglumide =Non Selective. Ulceroprotective effect. (Gut action). May increase analgesic property of Opioids and help reduce Tolerance to them (CNS Action).
□Lorglumide =Selective fir CCK A type. Gut action.
□Studies are on going to harness their potential as anti-anxiety or anorectics. (CNS actions)

:)
Next post - The secretin family.
Hope you'll are finding this helpful. Let me know if you have any doubts or suggestions. Bye until then=)

-:Drug Doses:-

Hi everyone !
here is collection of drug doses according to their classification,Hope it helps you:)

Pericarditis, pericardial tamponade, X descent and Y descent

Hello everyone!

Here's another awesome mnemonic submitted by Aditi!

"cPAY TAX"

In constrictive pericarditis, prominent Y descent is seen (X descent is also prominent.

In pericardial tamponade, prominent X descent is seen (Y descent is absent).

Thank you so much for sending your mnemonics to us, girl! (=

Causes of triple deformity of the knee mnemonic

To remember the causes of TRIPLE DEFORMITY of knee, remember word "TRIPLE"

T - TB
R - Rheumatoid arthritis
I - Illiotibial band
P - Polio
E - Excessive bleeding

Submitted by Aditi Bhosale