Enteric nervous system (ENS)

Recently, while studying pharmacology, I came to know about the third system of ANS - Enteric nervous system, apart from sympathetic and parasympathetic systems .

Here is some information of ENS:

It consists of highly organized neurons situated in the wall of GI tract.

It mainly includes Auerbach's plexus and Meissner's plexus.

The most interesting point about ENS is this network receives preganglionic fibers from the parasympathetic system and from postganglionic sympathetic neurons.

ENS controls GI motility, secretions, mucosal blood flow.

ENS causes relaxation or stimulation of smooth muscles.

Non-cholinergic excitatory transmitters such as substance - P plays a modulatory role in controlling ENS!

~Ojas

What is the difference? : Meconium vs. Meconium Ileus

Hey Folks, Jay here!

Meconium is the very first stool ("poop") of a Neonate. This is mainly composed of the material that it ingested during its intrauterine life. This can include, amniotic fluid, mucus, bile, intestinal epithelium cells, lanugo and water.

Classical Findings of RDS Infant!

Hi awesomites, Jay here! This is a short description on Classical clinical findings of a Neonatal Respiratory Distress Syndrome(RDS or NRDS) infant.

Scarlet fever notes and mnemonic

Hello. How are you awesomites?

Let's talk about scarlet fever today!

Scarlet fever, also known as scarlatina, is characterize by exudative pharyngitis, fever and scarlatiniform rash.

It's caused by erythrogenic toxin producing GABHS (Group A Beta Hemolytic Streptococci)

Characterized by:
- Fever, headache
- Sore throat, circumoral pallor
- Sandpaper rash (Pinpoint, erythematous blanchable papules), erythema trunk, pastia lines
- Lymphadenopathy

Diagnosis:
- Rapid antigen detection test is specific, but not sensitive.
- If it is negative, do throat culture.
- Elevated ASO, DNAse maybe seen.

Treatment:
- Treatment as long as 9 days after the onset of symptoms prevents rheumatic fever.
- Oral penicillin, amoxicillin for 10 days.
- Cephalosporins, macrolides are alternatives. (Penicillin resistant group A staphylococcus doesn't exist.)
- If adherence problem, intramuscular benzathine penicillin G.

That's all!
The only fever I have is for Scarlett Johansson =P
-IkaN

Erythroblastosis fetalis (HDNF)

It is a condition that develops when Rh-negative women is pregnant with Rh-positive baby .
It causes phagocytosis of the fetus's RBC's (Baby inherits Rh positive antigen from father ).
As mother is Rh-negative , exposure to fetus's antigen causes development of anti-Rh agglutinins .
These agglutinins(mostly IgG antibody ) diffuse through the placenta and enters fetus blood cells and leads to phagocytosis of the RBCs ,which leads to release of hemoglobin into blood !Then fetus's macrophages converts the hemoglobin into bilirubin ,which causes baby skin to become yellow(jaundiced).Although the severe form of anemia is responsible for many deaths of infants ,many children who barely survive the anemia exhibit permanent mental impairment , because of precipitation of bilirubin in the neuronal cells  ,causing destruction of many cells , condition known as Kernicterus

It usually doesn't affect the first child ,since sensitization occurs during parturition.However ,if Rh-negative mother was sensitized earlier with Rh antigen then first child can get affected .

Treatment:
1)One treatment of HDNF is to replace the neonate's blood with Rh-negative blood .About 400ml of Rh negative blood is infused over a period of 1.5 or more  hours ,while neonate's own blood is removed,the process may be repeated several times during the first week of life ,to prevent Kernicterus .

Prevention:
Anti-D antibody is administered to the expectant mother ,starting at 28-30 weeks of gestation.The anti -D antibody is also administered to Rh-negative women who deliver Rh -positive babies to prevent sensitization of the mothers to the D antigen .This greatly reduces the risk of developing large amounts of D antibodies during second pregnancy !

~ojas

DON'T use Perfumes to test Olfactory nerve!!! But why?

Hi folks,

Our Neurology professor said not to use Perfumes to test Olfactory nerve in Cranial nerve testing. But why?

The updated Glasgow Coma Scale

Hi Awesomites,

The Glasgow coma scale or GCS as we know it has changed since its inception in 1974.

So lets go!

Main differences are 

• We no longer use the term "Pain", but "Pressure"
• We no longer recommend "Sternal Rub", but "Trapezius Pinch" or "Supraorbital notch pressure" or careful "Fingertip pressure"(Peripheral stimulation)
• "To speech" is changed to "To Sound"
• "To pain" is changed to "To pressure"
• "Inappropriate speech" is changed to "Words"
• "Incomprehensible speech" is changed to "Sounds"
• Flexion is defined two way now as "Normal flexion" and "Abnormal flexion"

The differences between 1974 and 2014 updates are as follows.

You can read more details on the update, in this link. Download the pdf in the page which is the original paper.

Thanks,

With love,

Jay :) 

Anatomy of the larynx: Cartilages

Here's an awesome video on the anatomy of the larynx by A. P. Burkholderia!

Isn't he just awesome? :D

Beta HCG notes

Where is beta HCG produced? 

Syncytiotrophoblast.

Step 2 CK: Goodpastures syndrome notes

Hello!
Here's a short post on Goodpastures syndrome!

Cocaine in the brain - "The Addiction"

Hey Awesomites!

Here I will be talking about a social problem amongst the youngsters - “Addiction to cocaine”. 

Menstrual cycle and related problems

Here are some common menstural complaints that I studied today during my posting that I would like to share with you. There are many more though. Comment if you think I have missed out on something!

Contrast induced nephropathy notes

Features of contrast induced nephropathy

- Due to iodinated contrast agents (Other agents that cause AKI: Gadolinium for MRI, sodium phosphate solutions as purgatives)
- Prevented by use of non ionic contrast agents, IV hydration, acetyl cysteine.
- Serum Creatinine rises 24-48 hours after exposure. Resolves in a week.
- FeNa low, benign urinary sediment.
- Risk increases in CKD, Diabetic nephropathy, multiple myeloma.

Brachial plexus mnemonic

This was probably the most important answer you must have encountered during your 1st year.

Here are tricks to remember Brachial Plexus!

Analgesic nephropathy notes

Analgesic nephropathy

Characterized by:
Renal insufficiency
Papillary necrosis

Due to:
Toxic drug levels in inner medulla
Causes chronic tubulointerstitial damage
Results from papillary ischemia due to vasoconstriction of medullary blood vessels (vasa recta)

Caused by:
Phenacetin containing preparations
Aspirin
Caffeine

Symptoms:
Polyuria (Due to impaired concentrating ability)
NAGMA (Due to tubular damage)
Hematuria (Due to sloughed necrotic papilla)
Sterile pyuria and WBC casts may also be seen
Ureteric colic, obstruction (Due to sloughed necrotic papilla)

At increased risk of:
Premature aging
Atherosclerotic vascular disease
Urinary tract cancer

That's all!
-IkaN

Radial nerve mnemonic

I am gonna put radial nerve in the simplest form mostly including mnemonics how to learn it's huge muscles supply!

Remember when you were in 1st year and how these nerves used to test your patience?! Let's make it easy.

-Nerve root: C5-T1

-Sensory nerve supply:
Skin of dorsal surface of forearm
Lateral side of the dorsal part of palm
Lateral 3 & 1/2 digits

-Motor nerve supply:
(It supplies extensor compartment)
Here is mnemonic
S: Supinator.
I: Extensor indices.
D: Extensor Digitorum.
B: Brachioradialis.
A: Anconeus.
T: Triceps.
C: Extensor carpi radialis longus.
C: Extensor carpi radialis brevis .
A: Anconeus.
P: Extensor pollicis brevis.
P: Extensor pollicis Longus.
CU: Extensor carpi ulnaries.
ED: Extensor digiti minimi.

So mnemonic is
SID (C)CAP(P) (Read it as cap!) BAT Cu-ed.

Remember:
Cu = Extensor carpi ulnaris (Supplied by radial nerve not ulnar nerve as it is extensor muscle)

~ Ojas

Treatment of TTP mnemonic

Safia made a mnemonic of TTP and sent it to Medicowesome, hoping it would help someone. So sweet!

Treatment of TTP: CART
C: corticosteroids
A: asprin
R: rituximab
T: transfusion

In emergency situations, transfuse blood first!

Thanks Safia.

-IkaN

Cranial nerves type mnemonics

Here is one of the mnemonics which I made to remember types of cranial nerves
1)Olfactory  -Sensory
2)Optic.  -Sensory
3)Occulomotor-Motor
4)Pathetic(Trochlear)-Motor
5) Trigeminal-Mixed
6)Abducens-Motor
7)Facial-Mixed
8) Auditory-Sensory
9) Glossopharyngeal-Mixed
10)Vagus-Mixed
11)Spinal accessory-Motor
12) Hypoglossal-motor

"Some say marry money but my brother says beautiful bride matters more!"

S-Sensory ;M-Motor ;B-Both (Mixed)

~Ojas

Contraindications of thrombolytic therapy

BISHOPS

B = Bleeding disorder .
I = Intracranial Hemorrhage.
S = Stroke past 3 months .
H = Head injury past 3 months .
O =Oesophageal varices.
P = Pregnancy.
S =Surgery.

Made by: Khushboo shaikh
Written by: Ojas gite

Step 2 CK: Mortality benefit in Congestive Heart Failure (CHF)

Another USMLE Step 2 CK important topic :D

Things that have a mortality benefit in CHF mnemonic: "ABCDES"
A: ACEI and ARBS
B: Beta blockers
CD: implantable Cardiac Defibirillator
E: Epelerenone
S: Spironolactone

Reading material from UpToDate! =)

T wave Inversion Mnemonic

In this post, I'll be sharing a mnemonic to remember the causes of T wave inversion.