Sunday, January 1, 2017

Metoclopramide

Hello awesomites ! Today I am gonna talk about a drug named as "Metoclopramide".
Basically it's a anti-emetic drug.First let us know what is emesis !.In simple words emesis means vomiting.Chemoreceptor trigger zone (CTZ) is  located in area postrema and the nucleus tractus solitarius (NTS) of medulla oblongata.They both act as a important relay areas for afferent impulses arising in g.i.t.,throat and other viscera.
Metoclopramide is a Pro kinetic drug
It acts on GIT causing increase in peristaltic movement with relaxation of  pylorus .

Mechanism of action includes :

a)D2 antagonism:It Decreases dopamine concentration  and obviously acetylcholine concentration increases  !.Which causes activation of ACh receptors leading to increase in LES tone and gastric pressure .

b)5-HT4 agonism:Activates 5-HT4 receptors on primary afferent neurons (PAN) of the ENS,via excitatory interneurons.

Gastric hurrying and LES tonic effects are mainly due to this action which is synergised by bethanechol and attenuated by atropine .

c)5-HT3 antagonism: At high concentrations  it can block 5-HT3 receptors present on inhibitory myenteric interneurons and in NTS/CTZ .Increase in ACh concentration is also seen in minor condition


Long term use can cause parkinsonism-since decrease in dopamine , galactorrhea and gynecomastia .

It hastens use of many drugs like aspirin and diazepam by its action



~Jaskunwar Singh & Ojas 



Triad of Charcot

Hello

Charcot's triad in acute cholangitis: FOR
- Fever
- Obstructive jaundice
- Right upper quadrant pain

Chracot's triad in multiple sclerosis: SIN
- Scanning speech
- Intention tremors
- Nystagmus


Thats all
- Jaskunwar Singh

Multiple sclerosis mnemonic

Hey awesomites!
Presenting to you the first post of 2017 :)

Multiple sclerosis clinical features mnemonic:
DONALD TRUMP

D- Demyelinating disease
O- Optic neuritis
N- Neuromyelitis optica
A- Autoimmune aetiology
L- Leg pain
D- Depression
R- Relapsing and remitting type (most common)
U- Uhthoff's phenomenon
M- McDonald's criteria (diagnostic)
P- P100 latency of nerves (delayed)


Thats all
- Jaskunwar Singh

Saturday, December 31, 2016

2016: the flashback

Hey all!

In this post, I just want to share a flashback to the year 2016 and what I have learnt through the journey of these 365 days.

2016, you will be missed

Remember I promised 2016 was going to be awesome?

It was, it was. It was a beautiful year, personally.

Here's my year in review:

Create the change

Hello everyone

So it's the last day of 2016. And everyone is now talking about new year resolutions and stuff. But what do we want to resolve as medical students?

Remember the first day you joined the medical college? That day you promised yourself something. To be a good doctor one day and serve humanity. To study and work hard all day and night seven days a week and gain knowledge in every subject you study. You had taken your life- changing resolution on that first day itself.

I believe in change. I have always tried to explore myself and learn new things each day of my life. That's what we all should do. And not just in the initial days or weeks of the new year. Because you are known by your actions and not what you think.

So stop making resolutions and start taking your real life decisions. Change is the law of nature. Create the change in yourself each passing day for the better. That will make you feel good. And because your ultimate goal in life is not just to be a doctor but also be a good human being. Then one day you will be what you ever wanted to be.


That's all
- Jaskunwar Singh

Friday, December 30, 2016

Ectopia lentis mnemonic

Ectopia lentis (or lens dislocation) associated conditions mnemonic.


- MarFAN syndrome (FAN is up)- Superior dislocation of the lens
- HomocystinURIA (URINE goes down)- Inferior dislocation
- WeilMARCHesani syndrome (We will march forwards)- Anterior dislocation of the lens


Thats all
- Jaskunwar Singh




Top 10 series: Amiodarone

And here's a video on amiodarone!

Top 10 series: Methotrexate

Hello!
Here are top 10 facts about methotrexate!

Thursday, December 29, 2016

LAP score

Leukocyte Alkaline Phosphatase score is used to differentiate a reactive process from chronic myelogenous leukemia. Here I  just mention the conditions with high and low LAP score (not a mnemonic this time :p )

High lap score:
- Neutrophilia ( as in bacterial infections)
- Polycythemia vera (neoplasm of bone marrow)
- Blast phase of XML
- Hodgkin's disease
- Leukemoid reactions
- in newborns, children and pregnancy.

Low lap score:
- Chronic Myelogenous leukaemia (chronic phase)
- Paroxysmal nocturnal hemoglobinuria
- Hereditary hypophosphatasia


That's all
Happy Medicowesome :)

- Jaskunwar Singh

Normal pressure hydrocephalus

Hey awesomites

Normal pressure hydrocephalus is a type of brain malfunction characterised by:
- Dilatation of ventricles
- Distortion of fibres in corona radiata
- Normal pressure on lumbar puncture
- And a triad of symptoms:-
                    - Cognitive loss (dementia)
                    - Apraxia of gait
                    - Pee problems  (urinary incontinence)
I have made a mnemonic for this triad. Since cephalus in hydrocephalus means head so here's a cap to cover it. Mnemonic- CAP

The main aim of treatment in this condition is to drain the excess of CSF. Surgical installation of ventriculoperitoneal shunt is the usual method which aims to drain csf into the peritoneal lining of abdomen from where it is easily absorbed.


Thats all
- Jaskunwar Singh

Seasonal affective disorder

Hey awesomites

Seasonal affective disorder  (SAD) is common in winters months when days are short and nights are long. It is caused by abnormal melatonin metabolism and the patient presents with acute depressive and atypical symptoms.

Here's a mnemonic for atypical symptoms of Seasonal affective disorder.
SAD
S- Sleepiness
A- Appetite increase
D- Decreased energy

Note: Treatment of this disorder includes exposure to bright light therapy. Melatonin tablets should not be prescribed in such cases.


That's all
- Jaskunwar Singh

Wednesday, December 28, 2016

Vogt's triad in tuberous sclerosis mnemonic

Vogt's triad in tuberous sclerosis mnemonic:
EpiLoiAs
Epi- Epilepsy
Loi- Low IQ
As- Adenoma sebacum

- Jaskunwar Singh

Vogt's triad in congestive glaucoma mnemonic

Vogt's triad in acute congestive glaucoma:
GAP
G - Glaucomflecken
A - Atrophy of iris stroma
P - Pupil dilatation

Also, check out the Vogt's triad in tuberous sclerosis mnemonic here

- Jaskunwar Singh

Virchow's Triad Mnemonic (NEW)

Hey, guys Jay here!

Virchow triad is about the 3 reasons for Deep Venous Thrombosis.

So I remember it as,

HE'S Virchow.

H - Hypercoaguability
E - Endothelial damage
S - Stasis

Many people may have many mnemonics. But this is mine. Hope you find it helpful. :)

Jay :)

Complicated vs. Non complicated appendicitis


  • Complicated appendicitis has a perforated or gangrenous appendix.
  • Non complicated appendicitis has a non-perforated appendix.


The treatment plans are different too!


  • Non complicated appendicitis needs an immediate appendectomy
  • Complicated appendicitis need to go through an antibiotic course before going to an appendectomy.

Reference : Schwartz Principles of Surgery 10E

Jay :)

Oxidase vs. Oxygenase

Another confusing yet very simple thing


  • Oxidase does oxidation in Redox reactions.
  • Oxygenase adds an Oxygen to the substrate


It's not that hard to remember right?

Jay :)

Neurotransmitters associated with sleep mnemonic

Neurotransmitters associated with sleep mnemonic
SAND

S- Serotonin: helps initiate sleep cycle and promotes wakefulness.
A- Acetylcholine: levels are higher during REM sleep.
N- Norepinephrine: levels are lower during REM sleep.
D- Dopamine: high levels responsible for arousal and wakefulness.

Note:
- The regulation of levels of Acetylcholine and Norepinephrine is an important biochemical trigger for REM sleep. Higher levels of Ach and lower levels of NE means there is increase in the time period of Rapid eye movement phase of sleep cycle.

- Serotoninergic neurons are present in Distal Raphe nuclei which enhances wakefulness. Thats why the 5-HT activity decreases during NREM sleep and becomes silent during REM phase.

- Dopamine agonists, such as  bromocriptine, pramipexole and others are used to treat parkinson's disease which work by acting on dopamine receptors and compensate for the lack of dopamine which the brain cells no longer produce. They are used together with levodopa. By increasing dopamine levels they restore the balance of Acetylcholine and dopamine thus increasing wakefulness.

- Antipsychotic drugs are dopamine antagonists. So they decrease wakefulness and increase sleep time of a person.

- Higher levels of Ach during REM sleep is associated with erections in men.


Thats all
- Jaskunwar Singh

Dehydrogenase vs. Dehydratase

Another simple thing that we often get confused with in Biochemistry!

  • Dehydrogenase removes Hydrogen
  • Dehydratase remove H2O
Simple right?

Jay 

Synthase vs. Synthetase

This is very simple guys! Synthases don't use ATP to make the new bond between substrates while synthetases need an ATP.

ok fine! How to remember it?

Think of the additional T that comes in syntheTase is from ATP! ;)

Got a way to memorize it?

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 6 : LIGASES)

Hello guys, we come to an end of this 6 part enzyme series and also this is the 500th Medicowesome post for 2016! Woohoo! :D

Ok, back to our business! Ligases, what to they do? Obvio, they LIGATE! Or simply connect! But connect what?

Think of these guys as a Plumber who connects those pipes! ;)

Major subclasses
  • Synthetase - Formation of new bond between substrates using the energy from an ATP
  • Synthase - Link two molecules without using the energy from ATP (Confusing with Synthetase? They use ATP. Check here for a memory aid.)
  • Carboxylase - Formation of a new bond between a substrate and a CO2 using the energy from an ATP
Are we ok guys?

Jay  :)