Tuesday, February 21, 2017

Submissions: Adverse effects of Glucocorticoids mnemonic

Adverse effects of GLUCOCORTICOIDS:

Mnemonic is glucocorticoids itself!

Introduction to micro-organism series

Hello awesomites!

We have started with micro-organism series where we will discuss bacterias and viruses. But before that let's have a little introduction of Gram positive bacteria and negative bacteria!

Fanconis anemia mnemonic

Hello!

Here's a post on Fanconis anemia!

Saturday, February 18, 2017

Pierre Robin Sequence mnemonic

Hey Awesomites

Pierre Robin Sequence is one of the most common causes of isolated cleft palate in the newborns. Here's the mnemonic for the triad of symptoms- PRS

P- Cleft Palate only
R- Retrognathia (abnormal posterior position of jaw and maxilla)
S- Support to the lingual muscles is lost (Glossoptosis)

The sequence is known to be caused by genetic anomalies at chromosome 2, 11 or 17.


That's all

- Jaskunwar Singh

A Neurology Case Discussion


Hey guys, let's ponder upon the following case.
Before reading this case, just know that this is a case of cerebellar tumor. Now try to localize the tumor in the cerebellum by taking help of the symptoms of this kid. This will help you in the differential diagnosis given later.

A 4 year old complains of headache, drowsiness and occasional diplopia; he is unsteady on his feet with frequent falls. Examination demonstrates truncal ataxia, sometimes accompanied by incoordination of the limbs; variable ophthalmoparesis and papilledema on fundoscopic examination.

Any guesses on what this could be?

Ok so here goes the case discussion:

Medulloblastoma typically presents with a midline cerebellar syndrome, with hydrocephalus and resultant increased intracranial pressure.
Clinically, it can be distinguished from ependymoma involving the fourth ventricle by the early appearance of nausea and vomiting in the latter, due to involvement of area postrema. Cranial nerve palsies may appear with either tumor, and increasing intracranial pressure is typical of both.
The predominance of signs suggesting primary involvement of vermis distinguishes medulloblastoma from cystic or solid astrocytoma of the cerebellum which typically involves a cerebellar hemisphere rather than the vermis. Although rarely there are midline midline astrocytomas.

You are awesome if you were able to get this one right. :)

-VM

Fact of the day: Genesis of the U wave

Hey guys!!

As you know the U wave in the ecg is seldom seen especially in leads V2 and V3 physiologically especially during bradycardia.
And it is seen pathologically in Hypokalemia.

So how is it generated?
If you are thinking due to repolarization of papillary muscles, let me tell you that this hypothesis is now obsolete.

There are three trending theories at present trying to explain it:

1. Delayed repolarization of the subendocardial Purkinje fibres.

2. Prolonged repolarization of the midmyocardium ( M cells)

3. After-potentials resulting from mechanical forces in the ventricular wall.

That's it!

-VM

Thursday, February 16, 2017

Percutaneous endoscopic gastrostomy.

Hello awesomites let's know about PEG .

PEG stands for Percutaneous Endoscopic Gastrostomy .We normally use PEG tube .
also known as Feeding tube,Esophagogastroduodenoscopy  tube.=P

In simple language PEG is method of placing a tube into the stomach percutaneously followed by endoscopy .
Tube is passed into a patient's stomach through abdominal wall .
It is preferred route of nutritional support in patients having dysphagia or in unconscious patients.
It offers superior exposure to GI systems.
Most of the PEG tube has mushroom shaped device at the end that holds it in the stomach and prevent it from falling .If it falls do not wait till next day the hole may heal and this may create complications.

Whereas PEG  is also contraindicated in:-
-Distal enteral obstruction.
-Hemodynamic instability.
-Severe ascites.
-Sepsis
-Severe Gastroparesisi.
-Thrombocytopenia.

Wednesday, February 15, 2017

Scoliosis

Hello awesomites !It's been long time that I haven't written anything due to exam pressure =). Let's start with today's simple topic.

What is scoliosis?

-It's a disorder in which spine has sideways curve like "C" or "S" .It may increases or remain same.Patient usually suffers from breathing problems ,constipation due to tightened organs.
-Factors causing scoliosis are mainly genetic though environmental factors may cause scoliosis.
-Diagnosis is mainly by Plain X-ray.

Treatment?

-Current methods requires surgery to adjust growth rods every 6 months .This may require 8 to 10 procedures in total.

What is MAGEC rods ?

-MAGnetic Expansion Control rods are used as non-invasive adjustments.
Surgeons can lengthen the rods using a Handle-held external magnet.It takes 15 minutes and is performed every 3-6 months .It is also cost effective.Once a surgeon implants the device it's easy to use by remote.
MAGEC is used in children's (normally under 10 age) with severe spine deformity .

Stay awesome:)

~Ojas

Tuesday, February 14, 2017

Rheumatoid Arthritis deformities : Mnemonic

Hi everyone. This is just a mnemonic post on RA deformities.

So there are 2 important deformities that are definitely seen clinically but are hard to remember.
The Boutonniere and the Swan neck deformities both occur as some defect at 3 joints :
The Proximal Interphalangeal Joint (PIP)  and the Distal Interphalangeal Joint (DIP) and Metacarpophalangeal Joint (MCP).

So Remembering one of them is sufficient as the other one would be the exact inverse.

Remember :

Bout.on.ni.e.re

So Out one Ex .
Which means there's extension at DIP (the outer joint). Now after extension , alternate the next joint with flexion ( so Flexion at PIP ) followed by extension again ( so extension at MCP )

So , Boutonniere is -
DIP - Extension (out one is ex)
PIP - Flexion
MCP - Extension.

And Swan neck would be the opposite :
DIP - Flexion
PIP - Extension
MCP - Flexion

Hope this helped !
Stay awesome.

~ A.P.Burkholderia

Fact of the day: Tugging on heart strings

Hey Awesomites

Since its Valentine's day, here is a love fact you need to know:

Emotional instability and stress associated with constant anxiety (in case you are suffering from I-love-you-penia or broken-heart syndrome) may actually lead to acute emotional trauma to the heart and result in rupture of heart strings, the "chordae tendineae".

The chronic negative effects on heart are associated with Takotsubo cardiomyopathy, aka broken heart syndrome which involves weakening of myocardial muscles and rupture of chordae tendineae leading to right sided heart failure, ventricular arrhythmias and rupture.

So ease your suffering by talking to the love of your life on this special day and confess about your feelings today. <3

SourceTumblr

Ps- Medicine loves you and cares for you <3
- Jaskunwar Singh

Monday, February 13, 2017

Soap bubble appearance on X ray:Differential diagnosis

Hello everyone!
I always find X rays quite confusing especially when they appear same.
It's a short post about differentiating bone tumors.

Soap bubble appearance on X ray is expansile, eccentric vaguely trabeculated space having thin sharp defined sclerotic margins.
Mostly seen in bone tumors and other bone lesions.
On X ray they all appear same, only way to differentiate them is to know their location and other associated factors.
Commonly seen in
1) Aneurysmal bone cysts-
  Location of ABC is Metaphysis.
It occurs in younger age group i.e less
than 20 years. So the X ray of such
patient will have non fused and 
immature bone.
Preferred sites are long bones of upper and lower limb, especially femur.

2) Giant cell tumor(osteoclastoma) -
Location of GCT is epiphysis
Here the prevalent age group is 20-40, which means an adult sketetal structure.
While the preferred sites are same like ABC.
So if one see epiphyseal lesion with soap bubble appearance in mature bone, it has to be Giant cell tumor.
GCT presents with other classical signs of Egg shell crackling on palpitations.
Giant cells on histology.
Which are NOT the tumor cells. So its one of the example of misnomers. They are meant to misguide you.

Thats it :)
Stay awesome

-Khushboo

Pharmacology: Microsomal metabolism by CYP enzymes in phase 1 mnemonic

Thanks a lot for this video, Shilika!

Pharmacology: When dialysis is not the treatment mnemonic

Video by Shilika!

Sunday, February 12, 2017

Fact of the day: 'Experience- taking' from books

Today's fact is relatable for all medicos and books lovers <3

Yes, you can subconsciously take on the attributes of your favourite fictional characters when reading a story- not just the thoughts and beliefs of the character, but the whole state of being itself.

Well, it is more often seen in those who are depressed or who don't have much life experiences of their own.

Also, if the reader is able to relate experiences in the life of character of the story, he might take it to his own life and adopt the mindset and perspective of the character. This may lead to temporary or permanent changes in his real life.

Excessive openness to experiences may lead to schizotypal, narcissistic or paranoid personality disorders among others.


Happy reading :D

- Jaskunwar Singh

Saturday, February 11, 2017

Fact of the day: Handedness arises from genes in the spinal cord

Handedness is an asymmetry arising due to left-right differences in the development of nervous system. Evidences suggest that a human embryo of eight weeks is able to move its right arm more than the left arm.

Well, if you know something about neurologic development in-utero, you must know that at eight weeks signals are not transmitted from the brain yet. Instead the signals travel from the spinal cord.

The left side of the cord matures faster than the right cord. This means the genes that control growth and development are activated faster on the left cord than the right one. In the hindbrain, it is the other way around.


That's all
- Jaskunwar Singh