Friday, August 25, 2017

MIL: Polar cataract

Image: Polar cataract
Submitted by:  Sushrut

MIL: Rhabdomyosarcoma of the Right Eye

Image: Rhabdomyosarcoma of the Right Eye
Submitted by: Does not wish to reveal identity

MIL: Psoriasis

Image: Plaques of psoriasis
Submitted by: Dr. Manasi Shirolikar

Introducing Medicowesome Image Library (MIL)

Hello everyone!

I wish to create a visual learning experience by adding images and videos along with what we write.

But since most images on Google have copyright issues, the Medicowesome authors can't use them :(

That is why, I'm asking medical students, residents and acquaintances to send me images of what they see to help create the Medicowesome Image Library (MIL).

It can be anything - a histology slide, a microbiology agar, a pathology specimen, a rash, an instrument, an x-ray - anything!

Treatment of streptococcal tonsillopharyngitis: Important points for USMLE

Hello!

Here's a quick post of treatment of "strep throat" (my slang for "Tonsillopharyngitis due to Streptococcus pyogenes, also known as group A Streptococcus.")

Thursday, August 24, 2017

Question on sedative-hypnotics

Hello awesomites! Let us discuss about our previous question.

Question) Which of the following statement(s) is/are true regarding benzodiazepines?
A) It acts as GABA agonist
B) Diazepam is a short acting benzodiazepine
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver
E) Diazepam has higher abuse potential than midazolam
#Pharmacology
#Medicowesome

So here is answer of our previous pharmacology question
Correct answer is C and D.
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver.

Explanation:
BZDs has facilitatory action. They are not a GABA agonist.
Diazepam has rapid onset of action but prolonged action due to formation of active metabolite.
BZDs like nitrazepam, flurazepam etc are metabolised in liver by dealkylation and hydroxylation.
The dependence producing liability of BZD is low. They are Infrequently used now.

-Ojas

Classification of sedatives & hypnotics + notes for NEET

Hello awesomites!! So, here are my "Single page notes" on sedative-hypnotics. To the end of this post I have uploaded picture of my notes. So lets begin.

Classification:It is classified into 3 categories.

1)Barbiturates

Key points : 
a) No antidote.Poisoning treated by gastric lavage, symptomatic treatment and forced alkaline diuresis
b) Steep curve dose.
c) Inhibits all areas of CNS. Most sensitive is reticular system
d) It inhibits all areas of CNS. Mostly reticular system which leads to inability to maintain wakefullness.
e) May cause "Hyperalgesia".
f) Duration of REM sleep and stage 3, 4 of sleep cycle decreases
g) Contraindictated in acute intermittent porphyria
i) Hangover is common
                       
Barbiturates are further classified into three types. 

A) Long acting  
Phenobarbitone.

B) Short acting.
Butobarbitone
Pentobarbitone.

C) Ultra short acting
Thiopentone.
Methohexitone.

2)Benzodiazepines

Key points:
a) Antidote:Flumazenil is competitive antagonist. It takes 30-60 minutes for its action.
b) Flat dose curve.
c) Duration of REM sleep decreases but frequency increases.
d) Hangover less common
                
They are further classified into three categories

A) Hypnotics
-Diazepam:Causes analgesia(Barbiturates causes hyperalgesia as mentioned earlier.) and it also causes muscle relaxation
-Flurazepam :Paradoxical simulation and increase nightmare
-Nitrazepam:Increase REM sleep (Rest decreases)
-Temazepam
-Flunitrazepam : Tasteless BZD called as "
" Date rape drug"
-Midazolam:Causes blackouts and ataxia.
-Alprazolam
-Triazolam:Responsible for paranoia and other psychiatric disturbances.

B)Anti-anxiety
Remember OLA-CD
-Oxazepam
-Lorazepam:Absorption from intramuscular site is regular for other drugs its irregular.
-Alprazolam
-Chlordiazepoxide.
-Diazepam.

C) Anti-convulsants :
-Diazepam
-Lorazepam
-Clonazepam
-Clobazam
Remember: EasT LOT
E=Estazolam
T=Temazepam
L=Lorazepam
O=Oxazepam
T=Triazolam
These drugs directly conjugated without metabolism to active products. These are short acting and can be used in liver failure

3)Newer non-benzodiazepine hypnotics:

-Zopiclone:
a) Increases stage 3 and stage 4 duration
b) Indicated for patients BZDs for induction of sleep
c) Less rebound insomnia and hangover.
b) Active metabolite is eszopiclone.

-Zolpidem
a) Lacks anti-anxiety, muscle relaxants, and anti-convulsants actions.
b) Use in short term treatment of insomnia.
c) No rebound insomnia and hangover.

-Zaleplon
a) Decreases sleep latency without affecting sleep time.

-Suvorexant:
a) Its is Orexin antagonist. Orexin is wake-fullness receptor.
Ojas

Tuesday, August 22, 2017

Image Based MCQ on Instruments


Hello awesomites!
Yesterday we posted an Image based MCQ on Instruments and here is the answer to the question.
#Image_based
#Instruments
Q. What is the inner diameter of the device shown in the picture if it is to be used in adults?

A. 2-3 mm
B. 8-9 mm
C. 12-15 mm
D. 21-23 mm
The correct answer is B. 8-9 mm. The image given shows an Endotracheal tube that is available in different sizes for different age groups.
Internal diameter 3mm - 6mm is used for Paediatric cases.
Typically, an 8.0 or 8.5 mm for adult men and 7.5 to 8.0 mm for adult women is an ideal choice.
Thanks for your active participation in the question.
MD Mobarak Hussain (Maahii)

Monday, August 21, 2017

Cushing Vs Curling Ulcer

Hello!

Its time to differentiate between two confusing ulcers - Cushing and Curling.

What is Cushing Reflex?
It is a triad of Bradycardia, Hypertension and altered respiration following Head injury.

What is Cushing Ulcer?
Stress Ulcer following Head injury.
Most common site - Acid producing area of Stomach.

What is Curling Ulcer?
Stress Ulcer following Burn.
Thomas Blizzard Curling.
Reduced plasma volume leads to ischemia and cell necrosis of the mucosa.
Most common site - 1st part of Duodenum.
cURling = bURn

This may help you to remember the difference between these two.

Thanks

MD Mobarak Hussain (Maahii)

Latanoprost and Pilocarpine never go together

Latanoprost increases the uveoscleral outflow of the aqueous humor. Pilocarpine has a constrictive effect on the ciliary body as a whole. Hence, when the two are used together, their effects end up getting nullified with the physician bungling to achieve the target IOP.

That's all!

-Sushrut Dongargaonkar


Medicollabowesome: ENT Manifestations of HIV Infection

Medicollabowesome: Neurological Diseases in HIV patients

Medicollabowesome: HIV Infections - Clinical categories

Medicollabowesome: The increased burden of HIV and AIDS

Introducing Medicollabowesome



Hello everyone!

We, the Medicowesome authors, decided to do something new this month and bring to you - Medicollabowesome.

The idea originated from wanting to see how different people present information uniquely on the same topic. 

The Medicowesome authors decided that most of us will (try) to write on one particular topic every month. 

Hopefully, we will learn so much together :D

The topic for the month of August: HIV & AIDS. 

We've already begun writing (:

I invite readers to participate in Medicollabowesome too by emailing your article to us! 

Email the title, post and author name to medicowesome@gmail.com with "Medicollabowesome" in the subject line. 

This is so exciting! 

-IkaN