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

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.
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:
Epi- Epilepsy
Loi- Low IQ
As- Adenoma sebacum

- Jaskunwar Singh

Vogt's triad in congestive glaucoma mnemonic

Vogt's triad in acute congestive glaucoma:
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

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.

- 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?


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  :) 

Enzymes and the Type of Reactions they Catalyze ( Part 5 : ISOMERASES)

Ok what are isomers? Same molecular Formula, different structure! That is an Isomer! And presumably isomerases play with these isomers. But how?

  • Racemase - Conversion of D isomer to L isomer or vice versa(Read about them here more in IkaN's article)
  • Mutase - Conversion of one constitutional isomer into another. They shift one functional group from one place to another place within the same molecule.
Are we clear on this? 

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 4 : LYASES)

With part 4 we come to a little confusing group of Enzymes guys! LYASES! They are called Lyases, of course because they do Lyse! :P

ok the major subclasses?

  • Dehydratase - Removal of H2O from a substrate (Confusing with Dehydrogenase?Read Part1)
  • Decarboxylase - Removal of CO2 from a substrate
  • Deaminase - Removal of NH3 from a substrate
  • HYDRATASE - ADDING of H2O to a substrate
  • Aldolase - Produces Aldehydes via elimination reactions
Any questions guys? :)


Enzymes and the Type of Reactions they Catalyze ( Part 3 : HYDROLASES)

Back with Part 3 guys! It's Jay with Hydrolases! :P

There are 5 major classes of Hydrolases. They always Hydrolyse means breaking it down with the help of H2O.

  • Lipase - Hydrolysis of ESTER linkages of lipids
  • Protease - Hydrolysis of AMIDE linkages of proteins
  • Nuclease - Hydrolysis of SUGAR PHOSPHATE ESTER linkages of Nucleic Acids. Phosphodiesterases also do the same
  • Carbohydrase - Hydrolysis of GLYCOSIDIC bonds of Carbohydrates
  • Phosphatase - Hydrolysis of PHOSPHATE ESTER bonds.

Also please note, that the types of bonds in CAPITAL ITALICIZED letters are the major types of bonds in those biomolecules as well as the bonds that break due to these enzymes.

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 2 : TRANSFERASES)

Hey guys, Jay here once again with Part 2. Here we will talk about Transferases!

Transferases, do Transfer! But transfer what? There are two major types of Transferases!

  • Transaminase --> Transfer of an Amino group between substrates
  • Kinases --> Transfer of a Phosphate group between substrates often from ATP
  • Methyltranferase --> Tranfers single-carbon units between substrates
  • Phosphorylase -->Transfers inorganic phosphate to a substrate


What does Kinase even mean? It comes from the greek work Kinein means "To move". It originally had nothing to do with Phosphates. But now we almost exclusively use this for Phosphate transfers. :)

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 1 : OXIDOREDUCTASES)

Guys the post is quite long. So I thought to break it into 6 different parts. This post will cover Oxidoreductases.

There are 5 main types of Enzymes in this category. As the name suggests, two of them are Oxidases and Reductases. The other ones are Dehydrogenases, Oxygenases and Peroxidases.

  • Oxidases --> Oxidizes a substrate
  • Reductases --> Reduces a substrate
  • Dehydrogenases --> A double bond is introduced to the substrate, by removal of two H atoms. The H are accepted by a Coenzyme.
  • Oxygenase --> Directly incorporates Oxygen into the substrate
  • Peroxidase --> Uses Hydrogen Peroxide H2O2 as an electrone acceptor

Question? Yes! Removal of Hydrogen and adding of Oxygen are also considered a type of Oxidation because it increases the oxidation number of the substrate! Pre-Med Organic Chemistry anyone? ;)

See you soon with the other categories guys!

Jay :)

P.S. - Don't confuse Dehydrogenase with Dehydratase!!! We go through that here:)

Urgent vs. Emergent Tracheostomy

In English, Urgency and Emergency almost means the same. But when it comes to Medical literature, it has a little difference.

So what are the differences of Urgent and Emergent Tracheostomy?

Night terrors vs Nightmares

Hey awesomites!

People who have night terrors are often misdiagnosed, nightmares being the most common. Post traumatic stress disorder is another common misdiagnosis (in adults).
Here's the difference between night tremors and nightmares both of these are classified under a group of disorders, the Parasomnias!

Recent research suggests that getting an extra sleep for 30- 40 minutes a night reduces both nightmares and night terrors to a great extent.

Scheduled awakening therapy-
Another treatment strategy (for night terror) is "Scheduled awakening therapy". It involves waking the person from sleep 15- 30 minutes before the episodes typically occur so that the cycle is interrupted and prevent the onset of the night terror. But the child is not to be fully awaken in the middle of the night.
Thats where the idea of sleep guardian came from. The sleep guardian plans smartly and finds a right time to partially wake up the child and vibrate each night (for less than 3 minutes). This prevents the episode of night terrors and sleep is not actually totally disturbed.
This method of prevention of night terrors has shown 90% positive results within first week with 80% fewer night terrors after four weeks of use.

Thats all
- Jaskunwar Singh


Hello awesome people !
Today's topic is - ADAMANTINOMA ! (and no it's not what would only happen to Wolverine! Haha see what I did there ?! )

1)Also known as Ameloblastoma (Ameloblasts are enamel forming cells), Eve's disease (looks like ADAM & EVE had a tiff over who'd name it, and clearly it was a draw! :p)

2) Its a benign tumor, but behaves like a malignant one, it metastasizes to lungs. (so wanna be)

3) Sites : #Mandible (most common site) (anyone else going weak in the knees seeing Hugh Jackman's jawline?, cool now you'll remember it better!)
Talking of knees, #Tibia is the 2nd most common site !
#Pituitary because the stalk of pituitary and enamel arise from oral epithelium

3) Slow growing tumor, with multiple cystic spaces...patients often complain of falling teeth or fracture mandible :(

4) X ray shows a "Honeycomb" appearence

5) Treatment? Well since this tumor is very "Adamant" simple curettage will cause recurrence, hence we do a wide excision (1cm margin)...Sometimes a Hemimandibulectomy may have to be done! (Sounds like what Wolverine would do to his enemies!)
All the Wolverine fans put your hands up and read this again !!  :p
That's about it !!

Top 10 series: Phenytoin


Here are top 10 facts about of phenytoin.

Ulnar nerve

Ulnar nerve
Nerve root :C7-T1.
Key points :
On the back of medial epicondyle of humerus ulnar nerve can be palatable it produces tingling sensations Hence humerus is called as "Funny bone".
Ulnar nerve is not a content of Cubital fossa .
Remember:Ulnar nerve supplies total 15 muscles  in hand!
3 hypothenar eminence ,medial 2 lumbricals ,4 dorsal and 4 Palmer interossei and ADDuctor pollicis
Palmaris brevis
Forearm(Read carefully don't get confused)
Medial half of flexor digitorum profundus(Thinking about lateral half ??!!! Well ,it is supplied by Median nerve )
Flexor carpi ulnaris (Thinking about extensor carpi ulnaris ?! Read  carefully ,Supplied by radial nerve)
Clinical anatomy:
1)Musician nerve
2)Ulnar nerve lesion at the wrist :Ulnar claw hand which shows
a)Hyperextension at metacarpophalangeal joints and flexion at the interphalangeal joints ,involving ring and little fingers (Little finger is held in extension by extensor muscles )
b)Sensory loss is confined to the medial one third of the palm and medial one and a half fingers including nail bed .Medial half of dorsum of hands also shows Sensor loss
c)Vasomotor changes :Skin is warmer due to arteriolar dilation ,it is also drier due to absence of sweating because of loss of sympathetic supply.
d)Trophic changes:Long standing cases of paralysis lead to dry and scaly skin .The nails crack easily
It should be noted that median nerve lesions are more disabling.In contrast ,Ulnar nerve lesions leave a relatively efficient hand

Principal cell: How to remember it's function and location in the nephron

Principal cell

Top 10 series: Cyclophosphamide

And here's A. P. Burkholderias fav drug - Cyclophosphamide!

ENT instruments contents page

Hey, so because the contents page has expanded so much, I thought of making sub sections within the contents page for a few topics.

Here's the mini contents page for ENT instruments, this post is linked to the main contents page :)

Tuesday, December 27, 2016

Top 10 series: Rifampicin

Introducing a new series of videos :D

Hope you like them!

Chronic complications of pulmonary tuberculosis mnemonic

Chronic complications of pulmonary tuberculosis

Pulmonary complications-  HE CAL BOB
H- Haemoptysis
E- Emphysema
C- Cor pulmonale
A- Aspergilloma/ Atypical MTB
L- Lung calcification
B- Bronchiectasis
O- Obstructive pulmonary disease
B- Bronchopleural fistula

Extra- pulmonary complications- PALE
P- Poncet's polyarthritis
A- Anorectal fistula/ Amyloidosis
L- Laryngitis
E- Empyema necessitans/ Enteritis

Thats all
- Jaskunwar Singh

Monday, December 26, 2016

Herpes Zoster Ophthalmicus notes

Herpes zoster ophthalmicus

This viral infection is associated with a previous childhood exposure to varicella zoster (chickenpox) which remains hidden within and becomes active later in life when immune functions of the body weaken.

GUYS, did you check First Aid 2017? We are Super Proud of you IkaN!!!

Beloved Awesomites, I have a super-awesome announcement to make today regarding our Founder IkaN aka Nakeya Khozema Dewaswala.

She is the Image and Illustration editor in the recently released world famous medical book, First Aid 2017!!!

We are super proud of you sis, especially you being the only representative from South Asia in the book for this edition! We always knew you are an amazing medical student, but you proved you are totally exceptional with this feat.

This is another step toward your success sis. You are an inspiration to thousands and thousands of medical students around the world, and a living proof that if you want something, and if you struggle for it, you will certainly get it!

Me, myself am so lucky to have known you personally and be called as your bro, and I know, more than you have an AWESOME brain, you have an AWESOME heart! (Isn’t this why we love her a lot, Awesomites?)

Keep inspiring us sis! We at the Author Panel of Medicowesome, and the whole thousands of Medicowesome members, would like to congratulate you, and wish you all the very best in your all future endeavors!


Jay :) 
On behalf of the Author Panel of Medicowesome

P.S. - Special thanks to Krupal Patel in Medicowesome Whatsapp group who brought picture to our attention! :) 

Restless leg syndrome notes

RLS symptoms:
Urge to move legs
Symptoms begin with rest
Relief on movement

Associated with:
Renal failure
Peripheral neuropathy

Disordered dopamine function in association with abnormal iron metabolism

Sleep hygiene
Pramipexole, ropinirole
Iron for IDA

That's all!

Membranous and pseudo-membranous conjunctivitis notes

Pseudo-membranous conjunctivitis: mild form
Membranous conjunctivitis: severe form

Causative agents:
Corynebacterium diphtheriae
Beta- hemolytic streptococci
Streptococcus pneumoniae
Neisseria gonorrheae

Associated conditions:
Erythema multiforme
Stevens- Johnson syndrome

- Lid swelling
- mucopurulent bloody discharge
- white membrane
- easily peel off without bleeding

- Lids are hardened
- semisolid exudates: result in necrosis of conjunctiva and cornea
- difficult to peel off
- associated with bleeding from the undersurface

Important points to be noted:-
- The membrane forms more commonly over palpebral conjunctiva beginning from the edge of lid.
- There is enlarged preauricular lymph nodes with suppurative discharge.
- Marginal corneal ulcer due to secondary infection (especially streptococci).
- high risk of symblephron (adhesion between palpebral and bulbar conjunctiva)

- Penicillin (10,000 units/ ml) is the doc for acute diphtherial infection. Systemic administration and a quick injection of anti- diphtheritic serum (4,000- 10,000 units BD) 
- Removal of the membranes is not advised because of the risk of adhesion (symblephron).
- Local and systemic administration of bacitracin and penicillin is recommended in case of streptococcal infection.

Pseudotumor cerebri notes

Pseudotumor cerebri

Associated with:
Vitamin A toxicity

Signs and symptoms:
Sixth nerve palsy
Visual field defects
Pulsutile tinnitus

To rule out space occupying lesions - CT / MRI normal
Most accurate - Lumbar puncture with opening CSF pressure measurement

Weight loss

Why does increased ICP cause 6th nerve (Abducens) palsy?
Increased ICP can result in downward displacement of the brainstem, causing stretching of the sixth nerve secondary to its location within  Dorello's canal.

That's all!

Sunday, December 25, 2016

Amaurosis fugax mnemonics

I was studying the causes of Amaurosis fugax today.. so i just made random mnemonics and thought of sharing with you guys :D

Amaurosis fugax is a transient uniocular loss of vision either due to lack of blood supply to the brain or to the retina itself.

Disease modifying therapies for relapsing forms of multiple sclerosis - MS treatment mnemonic


I was reading treatment for MS today.

Do you want to remember the disease modifying therapies for relapsing forms of multiple sclerosis?

Here's a mnemonic! "Ms is Nat (not) glad. All terrified by mighty ox with fuming fungus."

Multiple sclerosis (Ms)
Natalizumab (Nat)
Glatiramer acetate (Glad)
Alemtuzumab (All terrified)
INF beta (By)
Mitoxanthrane (Mighty ox)
Dimethyl fumarate (Fuming)
Fingolimod (Fungus)

Remember, for acute attacks, use Glucocorticoids.

That's all!


Neurofibromatosis type 1 - Another mnemonic


So I needed another mnemonic for neurofibromatosis because my first mnemonic wasn't good enough xD

This time, the mnemonic is NODES!

That's all! 

Merry Christmas everyone! 


Neurofibromatosis type 1 old mnemonic:

Syndromic Management Of RTI/SRI

*Syndromic Management*📁📗🏳📘📕📒📓

Mnemonic :: *Great Girls Wont Buy Red Yellow Bags*

*Kit 1 - Grey*
*Kit 2 - Green*
*Kit 3 - White*
*Kit 4 - Blue*
*Kit 5 - Red*
*Kit 6 - Yellow*
*Kit 7 - Black*

*Kit 1 is GreaT*

*Kit 2 is Green*
_*BV CA Green TV*_
Coz no self respectingan would buy a green TV...he'll buy it out of love for wife😜😜😜

Bacterial Vaginosis
Candida Albicans
Trichomonas Vaginalis

*Kit-3 is ABC*
Benzathine penicillin

For Chancre and chancroid

Also notice C is 3rd letter and 3 letters ABC in the mnemonic for Kit 3

*Kit - 4 Remember that if you forget this then its BAD*

Azithral coz allergy to penicillin

*Kit - 5 is Red as in Mnemonic*
Remember that Red is for love and love is *Her* eyes and smile

*Kit - 6 is Yellow as in Mnemonic*

Yel *low* for *low*er abd pain

*Kit - 7 is Black* coz last colour is the colour palate also BLAC


Saturday, December 24, 2016

Vitamin D and multiple sclerosis

Hey awesomites!

Since I have written posts regarding the association of vitamin D deficiency with certain neurological disorders previously, I am here again with one more addition into the box (on sincere request of our main author IkaN.. :p ).


Hey here is exclusive classification of anticholinesterase drugs !,hopefully it will be useful.


Thursday, December 22, 2016

Hypoglycemia mnemonic

Hypoglycemia may present as a mere symptom of a disease or a life- threatening condition itself. I have made a mnemonic on the common signs and symptoms in a patient of hypoglycemia. Here it is..

M- Mood swings
E- Excess sweating
T- Tachycardia
A- Adrenal fatigue
B- Blood pressure changes
O- Obesity
L- Lips tingling
I- Increased appetite/ hunger
S- Shakiness (tremors)
M- Muscle pain

That's all
- Jaskunwar Singh

Crispy C.R.I.S.P.R.!

10 years ago,only a few would have thought that a device in our pockets would be good enough to access all the information of the world, would do social networking, calls, would calculate, act as a torch and what not. 

We today are on a similar brink ofrevolution in genetic engineering, where the effects would be so magnificent that they would need to be measured on a Richter scale! 

Enter CRISPR, which is an acronym for 'clustered regularly interspaced shortpalindromic repeats', a  crispy new technology which promises to shrink the costs involved in genetic engineering by 90%makes the procedure easier andshorter.

*What is it? 
We have managed to hack an antibacteriophage mechanism in bacteria to our advantage. 

Only a few bacteria survive bacteriophage invasion. To protect themselves from a further invasion, they store a part of the phage DNA into their archives. 

When another attack does occur, an RNA copy of the archived phage DNA is presented to what is known as a CAS 9 protein.

CAS 9 compares the two copies, one from the foreign DNA and the other from the archives, and is very precise at that. 

If it finds a 100% match, it cuts off thenew phage's DNA, thus rendering the attack a big embarrassment for the bacteriophage. :-p 

*What can we do with it? 
Oh, a lot of awesome things! 

-Pissing off viruses
In 2015, scientists armed with CRISPR achieved a significant reduction of HIV load from patiens. 
This year, in mice, they slashed off 51% HIV DNA from mice, just by a couple of shots in their tails! 

*Making cancer re evaluate its careerchoice
Malignant cell detection by the immune system can be enhanced. 

*Designer babies- 
A lot of desirable traits- super awesome eyesight, superman esque strength and so on, can be selected from a wide palette during embryogenesis.

*Bidding adieu to genetic diseases

*Making ourselves look hot at 120-

CRISPR holds the potential to slow and even reverse ageing! We can take a leaf off the books of certain aquatic species who already are doing that. 

.. and a lot more. 

*The last word
A few controversies sorround though.
- We don't know if any adverse 
  reactions may triggered, as our 
  knowledge is still just the tip of the
- Some powers like say dictators
   might use it to gain precedence.
- The fear of genetic pollution.

Anyway, these are just hurdles which we need to plan and overcome for a glorious future for humanity! 

Source- Kurzgesagt. 


Wednesday, December 21, 2016

Symptoms of corneal disorders mnemonic

I was studying corneal disorders and dystrophies, infections, inflammations today and noticed many common symptoms in the patients.
Now since its the matter of the eye, I must tell you how much I love photography and also i used to do some painting stuff long ago. So i made a random mnemonic out of it for the symptoms of corneal disorders.. :p
DSLR Photography and Painting Workshops.

D- Decreased vision
S- Sensations (foreign body)
L- Lacrimation
R- Redness
P- Photophobia
P- Pain
W- white cornea

Thats all
- Jaskunwar Singh

Bullous skin disorders-1 pemphigus vulgaris and bullous pemphigoid

Pemphigus vulgaris

Bullous pemphigoid!prettyPhoto

these two are the most commonly asked questions within bullous diseases.
the major difference you need to know is
pemphigus vulgaris- bullae are suprabasal. hence these are not tense and rupture easily..not very common in a clinical case for you to find a bulla
bullous pemphigoid- bullae are subepidermal..and hence tense.

a a bull..bullae in Bullous pemphigoid are tough and stronger


Layers of retina

Retina consists of 10 layers of cells and their nuclei so I tried to make it easier to memorize all layers. A lame one but hope it helps.. :p

There are outer 5 layers. So the outer ones start with 'O' in the first letter. And the inner 5 layers initiate with 'I' in the first letter.

That's all

- Jaskunwar Singh

Symptoms of conjunctival disorders mnemonic

Symptoms of conjunctival disorders:-

R- Redness
E- Edema of conjunctiva
D- Discharge
A- (a)ecchymosis
F- Foreign body sensation

That's all
- Jaskunwar Singh

Tuesday, December 20, 2016

Medipicsowesome: Adams Oliver syndrome

Hey everyone!

Hope you are enjoying Medipicsowesome!

Adams–Oliver syndrome (AOS) is a rare congenital disorder characterized by defects of the scalp and cranium (cutis aplasia congenita), transverse defects of the limbs, and mottling of the skin.

The baby has a defect in the frontal and parietal bone and terminal limb defects in the legs.

That's all!


Serological And Viral Markers Of Hepatitis B Infection Made Easy

Hello everyone
This is Shubham Patidar . Today I am posting my notes on Serological  and Viral Markers of Hepatitis B Infection  in concise and simple way. This is very important short note ask in pharmacology, pathology, community medicine, medicine , microbiology, in undergraduate theory exam . and mcq comes in post graduate medical examinations.
Enjoy Learning !
That's all !

Past Pointing Mnemonic

Hi everyone !
So this is another short post about 'Past pointing'. I hope you don't consider it pointless to discuss this. (I know, play along.)
There are a few tests called 'Finger-Nose-Finger' test and 'Finger-Nose' test. These detect how controlled and precise your movements are.
Say, for example , I ask a patient to touch my finger (which I place directly in front of him), then touch his own nose and touch my finger once again.
A normal person should be able to do this correctly and accurately.
However, in lesions of at least 2 structures of our body , the patient's finger overshoots the examiner's or can't seem to reach it correctly.
This is called 'Past Pointing' , as the patient shoots past the destination point.
2 important lesions where you get this are :
1. Cerebellar
2. Vestibular
So, in a Cerebellar lesion things are very straight forward.
You'd get pastpointing only on the side of the lesion as only that side has become stripped from the cerebellar control. The other side has intact Cerebellar control.
Cerebellum = Same side Past Pointing.
Cerebellum is Single and Lonely
The Vestibular System defects are slightly more complex and also very controversial. So irrespective of which side you try, you'd get Bilateral past pointing in a Vestibular lesion.
Such a pastpointing is generally more prominent on the side of the Slow Component of the nystagmus produced (Whatt?). Yeah. Also, the Slow side of nystagmus and the side of past pointing are also the same as the side to which you'd lose your balance in a Vestibular disorder !
So Remember :
My SLOW Vestibular friend FALLS to pointy end but can Swing BOTH ways .
So Slow Component of nystagmus , and Falling during gait testing would be present and Pointing would be towards the same side too.
But Past Pointing can Bilateral (Swings both ways).
Hope this helps. Let me know how I can improve it!
Happy studying ! :)

Symptomatic variations in cough

Hey Awesomites!

Cough is a common symptom that may be associated with an infection of upper respiratory tract, which if not given attention to can progress to a life- threatening chronic disease! Normally, its just a common reflex that helps clear mucus off from the throat and the upper airways. But there are certain variations in the presence and progression of cough. So what is your cough trying to tell you about your health? Let's know about this...

Vestibular Apparatus Mnemonic

Hi everyone. This is just a short post to help you remember the functions of the Vestibular System. Memorising this always gives me a vertigo. ;)

The Vestibular System has 2 components :
1. Semicircular canals
2. Utricle and Saccule.

So the Vestibular System detects the following :

Angular Acceleration/Rotational movements.
Linear Acceleration.
Position of Head in space.

So the Semi circular canals are concerned with Angular Acceleration. You can remember that as :
Circle = Rotates ; So SCC detect Rotational movements or Angular Acceleration

The rest are functions of Utricle and Saccule.
Remember : GPL - Girls Premiere League.
For : Gravity, Position of Head and Linear acceleration.

Now  remember :
Saccule - NOT Sleeping line. So Vertical movements.
Utricle - Horizontal (since sleeping line was not Saccule it will be Utricle)
Another way would be "UHH' Utricle for Horizontal.

Hope this helped you.
Happy studying ! :)

How to apply for USMLE exams: ECFMG certification using IWA in detail

This is a continuation of the main post, How to apply for USMLE exams (

Step 3 is elaborated in detail here:

Medipicsowesome: Thanatophoric dysplasia


First post of Medipicsowesome. Yaay!

Thanatophoric dysplasia (TD) is a lethal skeletal dysplasia. It is the 2nd most common lethal skeletal dysplasia after osteogenesis imperfecta type II.

It is characterized by extremely short limbs and folds of extra (redundant) skin on the arms and legs.

Other features of this condition include a narrow chest, short ribs, underdeveloped lungs, and an enlarged head with a large forehead and prominent, wide-spaced eyes.

Type I thanatophoric dysplasia is distinguished by the presence of curved thigh bones and flattened bones of the spine (platyspondyly).

Type II thanatophoric dysplasia is characterized by straight thigh bones and a moderate to severe skull abnormality called a cloverleaf skull.

This baby seems to have type II thanatophoric dysplasia.

The condition is uniformly fatal within a few hours of birth either from respiratory failure or from brainstem compression from a narrow foramen magnum.

This baby died a few hours after birth.

Cool fact: The term thanatophoric derives from the Greek words "thanatos" meaning "death" and "foros" meaning "bearing/carrying/bringing".

That's all!

Monday, December 19, 2016

Medipicsowesome: An introduction


The Medicowesome family has decided to create a library of medical pictures. Excited? =)

We are going to label all these posts as Medipicsowesome.

It'll contain pictures of specimens, diseases, instruments, etc.

Since we wish to avoid copyright issues, we will be taking permission for most pictures / giving credits from which they're taken. If a picture belongs to you and you do not wish to see it uploaded on the site, email us at and we will take it down immediately.

I have taken permission from the patients for pictures clicked in my wards, explaining they'll be uploaded on the blog for medical students to learn. Only after their permission, I have uploaded the pictures. To maintain confidentiality, I will blur eyes / faces too.

If you want to share cases you've seen on Medipicsowesome, we'll be happy to upload it. Just email us the picture with a description and make sure you have the permission of the patient!
Subject: Medipicsowesome submission

That's all!
The idea was come up by all authors, especially, Sakkan. Thanks for the encouragement everyone else! < 3

Median nerve

Median nerve
Root value :C5-T1
IMP points
1)Median nerve is most medial content of Cubital fossa
In Cubital fossa it gives 3
Branches to flexor muscles
Remember this mnemonics
Feel Climate (in) Rajasthan,Days (in) Singapore (in) PLs
Flexor carpi radialis  .(FELL CLIMATE -Rajasthan)
Flexor digitorum superficials(Days
in -Singapore) 
Palmaris Longus (PLs) .
In forearm it gives Anterior interosseous branch which supplies:-
1)Lateral half of flexor digitorum profundus (Well,medial half is supplies by ulnar nerve)
2)Pronator quadratus(my Fav!)
3)Flexor policies Longus(Extensor policies Longus and brevis both supplied by radial  nerve)
In palm ,median nerve supplies 5 muscles !
3 thenar muscles ,(Abductor pollicis brevis ,flexor pollicies brevis  ,opponens pollicis )
Lateral 2 lumbricals!
Clinical anatomy:
1)Known as labourers nerve /eye of hand
2)Pointing index finger occurs due to paralysis of long flexors of digit .
3)Ape or monkey thumb deformity if thenar muscles are paralysed
4)Must know carpal tunnel syndrome(Happens when median nerve is trapped )REMEMBER Skin over the thenar eminence is not affected as the branch of median nerve supplying it arises from forearm
5)FROMENT's.sign/Book holding test &paper holding test is done to test median nerve .
6) Complete claw hand when Ulnar and median nerves are paralysed.

Sunday, December 18, 2016

Hyperplasia - Physiologic or Pathologic?

Hyperplasia means increase in the cell number.

It tends to occur only in organs where the cells retain the ability to divide. It can be physiologic or pathologic.

The morphology of the organ on gross or the cells on microscopy does not differ in physiologic or pathologic hyperplasia. What differentiates the two is the inciting stimulus.

for eg- Breast/ Endometrial hyperplasia is a feature of pregnancy as well as in certain hormone producing tumors of the ovary. The tissue microscopically, only shows increased number of mature cells. However, the hyperplasia that occurs due to pregnancy (physiologic) process is labelled as "Physiologic" while that which occurs due to ANY pathologic process is labelled as
"Pathologic" hyperplasia.

An AIDS patient with abnormal CT scan

Hey! Here's a case kinda thingy that I made up.

An HIV positive male presents with loss of recent memory and left sided paralysis. A CT scan is done. What are the differentials based on the CT findings given below?

1. Multiple ring enhancing lesions
2. Single, periventricular ring enhancing lesion
3. Cerebral atrophy with secondary ventricular involvement
4. Multiple non enhancing white matter lesions

Answers given below

1. Multiple ring enhancing lesions - Toxoplasmosis. TMP SMX for prevention!

2. Single, periventricular ring enhancing lesion - CNS lymphoma. Usually, positive for EBV.

3. Cerebral atrophy with secondary ventricular involvement - AIDS dementia complex. Though paralysis would not be a feature. Only defects in short term memory and executive function is seen.

4. Multiple non enhancing white matter lesions - Demyelination of subcortical white matter suggestive of progressive multifocal leukoencephalopathy is caused by JC virus.

That's all!

Friday, December 16, 2016

ALS and Riluzole mnemonic

Riluzole is a glutamate inhibitor which is used in Amyotrophic laterla sclerosis.

How to remember this?

Unnecessary mnemonic #521

Rilu glues all.
Rilu - Riluzole
Glues - Glutamate inhibitor
Al - ALS

That's all!

I'm sorry, that was a terrible mnemonic. Forget ice bucket, I'd win the pathetic mnemonic bucket challenge :P


CSF rhinorrhea and meningitis treatment

Today I was asked a question in ENT viva that- in a patient of CSF rhinorrhea due to traumatic aetiology, what measures will you take to prevent the onset of meningitis and how will you manage the condition?

Thursday, December 15, 2016

Cyber knife

This new technique in radiotherapy is revolutionising the world of treatment in oncology. The technique is largely unheard and my intention of writing the post is to share it with a maximum number of people.

Invented by John R Adler, Peter and Russell Schönberg in 1990, 'CK' is about targetting radiation with a high accuracy to neoplastic tissues.

A linear accelerator of 6MV delivers X ray radiation of 6-800cGy while a  robotic arm maneuvers the 'linac' around the body of the patient so that most of the neoplastic cells are irradiated. An accuracy of 0.5 mm is maintained during the process.

For ensuring such level of accuracy, tissue tracking is needed. There are different methods of tracking for bones, lungs and viscera. For soft tissues like pancreas, gold fiducials(hair like implants) are inserted so that the movement of the tissues as the patient breathes can be identified accurately.

About 1-5 sessions are needed depending upon the pathology. There's no anaesthesia and long treatment hours involved, unlike surgery. Plus, the procedure is significantly cheaper than say, Whipple's pancreaticoduodenectomy!

-Thats all!

Causes of Acute Pancreatitis

Hi guys,

I have an exam soon and I was struggling with this, so, I made this up!

To remember causes of Acute Pancreatitis, you need to think of none other than your nursery school days! :P

So, here we go- ABCDEFGHI, (oh wait did I just say "HI" :P)

Now going a little off track, but, when I was small I used to do a lot of gardening, so I remember rest of the causes as Me POT.

Alcohol ingestion  (acute or chronic)
Biliary calculus
Connective tissue diseases- SLE, TTP,  PAN
Drugs- diuretics- frusemide, thiazide. (Others are anti retroviral drugs, sulphomamides, tetracycline, tamoxifen, etc)
Endoscopic procedures
Familial/ Genetic
Hereditary Pancreatitis/ Hyperparathyroidism/ hypercalcemia/ Hypertrigylceridemia
Infections- viral

Metabolic conditions - renal failure,
Penetrating Peptic Ulcer
OPC poisoning
Trauma to abdomen

Phew, a long list. Isn't it?

Hope it helps!!
That's it!


Head transplant

Recently during surfing on net ,i came across very interesting topic of surgery -Head transplant ,would like to share with you all people
World's 1st attempt to transplant a human head was launched in year 2015 at a surgical conference in united states.
Procedure was 1st put forward by Sergio canavero -an Italian neurosurgeon.
The actual procedure will be as followed :

Two teams will work in concert making deep incisions on patient's neck exposing vital arteries, veins and nerves ,next step is the most crucial step of cutting spinal cord using $200,000 diamond nanoblade !.
Head is than moved on to donors body and spinal cord can be fused together using polyethylene glycol to encourage the fat in cell membrane to mesh out once the neck is transplanted
and then patient would then be placed into a coma for about a month to prevent movement and to allow healing procedure
while implanted electrodes provide regular electrical stimulation to spinal cord finally when patients wakes up from coma he will be able to see his face and speak !!!! But will need a physiotherapy for 1 year to begin walking .
Dr sergio canavero said that surgery would be ready in 2017 probably .
A computer scientist Spiridonov with Werdnig-Hoffman disease has volunteered to offer his head to study as he is suffering from incurable spinal muscular atrophy and has decided to give one final shot to have a new body !


Tongue depressor and bipod stand

Boyle- davis tongue depressor

This instrument is used to lower down the tongue and hold it while the Davis mouth gag serves to hold the mouth open during tonsillectomy and other oral procedures. it comes in various sizes and used depending upon the age of patient.

The mouth gag is held in position by using the Draffin bipod stand which consists of two rods.

Thats all
- Jaskunwar Singh

Tonsil holding forceps

Denis Browne's tonsil holding forceps

Used in tonsillectomy to grasp the tonsils and pull medially. (dissection method)

The shaft is bent at an angle towards the handle. Ends of this instrument are cup- shaped with holes.

Thats all
- Jaskunwar Singh

Killian's nasal speculum

Killian's long bladed self- retaining nasal speculum

Used in Submucous resection (SMR) and septoplasty procedures.

It helps keep mucoperichondrial flaps away to make space for proper access and vision to the interior of nose and perform surgery efficiently.

IMPORTANT: In septoplasty, the flap is raised only on one side while in SMR, both sides flaps are raised. So due to cosmetic reasons and high risk of septal complications, septoplasty is preferred over the submucous resection.

Thats all
- Jaskunwar Singh

Direct Laryngoscope

As the name suggests, this instrument is used for direct visualization of larynx and hypopharynx. 

Wednesday, December 14, 2016

Diamond blackfan anemia notes and mnemonic

Diamond blackfan anemia
It is congenital pure red cell aplasia.

A 7 year old with hyperextensible joints

A 7 year old boy is brought to you. He is intellectually disabled. On examination, you notice hyperextensible joints. Large hands, large feet, protruding ears, elongated face are also seen. The patients testes are large in size compared to his age. Diagnosis?

Marfans syndrome
Ehler Danlos syndrome
Fragile X syndrome
Friedreichs Ataxia

Answer below
It's Fragile X syndrome. Why isn't it's Marfans? Because Marfans has normal IQ.

Here are my notes + mnemonic for Fragile X syndrome.

Did you know?
Fragile X is the most common cause of inherited mental retardation.
It was the first trinucleotide repeat disorder to be recognized.

That's all!

Walsham's forceps

Walsham's forceps

Uses: to correct lateral deviation of fractured nose and disimpaction
and repositioning of bony fragments.

Most students get confused between Walsham's forceps and Asch's forceps. The difference is in the structure of the instruments itself.

Walsham's forceps: paired instrument used for reduction of nasal bone fractures. One nasal blade is placed externally while the other blade goes into the nose and supports the nasal bone.
Also, the blades are not elevated in walsham's forceps as in the case of asch's.

Asch's forceps: unpaired instrument used for reduction of nasal septum and vomer fractures. It is used along with Walsham's forceps for the reduction procedures. The blades are elevated. (ASCh = Ascending)

Thats all
- Jaskunwar Singh

Trousseau's tracheal dilator

Trousseau's tracheal dilator

Used to widen the tracheal incision to aid in the insertion of
 tracheostomy tube.

Remember: It is curved at its ends so that it doesn't block the field of vision of the surgeon while making the incision and insertion of the tube.

Thats all
- Jaskunwar Singh

Toynbee's ear speculum

Toynbee's ear speculum

Uses: Examination of external ear and tympanic membrane

In operative procedures like myringoplasty, myringotomy.
Removal of wax, foreign body, otomycosis, ear discharge.

Different sizes for patients according to age.

Thats all
- Jaskunwar Singh

Tonsil artery forceps

This instrument is of two types: straight and curved.

Straight forceps (Birkitt's tonsil artery forceps) used to catch the bleeding point. (in tonsillar fossa) following tonsillectomy.
Birkitt's first tonsillar artery forceps
Wilson's second artery forceps
Curved forceps used as replacement forceps before tying a ligature to the bleeding points following tonsillectomy. (also called Second tonsillar artery forceps)

Thats all
- Jaskunwar Singh

Asch's forceps

Asch's septum forceps

Used for reducing procedures in cases of nasal septum fractures. (Reduction Rhinoplasty) 

The septum is grasped with the blades of this instrument and straightened to make proper alignment.

The blades are elevated. Remember ASCh- Ascending.

The instrument is often confused with Walsham's fracture. Both are used in reduction procedures of fractures of nasal septum.
To know about differentiating features, click here.

Thats all
- Jaskunwar Singh

Thudicum's nasal speculum

Used to examine external nose.

Light is focused at different sites to examine antero- inferior part of nasal septum, roof, floor, and lateral wall by tilting patient's head in various directions.

There's a specific technique to hold this instrument during examination of the patient. Its really simple but if you don't practice to hold it, you will forget it for sure.
 Keep your ring finger beneath one arm of the speculum and index finger in between the two arms. Press the other arm with middle finger such that the two lower ends meet. 

Here's the picture of the right way to hold it.-

Luc's forceps

Lets start with instruments used in surgical procedures of Otorhinolaryngology..

Firstly, lets talk about Luc's forceps.

This instrument has a fenestrated tip with sharp blades to hold
and grasp a tissue and cut it. So basically it is used for cutting.

1. As the name suggests, it is used in Caldwell- Luc's operation (Anterior antrostomy) for removing antral mucosa. 
2. Submucosal Resection of nasal septum. (to remove bone or cartilage from the septum required for a graft)
3. Polypectomy  
4. Turbinectomy

Thats all
- Jaskunwar Singh

A tip for confusing things

many of us have this tendency and inner hunger to know everything, but not all of us are prodigies now are we?

hence a typical example.
types of thyroplasty
type1- medialization of cord
type2- lateralization
type3- shortening
type4- lengthening

no many how many times i have read it, i am bound to get confused. i will remember that type 1 and type 2 had to do with changing the position of the cord from midline, but i am totally going to forget whether medialization was first or not. 
The examiners exploit this very weakness. some sadist i tell you! 

anyways not always will you be able to get your hands on mnemonics that will save your neck..and yes sometimes it is even really tough to remember the mnemonics themselves during exams -_-

my tip is 
just remember
type1- medialization
type3- shortening

hell with everything else..this attitude will save your neck more than you can imagine. use this with eveything confusing. 

just dont give your brain the chance to be and have a visual image of only the very core of the answer. and trust yourself that when push comes to shove you will be able to answer the question correctly 


Primary Health Care

Hey Awesomites

Today its a short post ( a mnemonic actually ;p )  on the principles and elements of primary health care. (I was asked in SPM viva a few days back. ;p )
As a rule, always find a mnemonic in the name itself, I took care of it and made it in the easiest way possible. So here it is ..

C- Community participation
A- Approach (multi- sectorial)
R- Right technology (appropriate)
E- Equitable distribution of health services.

Elements of primary health care: MI NEEDS
- MCH and family planning
- Immunization
- Nutrition
- Education
- Endemic and common diseases
- Drugs provision
- Sanitation.

Thats all
Happy Medicowesome :)

- Jaskunwar Singh

Caput v/s Cephalhematoma - Ways to remember.

Though simple, takes time in the exam if confused.
So here's a way to save the time meanwhile being sure of the answer for the topic.

Tuesday, December 13, 2016

Langerhans cell histiocytosis notes and mnemonic


I'm clearly doing a lot of notes + mnemonic posts. Here's another one on Langerhans cell histiocytosis!

Langerhans lingers
L - Lytic lesion of bones
I - Diabetes Insipidus
N - Nil
G - Eosinophilic Granulomas
E - Exophthalmos
R - Rrrrr.... :P
S - Skin rash

From study group:

Any mnemonic for Hand Schuller Christian disease?

Mnemonic by IkaN: Hands LIE
Lytic bone lesions
Insipidus (Diabetes Insipidus)

Mnemonic by Dev: CDE
Calavarial skull defect
Diabetes insipidus

Disclaimer: It's a morbid mnemonic. If you are sensitive and religious, don't read it.
Mnemonic by Vinayak: Jesus CHRIST was killed by hammering nails into his HAND, he DIed, his hands' bone got LYSED and we celebrate EXmas:
For calvarial skull defects, you know, wood was also hammered into his head. DI is diabetes insipidus. EX is exophthalmos.

That's all!

Monday, December 12, 2016

Study group discussion: Skeletal resistance to PTH in CRF

Hi guys! So the question that was asked in the study group is- Why is there skeletal resistance to PTH in Chronic Kidney Disease?


Skeletal Resistance to PTH has a multifaceted pathogenesis; the most imp factor being uraemia which screws with the PTH receptor's intracellular G-protein signaling mechanism in the Osteoblasts.
Dialysis in these patients increase the levels of Osteoprotegerin, which is a decoy molecule antagonizing the action of RANKL in promoting osteoclastogenesis; further intereference with the action of PTH.
Hyperphosphatemia and Hypocalcemia in CKD patients cause excessive release of PTH which leads to downregulation of its receptors on osteoblasts. 
Decreased levels of calcitriol screws in a special way, it makes the parathyroid gland think that the normal calcium level range is above the actual normal value, making the gland work overtime. For this we use calcimimetics like cinacalcet to decrease the set point back to the real normal value. And also without Calcitriol to assist, PTH's job becomes a lot more difficult. 

Earlier the most common CKD-related osteodystrophy was osteitis fibrosa cystica which was due to very high PTH levels causing pathologically increased bone turnover.
But now since we have developed drugs to tackle increased PTH levels, Adynamic Bone Disease has become the most common osteodystrophy because in the body of a CKD patient, it is already very difficult for PTH to carry out its function and if we are pharmacologically decreasing its values, we are ensuring that it works negligibly. 

That's enough Nephrology for one day! :)

ECG basics

So basically, ECG is  an electrical representation of heart activity on ECG paper. 

Here are some important postulates of ECG paper:

The needle of galvanometer travels 300 big squares in 1 minute or 60 seconds. 

That makes 0.2 seconds for each big square. 

In turn each big square is divided into 5 small boxes /squares.

So we get each small box counting about
0.04 seconds. 

So let's review all calculations:

1 Big square = 0.2 seconds.
1 small square = 0.04 seconds. 

Each P wave travels about 2 and 1/2 small  squares making upto 0.1 second.

The segment PQ (Sometimes we use PR) again takes 2 and 1/2 small squares making upto 0.1 second.

QRS complex used another 2 and 1/2  small squares making another 0.1 second. 

While S-T segments uses 10 small squares forming using 0.4 seconds.

Note: We normally consider 2 and 1/2 small squares but there can be 2 or 3 small squares. 


Sunday, December 11, 2016

Pentavalent vaccines

Hey Awesomites!

Let's discuss something about the pentavalent vaccines and what advantage they have in the immunization of newborns..

Friedreichs Ataxia notes and mnemonic

Here's another notes + mnemonic post on Friedreichs Ataxia

Genetic stuff:
- Due to mutated frataxin gene
- GAA trinucleotide repeats
- Autosomal recessive
- Mitochondrial iron accumulation due to loss of iron transporter coded by frataxin gene results in oxidized intramitochondrial iron accumulation.

Clinical stuff:
- Cardiomyopathy is the most common cause of death in FA. Cardiomegaly, conduction defects, murmurs, fibrosis are seen.
- Musculoskeletal abnormalities like foot deformities (Hammer toe, pes cavus, pes equinovarus) and scoliosis is seen.
- Diabetes mellitus is seen in 20% of patients

Neurologic stuff:
- Nystagmus
- Titubation
- Dysarthria
- Dysmetria
- Ataxia of trunk and limb movements.
- Loss of proprioception and vibratory sense.
- Extensor plantar response, absence of deep tendon reflexes and weakness is found.

That's all!

Mnemonic: Friedreichs FRIEDS! 

Duodenal atresia notes and mnemonic

Duodenal atresia


In this post, I wanted to emphasize duodenal atresia is associated with double bubble sign.

It's common in Downs syndrome and polyhydramnios maybe seen in utero.

Bilious vomiting is seen because the obstruction is after the ampulla of Vater.

Because the child is vomiting, abdominal distension is not seen.

That's all!
I need sleep right now.

The Sustainable Development Goals: Mnemonics and explanation

Hi everyone! I'm back with a note. This time on the Sustainable Development Goals (SDG's).

This is a crisp summary of what we need to know about them as Doctors or Health Care Practitioners (in any part of the world). They're so important that a major chunk of the Coldplay concert in Mumbai was based on them. (And every other person spoke about them. How Magic-al).

And they're Also very important for the Community Medicine students from India. So here goes :

SDG's were adopted by nations of the world on 25th September, 2015 to be achieved till 2030. 

They want to do 3 P's

End Poverty,
Bring Prosperity to all and
Protect the planet. 

A. The important Health related Goals

(Mnemonic by our IkaN)


(HE EWE as in Adam and Eve)

1 Poverty 

2 Hunger 

3 Health care 

4 Education 

5 Equality 

6 Water 

7 Energy 

B. Goal 3: Ensure Healthy lives and Promote Well Being. 


Remember: BAMS VIP
Baby Adult Mother Sex. 
(OR : Adult and Mother have Sex to get Baby)
Vaccine. Infections. Pollution. 

- Neonatal Mort - has 12 letters , so to be reduced to less than 12 by 2030. 

- Under 5 Mortality Rate  - 5*5 = 25. So less than 25 by 2030 

- Decrease the burden of NCDs to one third of present.
- Mental health burden to be reduced. Tobacco control. 
- Drug abuse to be tackled. 

- Maternal Mortality to less than 70 per 1 lakh world wide. 

- Sexual health and reproductive health strengthening. 

- Promote and develop.

- Tackle TB HIV Malaria Other tropical diseases Diarrheal diseases. 

- Air, Water, Soil, Noise pollution to be tackled. 

Kudos to IkaN who helped me out of this tough spot. This was a life saver and you're the best :* :)

Hope this helps everyone.
Until next time.


Saturday, December 10, 2016

Transient synovitis vs septic arthritis


In this post, I'll talk on how to to differentiate transient synovitis from septic arthritis.

Transient arthritis is non specific inflammation of the synovium, related to infection or trauma.

Septic arthritis is bacterial infection of the synovium of the joint.

Modified Kochers criteria can help distinguish the two.

Fever > 38.5
ESR > 40 mm/hr
WBC > 12,000 cells/mL
CRP > 20 mg/dL
Inability to bear weight on the affected limb

More the criteria, more likely the child has septic arthritis.

Here's a mnemonic for modified Kochers criteria: FEW Can Bear Kocher!

Fever, ESR, WBC, CRP, weight bearing.

Acute transient synovitis is the most common cause of painful hip in a child younger than 10 years. It is a diagnosis of exclusion and can mimic Osteoarthritis, Legg Calve Perthes disease, SCFE.

Treatment: Rest, anti inflammatory agents.

That's all!

Myotonic dystrophy notes and mnemonic


Here are my notes + a mnemonic

Congenital myotonic dystrophy
- Autosomal Dominant
- CTG trinucleotide repeat
- Genetic anticipation seen

- Hypotonia "floppy infant"
- Hollowing of temporal bones
- Tenting of upper lip
- Respiratory muscle weakness
- Arthrogryposis
- Posterior subcapsular cataracts (Subcapsular spokes in stellate conformation) 

Juvenile myotonic dystrophy

- Facial and upper body weakness (Hatchet face due to temporalis, masseter, facial muscle atrophy; frontal baldness)
- Inability to relax muscle (Sustained grip)

- Cardiomyopathy
- Heart block
- Congestive heart failure

- Intellectual impairment
- Gonadal atrophy
- Posterior subcapsular cataracts

- Thenar, hypothenar muscle atrophy (Myotonia evident on percussion)
- Tongue depression
- Dementia

That's all!
Be kind.

Henoch Scholein purpura notes and mnemonic

Hello! Here are my notes + mnemonic on HSP.

IgA-mediated vasculitis of small vessels (IgA and C3 in skin, renal glomeruli, and gastrointestinal tract).

Most common cause of nonthrombocytopenic purpura in children.

Usually follows an upper respiratory infection.

Clinical features are:
Maculopapular rash below waist (Progresses to petechiae to palpable purpura).
Abdominal pain.

That's all!

Friday, December 9, 2016

Rheumatoid arthritis mnemonic


Here's an old mnemonic on some of the clinical features of Rheumatoid arthritis.
Well, the name itself tells it.. RHEUMATOID ;p

R- Respiratory distress (Interstitial lung disease, bronchiolitis, pleural effusion)
H- Haematological manifestations (anemias, thrombocytosis, neutropenia)
E- Extra- articular RA (ExRA)
U- Urinary tract infections (mainly drug- induced)
M- Median nerve compression/ Morning stiffness
A- Amyloidosis
T- Tenosynovitis and bursitis
O- Ocular manifestations (Keratoconjunctivitis sicca, scleritis, episcleritis)
I- Immunologic manifestations (Sjogren's, Felty's and Caplan's syndrome)
D- Deformities (boutonniere, swan- neck, button- hole)

Thats all :)

- Jaskunwar Singh

A case on Medical ethics

Hello Awesomites!

Today I am gonna discuss with you a simple case based on medical ethics. A Forensic Medicine professor asked me in final viva last year. So here it goes...

Thursday, December 8, 2016

3 month old with hypotonia

3 month old baby with history of honey intake (Given by grandpa) presents with constipation, feeding difficulty, hypotonia. What is the cause of the baby's symptoms?

1. Ingestion of preformed toxin
2. Ingestion of pesticide
3. Ingestion of bacterial spore
4. Bacterial infection of the meninges
5. Urinary tract infection

Answer given below:

If you picked 1, you're wrong.

Infant botulism is caused by botulinium spores in honey, corn syrup that germinate and multiply in the intestinal tract and produce toxin.

Adult botulism is caused by ingestion of preformed toxin.

I just wanted to make that point clear. And emphasize how tricky any exam can get with word play.

Don't stress.

That's all! =)

Oh and the answer is 3.


How to apply for USMLE exams


Many medicowesomites have asked about how to apply for their USMLE exams. Finally, here is the procedure. Sorry this took so long

I have answered all the queries in the end.

If you have any more questions, comment in the commments section below and I'll try to reply :)

Descriptive Epidemiology

Hello everyone !
Here's a video telling you a little bit of the Descriptive Epidemiology.
Let me know how you like it and I can continue to make some more to finish it up and tell you more about Epidemics!

Wednesday, December 7, 2016

Stigmata of infective endocarditis

Hey Awesome people!

Here is another stigmata apart from those mentioned previously by IkaN in a post here,

Stigmata of infective endocarditis:-
(Remember- It's all in the hands)

Janeway's lesions: non- tender, erythematous macules on the palms and soles.
Osler's nodes: ephemeral spots of painful nodular erythema on hands and feet.
- Splinter haemorrhages: seen on the thumb of the patient.

Thats all!

- Jaskunwar Singh


For all those who don't know what is glaucoma here is the quick review :-

There is damage to the optic nerve, etiology of glaucoma is yet to be known.

Generally, there is increase in intraocular tension , intraocular pressure above 25-30mm Hg which can cause loss of vision. In acute inflammation, WBCs and tissue debris can block exit of intraocular fluid through channel of Schlemm and in chronic conditions, especially in older individuals, fibrous occlusion of the trabecular spaces appears to be culprit!

Buerger's disease

Hey awesomites!

Here's a short post on important points in diagnosis of Buerger's disease (don't confuse the name with Berger's disease which is IgA nephropathy) also known as Thromboangiitis obliterans.

- Recurrent inflammation and thrombosis of small and medium sized vessels
- Hands and feet are affected the most
- Vasculitis and ischemia (causing blackish discoloration of skin)
- Chronic smoking (a definite predisposing/ risk factor)

Clinical features and diagnostic criteria:
            - male patient 30-40 years of age
            - history of chronic tobacco use
            - Angiography: - cock- screw appearance of arteries of wrists and ankles
                                      - tree root/ spider leg appearance due to collateral circulation
            - Exclusion of other vascular diseases ( Raynaud's phenomenon, atherosclerosis, diabetes, hypertension, endocarditis, hypercoagulable states, auto-immune disorders) is important.
            - Skin biopsy (rare)

Note: A possible Rickettsial infection (mostly Rickettsia rickettsiae) could be there which adds on to the pathology of the disease!  (usually in cases of  amputation of the affected area)

Thats all!

- Jaskunwar Singh

Tuesday, December 6, 2016

Supracondylar fracture of the humerus

Supracondylar fracture of the humerus

- Transverse fracture of the distal part of the humerus.
- Bruises of anterior elbow (Proximal fragments buttons through the brachialis muscle)
- Posterior fat pad sign is seen in non displaced fracture of the humerus.

IMPORTANT: Assess radial and ulnar pulses because brachial artery can be compromised.

That's all!

Monday, December 5, 2016

Submissions: Selenium deficiency mnemonic

"Selena Gomez and Ke$ha both are young and have big hearts."

Selenium deficiency causes Keshan disease which is cardiomyopathy in young children. Also, singers like to dye their hair (Loss of hair pigment is seen in Selenium deficiency aka Keshan disease).

Submitted by Krutika.

Interesting fact: Keshans disease is thought to be caused by Selenium deficiency and coxsackie virus. It's common in places where selenium content in soil is low (China).

That's all!
Thanks Krutika for the mnemonic =)

How to browse through knowledge on Medicowesome

So we have written over 1000 posts. It's absolutely crazy! :D

About me

Hey Awesomites!

Well, I am not a new author here. I am honored to write so many posts for the blog . Let me introduce myself so that all of you can know about me...

Treatment of cholesterol-induced Alzheimer's

Hey awesomites!

Pathology done! Now lets know about its pharmacology here :)

Cranial Nerve Exits Mnemonic (2 2 4 4 )

Hey guys, Jay here!

This is a very simple self explanatory image which I made.

Brain abscess notes

Brain abscess notes

Here's what I studied =)

- Direct spread (Paranasal sinusitis, otitis media, mastoiditis, dental infection)
- Head trauma or surgical procedure
- Hematogenous spread (Pneumonia, endocarditis)

- Streptococci
- Bacteroides
- Pseudomonas
- Hemophilus
- Enterobacteriaceae
- MRSA (Head trauma, neurosurgical procedure)

- Headache > 75% patients
- Fever only in 50% patients (Important: Absence of fever should not exclude the diagnosis)
- Focal neurologic deficits > 60% patients
- Other symptoms - Papilledema, nausea, vomiting, drowsiness, confusion
Hemiparesis - Frontal lobe abscess
Dysphasia - Temporal lobe abscess
Nystagmus, ataxia - Cerebellar abscess

- MRI is better than CT.
- Ring enhancing lesion with surrounding edema on neuro imaging studies is seen.
- Most accurate: Brain biopsy
High yield: Biopsy is essential to distinguish brain abscess from cancer and also to determine the precise organism.

Don'ts: Do NOT do a LP. CSF analysis doesn't contribute to diagnosis or therapy. Increases the risk of herniation.

Extra: Abscesses due to Listeria have blood culture positive > 85% of the time.

- Meningitis
- Meningoencephalitis
- Brain tumors (Cancer can give fever)

- Empirical antibiotics should be modified after results of gram stain and culture.
- Surgical drainage.
- Prophylactic anticonvulsant therapy (High risk [>35%] of seizures)
- Glucocorticoids are reserved for substantial periabscess edema and mass effect due to increased ICP.
- Serial MRI or CT scan monthly to document resolution of abscess.

That's all!

Hypercholesterolemia and the Alzheimer's disease

Hey awesomites!

All of you know that cholesterol is synthesized locally in brain as well as peripherally in liver, both separated by a line of blood-brain barrier. But what about the case of hypercholesterolemia and how it eventually leads to increased amyloid depositions. what is the ultimate link between high serum levels of cholesterol and the Alzheimer's disease?