Monday, April 30, 2018

Conjunctival xerosis mnemonics

Conjunctival Xerosis

Hello everyone today let's discuss the causes and treatment of conjunctival xerosis.

So basically there are two types of conjunctival xerosis.
a. Epithelial xerosis
b. Parenchymatous xerosis

Epithelial xerosis.
The most common example is Xerophthalmia i.e. Vitamin A deficiency.

Let us discuss Xerophthalmia.

The cause of vitamin A deficiency is mostly its dietary deficiency or defective absorption.

The new WHO classification of Xerophthalmia

XN:   Night Blindness
X1A: conjunctival xerosis
X1B: bitots spots
X2:   corneal xerosis
X3A: keratomalacia <1/3rd of cornea
X3B: keratomalacia >1/3rd of cornea   
XS: corneal scar
XF: fundal changes – known as Uyemura spots, these are defects in the Retinal
Pigment Epithelium.

It consists of local ocular therapy with artificial tears along with vitamin A therapy.
Schedule for vitamin A is as follows :

>1 year of age – 1lakh IU i.m. given on 0 1 14 days
 2lakh IU orally given on 0 1 14 days

<1 year of age – half the dose.

This has to be carried along with treatment of underlying causes like malnutrition or other disorders like diarrhoea dehydration.

Other causes of night blindness:
1. High myopia
2. Late stage of angle closure glaucoma
3. Oguchi syndrome
4. Gyrate atrophy of choroid
5. Retinitis pigmentosa

Parenchymatous Xerosis
It mainly involves the adenoid layer of the conjunctiva.
It can take place due two main reasons     holla! We have a mnemonic here
1. Due to cicatrizing disorders  (cicatrizing disorders turn conjunctiva reasonably shrivelled)
2. Due to over exposure to atmosphere ( marked exposure causes parenchymatous xerosis)

Cicatrizing disorders
1. Cicatricial phemphigoid
2. Diptheric membranous conjunctivitis
3. Trachoma
4. Chemical burns
5. Radiotherapy
6. Stevens-johnson syndrome

Overexposure to atmosphere
1. Marked proptosis
2. Ectropion
3. Coma (lack of blinking)
4. Palsy of cranial nerve 7 (facial palsy)

That’s all for now,
Stay Awesome!
Keep calm and keep studying!

- Ashish G. Gokhale

Wednesday, April 25, 2018

Step 2 CK: Blunt abdominal trauma


When you are presented with a case of blunt abdominal trauma (BAT) in your exam, first determine whether the patient is stable or unstable.

Saturday, April 21, 2018

Medicowesome secret project: Trouble in St. Bowel High School

Coronary circulation: Fun fact about blood flow to the myocardium

Hello everyone, here is a post busting a myth about coronary circulation.

Many of us have always thought that the heart itself receives blood during diastole which is only partially true. Here is the complete story.

Getting back to basics, let us revise a bit about the cardiac anatomy.

Tuesday, April 17, 2018

USMLEowesome: United States Clincal Experience (USCE), electives and obs...

United States Clinical Experience - An overview

Intended audience: Those who want to know more about USCE

What this video will cover:
Why do you need USCE?
Types of USCE
Deciding where to apply, which electives?
Paperwork required for electives (brief overview)
Strong letter (applicable for USCE and the match)
CV (brief overview)
Visa interview: Important! Do not mess it up!
If you are not accepted: Have back ups!
If you are accepted: Video for another time :)

Links from the video:

Types of USCE:


Read this before your visa interview:

Link to the powerpoint:

That's all!


Sunday, April 15, 2018

USMLEowesome: Studying for the USMLE Step 1 exam


The intended audience for this video is those who have decided to give the exam and are starting to study for it.

Friday, April 13, 2018

Facebook: Microbiology Candida.

So, this post is the answer to our previous question asked on medicowesome facebook page. Question was

#Medicowesome #Microbiology

A vitreous aspirate from a case of metastatic endopthalmitis on culture yields Gram-positive round to oval cells, 12-14 mm in size. The aspirate on Gram staining show the presence of pseudohyphae. Which of the following is the most likely aetiological agent?

1)  Aspergillus.
2)  Rhizopus.
3)  Candida.
4)  Fusarium.

Answer: Option 3) Candida.

Let's analyse the question and extract the information one by one.
So, we get two things from the question.
a) The causative organism has pseudohyphae and
b) It is stained by gram stains.

Among the given options, only Candida can form pseudohyphae. All other options are filamentous fungi forming true mycelia and Candia is the only fungi that are usually gram positive on smears.

Some awesome points that must be known on Candida infections.

1) Candida is unicellular organism belonging to yeast like fungus categories. All Candida species are commensals of humans. So, their mode of transmission is endogenous while most of the fungus have mode of transmission as inhalation.
2) They form pseudohyphae.
3) Candida albicans is different from other candida because :-
   a) It forms true hyphae or germ tubes when grown in serum.
   b) It forms thick walled large spores called chlamydospores.
   c) It is dimorphic. It means it grows as yeast at 37°C and as molds at 25°C.

4) Test to differentiate between C. Albicans and other Candida is called germ tube test or Reynolds Braude phenomenon.
-C. Albicans when placed at 37°C in human serum forms germ cell tubes within 2 hours.
5)Candida albicans is the most common cause of mucosal candidiasis.
6) Candidiasis is the most common systemic mycosis. It is also the most common fungal infection in neutropenic and immunocompetent patients.
7) It causes oral thrush, oesophageal candidasis, cerebral candidasis and pulmonary candidiasis.

Extra information:

Their is one test which I learned online and some people consider it as diagnosis of candida infections.

The Spittle Test:
When you get up in the morning, and before you brush your teeth, eat or drink anything, fill a glass with bottled water at room temperature.
Spit some saliva gently into the glass.
Come back every 20 minutes for the next hour and check for some of these signs.

1) Strings coming down through the water from the saliva at the top.
2) Cloudy saliva sitting at the bottom of the glass.
3) Opaque specks of saliva.

Also, in above question we deducted that the given pathogenic organism is gram stain so we get to learn about stains as well.
Normally, fungi are stained by PAS and methenamine silver but some fungi are stained by special stains like :-

Candida is stained by gram stain.
Cryptococcus is stained by mucicarmine, India ink.
Histoplasma is stained by Giemsa stain.

Thanks for reading!
Ojas Gite.


Schizophrenia: Types and Prognosis mnemonic

Schizophrenia: Types and Prognosis mnemonic.

So to begin with, Schizophrenia is a psychiatric disorder classified under psychosis.
Psychosis is a mental state involving loss of contact with reality, causing deterioration of normal social functioning. 

Features of psychosis are:
Loss of insight.
Marked disturbance in personality and behaviour.
Loss of contact with reality.
Impairment in judgement.
Presence of delusions and hallucinations.

A quick recap : Psychosis is classified as   -

• Organic e.g. Substance related psychosis, head trauma
• Major e.g. Schizophrenia, mood disorders
• Third psychosis e.g. delusional disorder, acute and transient psychotic disorders.

There are 7 types of schizophrenia and the mnemonic goes like
PHC (primary health centre) U R SO far

1. Paranoid: The commonest type and good prognosis. The onset is later in life 3-4th decade. Major symptoms are delusion of persecution and grandeur.

2. Hebephrenic: 2nd most common and the worst prognosis. Disorganisation of thought, speech, affect and personality is more prominent than other types. Also there is marked emotional impairment.

3. Catatonic: The best prognosis (especially reactive catatonia). Characterised by marked disturbance in motor activity. Further divided into 3 forms i.e. Excited, Stuporous, and one alternating between the two.

4. Undifferentiated: Where symptoms do not fit in any subtypes.

5. Residual: Chronic type where the positive symptoms vanish and patient is left with 'residual' negative symptoms

6. Simple: only negative symptoms from onset (no positive symptoms at all)

7. Others (f): 
Schizophrenia + mental retardation = Pfropf syndrome
Schizophrenia + self-mutilation = Van-Gogh syndrome

Now let us see what exactly we mean by positive and negative symptoms.
Positive symptoms are those psychotic symptoms not seen in normal individuals (of course, haa!) but are “actively expressed” in the patients (something is added extra and so called positive).

Negative symptoms are normally expected behaviours like emotions like feelings thoughts and drives that a normal person experiences are absent in the patient (Normal things are being taken away and so called negative).

That’s all for now,
Stay awesome!
Keep calm and keep studying!
-Ashish G. Gokhale

Thursday, April 12, 2018

USMLEowesome: Basics about the Step 1 exam

This video is for those who have no idea about the Step 1 exam.

Things I forgot to cover in this video:
You can not retake the exam, if you pass or fail, you score stays forever!
How the score is reported and what is a good score.

It'll be covered in the next video.

Download the slides from here:

That's all!

Being street-smart during interviews: Flights!

During the hectic interview season and when you wanna travel from the east coast to the west coast, you will need flights for sure :D

Below are some tips about tickets and flights:

1- buying tickets:

> It is almost always cheaper to buy tickets online, check: Expedia, Kayak, Google flights and Cheapoair websites and compare the prices.

> Check Southwest (recommended) website too, its flights won’t show in the websites mentioned above.
What is special about Southwest is that it allows you to have 2 checked bags (up to 23 kgs each) for free! Also, you can change your flight one-time without paying anything or pay the difference between the 2nd ticket but without losing the original one.
Southwest has some nice offers too and tickets sometimes go as low as 49$ :O

> There is an app called “Hopper” on smartphones, it gives you the prices of different flights and notify you if the prices go up or drop. It also shows you which days are more expensive and which are cheap.
It sometimes shows you a bit more expensive price than the websites mentioned above so you can use it to have a general idea about cheaper days then buy the ticket from the internet.

2- When to buy the ticket?

> In general, the earlier you buy the ticket, the cheaper it will be. Be careful, sometimes this doesn’t happen and you suddenly find that the price of a certain flight has dropped so keep looking.

> Some airlines may have some offers on Black Friday and Cyber Monday so stick to your laptop these 2 days and save some money :D

> Avoid buying tickets during the Christmas season. Prices become crazy skyhigh!

3- Which airlines to choose?

I will talk about the ones I tried only:
American Airlines and United: pretty much the same (at least in my experience), the price of any checked bag is not included in the ticket so you need to pay for it (25$ or 35$). They also charge you 100$ if you have an overweight bag ( >23 kgs / 50 pounds ).

They have a rule that you have to check your “checked bag” 30 and sometimes 45 minutes before your flight, so even if you arrive 30 minutes before your flight and you have a bag to check, you will miss the flight and automatically rescheduled to the next one.

Spirit: Although some people had bad experiences with it, it still has one of the cheapest ticket prices, but put in mind that you ll pay for everything in your flight including the water you drink. (Interestingly, my experience with them was so smooth though)

Other airlines include but are not limited to: Delta and Frontier.

Some important tips:

> If you travelling to a small city, don't fly there directly. Instead, book your flights to the city with a bigger airport (mostly the capital of each state) then take a bus from their to your desired destination. This can also be done to states that are near each other (Fly to a state near to your final destination then take a bus from that state). This may help in saving a lot of money but will need more time.

> Don't forget to check the weather forecast, snow storms result in many cancellations.

> For international travelers to US, if your airport doesn't allow you to board the plane except if you have a return ticket, you can simply buy a return ticket within 24 hrs of your departure flight and cancel it after your check in. This is better than buying a round-trip ticket or paying a fee to change the date of the return flight especially if you are not sure of this date.

Update: 6/2/2018...Thanks to Hyndavi:

I used Delta airlines for most of the part.
1. They allow you a free carry-on bag which is good for carrying interview stuff. Compare prices with other airlines adding the baggage cost and make a purchase.

2. In December and January, there might be a lot of delays and flight cancellations. Make sure you call them after your trip and ask for compensation. They usually credit in miles which you can use at later stage. There are incidences where I claimed even after a month. Email or lodge a complaint.They are pretty responsive. American airlines is good too.

3. Whenever there is a delay or cancellation request them for an immediate rescheduling. For interviews during December and January, try to take the earliest flights possible to avoid missing an interview.

4.Try to carry a snack whenever possible as food in the airports repeatedly can cause unwanted expenditure.

5. Never check-in a carryon bag because a luggage missing or any delay can affect your interview. Sometimes, they just collect if before boarding and give it back after landing, which is ok.

6. Regarding Southwest, if you cancel a ticket, you get a credit into your Southwest account which you can use at a later stage. .
Comment below for any other tips you feel may be helpful :D Happy flying everyone :)


Wednesday, April 11, 2018

The USMLE journey cost


This blog covers the finances of the journey.

I know you are reading this because you are wondering if you can afford it, if it is all worth it.

For knowledge, I believe, destiny creates a way. Remember, to NOT quit your dreams because of green pieces of paper.

Medicowesome dentistry study group on Whatsapp

Hello everybody!

Inspired by the medical students study group, we decided to create a dentistry Whatsapp study group for dental students and we are really excited!

This idea is by one of our dentistry authors, Anisha and she'll be handling the group.

What's the study group for?
A bunch of dental students from all over the world, discussing study related concepts!
You may share your experiences, what you studied today, ask interesting questions to help other people learn or simply revise, ask doubts about things you don't understand, answer other people or just tell a fact you learnt that fascinates you.
We learn something new on a daily basis <3

How do I sign up for the group?

USMLEowesome: Introduction


What is USMLEowesome about?
A video series for those thinking or aiming for a residency in the United States.

Who is the intended audience?
Those who are new to the USMLE journey.

This video will also cover a little bit about me (IkaN) & an overview of the USMLE journey with my timeline.

Tuesday, April 10, 2018

How to use Anki Flashcards for studying


Since many of you guys requested it - A video demonstration on how to use AnkiDroid for studying during premed and med school!

Monday, April 9, 2018

Sample CV for electives


Since many of you guys have been asking for my CV for electives, I thought of uploading it for you to refer.

ECG changes seen in hyperkalemia and hypokalemia mnemonic

Here's a mnemonic by Shohrat Arazov!

When it seems out of your reach, should you try?

Here's an email I got from an awesomite who was extremely confused on whether or not to pursue something out of her reach (In this case, post graduate training in the US). Since it was an extremely personal email, I haven't posted the entire email here (just bits and pieces). Her email is in italics.

Sunday, April 8, 2018

Features of DNA replication: Semiconservative replication

Hello everyone!

Here is a feature of DNA replication that we don't think much about - the semiconservative replication!

Features of DNA replication: Unidirectionality and bidirectionality

Hello everyone!

DNA replication can be unidirectional or bidirectional, depending upon whether the replication from the point of origin proceeds only in one direction or proceeds in both the directions.

Medicowesome Anki flashcards

Hello everyone!

Here are the flashcards I used for step 2 CK and Step 3 -

Saturday, April 7, 2018

Some antibiotics in the US and their trade names

When you start your rotations, you'll hear many drug names that will sound new to you and since the drug names written in qbanks and books are the scientific ones, here is a brief list of some antibiotics and their trade names in the US:

Scientific name
Trade name
Ampicillin - Sulbactam
Piperacillin - Tazobactam
Zosyn ( also called Piptazo)
Dalfopristin - Quinupristin

Comment below for more “commonly used” antibiotics (or drugs in general) that may be added to this table.


Wednesday, April 4, 2018

Spanish learning tips for USMLErs

Speaking Spanish is a nice addition to your CV if you are planning to specialize in the US. Spanish is the 2nd most commonly spoken language in the US and some states especially southern ones like Texas and Florida have a huge Spanish-speaking population. Moreover, learning Spanish is fun :D

Here are some tips/methods that can help with that:

1- Language learning apps:

One of the best apps out there, it works on any device. Just make a free account and practice a bit every day to find out that you learned several thousand words without knowing.
In addition to the main “deck” offered by the smartphone app, you can study many other decks just by going to the website on a laptop and search for the language you want. The only pitfall is that the main deck doesn’t teach you grammar so you have to find other decks or sources.

Another great app which is similar to Memrise. I haven’t used it but I have heard great reviews about it.

Spanish Verbs Lite
A nice smartphone app that has a selective set of verbs with their conjugation in all tenses.
2- Social apps for languages:

Tandem and Hellotalk

Consider these apps like a Facebook/Tinder but for languages.
You enter your language and choose the language you wanna learn. These apps will match you with people who speak the language you wanna learn and you will be speaking the language that they wanna learn. Nice platforms to make “language learning friends” especially that you write about your interests so you can befriend others who have the same ones.
3- Youtube channels:

Butterfly Spanish
ِA very useful channel to boost your Spanish. I ll leave you with what Anna wrote about her channel:
“Learn Spanish for free with Spanish lessons that cover grammar, pronunciation, vocabulary, tips & tricks, and cultural aspects. My Spanish lessons are for all Spanish levels and are based on my passion for Spanish culture, language, and teaching.

A great channel which has many dialogues in both Spanish and English.

You can always search Youtube to find more stuff. This is one of the playlists when I searched for Medical Spanish:
4- Immersion:

Immerse yourself in Spanish. Use your Facebook in Spanish and maybe your smartphone too. You will automatically memorize words without even trying. You ll know that “me gusta, comentar and compartir” are the Spanish words for “like, comment and share”. After a while, you ll be amazed that you are picking more and more passively.
5- songs

Songs can stick in our minds in a magical way. Look for Spanish songs and read both the Spanish and English lyrics.
6- Friends

No matter how many progs and apps we use, nothing is like having a real conversation with a human being. The MATCH journey will let you meet people from Puerto Rico, Dominican Republic and many many others Spanish speaking countries. Practice with your friends and ask them to correct you.

A treasure to learn languages. Many podcasts are there, among the best is: coffee break Spanish.
Listen to the audio file, learn the accent, repeat. They also provide transcripts for the audio file in PDF form.
Coffee break podcasts are available for other languages including Italian and French.
8- Time Time Time

Specify a fixed period of your day to learn/talk in Spanish. This may be as short as 5 minutes up to a few hours. It may be when you wake up or before you sleep. Just develop a habit of learning new words and practicing your Spanish daily.

Some suggestions from the readers:

> Meetup
As the name suggests, this is a website through which you can meet people.
Create a free account, then choose your interests and discover groups of people who share your interests and hang out with them. Language learning is among the things you can choose and especially in the US, you ll meet many people who wanna learn Spanish.

>" Spouse - induced"learning
Some friends stated that having a spouse is one of the biggest motives to learn a new language :D

Comment below if you know any more tips/programs/apps/books that can help in mastering EspaƱol  :)


Neonatal Resuscitation Protocol

Here is a short (may be not very short) but concise flowchart on the neonatal resuscitation protocol by the American Academy of Pediatrics.

If I have forgotten to add any point, let me know.

Written by our Medicowesome Student Guest Author,
Devi Bavishi

Being street-smart during interviews: Banks!

Although many of the non-US IMG MATCH applicants will have a bank account during their rotations ahead of the MATCH, let’s talk about banks and IMGs in general!

The post may be updated if more banks join the list :D

below are some banks in which IMGs can open an account without having a Green Card:

Bank of America:

1- Available nearly everywhere
2- It gives you a temporary card that you can use for 30 days until your permanent card arrives
3- It has a nice mobile app (better than other banks in my opinion) that can basically do anything, easier than calling them or going to the bank.

1- To avoid the monthly fee of 12 dollars, you have to maintain your balance above 1500$ at any point during the month or you have to deposit 250$ per month.
2- For IMGs, they require 2 forms of identification (compared to one in most of the other banks). These 2 can be your passport and international driving license.
3- If you wanna travel outside the US, it is preferable to activate the “travel notice” feature (via visiting the bank or the app or calling them) because they may temporarily block your debit card if you are using it from a different country.

Don’t forget to go paperless (either using your mobile app or by asking them in the bank) to avoid having infinite unnecessary papers mailed to you especially if you are staying temporarily at a friend’s place!


Citizens Bank:

1- They require 1 form of identification.
2- To avoid their monthly fee of 10$, you can either deposit or let any friend deposit in your account each month even if a dollar OR simply you can open another account for free and auto-circulate a dollar monthly between the 2 accounts and voila, no fees at all.

1- They are less available in some states like Ohio and NY where you will find ATMs only and hardly any branches.
2- They don’t give you a temporary card when you open your account, so you should leave some cash with you till the debit card arrives.
3- YOU HAVE TO TELL THEM YOU WANNA GO PAPERLESS, or else they ll charge you 2 dollars monthly for bank statements that are mailed to your physical mailing address.

When you call Citizens Bank and it asks you for a Social Security Number (SSN) to let you talk to an employee, just wait and say nothing. You ll be asked about the SSN 3 times then you ll be auto-transferred to a human employee.

Good banking everyone :D and don’t forget to comment if you know more "IMG-friendly banks"

And that’s it
Update 4/8/2018

Some friends mentioned: CHASE and Wells Fargo so you may try them too
(Wells Fargo pros and cons are very similar to Bank of America)


Tuesday, April 3, 2018


Hello Awesomites!
Here's a quick review on the topic Euthanasia, a collection of asked MCQs on euthanasia.


Mercy killing or Assisted suicide
Physician assisted suicide is legal in some States of the US
Painless killing of a person who is suffering from incurable disease, senility, permanent damage to the brain which cannot be repaired or cured
Legally permitted in: USA, Uruguay, Poland, Australia, Switzerland, Nether lands
Not legalized in India


Active (Positive)euthanasia-
Act of commission
Death induced by direct/indirect action
legal in Netherlands and Belgium
E.g. giving large dose of a drug that hastens death

Passive (Negative)euthanasia-
Act of omission
No specific medicine or life supporting measures given
Death induced by discontinuation of life sustaining measures
legal in India
E.g. stopping heart lung machines in a severely defective new born, disconnecting ventilator in a brain dead patient

Voluntary euthanasia-
Euthanasia induced at the will of an individual by his request
A patient suffering from an incurable disease requesting the doctor to terminate his life

In/Non voluntary euthanasia-
Induced in patients who are unable to express their wishes
E.g. a person with irreversible coma or a severely defective infant
Paternalism - abuse of medical knowledge so as to distort the doctor-patient relationship in such a way that the patient is deprived of his ability to take rational choice.

Thank you!
MD Mobarak Hussain (Maahii)

About me

Hey Medicowesomites :D 

I have been posting here since some time and I would like to introduce myself

I am Murad Almasri from Palestine, I finished my med school in Egypt then did my USMLEs (step 3 left though) and will start my residency in Pediatrics in the US soon  :)

I am a positive person and I always like to know more and more's just like eating information 
I believe in sth called "encyclopedial knowledge"..try to know everything about everything.

 I love making mnemonics and collecting them, I think I've been doing that since high school maybe even before that and this helped me tremendously in the USMLEs.

 I like reading books especially novels - I am a big Harry Potter fan ^_^ .
I also like video games ( I sometimes ask myself who doesn’t :D ?) and of course moviesssss 

 Learning new languages is a passion for me too, I already know a few.

 Good luck Medicowesomites and enjoy this amaaaaaazing website :)


Sunday, April 1, 2018

Neural Crest Cells : Mnemonic

Hi everyone !
Here's a short mnemonic post !

Neural Crest Cells are very special cells that form at around 2-3 weeks of gestation.
They're right next to the Neural folds of the Neural tube to begin with and then eventually come to lie lateral to the tube, after which they migrate to various parts of the body giving rise to a bunch of things.

It's kind of SUPER IMPORTANT to memories what structures arise out of the Crest cells.
One of the reasons for it is that neural crest cell tumors will express certain neuroendocrine markers and that will make it easier to detect them on histopathology.
The other reason is that it's literally the most favorite embryology question - whether it's  NEET PG or Step1!

So here goes :

Mnemonic - LAMAS BABy

L - Lepto meninges (Pia + Arachnoid)
A - Adrenal Medulla
M - Melanocytes
A - ANS Ganglia
S - Schwann Cells

B - Branchial Arches
A - Aortopulmonary windows + Endocardial Cushions
B - Bronchogenic cells - Pneumocytes
Y - Yo

This will also help you understand why Melanomas , Bronchogenic Carcinoma , Schwannoma, Pheochromocytoma and even Neuroblastoma are all positive for similar markers and have similar appearances at times along with similar histopathological fetaures.

Hope this list covers them all!
Happy Studying!
Stay Awesome!

~ A.P. Burkholderia