Showing posts with label USMLE Step 2 CK. Show all posts
Showing posts with label USMLE Step 2 CK. Show all posts

Friday, June 25, 2021

Celiac Disease (Spectrum of Manifestations)

 Hello friends! I hope all of you are doing well. Today I wanted to share with you the many faces of Celiac Disease. Although considered as the disease which chiefly causes gastrointestinal symptoms, the entire spectrum of possible manifestations it can cause is quite broad.

Some significant associations are as follows:

1.) GI- Enteropathy associated T-cell lymphoma (EATL), Microscopic colitis

2.) Liver- NASH

3.) Spleen- Functional Asplenia (SLE & Amyloidosis being other notable causes)

4.) CNS- Seizures with posterior cerebral calcification, Neuro-psychiatric symptoms, Ataxia

5.) Hematology- Evans syndrome

6.) Pulmonary- Diffuse alveolar hemorrhage

Here is the full spectrum. Hope you like it.

-Kirtan Patolia

Saturday, May 29, 2021

Psychogenic non epileptic seizure (PNES)

 PNES  characteristics : 

  • No loss of consciousness or postictal period

  • Psychiatric conditions (depression, anxiety)
  • Physical/sexual abuse
  • Epilepsy

Mnemonic = “WALT” - means Unsteady! 

Thank you! 🩺🫀

Friday, May 28, 2021

Red blood cell transfusion thresholds mnemonic

 Hello everyone! Just look here.. 

What does it mean ? SHOAN …? 
the name Shoan is of Hebrew origin and means "Gift of Salvation". 
That’s all!
Thank you! 🩺🫀

Subarachnoid haemorrhage

Clinically important steps required for SAH management ( from its onset ) 

  • Most commonly due to ruptured saccular (berry) aneurysm
  • Severe & sudden onset of headache different from previous headache pattern or described as "worst headache of my life"
  • Nausea, vomiting, brief loss of consciousness, focal neurologic deficits, or meningismus
  • Noncontrast head CT >90% sensitive within 2-6 hr of SAH onset
  • Lumbar puncture required to exclude SAH definitively in patients with negative CT scan of the head
  • Xanthochromia confirms diagnosis (usually >6 hr from SAH onset)
  • Cerebral angiography to identify bleeding source

Happy studying! 
Thanks folks! 🩺

Biophysical Profile Mnemonic


Biophysical Profile 
Just add an extra “V” 
See the management here .. 

“ The value of experience is not in seeing much, but in seeing wisely”.  - William Osler  

Thank you! 🩺

Tuesday, May 25, 2021

Basal Ganglia Circuit

Hello everyone!  Confusing loop has now simplified look! 👀 

First of all, Basal ganglia receives cortical input, provides negative feedback to cortex to modulate movement.

3 things must be remembered. 

  • SNc (Substantia nigra) input to the striatum via the nigrostriatal dopaminergic pathway releases GABA.
  • Dopamine binds to D1 , stimulating the excitatory pathway, and to D2 , inhibiting the inhibitory pathway. 
  • Pathways from Thalamus to Motor cortex & from Motor cortex to Basal ganglia - “Stimulatory” 

That’s why this circuit is important in voluntary movements and adjusting posture. 

Here is my attempt to simplify this circuit through a drawing. By understanding that you’ll never forget it! 

  • I-N-hibitory pathway goes through Gp-I & N-ucleus(Subthalamic)!
  • If BG output = +, then increased motor activity
  • If BG output = -, then decreased motor activity 

In PARKINSON’S DISEASE, SNc degenerates = lose dopaminergic input to BG
Less stimulation of direct pathway (⬇️gas) and less Inhibition of Indirect pathway (⬆️ brake) = overall indirect wins =less motor activity. This explains bradykinesia and rigidity of PD but not tremor. 

STN and GPi are targets of Deep Brain Stimulation in PD. 
Deep brain Stimulation INHIBITS activity in these structures—inhibiting either would lead to decreased inhibitory output of BG = increased motor activity-> improve PD symptoms. 

Lesion of STN -HEMIBALLISMUS= uncontrolled erratic large amplitude movements on one side.  Why INCREASED movement with STN lesion? 
By decreasing STN excitation of GPi we essentially ‘remove’ indirect pathway from equation, and direct pathway becomes unchecked -> ⬆️ movement      

Thank you! 🩺

Sunday, May 16, 2021



(Hand-Foot-Mouth Disease) 



Coxsackie A virus

Herpes Simplex type 1 virus (HSV-1)


3-10 years

6 months-5 years

CLINICAL                             PRESENTATION                  

Grayish Vesicles on                Posterior Oropharyn   

(soft palate, tonsils,

tonsillar pillars, Uvula)                    


Clusters of vesicles on       Anterior Oropharynx

(Lips, buccal mucosa, tongue, gingiva, hard palate)



Supportive management with oral hydration and analgesics

Oral Acyclovir

Tuesday, May 11, 2021

ARDS management mnemonic

 Maintenance “DOSE”

Dry Lungs - “Dry lungs -Happy lungs”

  • Maintain negative fluid balance to reduce pulmonary edema

Open but not Over-distended 

Sunday, May 9, 2021

Management of asymptomatic carotid atherosclerotic disease and carotid artery stenosis mnemonic

Super short post!

A) Asymptomatic

≥80% stenosis: Carotid endarterectomy
≤79% stenosis: Medical management

Mnemonic AGES: Asymptomatic Greater than Eighty Surgery

B) Symptomatic

≥70% stenosis: Carotid endarterectomy

Mnemonic SSS: Symptomatic Seventy Surgery

50%-69% stenosis
Male: Carotid endarterectomy
Female: Medical management

Mnemonic MMM: Males Manage More than fifty with surgery

<50% stenosis: Medical management

That's all!

Saturday, April 24, 2021

Ampicillin-rash in infectious mononucleosis


Penicillins such as amoxicillin and ampicillin are currently not recommended in patients with infectious mononucleosis with bacterial secondaries (streptococcal tonsillo-pharyngitis). Why?

Sunday, February 28, 2021

Essential tremor - a mnemonic.

Do you often forget the features of 'essential tremor'? Well shake no more, 'coz here's a mnemonic that will straighten things up for ya!