Immunology emoticon game

And it's back again! Except, it is more tougher conceptually.

We figured guessing words out of emoticons is too lame and easy for you medicos and thought we'd add questions to make it more fun!

Immunology emoticon game

Study group experience #17

Pathophysiology of liquefactive and coagulative necrosis in hypoxia

Leucine, tryptophan and niacin
CPS 1 and CPS 2

T4 level
Tonsils and pharynx review questions

Food, pain and ulcers
Refsums disease
Kimmelstiel-Wilson in medicine
Pheochromocytoma and eleven  

Kochs contact
Questions on tuberculosis  

Differentials of wasting of small muscles of the hand

We did a massive change in all 4 groups, we clubbed Asians in two groups and Non Asians in two groups. Now the groups are segregated time zone wise, leading to better fruitful discussions! Though we do a bit of a mix and match here and there.

Also, we recently made group 5. It's a lot of discussions to take it for people who are in all 5 groups!

Study group discussion: T4 level

Studying the anatomy of the thorax.. Does anyone know the events occurring at T4 level?

At t4 level:
- Arch of aorta starts and ends at this level
- Azygous vein ends here to join SVC
- Trachea divides into primary bronchi

Study group discussion: Food, pain and ulcers

How does food relieve pain in duodenal ulcer and aggravate pain in stomach ulcer?

Food reaching stomach causes acid secretion. Therefore, pain increases.

In case of duodenal ulcer, eating causes pyloric spincter contraction, acid is prevented from reaching the duodenum
Therefore, pain is relieved.

Beckwith-wiedemann syndrome mnemonic

"Becky is big."
Beckwith-wiedemann syndrome mnemonic

"Big body"
Macrosomia

"Big tongue"
Macroglossia

"Big abdomen"
Omphalocele

"Big pancreas"
Hyperinsulinemia -> Hypoglycemia

"Big organs"
Visceromegaly

"Likes to get bigger"
Associated with Wilms tumor, gonadoblastoma and neuroblastoma


That's all!

-IkaN

Study group discussion: Pheochromocytoma and eleven

What is rule of 11 for pheochromocytoma?

11% are extra-adrenal
11% are bilateral
11% are malignant
11% are found in children
11% are familial
11% are not associated with hypertension
11% contain calcification

Fallopian tube facts and mnemonics

Hello! I read some facts about the fallopian tube so I'll be sharing it with you today!

What part of the fallopian tube does fertilization occur?
Ampulla of the fallopian tube is the most common site for fertilization.

Sometimes, the embryo isn't transported to the uterus by the cilia, causing ectopic pregnancy. This is why, ampulla of the fallopian tube is the most common site of ectopic pregnancy.

How do I remember this? Mnemonic!

FAME
Fertilization
AMpulla
Ectopic

Another random fact to remember is, isthmus is most common site of rupture of ectopic pregnancies because it is inflexible and has a thick muscularis.

Mnemonic: ISTHMUS
Inflexible
Stiff
THick
MUScularis

That's all!
-IkaN

Congenital cytomegalovirus infection

Meckel Gruber syndrome mnemonic

Hello everyone!

We are going to learn about Meckel Gruber syndrome today!

It's an autosomal recessive syndrome characterized by GRUBEP!

G: ambiguous Genitalia
R: Renal dysplasia
U: Ureteric hypoplasia
B: Bladder hypoplasia
E: Encephalocele
P: Polydactyly
Pancreatic dysplasia

That's all!

There is nothing free except the grace of God.

-IkaN

Remembering Apgar scoring.

Hello awesomites, finding it difficult to remember the components of Apgar score? Well, I think grouping them makes it easy-

1. The heart and lungs lie close hence,  you can group 'heart rate' and 'respiratory effort' together.

2. Reflexes are carried out none other than muscles, hence 'muscle tone' and 'reflex irritability' or 'reflex response' go into the second group.

3. Color, now it is easy to remember.

That's all!

Study group discussion: CPS 1 and CPS 2

Today's discussion is about Carbamoyl Phosphate Synthetase!

What are differences between CPS 1 and CPS 2?

CPS 1 works in the urea cycle.
CPS 2 in pyramidine synthesis.

CPS 1 is mitochondrial.
CPS 2 is cytosolic.

(Medicowesome mnemonic: Two is cys-two-lic)

The source of nitrogen for CPS 1 is ammonia.
For CPS 2, it is the amide group of glutamine.

N acetyl glutamate is activator for CPS 1.
ATP is activator for CPS 2.

Woah that's a lot of points I didn't know about!

Study group discussion: Leucine, tryptophan and niacin

Which essential amino acid interferes with the conversion of which another essential amino acid into niacin?

Leucine.

In shorghum or jowar, high leucine content inhibits conversion of tryptophan into niacin active form.

Any one knows the mechanism?

Because it inhibits quinolinate phopshoribosyl transferase.

Hormonal changes during menopause mnemonic

Short post for the day! :)

"EPIc FALL"
- Estrogen
- Progesterone
- Inhibin
levels Fall during menopause.

Estrogen and osteoporosis

Lack of estrogen causes a decrease in osteoprotegerin.

Osteoprotegerin (OPG), also known as osteoclastogenesis inhibitory factor (OCIF), is a cytokine and a member of the tumor necrosis factor (TNF) receptor superfamily.

Osteoprotegerin inhibits the differentiation of macrophages into osteoclasts and also regulates the resorption of osteoclasts.
Mnemonic: Osteoprotegerin protects bone (By preventing macrophage differentiation into osteoclasts.)

Osteoprotegerin, a RANK homolog, works by binding to the RANK-ligand on Osteoblast/Stromal cells, thus blocking the RANK-RANK lingand interaction between Osteoblast/Stromal cells and Osteoclast precursors. This has the effect of inhibiting the differentiation of the Osteoclast Precursor into a mature Osteoclast.
Mnemonic: Osteoprotegerin ranks high in protecting bones.

So, estrogen kinda inhibits the osteoclasts which causes osteoporosis is the moral of the story?

Yep.

Extra: Recombinant human osteoprotegerin specifically acts on bone, increasing bone mineral density and bone volume. Osteoprotegerin has been used experimentally to decrease bone resorption in women with postmenopausal osteoporosis and in patients with lytic bone metastases.

That's all!

-IkaN

Submissions: Chagas disease notes

Here are some beautifully presented points on Chagas disease written by Jolhf Mathai Koshy.

I didn't know about Romanas sign and Chagomas.

The MEGA mnemonic for cardiomegaly, splenomegaly, megaeosophagus and megacolon is brilliant.

Now, my brain is swollen up with sweet information! Thanks a lot, Jolhf!

-IkaN

Related post: Study group discussion on Chagas disease

Whipples disease mnemonic

Mini post of the day!

Whipples disease responds to antibiotics like ceftriaxone and TMP-SMX.

"Whip Whipples with antibiotics."

W: Caused by T. Whippleii
Hip: Reminds me of arthralgias
P: For PAS positive macrophages
L: Lymphadenopathy
E: Eye findings

Celiac disease mnemonic

Hello. Something about celiac disease today!

"In celiac disease, the gut is cealed (sealed) with GLUe."

Study group discussion: Kimmelstiel-Wilson in medicine

Review - How do KW lesions, disease and syndrome differ from each other?

KW lesions refer to nodular glomerulosclerosis - the KW nodules

KW syndrome is nephrotic syndrome developing due to the lesions.

KW disease refers to any other manifestations occurring due to the lesions.

Any other manifestations like?

Manifestations of glomerulonephropathy. I guess hematuria, anasarca, uremia and others.

Study group discussion: Questions on tuberculosis

20 year old girl with a TB contact history comes to OPD with complaint of hemoptysis. Her TST is 20mm and her smear & culture is positive for mycobacterium TB.

Now some questions related to pulmonary TB!

What is brocks syndrome?

When the enlarging hilar lymph node causes collapse of bronchi, leading to bronchiectasis is called Brocks syndrome. Specially right middle lobe.

What do you exactly mean by post primary tuberculosis?

Post primary refers to TB that occurs few weeks after primary TB when the immunity has developed.

Chemoprophylaxis with which drug should be prescribed if a patient is gonna undergo some immunity wrecking thing like eg, gonna take long term steroids and their CXR shows evidence of previous TB?

Isoniazid.

Breech mnemonic

Hello!

So today, I forgot the types of breech.

And that's why, I made a illustration with eh mnemonic.

There are two types of full breech:
- Complete breech
- Frank breech

There are many types of incomplete breech:
- Footling
- Kneeling

That's all!

-IkaN

Study group discussion: Kochs contact

Question: Definition of Koch's contact!

Answers, comments posted on the group -

1. Should have:
Sputum positive pulmonary tuberculosis or sputum negative culture positive pulmonary TB

2. Person who is open case of Koch, person who just started AKT and person who completed AKT within 2 years.

Extras:

It was my pediatrics viva question. I didn't know the answer back then! Thanks!

The contact should be a member of the household or be frequenting regularly.

The first identified case in a household is called as index case.