ORS week poster: 5 reasons why ORS is a superhero

So here it is - the superhero poster I made for ORS week :D

ORS superhero poster

Vitamin D resistant rickets mnemonic

Vitamin D resistant rickets mnemonic

"WASP"
Wa: Waddling gait
S: Short stature
P: Phosphate low

Difference between secondary and superinfection

Should antibiotics be prescribed for an adult with the usual fever, headache and sore throat symptoms?

Not unless he develops secondary bacterial infection.

Metachromatic Leukodystrophy mnemonic

Inspired by the case I saw in the OPD yesterday, I thought I'd share a mnemonic I use to remember the same.

"Aryl has many Colorful look a like, Cerebral brothers. They are Clumsy and Crazy."

Internship diaries: Metachromatic leukodystrophy

Hey everyone! I'm posting the study group discussion we had because it's so much less to type :D

I saw a case of metachromatic leukodystrophy in the OPD yesterday.

Can anyone tell me what is metachromatic dystrophy?

For those who don't know, it's a lysosomal storage disease. Deficiency of the enzyme aryl sulfatase A causes accumulation of cerbroside sulfate.

Study group discussion: Hot vs Cold fomentation

Can anyone tell me when should we give hot fomentation and when should we give cold fomentation?

Immediately after an injury -  Cold fomentation.
Later on - Hot fomentation.

Cold is for acute injuries like sprains, joint injuries, sports injuries.

Hot is more for chronic conditions like back aches, muscle spasms.

The point is after an acute injury, you need to reduce the swelling and inflammation. So you cool the area to decrease blood flow.

After a day of injury, you would want to increase blood flow to heal the area.

Amazing!

Study group discussion: Fluids in inferior wall myocardial infarction

Why are fluids indicated in inferior wall MI?

Inferior wall MI is associated with severe hypotension. So first, correct the hypotension, then, thrombolyse.

Yes, but any reason for the hypotension?

Because inferior wall has vagal plexus. Patients with inferior wall MI are parasympathetic i.e. high vagal tone.

Study group discussion: Referred pain

Can someone please give me regions of referred pain areas?
Eg. Pain in the shoulder could infer problem with diaphragm.

Right shoulder pain - problem with gall bladder (eg. Cholecystitis)
Left shoulder and ulnar border of left arm and hand - myocardial infarction.

Knee pain can refer to hip.

Renal colic pain is referred to the back.

Splenic rupture can refer pain to left shoulder - Kehr's sign

What is Kehr's sign please?

Splenic rupture or hemorrhage irritates the diaphragm on left side and that refer s the pain to the left shoulder. Same like cholecystitis on right side.

Study group discussion: ECCE

Why ECCE is not done when zonules are not intact?

What is ECCE?

Extra capsular cataract extraction.
Because the IOL will be implanted in the remaining posterior capsule - And if the zonule is not intact, it may cause lens subluxation.

Awesome.

Study group discussion: Cystogastrotomy for pseudopancreatic cyst

One interesting question:
In cystogastrotomy, as surgical treatment for pseudo pancreatic cyst...Why do food particles don't enter from stomach to pseudocyst through the communication?
This question asked by surgical professor in OT today.

Because cyst will be always in positive pressure and clinical studies show that the cyst rapidly decompresses. Approximating the mucosa with cyst wall, which has no epithelial lining, leads to rapid shrinkage of stoma. Within few days, neither the stoma nor the cyst is evident on radiology or endoscopy.

Wow. This is great stuff!

Study group discussion: Serum ascites albumin gradient

Can anyone explain the serum ascites albumin gradient in a super simplified way?

High SAAG: Imbalance between hydrostatic and portal pressures.

Low SAAG: Ascites due to protein leakage.

SAAG = Serum albumin - Albumin in ascitic fluid. And is directly proportional to portal pressure.

Internship diaries: Calcium channel blockers and peripheral edema mnemonic

As you all know, I am doing internship or housejob and it's really tiring but a good learning experience. Lemme share what I learnt / revised today!

In my medicine OPD, we start most newly diagnosed hypertensive patients on amlodipine, a calcium channel blocker. Many of the patients, after a few weeks of therapy, come back complaining of lower extremity edema. You check their electrolytes, LFT's and RFT's and they are all normal.

Conn's syndrome mnemonic

Hi. I keep forgetting that Conn's syndrome is hyperaldosteronism. Can you help me out with this?

Sure! :D

The N's are for sodium - Hypernatremia!

The C makes a K for potassium, which is less than the number of N's, therefore, hypokalemia!

Also, Na+ is sodium. A could remind you of Aldosterone.
AL could remind you of ALkalosis.

That's all!

-IkaN