Study group discussion: Contraindications of ACE inhibitors

Why ACE inhibitors are contraindicated -
During pregnancy
In CCF due to severe aortic stenosis
Bilateral renal artery stenosis

Please explain.

Study group discussion: Polygonal cells

What are polygonal cells ?

I know I'm stating the obvious, but can I guess cells which are polygonal in shape? :P

According to Google, Polygonal cells have many sides. (Four to five mostly)

The skin has a layer of polygonal cells called the stratum spinosum.

Criteria for LVH in ECG

Hey everyone!

Someone requested me to do a criteria for LVH in ECG. Here are a few!

Cornell criteria: Add the R wave in aVL and the S wave in V3. If the sum is > 28 mm in males or > 20 mm in females, then LVH is present.

Mnemonic: 20 carnivals tree

caRniVALS (Corn evil? Cornell?) tree

R in aVL (caRniVaL).

S in V three (tree).

3 looks like a Mirrored 8.

So 28 in Males, 20 in females.

Study group discussion: Decerebrate and Decorticate rigidity

Can anyone please explain how do we get decerebrate & decorticate posturing?

ORS and baby - My ORS week poster

It's ORS week again! And this time, I made the poster in Marathi, one of my favorite languages!

ORS week poster in Marathi

For all those who don't know Marathi, here's a translation. (The dialogue might not sound as cute in English, but here it goes!)

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.