COPD: Tips for step 2 CK and rounds

Hello! I have a pulmonary rotation going on and I thought I'd shed light on management of COPD :D

During rotations, you may be asked what you want to do for the patient. I have written "Plan" for what you might want to answer to impress your attending. I've included a few common brand names too :)

Inhalers: Remember inhalers only improve symptoms and have no mortality benefit and do not affect the progression of the disease.

Submissions: Crohn's disease mnemonic

This was submitted to us by Subbiah. Thanks!

Submissions: Anastomosis around the Scapula

This was submitted to us by Aparna. Thanks, girl!

Submissions: Anticoagulants mnemonic

This awesome mnemonic on Anticoagulants was submitted by Dr Vinayak Hiremath.

Hidden bleeds

So this is what my fellow asked me today: Say, there is a patient whose hemoglobin is dropping, dropping, dropping and he has barely any significant signs or symptoms.. Besides the GI tract, where else can you have a significant bleed which can be hidden? There are three such places.

Guess before you read the answer! :D

In my words: Diagnosing a PE

I was reading about Pulmonary Embolism for USMLE Step 2 CK and started typing notes for myself to refer. I thought I'd upload it for you guys to read as well.

Disclaimer: I am talking to myself in the blog. I hope it makes sense.

I'll be talking about two scenarios -
High pretest probability scenario: Dude who sat in a 24 hour flight, smokes a lot, is taking OCP's, got his hip replaced and can't move at all.
Low pretest probability scenario: Dude who is dyspneic, hypoxic and has a normal chest x-ray.

Let's start with scenario #1 - The high pretest probability:

If there's a high index of suspicion and a treatment option is given in the options, choose the treatment one because you don't want to waste time in imaging.

If there's a high index of suspicion and a treatment option is not given in the options, they want you to choose a diagnostic modality. The "next best step" in the diagnosis. What do you choose?

Why does oxygen cause hypercapnia in COPD?

In medical school, we learnt that oxygen administration in patients with chronic obstructive pulmonary disease (COPD) induces hypercapnia through the 'hypoxic drive' mechanism. I had talked about this in my previous blog here.

Today, I found out that it is a myth. Well, sort of. It has a minor role. At least, in COPD.

Studies found out that the minute ventilation had a limited effect on PaCO2 :/

So... What caused the CO2 increase then?

How would you look upside down?

Hey everyone!

I attended a conference of aging of the face two weeks back. Did you know that aging of the face can be related to gravity? Yep it is.

Well, here's what's REALLY interesting: To reinforce this theory, they found out that inversion photographs of aging patients (either in a supine or Trendelenburg position) demonstrate an appearance consistent with that of photographs taken approximately 10–15 years prior.

Here's a picture:

Antipseudomonal antibiotics mnemonic

Hope you're having a good day!

"CP cover Crazy Pseudomonas."

Cephalosporins (Like Ceftazidime, cefepime, cefoperazone, cefpirome)
Ciprofloxacin (Fluoroquinolones)
Carbapenems (Meropenem, Doripenem)
Colistin
Polymyxin B
Piperacillin tazobactam (Anti pseudomonal penicillins)

I also remember that antibiotics that have the letters "AZ" cover Pseudomonas.

Organisms covered by Azithromycin mnemonic

Hey!

Today, during rounds, I was asked which organisms does Azithromycin cover that ceftriaxone doesn't and I kinda blanked out :(

PS: They were talking in context to community acquired pneumonia (CAP) and so does this post.

So.. Mnemonic!

Phagocytes, Monocytes, Macrophages, Histiocytes?! What's the difference between them?

Hey guys!

If you've always found it difficult to make a distinction between those terms about wha they mean then this post is for you. Let's  just settle it once and for all.

Study group discussion: Lipid Metabolism Deficiency Enzymes

Hey guys, this is a minor post about Lipid Metabolism Deficiency enzymes we talked about in Medicowesome Whatsapp Group. (If you want to join our group, please email us!)

DNA viruses mnemonic

DNA is the blueprint of biological life as we know. 

Viruses contain either DNA or RNA, they NEVER contain both. Now whether viruses containing DNA makes them superior to there only-RNA containing counterparts..that is debatable.