Bartters, Gitelmans and Liddles syndrome mnemonic

Hello!

Bartters, Gitelmans and Liddles syndrome present with chloride resistant (high urinary chloride) hypokalemic metabolic alkalosis.

What differentiates them:
Bartters: Hypercalciuric (Furosemide like! Loops lose calcium, remember?)
Gitelman: Hypocalciuric (Thiazides don't!) and Hypomagnesemia. Presents with cramping and spasms.
Liddles: Presents with hypertension, metabolic alkalosis and hypokalemia (Aldosterone excess like, but it is truly pseudohyperaldosteronism!)

It is characterized by: Hyporeninemic hypoaldosteronism, hypertension, hypokalemia and enhanced erythrocyte sodium influx

Here's a mnemonic for it!

"FaceBook GoT ALL pseudo HYPER about a Little syndrome"

FB - Bartter's is like Furosemide
GoT - Gitelman Thiazide
All pseudo hyper little - Liddles is like pseudo HyperALdosteronemia (Remember, it is pseudo - aldosterone levels are normal/low)

These syndromes are rare, so it’s important to rule out more common causes (Like diuretics)

That's all!

Here's an aphorism by Sir William Osler: “Care more for the individual patient than for the special features of his disease.” :)

-IkaN

Bile acid sequestrants mnemonic

Hello! The bile acid binding resins are:
Cholestyramine
Colestipol
Colesevelam

I'll talk about Cholestyramine in this post!

Iron deficiency anemia

   IRON DEFICIENCY ANEMIA

-The commonest nutritional anemia in India

-Causes:
Decreased Intake
Lack of absorption (eg. Celiac disease)
Increased loss ( in the form of blood loss through any system)

- More common in women d/t menstrual bleed, increased requirement in pregnancy and lactation.

 CLINICAL PRESENTATION
Increased fatiguability
Pica
May present as a triad with dysphagia and esophageal web in Plummer Vinson syndrome
Glossitis

INV:
Low Hb
Low Rbc count
Low MCV, MCH And MCHC
Low S. Ferritin
Raised TIBC
Reduced Transferrin saturation
Microcytic hypochromic picture on Peripheral blood smear; Pencil cells may be seen

Heyde's syndrome mnemonic

Greetings! Short post for the day about Heyde's syndrome!

The mnemonic is: Heydes' hidden bleeding heart.

Pathophysiology of achalasia mnemonic

Hello!

This post is about the pathophysiology of achalasia!

In achalasia, there is loss of NO and VIP releasing inhibitory neurons. Thus, the loss of the inhibitory innervation in achalasia results in the manometric consequence of failure of LES relaxation as well as loss of esophageal peristalsis.

Classification of enzymes mnemonic

Hello!

This mnemonic on classification of enzymes was submitted by Mohd. Ayub Ali.

The mnemonic is, "On The Himalayas, Lyf (life) Is Lightened."

Intermediates in Gluconeogenesis mnemonic

Hi guys!

So today I wanted to talk to you about Gluconeogenesis.

The first thing is that gluconeogenesis takes place in the mitochondria.

Now when anyone says, "mitochondria", I (and probably all of us) immediately jump to, "mitochondria is the powerhouse of the cell".

Why does Digoxin toxicity result in increased automaticity?

Hey everyone!

Digitalis and other cardiac glycosides are known to cause an AV nodal delay.

Then why does too much Digoxin result in some arrhythmias that are due to increased automaticity? Brady arrhythmias are explainable. But why tachy arrhythmias?

Atrial fibrillation in WPW syndrome

Random fact that I learnt today!

If a patient with WPW syndrome develops symptomatic atrial fibrillation, what is the drug of choice?

Answer is procainamide.

Stable patients suspected of having WPW with atrial fibrillation should not receive agents that predominantly block atrioventricular conduction, but they may be treated with procainamide or ibutilide.

Why?
Because if you block the AV node using beta blockers, calcium channel blockers or digoxin, you will favour conduction to the accessory pathway. This will worsen the arrhythmia.

That's why, in stable patients, chemical cardioversion is preferred.

If instability is present, electrical cardioversion is required.

That's all!
-IkaN

Related post: Supraventricular tachycardia mnemonic

Organisms covered by Ampicillin mnemonic

So here it is...

Ampicillin HELPS to clear Enterococci!

Haemophilus influenzae
E. Coli
Listeria monocytogenes
Proteus
Salmonella

Ps: Gram-negative organisms have 'porin' channels in their outer lipid membrane through which the Beta-lactam antibiotics enter the cell. Also the lipopolysaccharide layer that contains endotoxins! (Gram-positive organisms do not have such things in their cell wall)
The only exception is Listeria monocytogenes that has little amounts of such endotoxins, inspite of being Gram-positive bacteria!

That's all!

-JasKunwar Singh

Interesting facts about testing 9th, 10th and 11th Cranial nerves

Hey guys!
So here's my first blog! Hope you like it!

Did you know that when 11th cranial nerve is involved on one side, you check for turning of head to opposite side and shoulder shrugging on the same side?

But when involved bilaterally, the patient can't turn their head.

So to test bilateral sternocleidomastoids, you ask the patient to sit up from sleeping position. He'll have head lag!

Here's another interesting fact:
Gag reflex is involved in 9th or 10th cranial nerve nerve palsy... This specifically localises lesion at medulla because both nerves originate there.

That's all!
Thanks ☺

-Rippie

Viral hepatitis - A histologic clue to the causative virus

Viral hepatitis is predominantly caused by hepatotropic viruses, although others like EBV, CMV are also implicated in the causation. Though serological markers serve as a gold standard for diagnosis, the following histologic clues help a pathologist to suspect the causative virus.

HAV - The portal tracts show a large amount of plasma cell infiltrates.

HBV - Presence of Ground Glass cytoplasm

HCV- Lymphoid aggregates in the portal tracts with macrovesicular steatosis of hepatocytes (most marked with Type 3)
Steatosis in zone 1 is mainly due to HCV while steatosis in zone 3 is mainly due to metabolic causes or alcohol.
EBV - Beads on a string pattern of sinusoidal infiltrates of Atypical lymphocytes.

CMV- Formation of microabscesses with intracytoplasmic and intranuclear inclusions.

Herpes virus- Nonzonal punched out necrosis with nuclear ground glass (Cowdry A) inclusions.

Thus, a good pathological suspicion would add to the confirmatory serological reports.

How to write for Medicowesome (And instructions for new authors)

Hello!

You can write for Medicowesome and share your awesomeness with everyone around the world! It goes on the "Submissions" page. If you want me to share your notes / knowledge / mnemonics on Medicowesome, email them to me (medicowesome@gmail.com) and I'll post it for you!

If you wanna be an independent author at Medicowesome, here's what you need to do:

Email me your id at medicowesome@gmail.com asking that you want to write for Medicowesome. I'll say yaay! Of course, yes! :D (You could also send a few sample blog posts and a fancy CV. jk.)

Make a blogger account (blogger.com) using your Gmail account.

Send me your email address. I will send you an author invitation, you must accept it within 24 hours.