Saturday, November 5, 2016
Tetanus are Anaerobic! Can Oxygen infusion into the wound, heal tetanus?
Thursday, November 3, 2016
Non-Hodgkins lymphoma treatment (CHOP regimen) mnemonic
If you can't remember the drugs used in the CHOP regimen of Non-hodgkin's lymhoma, I have a mnemonic for you.
Hodgkins lymphoma treatment (ABVD regimen) mnemonic
If you can't remember the drugs used in the ABVD regimen of Hodgkin's lymhoma, I have a mnemonic for you.
Study group discussion: ADP fibrinogen test
What is ADP (Adenosine diphosphate) fibrinogen test?
ADP, formed by Ib receptor, acts on IIb IIIa receptor through fibrinogen and causes aggregation.
In vWD and Bernard Soulier disease (Ib defect), if you add ADP, aggregation would take place and test will be normal as it acts on IIb IIIa receptor.
In glanzmann thrombasthenia, the IIb IIIa receptor is deficient. ADP can not act on the receptor, if added. That's why, the test becomes abnormal.
Therefore, the test is normal in vWD, Bernard soulier disease and abnormal in glanzmann thrombasthenia.
Explained by Abhishek Shukla
Wednesday, November 2, 2016
PATCHED: When the tonsils shows a membrane
I'm back with a simple mnemonic to deal with a questionably common but very important issue: The Patch On The Tonsil.
Difference between neuroleptic malignant syndrome and serotonin syndrome
Evolves over one to three days.
Sluggish neuromuscular responses (Rigidity, bradyreflexia)
Typical course: Mental status changes appear first, followed by rigidity, then hyperthermia, and autonomic dysfunction (Tachycardia, high BP, tachypnea)
Monday, October 31, 2016
Fever : What questions to ask your patient and why
So we're familiar with the definition and measurement of fever. But while taking a case or interacting with a patient with this simple and most basic symptom , what all should we ask for to make sure we don't miss out on anything ?
1. Onset and Duration.
When did the fever begin - and for how long has it lasted. (This would give a clue whether the person suffers from an Acute Febrile Illness - which can generally be attributed to Infectious Disease , or a rather Chronic form of fever which could be due to Granulomatous diseases or even Neoplastic and Autoimmune conditions )
(Has it worsened or Become better since its onset. This gives a clue about the present status of the patient. )
(It's essential to include the presence or absence of chills+Rigors + Sweat immediately in the fever description. Presence of Chills and Rigors indicate any infectious process in the body and can be found in Malaria and UTI's among other conditions. Sweating after feeling hot and then cold is characteristically associated with Malaria)
(Important : Presence of the B Symptoms - which are Night Sweats ; Fever ; Weight loss. Seen with Lymphomas and TB)
(It's of extreme value to understand the pattern of the fever.
If the fever is present throughout the day with a variation of not more than 1°C it is of the Continuous Type : As seen in Enteric Fever and even UTI's .
If the fever is present throughout the day but the variation is more than 1°C it is of the 'Remittent' variety. It may not be possible to distinguish between these 2 on history alone.
Intermittent is when the fever stays only for some duration during the day and the patient is afebrile during the remaining part )
(Night rise of fever could be suggestive of Tuberculosis)
(Viral exanthems like Dengue , Chikungunya , Zika or even Rickettsial diseases commonly present with some form of rashes)
(Another possibility could be a primary Skin condition induced fever )
(Arboviruses like Dengue and Chikungunya are infamous for these. Arthralgia is especially debilitating in Chikungunya fever. Body ache is also common in both. Retro-orbital pain and Bifrontal headache are common with Dengue.)
(Presence of these - especially during the post monsoon season should raise suspicion of Leptospirosis or Acute Viral hepatitis. Enteric fever may be considered)
(Presence of these should raise query of TB or Pneumonia )
( UTI is a common cause of AFI especially in Diabetics )
( Characteristic of Meningitis /Encephalitis)
A.P.Burkholderia
Sunday, October 30, 2016
Study group discussion: Why are agglutinates not seen in warm type autoimmune hemolytic anemia?
Why are agglutinates not seen in warm type autoimmune hemolytic anemia?
Because the antibody is IgG. IgG is called incomplete antibody.
RBCs have a strong negative charge on their surface called zeta potential. So the shortest distance attainable between two RBCs is 18nm. IgM molecule has a large pemtameric structure, so it has a distance of 30 nm between two binding sites. Hence, it is able to agglutinate RBCs.
But the small IgG molecule has only 12 nm gap between two binding sites. So it can't bind to multiple RBCs and hence fails to agglutinate them.
So it just coats the RBCs, which is taken to spleen to be killed.
That's all!
Thank you, Divya, for explaining this to us =)
-IkaN
Saturday, October 29, 2016
Marijuana and cannabinoids intoxication mnemonic
Autonomic hyperactivity (Mild hypertension, dry mouth)
Racing heart (Tachycardia)
Injection (Scleral, conjunctival injection)
Judgement impaired
Uphoria (Euphoria)
Anxiety
Nystagmus
Ataxia
Step 2 CK: Treatment of narcolepsy and cataplexy
Patients with sleepiness severe enough to require medication can be treated with stimulant medications.