Tuesday, February 21, 2017
Fact of the day: Talking to yourself is a sign of smartness
Micro-organism series: Staphylococcus aureus
Aerobes and facultative anaerobes
Diameter: 1 micrometer
Gram profile: Gram positive Cocci
Arrangement: Grape like clusters
Motility: Non-motile
Sporeing or not: Non-sporing
Capsule: Usually capsulated. Non-capsulated strains have small amount of capsular material on the surface
Ordinary media: They grow readily with temperature range of 10-42°C ( Best at 37°C) and pH around 7.4 - 7.6
Nutrient agar:
You can remember how colony looks by the name STAPHYLOCOCCUS it self.
S - Smooth
O - Opaque
C - Circular
C - Convex
Easily emulsifiable.
It produces golden yellow pigment. Pigment production occurs best at 22℃ and only in aerobic culture. Growth represents "Oil-paint appearance".
Selective media:
Ludlam's medium - Lithium chloride and tellurite.
Mannitol salt agar or salt milk agar- 1%Mannitol, 7.5%NaCl, Phenol red indicator.
Columbia colistin nalidixic acid agar.
Liquid media: Turbidity.
Biochemical Reactions:
Oxidase : Negative
Mannitol: Positive
Indole: Negative
MR andVP: Positive
Phosphatase : Positive (Useful for screening as S epidermidis is negative or slightly positive )
Urease : Positive
Produces thermonuclease enzymes.
Virulence factors :
Extracellular enzymes :
Coagulase (Most virulent)
Lipase
Hyaluronidase
Staphylokinase
Toxins:
Alpha: Most important hemolysin.
Beta: It is sphingomyelinase. Exhibits hot and cold phenomenon.
Leucocidin and gamma lysin is grouped under synergohymenotropic toxins.
9 types of enterotoxins: Responsible for staphylococcal food poisoning. Causes nausea, vomiting and diarrhoea within 2-6 hours.
A, B, C1, C2, C3, D, E, H and I.
Super antigens:
Exfoliative
Enterotoxins
(What are superantigens and how do they work?)
Remember " SOFT PENIS"
S - Skin infections
O - Osteomyelitis and arthritis
F - Food poisoning
T - Toxic shock syndrome
P - Pharyngitis and Pneumonia (Rarely)
E - Endocarditis
N - Necrotizing fascitis
I - Impetigo
S - Sepsis
Sputum - Respiratory Infections
Blood - Septicaemia
Urine - UTI
CSF- Meningitis
Faeces - Food poisoning
Sterile containers should be used
Sterile swabs for specimen from nose/perineum.
Gram stained smears is useful in case of pus, cocci in clusters may be seen.
Treatment:
Sensitive to penicillin: Penicillin G is DOC (Drug of choice)
Penicillin allergy: Cefazolin is DOC
Methicillin resistant S.aureus: Vancomycin
Vancomycin resistant: S.aureus: Streptogramins, Linezolid, Telavancin.
That's all!
Finally done!
Stay awesome :)
Submissions: Adverse effects of Glucocorticoids mnemonic
Mnemonic is glucocorticoids itself!
Introduction to micro-organism series
Sunday, February 19, 2017
Fact of the day: Factors that are lost in stored blood
Saturday, February 18, 2017
Pierre Robin Sequence mnemonic
Pierre Robin Sequence is one of the most common causes of isolated cleft palate in the newborns. Here's the mnemonic for the triad of symptoms- PRS
P- Cleft Palate only
R- Retrognathia (abnormal posterior position of jaw and maxilla)
S- Support to the lingual muscles is lost (Glossoptosis)
The sequence is known to be caused by genetic anomalies at chromosome 2, 11 or 17.
That's all
- Jaskunwar Singh
A Neurology Case Discussion
Hey guys, let's ponder upon the following case.
Before reading this case, just know that this is a case of cerebellar tumor. Now try to localize the tumor in the cerebellum by taking help of the symptoms of this kid. This will help you in the differential diagnosis given later.
A 4 year old complains of headache, drowsiness and occasional diplopia; he is unsteady on his feet with frequent falls. Examination demonstrates truncal ataxia, sometimes accompanied by incoordination of the limbs; variable ophthalmoparesis and papilledema on fundoscopic examination.
Any guesses on what this could be?
Ok so here goes the case discussion:
Medulloblastoma typically presents with a midline cerebellar syndrome, with hydrocephalus and resultant increased intracranial pressure.
Clinically, it can be distinguished from ependymoma involving the fourth ventricle by the early appearance of nausea and vomiting in the latter, due to involvement of area postrema. Cranial nerve palsies may appear with either tumor, and increasing intracranial pressure is typical of both.
The predominance of signs suggesting primary involvement of vermis distinguishes medulloblastoma from cystic or solid astrocytoma of the cerebellum which typically involves a cerebellar hemisphere rather than the vermis. Although rarely there are midline midline astrocytomas.
You are awesome if you were able to get this one right. :)
-VM
Fact of the day: Genesis of the U wave
Hey guys!!
As you know the U wave in the ecg is seldom seen especially in leads V2 and V3 physiologically especially during bradycardia.
And it is seen pathologically in Hypokalemia.
So how is it generated?
If you are thinking due to repolarization of papillary muscles, let me tell you that this hypothesis is now obsolete.
There are three trending theories at present trying to explain it:
1. Delayed repolarization of the subendocardial Purkinje fibres.
2. Prolonged repolarization of the midmyocardium ( M cells)
3. After-potentials resulting from mechanical forces in the ventricular wall.
That's it!
-VM
Friday, February 17, 2017
Fact of the day: Citrobacter causes brain abscesses in neonates
Why does cyanotic heart disease predispose to brain abscess?
Step 2 CK: Treatment of Multiple Sclerosis and mnemonics!
This post is all about treatment of Multiple Sclerosis.