Causes of Radio Radial and Radio femoral delay

Hello :)

Before this post I didn't realise the importance of checking and comparing both the radial pulses.

Pulse, by definition, is the expansion and elongation of the arterial wall imparted by the column of blood, passively produced by the pressure changes during ventricular systole and diastole.
Always report the pulse under following headings.

Assessment of pulse include :-

1. RATE (beats/min)
-Tachycardia (>100bpm)
-bradycardia (<60bpm)

2.RHYTHM
-regular
-regularly irregular (2nd degree heart block)
-Irregularly irregular (Atrial fibrillation, ventricular premature beat)

3.EQUALITY

4.CHARACTER

5.PERIPHERAL PULSES

6.APEX PULSE DEFICIT (atrial fibrillation )

7. RADIO RADIAL /RADIO FEMORAL DELAY

Today , I will discuss the causes of Radio Radial and Radio Femoral delay.

CAUSES OF RADIO RADIAL DELAY :-

1. Normal anatomical variations
2. Thoracic inlet syndrome, e.g. cervical rib
3. Aneurysm of Arch of aorta
4. Presubclavian coarctation
5. Supravalvular aortic stenosis
6. Pulseless disease
7. Peripheral embolism or artheromatous plaques
8. Artherosclerosis of aorta
9. Pressure over axillary artery by lymph nodes
10. Iatrogenic, Blalock-Tausig shunt operation in TOF

CAUSES OF RADIO FEMORAL DELAY :-

1. Coarctation of aorta
2. Artherosclerosis of aorta
3. Thrombosis or embolism of aorta
4. Aortoarteritis

That's all for today,
-Upasana Y. :)

Iodized salt test

Hello :)

We all know that salt is used as a medium for iodization.
Iodized salt is used prophylactically to prevent endemic goiter as public health importance.
Iodide deficiency disorder IDD include :-
-goiter
-Hypothyroidism
- Subnormal intelligence
-Mental retardation
-Neuromuscular weakness
-Hearing and speech defect
-endemic cretinism
-Still birth

To check whether given packet of salt contain iodine or not, we use different method.
Rapid kit test is one of the test.
The kit consist of 2 ampoule  test solution and 1 recheck solution bottle.
In the diagram I made 3 bottles to represent the 3 component of the test.
Alkalinity of salt doesn't give colour. So we use recheck solution in the end of the test .
The colour of the test sample is compared with the standard colour chart for calculating the salt iodine content.

I want to thank my teacher for an explanation :)

-Upasana Y. :)

Microbiology question

#Microbiology
#Medicowesome
A patient is suffering from features of septic shock with following clinical picture.Most probable causative organism is
A) Staphylococcus
B) Listeria
C) CMV
D) Meningococcus

Answer is "D" that is Meningococcus.
It is a classical case of Waterhouse-friderichsen syndrome/Purpura fulminans/Fulminant meningococcemia:It is simply trauma to adrenal gland causing extensive bleeding, multiple organ failure, leucopenia, thromobocytopenia and consistent development of DIC.Low level of blood glucose and sodium and high level of ACTH and potassium level is suggestive of adrenal failure.
It differs from other septic shock because of the presence of prominent hemorrhagic skin lesions petechia, purpura.

Image Based MCQ on Twin Pregnancy

Hello awesomites! 

Yesterday we posted an Image based MCQ on Twin Pregnancy. Here's the answer for it. 

#Radiology
#Obs_Gynae
Q. What is the diagnosis of the given USG image? 

A. Polyhydramnios 

B. Diamniotic Monochorionic twins 

C. Diamniotic dichorionic twins

D. Monoamniotic Monochorionic twins. 

The correct answer is C. Diamniotic dichorionic twins. 

The twin peak sign (also known as the lambda (λ) sign) is a triangular appearance of the chorion insinuating between the layers of the inter twin membrane  and strongly suggests a dichorionic pregnancy.  It is best seen in the first trimester (between 10-14 weeks). While the presence of a twin peak sign is a useful indicator of dichorionicity its absence, however, is not that useful in confidently excluding it.

It should be noted that the 'twin' in 'twin-peak' refers not to the presence of two peaks, but that it relates to twins. In pregnancies with more than two fetuses, the chorionicity and amnionicity of the each fetus may be different, and therefore this sign only aids in determining chorionicity of adjacent twins.

That's all! 

Thank you 

MD Mobarak Hussain (Maahii) 

Hill’s criteria in Aortic Regurgitation

Hey Awesomites

Normally, the lower limbs systolic blood pressure ( measured on popliteal artery by indirect method, using sphygmomanometer ) is 10-20 mmHg higher than that of upper limbs ( brachial artery ).

This is because:

1. The lower limb vessels are more muscular than the upper limb vessels.

2. Lower limb vessels are in direct continuation of the Aorta, whereas the upper limb vessels form an angle of 90°.

3. The increased blood pressure is the result of summation effects of reflected pressure waves.

As a result, the pressure waves are transmitted at a higher speed in the wall of lower limb vessels which then get reflected at the end to increase further with the incoming wave.

In Aortic Regurgitation, the greater amplitude of pressure waves results in exaggerated increase in systolic blood pressure of lower limbs vessels compared to that of upper limbs.

The grading of severity of aortic regurgitation based on Hill’s criteria is as follows :
Mild - difference of 20-40 mmHg
Moderate - difference of 40-60 mmHg
Severe - difference of >60 mmHg.

Thats all
Hope that helped :)
- Jaskunwar Singh

Image based MCQ on pediatric infections

Hey Awesomites

Yesterday we posted an MCQ on a pediatric infection with characteristic appearance of rash on face, involving both cheeks.

Image Based MCQ on Fracture

Hello awesomites!
Yesterday we posted an Image based MCQ on Fracture of forearm bones and here's the answer for it.
Q. The X-ray of forearm in AP and Lateral views as shown in the image is diagnostic of

A. Galeazzi fracture-dislocation
B. Barton fracture
C. Monteggia fracture-dislocation
D. Colles fracture

Ans: c) Monteggia fracture-dislocation

Monteggia fracture-dislocations is defined as fracture of the ulnar shaft along with concomitant dislocation of the radial head.

Mechanism: Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH).

Classification: The Bado classification is used to subdivide the Fracture dislocation into four types.

Type I: anterior dislocation of radial head (Most common)
Type II: posterior dislocation of radial head
Type III: lateral dislocation of radial head
Type IV: anterior radial head dislocation as well as proximal third ulnar and radial shaft fractures

That's all!
Thanks for your active participation.

MD Mobarak Hussain (Maahii)

Causes of chemosis mnemonic

Chemosis is known as oedema of conjunctiva.

Reason:due to exudation from the abnormal capillaries.This retained exudate gives a swollen and gelatinous appearance.

Regions: loosely attached areas of the bulbar conjunctiva and fornices.

Causes: ABC

A: Acute inflammations like gonococcal conjunctivitis, panophthalmitis, dacryocystitis, periostitis, orbital cellulitis.

B: Blood conditions (abnormal) like anaemia, urticaria, angioneurotic oedema, lymphocytic infiltration.

C: Circulatory obstruction in conditions like pulsating exophthalmos or due to pressure of an orbital tumour which may interfere with the lymph and blood drainage.

Thanks for reading.

Madhuri

Causes of hematuria mnemonic

Hey Awesomites

Some common Glomerular causes of Hematuria:
( mnemonic: GH )
- Glomerulonephritis ( post infectious, membranoproliferative, rapid progressive, IgA nephropathy )
- Henoch- Schonlein nephritis

Non - glomerular causes of hematuria :
( mnemonic : HEMATURIa )
- Hemorrhage ( cystitis, PCKD )
- Allergic reaction ( interstitial nephritis )
- Trauma or Tumors
- Urinary tract infections / increased Urinary calcium 

Thats all

- Jaskunwar Singh 

Renal colic : Important points

Hey Awesomites

Some important points to be noted regarding renal colic:

Tay Sachs Disease

Hello Awesomites!
Here's a Blog on Tay Sachs Disease and some common questions related to it.

Tay-Sachs disease

It is a genetic disorder that results in the destruction of nerve cells in the brain and spinal cord. Tay–Sachs disease is caused by a genetic mutation in the HEXA genes on chromosome 15. It is inherited from a person's parents in an autosomal recessive manner. The mutation results in problems with an enzyme called beta-hexosamidase A ,located on lysosomes,which results in the build up of the toxin GM2 ganglioside within cells. The most common type, known as infantile Tay–Sachs disease, becomes apparent around three to six months of age with the baby losing the ability to turn over, sit, or crawl. This is then followed by seizures, hearing loss, and inability to move. An eye abnormality called a cherry-red spot, which can be identified with an eye examination, is characteristic of this disorder. Death usually occurs in early childhood. Less commonly the disease may occur in later childhood or adulthood. These forms are generally milder in nature.Diagnosis is by measuring the blood hexosaminidase A level or genetic testing.

Frequently asked questions -

The substance which accumulates in Tay Sach’s disease is Ganglioside.
Deficiency of enzyme Hexosaminidase-A causes Tay Sach’s disease.
Cherry red spot at macula may be seen in Tay Sach’s disease.

That's all!
Thank you.

MD Mobarak Hussain (Maahii)

Myopathies series - Part 6

Hello :)

Now we will discuss individual myopathies in detail.

We have discussed the association between metabolic disorder and myopathies.
Metabolic myopathies Intro
Metabolic myopathies (differential diagnosis)
In this part, we will discuss the association between structure of cell (myocytes) and myopathy. Look at the diagrams below :-

Q.IDENTIFY THE GIVEN MUSCULAR DYSTROPHIES (Comment below)

In the next post, I will explain the pictures in detail.
I hope it helped.
-Upasana Y. :)

Fact of the day : Neurovascular knockout

Hey Awesomites

Stimulation of trigeminal nerve in the face, vagus nerve, or carotid sinus in the neck may cause a reflex drop in heart rate, dilatation of peripheral blood vessels, and constriction of cerebral blood vessels, which leads to a sudden loss of brain perfusion and unconsciousness. This type of knockout is called "neurovascular knockout".

Blow to the eyesocket, as during boxing may cause a similar knockout, called the oculocardiac reflex due to stimulation of trigeminal nerve ( ophthalmic branch ) and vagus nerve.

- Jaskunwar Singh