How to use EndNote for Windows (For beginners only)

Approach to seeing patients on July 1st for Internal Medicine residents

Zika virus mnemonic

Two components of Sulfasalazine : Indications

Hello

Sulfasalazine has two components:
- 5-ASA
- Sulfapyridine (SP)

High-yield : Risk of stroke with cardioversion

Hello

Electrical/chemical cardioversion performed in a case of atrial fibrillation may carry a high-risk of stroke, especially if >48 hours of time has passed (thrombus formation takes about 48 hours).

Causes of holosystolic murmur mnemonic

Hello

Causes of holosystolic murmur: MTV reality shows
- Mitral regurgitation
- Tricuspid regurgitation
- Ventricular septal defect

- Jaskunwar Singh

High-yield : Absence of tachycardia in cardiac tamponade (mnemonic)

Hello

Tachycardia is a characteristic feature of decreased systolic blood pressure in the patients of cardiac tamponade. However, there are exceptions to be taken care of during diagnosis and workup on the patients with following conditions (absence of tachycardia):

A Factor A Day Keeps Colon Cancer Away

Protective Factors For Colon Carcinoma

A - Aspirin,vitamin A 
B - Bisphosphonates
C - Calcium, Coffee, vitamin C
D - Dietary Fiber
E - vitamin E
F - Fruits
G - Green Vegetables

Chest pain in acute pericarditis vs myocardial infarction

Hello

Acute myocardial infarction is one of the miscellaneous causes of acute pericarditis. Differentiating features of chest pain in these two cases are many, but the high-yield points to be noted are:-

Mnemonico diagnostico - murmur in mitral stenosis

Hello

Mitral stenosis murmur features:
(mnemonic: MITRAL STENOSIS)

Pericardial knock v/s Pericardial rub

Hello

Pericardial knock:
- most common cause is constrictive pericarditis
- occurs during the healing phase of the disease (fibrocalcifications)
- during the early diastolic phase of cardiac cycle (after opening snap)
- On auscultation: high frequency sound

Pericardial rub:
- commonly seen in acute fibrinous or sero-fibrinous pericarditis
- sero-fibrinous exudate in between two layers of pericardium (disease process going on)
- may occur during ventricular systole, or ventricular early diastole (due to expansion) or late diastole (due to atrial contraction).
- on auscultation: rough scraping sound described as "leather rubbing against leather"


That's all
- Jaskunwar Singh

Apraxia vs autotopagnosia

Hello Awesomites !

Here we will discuss two from many parietal lobe lesion.

1.APRAXIA

Inability to carry out well organized voluntary movement correctly.
Despite motor, sensory & coordinated functions are not significantly impaired.

Ideomotor : It is a type of apraxia.
Patient performs the task but makes errors; there is a common tendency to substitute a body part for an object.

2.AGNOSIA

Abnormalities of perception of sensation despite normal sensory pathways.

Visual & body perception are impaired in parietal lobe lesions 

Agnosia of body scheme or autotopagnosia

Inability to locate, identify & orient one’s body parts.

Suppose while on rounds in neurology ward:- You see a patient brushing his knee early morning.(according to above discussion)

Apraxia -Patient has forgotten how to use toothbrush.Brushing knee as a toothbrush rather than pretending to hold one.

Autotopagnosia- the patient has forgotten the body part itself.

In either case localisation of lesion is PARIETAL LOBE.

Isn't the interpretation of one neurological sign seems interesting?

"Eyes see what mind knows"

Below is the link which is very descriptive and I came across it while reading more on this topic.

Parietal lobe

Happy studying !

-Upasana Y.

Beta 2 agonist and effect on muscles

Hello Awesomites !

I used to have a doubt why does Salbutamol cause uterine relaxation but causes contraction of skeletal muscle and cardiac muscle(tremors and tachycardia)?

Despite they have same receptors (Beta 2) how can be the action on muscle is so different.
Grossly it seems like one receptor Beta 2. This beta2 adrenergic receptor is a type of GPCR.
GPCR  are Gs, Gq ,Gi type.

Beta 2 receptor anywhere (Uterus -smooth muscle, heart- cardiac muscle, hands- skeletal muscle) is also same type of GPCR i.e Gs.

Still no difference.

Gs activates adenyl cyclase to form cAMP from ATP.
cAMP increases in all type of muscle on stimulation of Beta 2 receptor.
But it cause relaxation in smooth muscle (inhibit myosin light chain kinase)
And causes contraction of heart and skeletal muscle (activate cAMP dependent protein kinase A lead to activation of L-type calcium channel).

At one level we all may appear to be doing same thing yet at other level we are different and have our role.:)

 Happy studying !
-Upasana Y.