Hey awesomites! Happened to read two interesting things today-
1. The Y sperm is relatively lighter due to the acrocentric chromosome, amounting to the relatively skewed sex ratio towards males across the globe.
2. Homeobox gene 8 controls the expression of forelimbs, messing with it causes alters the position of the forelimbs.
That's all!
"There are two ways to learn something - One is through pure logic ie, from first principles (building up a concept). The other is mnemonics (To help retrieve info quickly... To avoid all the time and thinking taken to derive it).
The best thing is to learn both ways. If you forget the mnemonic, you can derive it from the concept. If you forget the concept, you'd at least have the mnemonic." - SG
Many people question whether mnemonics really help. This is what I have to say in explanation. Learn both like SG said. They'll help if you manage to remember, if you forget, you can use your knowledge and understanding to come to the same conclusion.
That's all!
SG is a good friend and is very philosophical on learning. These are some random thoughts that she sent and I thought of sharing them because I strongly agree!
-IkaN
Toxoplasmosis is transmitted through:
Cat bite
Droplets
Orofecal route
Cat scratch
This is a tricky question if you haven't revised parasitology. You'll vaguely remember the association with cats, so you'll be tempted to pick one which mentions the word cat.
Remember, toxoplasmosis is transmitted through cat feces, so orofecal route is the correct answer.
That's all!
-IkaN
Hi!
Drugs used for GBS prophylaxis mnemonic: PACE CV
Penicillin
Ampicillin
Cefazolin
Erythromycin
Clindamycin
Vancomycin
Indications of GBS prophylaxis:
- Previous infant with invasive GBS disease.
- GBS bacteriuria / positive culture during current pregnancy.
- Unknown GBS status with:
- Delivery at < 37 weeks
- Amnionic membrane rupture > 18 hours
- Intrapartum temperature > 100.4 (38.0)
That's all!
-IkaN
Hello!
SAAG is serum albumin ascites gradient.
SAAG is >1.1 in portal HTN, CHF, HVT and constrictive pericarditis.
The mnemonic for this is SAAG is High in conditions with an H.
portal Hypertension
congestive Heart failure
Hepatic vein thrombosis
Heart constriction (Constrictive pericarditis)
For completion, SAAG < 1.1 is seen in nephrotic syndrome, cancer and infections (except SBP)
That's all!
Have an amazing day!
-IkaN
Smoking is a risk factor for quite a number of cancers. But it can be protective for certain diseases as well..like ulcerative colitis.
It is also protective for endometrial carcinoma and how?
1. It reduces estrogen level
2. Decreases weight
3. Associated with early menopause.
Remember that endometrial cancer is due to excess estrogen..and even being obese or having diabetes mellitus is a well known risk factor
Irrespective smoking is bad for health. Each cigarette reduces your life span by 11 minutes or so they say.
Live happy stay healthy
-sakkan
Hey!
Thought this will help.
Dinosaurs are Extinct. Ex-two-inct.
Dinoprostone is PGE2.
Carboprost. Carbofrost.
Carboprost is PGF2 alpha.
MIsoprostol - M flipped is E and I looks like 1.
Misoprostol is PGE1.
That's all!
-IkaN
Hello!
Here's a mnemonic for biophysical profile: BAT HAM
Breathing
Amniotic fluid volume
Tone
Heart rate Acceleration
Movements
Here's an overview of interpretations from the BPP score.
BPP 10/10
BPP 8/10 (Normal AFV)
No fetal indication for intervention.
Repeat weekly.
BPP 6/10 (Normal AFV)
Equivocal. Repeat test within 24 hours.
BPP 4/10 (Normal AFV)
Fetal lungs mature (>37 weeks), deliver.
Fetal lungs immature, betamethasone, repeat test within 24 hours.
General rule: If oligohydramnios, consider delivery.
BPP 8/10 (Decreased AFV)
BPP 6/10 (Decreased AFV)
Assess clinical scenario, consider delivery depending on gestational age, risk of fetal, maternal death, etc.
BPP 4/10 (Decreased AFV)
If >32 weeks, deliver.
If <32 weeks, observe.
BPP 2/10
BPP 0/10
Deliver regardless of gestational age.
That's all!
I wrote this down from a number of resources, including uptodate
-IkaN
Here is some food for thought.
Think about which of the following scenario is worse:
1- Mom is O- and baby is O+ first pregnancy
2- Mom is O- and baby is O+ second pregnancy
3- Mom is O+ and baby is O+ second pregnancy
4- Mom is O+ and baby is A+ second pregnancy
5- Mom is O- and baby is A+ second pregnancy
6- Mom is O+ and baby is O- first pregnancy
Answer is 2
Rh incompatibility in second pregnancy. In presence of ABO incompatibility, Rh incompatibility, has lesser effect.
Detailed explanation:
The most common group O has anti A IgM, anti B IgM and anti AB IgG.
Group A has anti B IgM.
Group B has anti A IgM.
Group AB has no antibodies.
So if I was dumb enough to transfuse GroupyA blood to a group B guy there would be hemolysis. But what would be the mechanism for this?
The patient with group B would have anti A IgM. IgM is a very potent complement activator. IgM is very trigger itchy, it first shoots the cell and then asks questions. So this hemolysis is very fast.
Now coming to the Rh question, imagine there was a mom with O- group and baby with O+ group.
In first pregnancy, the mom is not exposed to the Rh antigen until delivery, so the 1st baby is safe. But there would be a mixture of baby and mom's blood.
Now imagine a weird person (Rh+ cell) walking through an airport, he would taken by the TSA (macrophage) for an "interrogation". So the macrophages do this interrogation (phagocytosis) in the dark corners of spleen and pick up info (antigens) about these weirdos. This info is passed to T cells and they issue warrants to B cells (IgG) for identifications of these guys and they are killed on site (IgG mediated destruction)
You can see that this will, obviously, take time time. When she gets pregnant with Rh incompatibile kid again, the IgG have been synthesized and they cross placenta and attack the baby RBC's. Voila - Hydrops fetalis.
Now imagine a mom who is O- and has a baby with A+ group. This time, at delivery, there is mixing of blood again!
But the mom has anti A IgM which is so fast like a ninja, kills of the majority of the cells before they go for their interrogation with macrophages in spleen... So ABO incompatibility actually protects against the Rh sensitization.
What's the clinical significance of Rh incompatibility?
Whenever you take care of a pregnant lady, you will confirm her blood group and if you suspect Rh incompatibility you would give her "Rh IgG" (standard dose) at 28 weeks, even though the fetal blood is not exposed to mom's immune system, this is done just in case - there might be a fall, injury etc and baby's blood may get into mom's circulation.
Why do you give Rh IgG when you want prevent the disease which is itself caused by IgG?
Rh IgG are heat treated and they cannot cross the placental barrier unlike normal IgG.
And finally, you give another dose of Rh IgG after delivery. But this time, you actually estimate the amount of fetal blood which is mixed with mom's blood by doing "Kleihauer betke test" and you give an appropriate dose.
Explained by DJ AweSpear.
Related posts:
Rh incompatibility
Hydrops fetalis
Blood group doubts
Removal of antigens from RBC's
Barts hemoglobin mnemonic
To make this post fun, I created hypothetical scenarios. This will help making a differential diagnosis =)
Scenario 1: Patient is a rose gardener.
Scenario 2: Patient is an aquarium cleaner.
Scenario 3: Patient is a vegetable labourer in a farm. Honey colored drainage is seen at the site of ulceration. It is followed by subcutaneous nodules draining the primary lesion.
Scenario 4: There was a painful chancre at the primary lesion. After 5 days, tender lymphadenitis developed.
Answers:
Scenario 1: Sporothrix schenckii
Scenario 2: Mycobacterium marinum
Scenario 3: Lymphocutaneous disease by nocardia brasiliensis.
Scenario 4: Tularemia
Reading material:
Sporotrichosis, often occurring in gardeners, remains the most recognized cause of nodular lymphangitis.
Injuries sustained in marine environments suggest Mycobacterium marinum infection.
An incubation time of 1 to 5 days, a painful chancre at the initial lesion site, and prominent tender lymphadenitis strongly implicate tularemia.
Frankly purulent discharge from the primary lesion is associated with some infections due to Francisella and Nocardia species.
That's all!
-IkaN
Karyotype in:
Turners syndrome
Kallmanns syndrome
Klinefelters syndrome
Answers:
45 XO
46 XX or 46 XY
47 XXY
Remember H for Hantavirus infections.
Hantavirus infections are associated with high Hematocrit, pulmonary edema (Heart failure like lungs), Hemorrhagic fever and Hypotension.
They're transmitted through deer mice feces.
That's all!
-IkaN
