Vitamin D and multiple sclerosis

Hey awesomites!

Since I have written posts regarding the association of vitamin D deficiency with certain neurological disorders previously, I am here again with one more addition into the box (on sincere request of our main author IkaN.. :p ).

Anticholinesterase

Hey here is exclusive classification of anticholinesterase drugs !,hopefully it will be useful.

~Ojas

Hypoglycemia mnemonic

Hypoglycemia may present as a mere symptom of a disease or a life- threatening condition itself. I have made a mnemonic on the common signs and symptoms in a patient of hypoglycemia. Here it is..
METABOLISM

M- Mood swings
E- Excess sweating
T- Tachycardia
A- Adrenal fatigue
B- Blood pressure changes
O- Obesity
L- Lips tingling
I- Increased appetite/ hunger
S- Shakiness (tremors)
M- Muscle pain


That's all
- Jaskunwar Singh

Crispy C.R.I.S.P.R.!

10 years ago,only a few would have thought that a device in our pockets would be good enough to access all the information of the world, would do social networking, calls, would calculate, act as a torch and what not. 

We today are on a similar brink ofrevolution in genetic engineering, where the effects would be so magnificent that they would need to be measured on a Richter scale! 

Enter CRISPR, which is an acronym for 'clustered regularly interspaced shortpalindromic repeats', a  crispy new technology which promises to shrink the costs involved in genetic engineering by 90%, makes the procedure easier andshorter.

*What is it? 
We have managed to hack an antibacteriophage mechanism in bacteria to our advantage. 

Only a few bacteria survive bacteriophage invasion. To protect themselves from a further invasion, they store a part of the phage DNA into their archives. 

When another attack does occur, an RNA copy of the archived phage DNA is presented to what is known as a CAS 9 protein.

CAS 9 compares the two copies, one from the foreign DNA and the other from the archives, and is very precise at that. 

If it finds a 100% match, it cuts off thenew phage's DNA, thus rendering the attack a big embarrassment for the bacteriophage. :-p 

*What can we do with it? 
Oh, a lot of awesome things! 

-Pissing off viruses
In 2015, scientists armed with CRISPR achieved a significant reduction of HIV load from patiens. 
This year, in mice, they slashed off 51% HIV DNA from mice, just by a couple of shots in their tails! 

*Making cancer re evaluate its careerchoice- 
Malignant cell detection by the immune system can be enhanced. 

*Designer babies- 
A lot of desirable traits- super awesome eyesight, superman esque strength and so on, can be selected from a wide palette during embryogenesis.

*Bidding adieu to genetic diseases

*Making ourselves look hot at 120-

CRISPR holds the potential to slow and even reverse ageing! We can take a leaf off the books of certain aquatic species who already are doing that. 

.. and a lot more. 

*The last word
A few controversies sorround though.
- We don't know if any adverse 
  reactions may triggered, as our 
  knowledge is still just the tip of the
  iceberg.
- Some powers like say dictators
   might use it to gain precedence.
- The fear of genetic pollution.

Anyway, these are just hurdles which we need to plan and overcome for a glorious future for humanity! 

Source- Kurzgesagt. 


  

Symptoms of corneal disorders mnemonic

I was studying corneal disorders and dystrophies, infections, inflammations today and noticed many common symptoms in the patients.

Now since its the matter of the eye, I must tell you how much I love photography and also i used to do some painting stuff long ago. So i made a random mnemonic out of it for the symptoms of corneal disorders.. :p

DSLR Photography and Painting Workshops.

D- Decreased vision

S- Sensations (foreign body)

L- Lacrimation

R- Redness

P- Photophobia

P- Pain

W- white cornea

Thats all

- Jaskunwar Singh

Bullous skin disorders-1 pemphigus vulgaris and bullous pemphigoid

Pemphigus vulgaris

http://www.medpictures.org/pemphigus-vulgaris-pictures.html

Bullous pemphigoid

http://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1#!prettyPhoto



these two are the most commonly asked questions within bullous diseases.
the major difference you need to know is
pemphigus vulgaris- bullae are suprabasal. hence these are not tense and rupture easily..not very common in a clinical case for you to find a bulla
bullous pemphigoid- bullae are subepidermal..and hence tense.

a mnemonic..like a bull..bullae in Bullous pemphigoid are tough and stronger

-sakkan

Layers of retina

Retina consists of 10 layers of cells and their nuclei so I tried to make it easier to memorize all layers. A lame one but hope it helps.. :p

There are outer 5 layers. So the outer ones start with 'O' in the first letter. And the inner 5 layers initiate with 'I' in the first letter.

That's all

- Jaskunwar Singh

Symptoms of conjunctival disorders mnemonic

Symptoms of conjunctival disorders:-

RED AF

R- Redness

E- Edema of conjunctiva

D- Discharge

A- (a)ecchymosis

F- Foreign body sensation

That's all

- Jaskunwar Singh

Medipicsowesome: Adams Oliver syndrome

Hey everyone!

Hope you are enjoying Medipicsowesome!

Adams–Oliver syndrome (AOS) is a rare congenital disorder characterized by defects of the scalp and cranium (cutis aplasia congenita), transverse defects of the limbs, and mottling of the skin.

The baby has a defect in the frontal and parietal bone and terminal limb defects in the legs.

That's all!

-IkaN

Serological And Viral Markers Of Hepatitis B Infection Made Easy

Hello everyone
This is Shubham Patidar . Today I am posting my notes on Serological  and Viral Markers of Hepatitis B Infection  in concise and simple way. This is very important short note ask in pharmacology, pathology, community medicine, medicine , microbiology, in undergraduate theory exam . and mcq comes in post graduate medical examinations.
Enjoy Learning !
That's all !

Past Pointing Mnemonic

Hi everyone !
So this is another short post about 'Past pointing'. I hope you don't consider it pointless to discuss this. (I know, play along.)

There are a few tests called 'Finger-Nose-Finger' test and 'Finger-Nose' test. These detect how controlled and precise your movements are.
Say, for example , I ask a patient to touch my finger (which I place directly in front of him), then touch his own nose and touch my finger once again.
A normal person should be able to do this correctly and accurately.
However, in lesions of at least 2 structures of our body , the patient's finger overshoots the examiner's or can't seem to reach it correctly.
This is called 'Past Pointing' , as the patient shoots past the destination point.

2 important lesions where you get this are :
1. Cerebellar
2. Vestibular

So, in a Cerebellar lesion things are very straight forward.
You'd get pastpointing only on the side of the lesion as only that side has become stripped from the cerebellar control. The other side has intact Cerebellar control.
Cerebellum = Same side Past Pointing.
Cerebellum is Single and Lonely

The Vestibular System defects are slightly more complex and also very controversial. So irrespective of which side you try, you'd get Bilateral past pointing in a Vestibular lesion.
However,
Such a pastpointing is generally more prominent on the side of the Slow Component of the nystagmus produced (Whatt?). Yeah. Also, the Slow side of nystagmus and the side of past pointing are also the same as the side to which you'd lose your balance in a Vestibular disorder !
So Remember :
My SLOW Vestibular friend FALLS to pointy end but can Swing BOTH ways .
So Slow Component of nystagmus , and Falling during gait testing would be present and Pointing would be towards the same side too.
But Past Pointing can Bilateral (Swings both ways).

Hope this helps. Let me know how I can improve it!
Happy studying ! :)

~A.P.Burkholderia

Symptomatic variations in cough

Hey Awesomites!

Cough is a common symptom that may be associated with an infection of upper respiratory tract, which if not given attention to can progress to a life- threatening chronic disease! Normally, its just a common reflex that helps clear mucus off from the throat and the upper airways. But there are certain variations in the presence and progression of cough. So what is your cough trying to tell you about your health? Let's know about this...

Vestibular Apparatus Mnemonic

Hi everyone. This is just a short post to help you remember the functions of the Vestibular System. Memorising this always gives me a vertigo. ;)

The Vestibular System has 2 components :
1. Semicircular canals
2. Utricle and Saccule.

So the Vestibular System detects the following :

Angular Acceleration/Rotational movements.
Linear Acceleration.
Gravity.
Position of Head in space.

So the Semi circular canals are concerned with Angular Acceleration. You can remember that as :
Circle = Rotates ; So SCC detect Rotational movements or Angular Acceleration

The rest are functions of Utricle and Saccule.
Remember : GPL - Girls Premiere League.
For : Gravity, Position of Head and Linear acceleration.

Now  remember :
Saccule - NOT Sleeping line. So Vertical movements.
And
Utricle - Horizontal (since sleeping line was not Saccule it will be Utricle)
Another way would be "UHH' Utricle for Horizontal.

Hope this helped you.
Happy studying ! :)

How to apply for USMLE exams: ECFMG certification using IWA in detail

This is a continuation of the main post, How to apply for USMLE exams (http://www.medicowesome.com/2016/12/how-to-apply-for-usmle-exams.html)

Step 3 is elaborated in detail here:

Medipicsowesome: Thanatophoric dysplasia

Hello!

First post of Medipicsowesome. Yaay!

Thanatophoric dysplasia (TD) is a lethal skeletal dysplasia. It is the 2nd most common lethal skeletal dysplasia after osteogenesis imperfecta type II.

It is characterized by extremely short limbs and folds of extra (redundant) skin on the arms and legs.

Other features of this condition include a narrow chest, short ribs, underdeveloped lungs, and an enlarged head with a large forehead and prominent, wide-spaced eyes.

Type I thanatophoric dysplasia is distinguished by the presence of curved thigh bones and flattened bones of the spine (platyspondyly).

Type II thanatophoric dysplasia is characterized by straight thigh bones and a moderate to severe skull abnormality called a cloverleaf skull.

This baby seems to have type II thanatophoric dysplasia.

The condition is uniformly fatal within a few hours of birth either from respiratory failure or from brainstem compression from a narrow foramen magnum.

This baby died a few hours after birth.

Cool fact: The term thanatophoric derives from the Greek words "thanatos" meaning "death" and "foros" meaning "bearing/carrying/bringing".

That's all!
-IkaN

Medipicsowesome: An introduction

Hello!

The Medicowesome family has decided to create a library of medical pictures. Excited? =)

We are going to label all these posts as Medipicsowesome.

It'll contain pictures of specimens, diseases, instruments, etc.

Since we wish to avoid copyright issues, we will be taking permission for most pictures / giving credits from which they're taken. If a picture belongs to you and you do not wish to see it uploaded on the site, email us at medicowesome@gmail.com and we will take it down immediately.

I have taken permission from the patients for pictures clicked in my wards, explaining they'll be uploaded on the blog for medical students to learn. Only after their permission, I have uploaded the pictures. To maintain confidentiality, I will blur eyes / faces too.

If you want to share cases you've seen on Medipicsowesome, we'll be happy to upload it. Just email us the picture with a description and make sure you have the permission of the patient!
Email: medicowesome@gmail.com
Subject: Medipicsowesome submission

That's all!
The idea was come up by all authors, especially, Sakkan. Thanks for the encouragement everyone else! < 3
-IkaN

Median nerve

Median nerve
Root value :C5-T1
IMP points
1)Median nerve is most medial content of Cubital fossa
In Cubital fossa it gives 3
Branches to flexor muscles
Remember this mnemonics
Feel Climate (in) Rajasthan,Days (in) Singapore (in) PLs
Flexor carpi radialis  .(FELL CLIMATE -Rajasthan)
Flexor digitorum superficials(Days
in -Singapore) 
Palmaris Longus (PLs) .
In forearm it gives Anterior interosseous branch which supplies:-
1)Lateral half of flexor digitorum profundus (Well,medial half is supplies by ulnar nerve)
2)Pronator quadratus(my Fav!)
3)Flexor policies Longus(Extensor policies Longus and brevis both supplied by radial  nerve)
In palm ,median nerve supplies 5 muscles !
3 thenar muscles ,(Abductor pollicis brevis ,flexor pollicies brevis  ,opponens pollicis )
Lateral 2 lumbricals!
Clinical anatomy:
1)Known as labourers nerve /eye of hand
2)Pointing index finger occurs due to paralysis of long flexors of digit .
3)Ape or monkey thumb deformity if thenar muscles are paralysed
4)Must know carpal tunnel syndrome(Happens when median nerve is trapped )REMEMBER Skin over the thenar eminence is not affected as the branch of median nerve supplying it arises from forearm
5)FROMENT's.sign/Book holding test &paper holding test is done to test median nerve .
6) Complete claw hand when Ulnar and median nerves are paralysed.

~Ojas

Hyperplasia - Physiologic or Pathologic?

Hyperplasia means increase in the cell number.

It tends to occur only in organs where the cells retain the ability to divide. It can be physiologic or pathologic.

The morphology of the organ on gross or the cells on microscopy does not differ in physiologic or pathologic hyperplasia. What differentiates the two is the inciting stimulus.

for eg- Breast/ Endometrial hyperplasia is a feature of pregnancy as well as in certain hormone producing tumors of the ovary. The tissue microscopically, only shows increased number of mature cells. However, the hyperplasia that occurs due to pregnancy (physiologic) process is labelled as "Physiologic" while that which occurs due to ANY pathologic process is labelled as
"Pathologic" hyperplasia.
 

An AIDS patient with abnormal CT scan

Hey! Here's a case kinda thingy that I made up.

An HIV positive male presents with loss of recent memory and left sided paralysis. A CT scan is done. What are the differentials based on the CT findings given below?

1. Multiple ring enhancing lesions
2. Single, periventricular ring enhancing lesion
3. Cerebral atrophy with secondary ventricular involvement
4. Multiple non enhancing white matter lesions

Answers given below
.
.
.
.
.

1. Multiple ring enhancing lesions - Toxoplasmosis. TMP SMX for prevention!

2. Single, periventricular ring enhancing lesion - CNS lymphoma. Usually, positive for EBV.

3. Cerebral atrophy with secondary ventricular involvement - AIDS dementia complex. Though paralysis would not be a feature. Only defects in short term memory and executive function is seen.

4. Multiple non enhancing white matter lesions - Demyelination of subcortical white matter suggestive of progressive multifocal leukoencephalopathy is caused by JC virus.

That's all!
-IkaN

ALS and Riluzole mnemonic

Riluzole is a glutamate inhibitor which is used in Amyotrophic laterla sclerosis.

How to remember this?

Unnecessary mnemonic #521

Rilu glues all.
Rilu - Riluzole
Glues - Glutamate inhibitor
Al - ALS

That's all!

I'm sorry, that was a terrible mnemonic. Forget ice bucket, I'd win the pathetic mnemonic bucket challenge :P

-IkaN

CSF rhinorrhea and meningitis treatment

Today I was asked a question in ENT viva that- in a patient of CSF rhinorrhea due to traumatic aetiology, what measures will you take to prevent the onset of meningitis and how will you manage the condition?