Smile, stay confident.
Keep calm.
And rock those vivas!
This video is on how to not make silly mistakes during pracs!
Keep calm.
And rock those vivas!
This video is on how to not make silly mistakes during pracs!
Monday, January 9, 2017
The SAAG solution (Serum-Ascites Albumin Gradient simplified)
Yo people!
A good friend of mine asked me to review the concept of SAAG. So let's dive into a "Puddle" of ascitic fluid. :P
As you guys all know, SAAG stands for Serum-Ascites Albumin Gradient and it helps to differentiate the causes of ascites. What it means is pretty self explanatory, it is the difference (gradient) between the levels of albumin (a plasma protein) in two compartments i.e. Serum and Peritoneal fluid.
A good friend of mine asked me to review the concept of SAAG. So let's dive into a "Puddle" of ascitic fluid. :P
As you guys all know, SAAG stands for Serum-Ascites Albumin Gradient and it helps to differentiate the causes of ascites. What it means is pretty self explanatory, it is the difference (gradient) between the levels of albumin (a plasma protein) in two compartments i.e. Serum and Peritoneal fluid.
Tetralogy of fallot
Hello readers today's blog is small one -Fallot's tetralogy .
What is Fallot's tetralogy?
It is a congenital disorder of heart .It is caused to foetus may be because of alcoholic mother or who has diabetes or may be due to rubella infection caused during pregnancy.It is caused due to deletion of chromosome 22
Signs and symptoms:-
As the name suggest ,there are four signs
All four of them are related to heart .
Mnemonic is PVR -f cinema.
-Pulmonary stenosis
-Ventricular septal defect .
-Right ventricular hypertrophy
-Over-riding of aorta ,due to which blood from both the ventricles may enter aorta.
Due to defect in heart ,there is low oxygen supply to tissue this may lead to cyanosis when there is high amount of pulmonary stenosis but when there is moderate amount of pulmonary stenosis this may lead to pink tit that is pinkish colouration of skin.There is also clubbing .
Treatment:
Open heart surgery is only treatment for fallots tetralogy .
The appropriate time for surgery depends on the pulmonary stenosis .
However patient should be on life long medication for healthy life
That's all :)
Have a happy day.
~Ojas
Microbiology of legionella mnemonic
Legionella: Facultative intracellular, gram negative rod
Pili: They are all involved in adherence and intracellular replication of L. pneumophila
Flagella: Within the host cell vacuole, legionella are nonmotile, whereas in the later stages of infection and cell lysis, legionella are flagellated and highly motile. Motility enables Legionella to escape from a spent host and facilitates its attempt to find a new host by dispersion into the environment.
Flagella: Within the host cell vacuole, legionella are nonmotile, whereas in the later stages of infection and cell lysis, legionella are flagellated and highly motile. Motility enables Legionella to escape from a spent host and facilitates its attempt to find a new host by dispersion into the environment.
Sunday, January 8, 2017
Extra Ocular Muscles Insertion : Mnemonic
Hello everyone ! I hope you'll have been enjoying the Top 10 Series that we've started. This is a short post on the insertion of Extra ocular muscles in the eye.
So there are 4 Extra Ocular muscles whose insertion on the sclera we need to be aware of ( in terms of distance from the Limbus). The Recti.
Remember :
I'M Low Standard
I'M Low Standard
I = Inferior Rectus. 5.5
M = Medial Rectus 6.6 (or 6.5 but just remember 6.6 for easiness)
L = Lateral Rectus 6.9 (Loser)
S = Superior Rectus 7.7
M = Medial Rectus 6.6 (or 6.5 but just remember 6.6 for easiness)
L = Lateral Rectus 6.9 (Loser)
S = Superior Rectus 7.7
So basically it starts with 5.5 , 6.6, 6.9 and finally 7.7.
3 of these are the same number repeated (5.5 , 6.6 and 7.7) but LR is a loser. Hence it does not follow the rule and is a badass hence does a 69. :p
3 of these are the same number repeated (5.5 , 6.6 and 7.7) but LR is a loser. Hence it does not follow the rule and is a badass hence does a 69. :p
Hope this helped !
Thank you.
Happy studying!
Thank you.
Happy studying!
~A.P.Burkholderia
Temporomandibular joint: Notes for MBBS exam
In today's blog, we will be showing you how to write answers of joint in your theory exams.
Example question: TMJ
I would like you guys to know that since there is a lot of time limitation in theory exams, you should:
1. Draw diagrams ("Anatomy paper without diagram is as good as flower without fragrance!")
2. Name everything you know
3. Elaborate
Before the exam, choose the diagrams you would draw for sure and optional diagrams ("If I get time...")
Saturday, January 7, 2017
ADRs of Sulphonamides mnemonic
Hey Awesomites!
Adverse drug reactions of Sulphonamides mnemonic-
SULPHONAMIDES
S- Stevens- Johnson syndrome
U- Urinary crystals formation and bleeding
L- Lyell's syndrome (TEN)
P- Photosensitivity
H- Hepatic/ Hematologic
O- Ocular side effects
N- Neonatal jaundice/ Nausea and vomiting
A- Antimetabolites (inhibit folic acid synthesis)
M- Miscarriage (pregnancy and fetal abnormalities)
I- Intolerance
D- Dermatitis
E- Eosinophilia
S- Serum sickness
Thats all
- Jaskunwar Singh
Adverse drug reactions of Sulphonamides mnemonic-
SULPHONAMIDES
S- Stevens- Johnson syndrome
U- Urinary crystals formation and bleeding
L- Lyell's syndrome (TEN)
P- Photosensitivity
H- Hepatic/ Hematologic
O- Ocular side effects
N- Neonatal jaundice/ Nausea and vomiting
A- Antimetabolites (inhibit folic acid synthesis)
M- Miscarriage (pregnancy and fetal abnormalities)
I- Intolerance
D- Dermatitis
E- Eosinophilia
S- Serum sickness
Thats all
- Jaskunwar Singh
Neurodevelopmental maturity and adulthood
Hey Awesomites!
When do you really attain adulthood?
18. That's when you are legally declared an adult. Right? Oh so you already got the answer. Hey no wait.. we are medical professionals and students of science. So talking in a legal way doesn't always seem right, because from a scientific perspective, adulthood is still an unsolved mystery. Let me tell you about it here..
When do you really attain adulthood?
18. That's when you are legally declared an adult. Right? Oh so you already got the answer. Hey no wait.. we are medical professionals and students of science. So talking in a legal way doesn't always seem right, because from a scientific perspective, adulthood is still an unsolved mystery. Let me tell you about it here..
Friday, January 6, 2017
Increased Intracranial pressure clinical features mnemonic
Increased intracranial pressure clinical features mnemonic- 5Ps
P- Persistent projectile vomiting (due to stimulation of CTZ)
P- Persistent headache (the patient presents it as the "worst" headache of his life)
P- Palsy (sixth nerve palsy and diplopia)
P- Papilledema (bilateral)
P- Personality disturbances (behavioral changes)
Thats all
- Jaskunwar Singh
The basics :Parkinson's disease
Hey,Hello! awesomites ,this blog is just a small review of some old and new things I learned about Parkinson's disease.
The very first thing I learned is:- parkinson's disease and parkinsonism are two different terms !!!.
-Parkinsonism is a complex term it includes many symptoms while parkinson's disease is a progressive neurodegenerative disorder .
-Parkinosons disease is actually cause of parkinsonism .
Let's start with Parkinson's disease
-Main cause is decrease dopamine secretion in body mainly due to injury to substantia nigra which sends dopamine secreting nerve fibers to caudate nucleus and putamen.
Signs and symptoms:
- Characteristics features is tremors .Tremors occurs during all walking hours and therefore it is a type of involuntary tremor in case of cerebellar disease there is an intension tremor because tremors are seen when patient perform any work.
-Also festinant gait is found
-Akinesia is also seen
-Lead-pipe rigidity is seen earlier in hands and legs followed by neck and trunk.
Causes:
-Any serious injury that affects dopamine secretion !
-Also some medication which decreases dopamine secretion or blocks dopamine receptors.
-Apart from that certain drugs also induces Parkinson's disease like drugs used to treat schizophrenia and other neuroleptic drugs like
Clozapine.
Risperdal.
Quetiapine.
Apart neuroleptic drugs,others drugs like prochlorperazine,metoclopramide.
Also calcuim channel blockers causes Parkinson's
Drug induced Parkinson's remains same ,it doesn't progress
Categories of drugs used for treatment of parkinsonism:-
-Dopamine agonist.
-Anticholinergic.
-COMI inhibitors.
~Ojas
Thursday, January 5, 2017
The basics : Constipation
Today I am gonna give some brief review about how to treat constipation .So let's start with basics
Why constipation occurs ?
-Water serves as a transporter of stools ,decrease in concentration of water in intestine can lead to constipation ,it may be either due to increase absorption from the extracellular space or decrease water content in body.
-Decrease bowel moment
How to treat constipation?
-As now we know cause of the constipation ,we can treat constipation either by :-increasing water content or decrease loss of water from intestinal lumen
And also by increasing bowel moments so less water or salts are absorbed (Yet some drugs uses another mechanism.)
Drugs used :-
1)We can use Dietary fibers which will just form a bulk in intestine and will increase water content of faeces ,also due to bacterial degradation some osmotic active substances are produces which further increases water content Hey but there is one drawback ,it may causes gas :D.
2)Stool softeners:
-They permit water and lipid to penetrate stool .
-They are either given orally or rectally!
(Yes a drug acting on intestine can also given rectally)
-Again there is one drawback ,prolong use can cause impair absorption of fat soluble vitamins ( A,D,E,K)
3)Osmotic laxatives (Laxative is term used for drugs for treatment of constipation)
-Colon can neither concentrate /dilute fecal fluid so fecal fluid is isotonic throughout the colon
-Generally we use non-absorable sugars /salts eg:-Magnesium citrate & sodium phosphate.
-Osmotic laxatives are commonly used but should not be used in patient with renal insufficiency.
-But patient using sodium phosphate must take adequate water to compensate fluid loss due to it
,It may causes hyperphosphatemia,hyper natremia , hypocalcemia,hypokalemia.
-So should not be used in cardiac patients
4)Stimulant laxatives
a) Anthraquinones:It after hydrolysis produces bowel moment in 6-12hrs if given orally or within 2 hrs if given rectally.!
-It may causes melanosis coli.
b)Diphenylmethane derivatives : It increases bowel moments in 6-10hrs when given orally and in 30-60mins when given rectally.
-It has minimum systemic absorption
5) Opioid receptor antagonism
-Now this is an interesting type of drug mechanism rather than increasing motility it "decreases" motility .
Confused ?!!
Still it is used in prevention of constipation ?!
Yes ,by decreasing motility it prolonges the transient time required for absorption of water and salts from surrounding
Eg:-Methylnaltrexone & alvimopan.
~Ojas
Wednesday, January 4, 2017
The basics: Peptic ulcer
Peptic ulcer is excoriated area of stomach or intestinal mucosa caused by excessive gastric acid secretion or upper intestinal tract secretion .A type of peptic ulcer called as marginal peptic ulcer is caused during surgical process whenever there is opening made in between stomach and jejunum of small intestine like gastrojejunostomy.
Common site of peptic ulcer ?
Mostly on lesser curvature of antral end of stomach and rarely on lower end of stomach.
Mostly on lesser curvature of antral end of stomach and rarely on lower end of stomach.
Causes of peptic ulcer ?
1)Increase in acid secretion and peptic content in stomach .
2) Irritation to mucosa.
3)Poor blood supply .
4)Poor secretion of mucus.
5)Infection by H.pylori.
1)Increase in acid secretion and peptic content in stomach .
2) Irritation to mucosa.
3)Poor blood supply .
4)Poor secretion of mucus.
5)Infection by H.pylori.
Treatment of peptic ulcer.
We give anti-ulcer therapy for peptic ulcer treatment
Following are goals of anti-ulcer therapy
a) Relief of pain.
b)Ulcer healing.
c)Prevention of complications.(like bleeding ,perforation)
d)Prevention of relapse.
We give anti-ulcer therapy for peptic ulcer treatment
Following are goals of anti-ulcer therapy
a) Relief of pain.
b)Ulcer healing.
c)Prevention of complications.(like bleeding ,perforation)
d)Prevention of relapse.
Approach of treatment of peptic ulcer :
(I have made some lame tricks for memorising drugs name:D ,if you have some mnemonics please comment !)
1) Decrease acid secretion :It includes total 4 categories ,they are described below .
(I have made some lame tricks for memorising drugs name:D ,if you have some mnemonics please comment !)
1) Decrease acid secretion :It includes total 4 categories ,they are described below .
a) H2 Anti-histamine (They all end with -tidine)
-Cimetidine .
-Famotidine.
-Ranitidine.
-Roxatidine.
-Cimetidine .
-Famotidine.
-Ranitidine.
-Roxatidine.
b)Proton -pump inhibitor.(ends with -prazole)
-Omeprazole.
-Esomeprazole.(Read it as Es-omeprazole)
-Lansoprazole.
-Pantoprazole.
-Rabeprazole.
-Dexrabeprazole
(Read it as Dex-rabeprazole!)
-Omeprazole.
-Esomeprazole.(Read it as Es-omeprazole)
-Lansoprazole.
-Pantoprazole.
-Rabeprazole.
-Dexrabeprazole
(Read it as Dex-rabeprazole!)
c)Anti-cholinergic drugs:
-Pirenzepine .
-Propantheline.
(Read it as Propan-the-line).
-Oxyphenonium .
-Pirenzepine .
-Propantheline.
(Read it as Propan-the-line).
-Oxyphenonium .
d) Prostaglandin analogue:Misoprostol !
2)Neutralization of gastric acid secretion
(Antacids) .It includes 2 categories
a) Systemic:
-Sodium bicarbonate .
-Sodium citrate.
(Antacids) .It includes 2 categories
a) Systemic:
-Sodium bicarbonate .
-Sodium citrate.
b)Non-systemic:
-Magnesium hydroxide .
-Magnesium trisilicate.
-Aluminium hydroxide.
-Calcuim carbonates.
-Magnesium hydroxide .
-Magnesium trisilicate.
-Aluminium hydroxide.
-Calcuim carbonates.
c)Ulcer protective:
-Sucralfate.
-CBS (Colloidal bismuth subcitrate!).
-Sucralfate.
-CBS (Colloidal bismuth subcitrate!).
d)Anti-H pylori drugs:
-Amoxicillin.
-Tetracyclin.
-Clarithromycin.
-Tinidazole.
-Metronidazole.
-Amoxicillin.
-Tetracyclin.
-Clarithromycin.
-Tinidazole.
-Metronidazole.
~Ojas
Tuesday, January 3, 2017
Mental distractions
Hey Awesomites!
Let me ask you a question.. how much focused you are during your study time? Well, as a medical student you try your best to focus on what is written in the book and in making your own notes. You are not aware of your surroundings anymore. Someone comes nearby and calls you or sits just beside you but still your eyes are on those words and difficult medical terms of the diseases and syndromes and the drugs used to treat them. This is called Change blindness, a perceptual phenomenon that occurs when you don't notice a major change in the environment because you are too focused on one particular thing.
Let me give you another example. A young guy is standing in a long queue at a place while some people arrive from the opposite side. He starts staring on a cute little child who was looking at him too. They share smiles, and eye contact for several minutes while the mother carrying the child moves on. The guy just stands still there and is not aware of the surroundings when other people behind shout at him because he is not moving forward or letting them go. All of a sudden he realizes where he is and so walks ahead. This transient moment is the change blindness. :D
Note: Even maintaining an eye- contact with someone, even a child in this case may prove strenuous for the brain especially during reasoning and verbal processing and so is itself a distraction (distracting the young guy from the queue and instead focusing on that child). That is why we periodically avert our eyes during conversations.
During this particular moment this guy activated his visual association area (visual cortex) while looking at that child which meant he was just paying attention to the perceptual details (the depth of eyes of that child, cuteness, innocence, love).
On the other hand, the older adults may notice changes and patterns happening around while doing a particular task as well. Reduced focus (mental distractions) in the aging brain is responsible for the abstract thinking in them that is needed for problem solving and creative work.
In other words, the healthy aging people show thinking patterns that allow them to make connections among pieces of information that are right in front of them as well as information they have have encountered in the past. For example, an older adult involved in a conversation might pick up information on current road conditions from a television nearby, whereas a younger adult might be paying a closer attention to the conversation itself. Later on, the older adult might make use of the information from the TV broadcast while planning a route home.
The study suggests that older adults tend to have more focused attention in the morning and more of the abstract thinking later in the day. College students on the other hand tend to have their peak attention in the afternoon or evening and are less focused in mornings.
Inability to remember details of major events or just the location of objects begins in early midlife (the 40s) which does not mean the brain function is deteriorating, instead it may be the result of the changing focus of brain on the particular information during the process of memory formation and its retrieval. The experiments on this study have concluded that the middle- aged and older adults don't really show the same level of visual cortex activation as the young do when they recall the information. Instead, their medial prefrontal cortex is activated, a part of the brain that is involved in learning associations between events and the corresponding adaptive responses. The mPFC likely relies on the hippocampus to support rapid learning and memory consolidation.
Thats all
- Jaskunwar Singh
Let me ask you a question.. how much focused you are during your study time? Well, as a medical student you try your best to focus on what is written in the book and in making your own notes. You are not aware of your surroundings anymore. Someone comes nearby and calls you or sits just beside you but still your eyes are on those words and difficult medical terms of the diseases and syndromes and the drugs used to treat them. This is called Change blindness, a perceptual phenomenon that occurs when you don't notice a major change in the environment because you are too focused on one particular thing.
Let me give you another example. A young guy is standing in a long queue at a place while some people arrive from the opposite side. He starts staring on a cute little child who was looking at him too. They share smiles, and eye contact for several minutes while the mother carrying the child moves on. The guy just stands still there and is not aware of the surroundings when other people behind shout at him because he is not moving forward or letting them go. All of a sudden he realizes where he is and so walks ahead. This transient moment is the change blindness. :D
Note: Even maintaining an eye- contact with someone, even a child in this case may prove strenuous for the brain especially during reasoning and verbal processing and so is itself a distraction (distracting the young guy from the queue and instead focusing on that child). That is why we periodically avert our eyes during conversations.
During this particular moment this guy activated his visual association area (visual cortex) while looking at that child which meant he was just paying attention to the perceptual details (the depth of eyes of that child, cuteness, innocence, love).
On the other hand, the older adults may notice changes and patterns happening around while doing a particular task as well. Reduced focus (mental distractions) in the aging brain is responsible for the abstract thinking in them that is needed for problem solving and creative work.
In other words, the healthy aging people show thinking patterns that allow them to make connections among pieces of information that are right in front of them as well as information they have have encountered in the past. For example, an older adult involved in a conversation might pick up information on current road conditions from a television nearby, whereas a younger adult might be paying a closer attention to the conversation itself. Later on, the older adult might make use of the information from the TV broadcast while planning a route home.
The study suggests that older adults tend to have more focused attention in the morning and more of the abstract thinking later in the day. College students on the other hand tend to have their peak attention in the afternoon or evening and are less focused in mornings.
Inability to remember details of major events or just the location of objects begins in early midlife (the 40s) which does not mean the brain function is deteriorating, instead it may be the result of the changing focus of brain on the particular information during the process of memory formation and its retrieval. The experiments on this study have concluded that the middle- aged and older adults don't really show the same level of visual cortex activation as the young do when they recall the information. Instead, their medial prefrontal cortex is activated, a part of the brain that is involved in learning associations between events and the corresponding adaptive responses. The mPFC likely relies on the hippocampus to support rapid learning and memory consolidation.
Thats all
- Jaskunwar Singh
Classification of closed globe injuries
Closed globe injury classification:-
- Based on the mechanism of injury (type) :
A. Contusion (blunt trauma)
B. Lamellar laceration (due to a sharp object or blunt trauma)
C. Superficial foreign body (organic matter or metals)
D. Mixed (combined injuries)
- Based on the visual acuity (grade) :
A. >20/40 (0.5)
B. 20/50 - 20/100 (0.4 - 0.2)
C. 19/100 - 5/200 (0.2 - 0.025)
D. 4/200 - Light Perception (0.02 - L+ P+ )
E. No Light perception
- Based on the pupillary defect :
A. Relative afferent pupillary defect (RAPD) positive
B. Relative afferent pupillary defect (RAPD) negative
- Based on the Zones of violations :
Zone I- External (superficial injuries of bulbar conjunctiva, cornea and sclera)
Zone II- violation of the Anterior segment (structures in anterior chamber and the pars plicata)
Zone III- violation of the Posterior segment (structures posterior to the posterior lens capsule- retina, vitreous and optic nerve)
Thats all
- Jaskunwar Singh
- Based on the mechanism of injury (type) :
A. Contusion (blunt trauma)
B. Lamellar laceration (due to a sharp object or blunt trauma)
C. Superficial foreign body (organic matter or metals)
D. Mixed (combined injuries)
- Based on the visual acuity (grade) :
A. >20/40 (0.5)
B. 20/50 - 20/100 (0.4 - 0.2)
C. 19/100 - 5/200 (0.2 - 0.025)
D. 4/200 - Light Perception (0.02 - L+ P+ )
E. No Light perception
- Based on the pupillary defect :
A. Relative afferent pupillary defect (RAPD) positive
B. Relative afferent pupillary defect (RAPD) negative
- Based on the Zones of violations :
Zone I- External (superficial injuries of bulbar conjunctiva, cornea and sclera)
Zone II- violation of the Anterior segment (structures in anterior chamber and the pars plicata)
Zone III- violation of the Posterior segment (structures posterior to the posterior lens capsule- retina, vitreous and optic nerve)
Thats all
- Jaskunwar Singh
Blood Indices
Hello readers,today I am gonna tell you about some blood indices -there meaning, normal values, and units ! . Hopefully they will be useful . I always use to mess up them during my very first year :(
1)Mean corpuscular volume (MCV):It denotes the volume in a single RBC .It correspond to size of RBCs ,so when MCV is in normal range it denotes normocyte .When MCV increases , RBCs are known as macrocytic eg : megaloblastic anemia and when it decreases ,cell are microcytic eg: iron deficiency anemia.
MCV can be calculated by automated hematology analyzer or by using hematocrit value
MCV:-Hematocrit (%) ×10/RBC count
(million /cubic mm).
Unit of MCV is femtolitre(fL)
Normal value is 80-95 fL
2)Mean corpuscular hemoglobin(MCH):-
It's the quantity or amount of hemoglobin present in one RBC. It's normally expressed in picogram or microgram .
Normal range is 27-31 pg
Formula -
MCH :-Hb (gm per 100mL)/Total RBCs in blood(million per cubic mm) . I think no need to tell MCH decreases in anemia :D
3)Mean corpuscular hemoglobin concentration: It is concentration of hemoglobin in one RBC.It is actually the amount of hemoglobin expressed in relation to volume of RBC.(It's actually
Combination of above two terms )
So we express it in gram /dL
Normal value is 33-36 gm/dL
Formula :
MCHC:
Hb(g/100mL)×100/Hematocrit(%).
When RBC size decrease , RBC is known as hypochromic
In pernicious anemia RBCs are macrocytic and normochromic While in iron deficiency RBCs are microcytic and hypochromic.
We don't have hyperchromic RBC because content of RBC is limited !
~Ojas
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