Friday, February 10, 2017
Immunohistochemistry and cytogenetics for leukemias: Part 2
The Romberg's test does not test cerebellar function
This is a topic that most medical students discuss at some point of time. I have found myself in the midst of similar conversations over my years at medical school.
After much study, I happened to reach an understanding that clarified the purpose of the test and provided a way to understand the results as well.
It would help if you think of the cerebellum as a processor (such as a C.P.U. in a computer).
There are 3 main inputs:

Romberg's test (3 steps):
1. Ask patient to stand with feet together.
2. Ask patient to close both eyes.
3. Maintain the posture for 60 seconds.
The Romberg's test is positive if the patient cannot stand for 60 seconds with feet together and eyes closed.
It is essential to understand that without the processor, the inputs do not matter (as there will be no output and no result).
Thus in Cerebellar ataxia, the patient will be unable to perform any of the above 3 steps and thus the Romberg's test cannot be performed on this patient.
In a situation where the cerebellar function is intact and Romberg's test is performed:
The first input (Vision) is lost when the eyes are closed.
It is now unto the 2 other pathways (Proprioceptive and Vestibular pathways) to provide input to the cerebellum.
Thus the Romberg's test will be positive in cases of:
1. Proprioceptive dysfunction e.g. Sensory peripheral neuropathy & Dorsal column dysfunction
2. Vestibular dysfunction e.g. Vestibular neuritis
This was my attempt to provide a brief summary about this topic and it has been compiled to the best of my understanding. Please feel free to discuss it further, in the comments section below.
Have a great day!
- Vikramjeet Kakade
Fact of the day: Most efficient sleep position to clear the brain of waste
Lateral position and right posture while sleeping is considered advantageous for those suffering from neurologic and psychiatric disorders due to this reason.
Thursday, February 9, 2017
Spermatic Cord contents : Mnemonic
Hello. This is about the things that your thing contains if you're a guy :p
So the spermatic cord is an important content of the inguinal canal in men.
And it contains a host of things.
Remember :
Plenty of Dick Contributes To Good Sex Life
Plenty of = Pampiniform plexus
Dick = Ductus Deferens
Contributes = Cremasteric artery
To = Testicular Artery
Good = Genitofemoral Nerve (Genital br)
Sex = Sympathetic plexus
Life = Lymphatics.
So it's 3 Arteries + 2 nerves + 3 other things.
Hope you like this !
Stay awesome.
Fascia of the thigh : Mnemonic
Hi everyone. This is a short post where I tell you about the thigh fascia.
So fascia of the thigh is super important during surgery , and we are expected to know its layers.
So it's got 2 layers : Camper's and Scarpa's.
Now which is outer and which is inner ?
Remember :
OC IS good.
So OC = Outer Camper
IS = Inner Scarpa
Hope you liked this!
Stay awesome.
Fact of the day: Most common causes of non gonococcal urethritis
Structure and properties of poxviruses mnemonic
Wednesday, February 8, 2017
Memory aid for urease positive organisms
Here's a little memory aid for urease positive organisms.
Alcohol and Drug Interactions: 4th Part
Hii friends...
This is the last post in the series: Alcohol and Drug Interactions. The previous posts in this series were Disulfiram-like Reaction, 2nd Part, and 3rd Part.
With Warfarin
1. Binge drinking- Leads to inhibition of warfarin metabolism by CYP450 enzyme system. So it can precipitate warfarin toxicity with increased bleeding tendency in the body.
2. Chronic Alcohol consumption- Leads to induction of CYP450 enzyme system, so increases metabolism of Warfarin in the liver. So higher than usual dose of warfarin is needed to exert appropriate anticoagulant action in the patient.
With Opioids
Alcohol increases the sedative effects and also increases the risk of respiratory depression. It also attenuates cough reflex and gag reflex, so the patients have a higher risk of getting food stuck in their respiratory tract, remember Cafe Coronary.
With NSAIDs
1. NSAIDs have been implicated in an increased risk of ulcers and gastrointestinal bleeding in elderly
people. Alcohol may exacerbate that risk by enhancing the ability of these medications to damage the
stomach mucosa.
2. Alcohol also potentiates the antiplatelet actions of Aspirin, hence increase the risk of bleeding in the patients.
3. Intake of alcohol with acetaminophen can increase the risk of acetaminophen-related toxic effects
on the liver. Acetaminophen breakdown by CYP2E1 (and possibly CYP3A) results in the formation of a toxic product(NABQI) that can cause potentially life-threatening liver damage. As mentioned earlier, heavy alcohol use enhances CYP2E1 activity. In turn, enhanced CYP2E1 activity increases
the formation of the toxic acetaminophen product. In people who drink heavily or who are fasting
(which also increases CYP2E1 activity), liver injury may occur at doses as low as 2 to 4 grams per day.
That concludes this series. I hope it will help you to guide your patients towards drinking alcohol more judiciously. :p
-VM