Hey guys!
This post will be focused on the pathophysiology of Hyperthermia in Pontine Haemorrhage( which may manifest as the Locked-in Syndrome, remember that super-awesome House episode? <3 )
1. First try the easy simple reason. Hypothalamus has been basically cut off from the body below pons and there has been Haemorrhage. Therefore, there will be a Sympathetic outflow causing peripheral vasoconstriction. Meanwhile the internal visceral organs are still functioning and consequently producing heat. So without hypothalamus, the body's ability to produce heat has transcended it's ability to lose heat.
2. The next reason is a bit "cooler", literally. Our body hates Hypothermia more than Hyperthermia, thanks to evolution. (Ice Age!!!) Now there is no central thermoregulation but peripheral one is still intact. And the peripheral thermoreceptors are much more sensitive to lower temperatures or basically cold environment. Once again, without the Hypothalamus, the body is defending itself too vigorously against Hypothermia as to contribute ironically to Hyperthermia.
3. This reason is the only one which you should know since this will explain how Baclofen, a GABA-B Agonist works to treat this Hyperthermia. Remember the Medial Forebrain Bundle, it connects Hypothalamus to a lot of structures, one of them being Nucleus Raphe in the Pontine reticular formation. This is a very crucial portal in control of Sympathetic nervous system outflow by Hypothalamus. Simply speaking, if the body is hot, Hypothalamus will send inhibitory (GABAergic and Dopaminergic) signals to this nucleus and if the body is cold, it will send excitatory (Glutaminergic and Serotonergic) signals. And apparently this connection is lost in Pontine Haemorrhage, so we substitute it with a drug.
P.S. Now you can guess how Bromocriptine and Apomorphine cause Hypothermia. :)
-VM
Chronic PPI usage is associated with an increase occurrence of bone fractures, at present, the likely mechanism of this affect, is not at all clear.
The assumed mechanism is that long-term PPI use leads to decreased intestinal absorption of calcium resulting in negative calcium balance, increased osteoporosis, development of secondary hyperparathyroidism, increased bone loss and increased fractures.
An acidic environment in the stomach facilitates the release of ionzed calcium from insoluble calcium salts, and the calcium solubilization is thought to be important for calcium absorption.
That's all!
Happy studying!
-IkaN
Hello.
This was a question from one of our readers..as to how to deal with psm.
Personally I too have dealt with a lot of trauma related to it. So I will share you my own tips and tricks.
Just keep this basic funda in your head while dealing psm. YOU DONT HAVE TO READ EVERYTHING.
Never start reading psm chapters from the very first page. You will be lost in a whirlpool so huge and exhaust yourself to the limits in a matter of hours..and you are bound to never touch the book again.
Now how to approach it..if say your professor is teaching a chapter on contraceptives. Just go through ONLY last three year worth questions..and mark out all the questions just for contraceptives. Never do the whole ten years or five years questions together. Cause you will end up marking the whole book..and that depresses you. So first start last three years.
Once you have done the marking. Psm has one lovely plus point..that apart from the humongous text..it also has charts and diagrams. READ the diagrams first..the flow charts those should be the ones you should learn first. And for answers who don't have flow charts..and have things like components and sub headings of this and that and shit..I suggest just mugg up the names of the sub topics. Just the names only. Make mnemonics, make weird stories..do whatever but you need to learn them.
This trick is important cause think of your examiner. He is tired of reading the same old answers over and over again. So if you go ahead and make beautiful flow charts..or if you just emphasise on the various components and sub headings itself..your job is half done.
And regarding the actual reading of the text. Do it later when you feel more confident..and that time also just stick to the specific answers from previous yr papers.
psm is crazy huge..I have learnt that during exams it was more easy to make up matter to write for psm..but what I didn't remember was that one word of the sub headings or details of the flow chart.
And that's where you go wrong.
Let me know if it helped you and also if any other doubts.
-sakkan
Hello all, let me slip in a quick mnemonic on Neomycin and Amikacin
1.Highest nephrotoxic drug-
Neomycin
2.Highest auditory toxicity is with-
Amikacin
N for N and A for A. Easy one to remember for the MCQs!
That's all!
-Sushrut
