Hello!
So I have divided the post into two parts - A short summary for those who don't have the time to read everything (#TLDR) and a nice long explanation for those who want to read everything :)
Let's start with TLDR.
Thursday, March 16, 2017
Buzz words for congenital syphilis!
Following are some important signs and buzzwords that are testable ...And high yeild for entrances.
Olympian Brow: Bony prominence of the forehead caused by persistent or recurrent periostitis
Clavicular or Higoumenakia sign:Unilateral or bilateral thickening of the sternoclavicular third of the clavicle
Saber shins :Anterior bowing of the midportion of the tibia
Scaphoid scapula :Convexity along the medial border of the scapula
Hutchinson teeth:Peg-shaped upper central incisors; they erupt during 6th yr of life with abnormal enamel, resulting in a notch along the biting surface
Mulberry molars :Abnormal 1st lower (6 yr) molars characterized by small biting surface and excessive number of cusps
Saddle nose :Depression of the nasal root, a result of syphilitic rhinitis destroying adjacent bone and cartilage
Rhagades:Linear scars that extend in a spoke-like pattern from previous mucocutaneous fissures of the mouth, anus, and genitalia
Juvenile paresis :Latent meningovascular infection; it is rare and typically occurs during adolescence with behavioral changes, focal seizures, or loss of intellectual function
Juvenile tabes : Rare spinal cord involvement and cardiovascular involvement with aortitis
Hutchinson triad :Hutchinson teeth, interstitial keratitis, and 8th nerve deafness
Clutton joint :Unilateral or bilateral painless joint swelling (usually involving knees) from synovitis with sterile synovial fluid; spontaneous remission usually occurs after several weeks
Interstitial keratitis: Manifests with intense photophobia and lacrimation, followed within weeks or months by corneal opacification and complete blindness
8th nerve deafness: May be unilateral or bilateral, appears at any age, manifests initially as vertigo and high-tone hearing loss, and progresses to permanent deafness.
Well all these are late manifestations of congenital syphilis occuring after 2 years of life.
It is important to recognise these signs clinically and also on the exams...
-Medha.
Pathophysiology of myopathy caused during hypothyroidism and hyperthyroidism
Hello awesomites! Today's topic of discussion is - Myopathy in thyroid disease.
Interestingly, it is caused by both, hypothyroidism as well as hyperthyroidism.
What is myopathy?
It is a disease of muscle tissue where, ultimately, muscles get weak and are unable to perform work due to deficiency of ATP.
Why is there myopathy in hyperthyroidism?
The thyroid hormone is a catabolic hormone. Hyperthyroidism increases energy expenditure, glucose turnover, lipolysis, and protein breakdown (proteolysis). But here is the catch - Hyperthyroidism increases whole-body protein turnover and breakdown before any measurable changes in energy expenditure or glucose and fat metabolism, suggesting that amino acid and protein metabolism is an early and primary target for thyroid hormone action in humans. It was therefore concluded that the thyroid-hormone concentration may be an important factor in regulating muscle proteolysis. The altered protein metabolism causes myopathy.
Then, one may ask, why myopathy in hypothyroidism? Less thyroid hormone should lead to less protein breakdown, shouldn't it?
Well, this is a good question! Slightly complex and tricky to answer though.
In hypothyroidism, there is abnormal glycogenolysis, defective mitochondrial oxidative metabolism and triglyceride storage.
Abnormal glycogenolysis and triglyceride storage: Less glucose is released and utilised because of this. The body starts using more proteins usually derived from muscles leading to myopathy.
Mitochondrial oxidative metabolism defect: Thyroid hormone is responsible for activation of bc1 complex also known as complex 3 & succinate dehydrogenase. Less activation of bc1 leads to less formation of ATP from glucose.... So again, the body switches to proteins from muscles as a source of energy!
That's all!
Stay cool :)
Stay cool :)
~Ojas
Wednesday, March 15, 2017
Fact of the day: Regulate brain activity with your type of music
Hey Awesomites
Which genre or type of music do you like the most? Well, it surely has to do a lot with the functioning of our brain. Some of you may like slow music while others like to rock n roll on the floor while listening to their favourite beats. I am more of the latter type too, depending on the mood. ;p
Which genre or type of music do you like the most? Well, it surely has to do a lot with the functioning of our brain. Some of you may like slow music while others like to rock n roll on the floor while listening to their favourite beats. I am more of the latter type too, depending on the mood. ;p
Tuesday, March 14, 2017
Pediatric drawing milestones mnemonic
I share two mnemonics in this video - The count numbers on your hand mnemonic and the draw it yourself mnemonic xD
Tricyclic antidepressants (TCAs) - MOA and side effects
Hello!
This is a fun and concise post on the pharmacology of TCAs. Excited? :D
This is a fun and concise post on the pharmacology of TCAs. Excited? :D
Monday, March 13, 2017
Saturday, March 11, 2017
Fact of the day: Paradoxical undressing in fatal hypothermia
Hypothermia causes paradoxical undressing.
This typically occurs during moderate to severe hypothermia, as the person becomes disoriented, confused, and combative. They may begin discarding their clothing, which, in turn, increases the rate of heat loss. It is estimated that twenty to fifty percent of hypothermia related deaths are due to paradoxical undressing.
Why does this happen?
This typically occurs during moderate to severe hypothermia, as the person becomes disoriented, confused, and combative. They may begin discarding their clothing, which, in turn, increases the rate of heat loss. It is estimated that twenty to fifty percent of hypothermia related deaths are due to paradoxical undressing.
Why does this happen?
Friday, March 10, 2017
Fact of the day: Psychosomatic symptoms love to travel
Hey Awesomites
Yes, you read it right. The symptoms of psychosomatic disorders flit from one body part to another, and just too easily and quickly ( they love to travel a lot ;p ) . Just as one symptom is discovered, it disappears and another one emerges in some other part of the body.
The psychosomatic symptoms have been linked to a chameleon. Every time a medicine tries to pin them down, they become something different.
That's all
- Jaskunwar Singh
The colours of a chameleon are not more numerous and inconstant than the varieties of the hypochondriac and hysteric disease.
- Robert Whytt
NYHA Classification Mnemonic
Hey guys, this post will help you to remember the definitions of the four NYHA classes.
So first just remember two phrases-
"Patient with a heart disease" and "in ordinary or accustomed activities". For convenience I will use letters A and B to refer to these phrases respectively. Now I will just fill in the gap between them.
1. NYHA Class I:
A--- will not get dyspnea ---B.
2. NYHA Class II:
A--- will get dyspnea ---B.
3. NYHA Class III:
A--- will get dyspnea in less than ---B.
4. NYHA Class IV:
A--- will get dyspnea at rest.
This system of classification has its flaws since the definition of "ordinary and accustomed activities" is entirely subjective. Like for example if a rich businessman gets breathless after walking 1 km, you may label him as NYHA Class II, but the same case in a hard working labourer will have to be labelled as NYHA Class III.
And another thing that NYHA has recently clarified NYHA Class III a bit further, it has included self-care activities in it's spectrum. As a supposition, if a 56 year old male person gets breathless while shaving or bathing then it is NYHA Class III.
-VM
Authors' diary: Medicowesome secret project
We initially introduced the secret project very mysteriously and kept the details highly confidential just for fun! Let me tell you more about it...
Thursday, March 9, 2017
Grave's ophthalmopathy features mnemonic
Hey Awesomites
Grave's disease, a common cause of primary hyperthyroidism causes some epic features of ophthalmopathy apart from lid retraction and lid lag. Mnemonic: EPIC
E- Exophthalmos
P- Periorbital Edema
I- Involvement of ocular muscles (diplopia)
C- Conjunctival irritation and chemosis
- Jaskunwar Singh
Grave's disease, a common cause of primary hyperthyroidism causes some epic features of ophthalmopathy apart from lid retraction and lid lag. Mnemonic: EPIC
E- Exophthalmos
P- Periorbital Edema
I- Involvement of ocular muscles (diplopia)
C- Conjunctival irritation and chemosis
- Jaskunwar Singh
Amiodarone- induced thyroid dysfunctions
Hello
Amiodarone, a potent class III anti- arrhythmic drug is contraindicated in thyroid patients or those with subclinical disease. The reason lies in the pharmacokinetic profile of this drug.
The drug has a structural resemblance to triiodothyronine (T3) and thyroxine (T4). In the body, it is metabolized by dealkylation to Desethylamiodarone (DEA), the intrathyroidal concentration of which is higher than the parent drug.
Normal daily recommended intake of iodine for adults is approx. 0.15mg (150mcg). Each 200mg tablet of amiodarone contains about 74.4mg of iodine with 7.4mg (10%) being released as free form. This is roughly 50- fold higher than the normal. Therefore, total body stores may remain increased for upto 9 months after stopping the drug.
High iodine content of this drug inhibits local type-1 5'- deiodinase activity (blocking conversion of T4 to T3) and type- II 5'- deiodinase activity in the pituitary. As a result, TSH is increased initially (mild elevation) and then return to normal or may even decrease in euthyroid patients after weeks, while T4 is normal or raised, and T3 levels decrease.
The increased delivery and uptake of iodine by the thyroid gland may cause increase in hormone production and release, a condition called type-1 Amiodarone- induced thyrotoxicosis (AIT) . In other cases, excessive thyroid tissue destruction due to destructive thyroiditis may lead to type-2 Amiodarone- induced thyrotoxicosis. These are hyperthyroid states!!
Discontinuation of the drug is recommended, if not, then high doses of thioamides and corticosteroids may work in AITs.
Amiodarone may also cause hypothyroidism (AIH) in patients depending upon the iodine status of individuals and prior thyroid disease. Wolff- chaikoff effect is shown by thyroid cells due to failure of thyroid hormonogenesis. Levothyroxine is the drug of choice.
Thats all
- Jaskunwar Singh
Amiodarone, a potent class III anti- arrhythmic drug is contraindicated in thyroid patients or those with subclinical disease. The reason lies in the pharmacokinetic profile of this drug.
The drug has a structural resemblance to triiodothyronine (T3) and thyroxine (T4). In the body, it is metabolized by dealkylation to Desethylamiodarone (DEA), the intrathyroidal concentration of which is higher than the parent drug.
Normal daily recommended intake of iodine for adults is approx. 0.15mg (150mcg). Each 200mg tablet of amiodarone contains about 74.4mg of iodine with 7.4mg (10%) being released as free form. This is roughly 50- fold higher than the normal. Therefore, total body stores may remain increased for upto 9 months after stopping the drug.
High iodine content of this drug inhibits local type-1 5'- deiodinase activity (blocking conversion of T4 to T3) and type- II 5'- deiodinase activity in the pituitary. As a result, TSH is increased initially (mild elevation) and then return to normal or may even decrease in euthyroid patients after weeks, while T4 is normal or raised, and T3 levels decrease.
The increased delivery and uptake of iodine by the thyroid gland may cause increase in hormone production and release, a condition called type-1 Amiodarone- induced thyrotoxicosis (AIT) . In other cases, excessive thyroid tissue destruction due to destructive thyroiditis may lead to type-2 Amiodarone- induced thyrotoxicosis. These are hyperthyroid states!!
Discontinuation of the drug is recommended, if not, then high doses of thioamides and corticosteroids may work in AITs.
Amiodarone may also cause hypothyroidism (AIH) in patients depending upon the iodine status of individuals and prior thyroid disease. Wolff- chaikoff effect is shown by thyroid cells due to failure of thyroid hormonogenesis. Levothyroxine is the drug of choice.
Thats all
- Jaskunwar Singh
Wednesday, March 8, 2017
Fact of the day: Burning the heart to ashes
An interesting fact about heart I read today:
The heart is resilient, literally. When a body is burnt, the heart is the last organ to oxidize. While the rest of the body can catch flame like a polyester sheet on campfire, it takes hours to burn the heart to ash because it's deep inside!
That's all!
Did you know? According to Hindu mythology, when Arjuna cremated the body of Lord Krishna, his whole body turned into ashes, except his heart which was still burning. Arjuna washed the ashes and burning heart into the river.
- Jaskunwar Singh
Subscribe to:
Posts (Atom)