Facts and Fallacies: Vitamin D link to cancer

Hey Awesomites

Vitamin D has been shown beneficial for a variety of disorders and diseases. Recent studies now suggest that those deficient in vitamin D are at a  higher risk of developing cancer compared to those with adequate levels.

Brainstem Syndromes!

So let's get done with all the important brainstem syndromes once and for all !

I would be writing on all of them one by one...

Also ...I will try and incorporate many of my diagrams to help you guys make it seem less daunting...

Starting from the Midbrain the first syndrome is..

(The image shows the level of the lesion)

1):Parinaud's Syndrome

Lesion location:Midbrain dorsum ,superior  collicculi.

Structures involved: Quadrigeminal plate region; pretectum; periaqueductal gray matter

Etiology: •Due to mass lesion in the region of the posterior third ventricle, most often pinealoma, or due to midbrain infarction.

Clinical features:
•Impaired upgaze as centre for upward gaze is affected
convergence retraction nystagmus;
Argyll Robertson pupil :dilated pupils with light near dissociation.

A closer look at the structures involved .

I hope it helped !Also do share your Neuroanatomy diagrams and and more information on Parinaud Syndrome.

Have a nice day!

-Medha!

How I remember the duration of symptoms for Generalized anxiety disorder (GAD) required for diagnosis

The symptoms of generalized anxiety disorder should be present for at least 6 months. For me, it's hard to remember the duration of the symptoms in psychiatry. So I mnemonic-ify them :D

I remember G6PD, and say G6AD instead!

For those who don't know what GAD is here is the DSM V criteria for diagnosis of Generalized Anxiety Disorder...

Transposition of Great Arteries!

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.

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 :)

~Ojas

Medicowesome secret project: Exam time

What is the secret project? How can I participate?

Medicowesome secret project: Embryo – Male or female?

What is the secret project? How can I participate?

Medicowesome secret project: Ghrelin

What is the secret project? How can I participate?

Medicowesome secret project: Biostatistics

What is the secret project? How can I participate?

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

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

Medicowesome secret project: Life of a blind man

What is the secret project? How can I participate?

Medicowesome secret project: Who am I?

What is the secret project? How can I participate?

Medicowesome secret project: An Alcoholic's Tale

What is the secret project? How can I participate?

Tricyclic antidepressants (TCAs) - MOA and side effects

Hello!
This is a fun and concise post on the pharmacology of TCAs. Excited? :D

Fact of the day: Green - The colour of medicine

Green used to be the "Colour of medicine"

Why?

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?

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...