Hello everyone!
Brain sections are super hard to remember, I imagine them as monsters and this is how I draw them:
Thursday, April 27, 2017
How to draw midbrain sections and lesions (Fun mnemonic diagrams)
Brain sections are super hard to remember, I imagine them as monsters and this is how I draw them:
Paraneoplastic Dermatoses - Bazex Syndrome.
Hello everybody,
So to continue our series on cutaneous manifestations of internal malignancies
Let's quickly learn about Bazex Syndrome.
Bazex syndrome — acrokeratosis
paraneoplastica is a paraneoplastic phenomenon associated with squamous cell carcinoma of the upper digestive tract.
Presents more commonly in Males and over the age of 40.
Presentation: Erythematous to violaceous psoriasiform plaques predominantly located in acral areas (especially the fingers, toes, nose, and helices).
Nail dystrophy, palmoplantar keratoderma, and alopecia are common.
In most patients, manifestations of Bazex syndrome precede the diagnosis of malignancy or the malignancy is diagnosed concurrently.
The lesions of Bazex syndrome are usually resistant to targeted therapies, but treatment of the neoplasm usually leads to resolution of the cutaneous findings, although not always.
Let's learn together!
-Medha!
Wednesday, April 26, 2017
Tuesday, April 25, 2017
Exam Prep Hacks -Tips for a lazy person
Hola everyone!
This post is for those people who really struggle during exam time, not because they can't understand studies or are stressed, but for someone who is really lazy and no amount of stress can change that (believe me I'm one of those :P)
So if you're someone who puts on their best game forward during exams and becomes a ninja - this post is not for you! :P
Okay, so you know your exams are just around the corner and you have shit loads of syllabus to complete and you know there will be last minute panic yet you do not make a strategy and "go with the flow", completely regret it later and are desperate to change this.
Understand that this post won't make you active all of a sudden, this post is all about embracing your laziness and turning into an asset and to rock your exams always without being under constant stress ;)
Let's get down to the basics then.
1. Always set rewards for yourself.
Sitting continuously for 5-6 hours IS JUST NOT POSSIBLE. Your concentration span is of a fly and you get distracted very easily, so instead of setting a target of studying for 5-6 hours continuously and then being disappointed later, make short targets. Like finishing one or two topics in one sitting and then maybe watching an episode of friends or going out for a walk. This way you feel like you've "earned" the break and will keep you motivated.
2. JUST SWITCH OFF YOUR PHONE.
Let's face it. Our phone's are the greatest source of distraction. Be it a whatsapp text, facebook notification or instagram post, we are constantly checking our phones. Either turn the internet off or put it on do not disturb mode, check the phones during your breaks.
3. Exercise!!!
Okay yes I get it, how is exercise gonna help me study? Remember endorphins- feel good hormones? Yeah well, they are secreted whenever we exercise. Exercise also help increase the blood flow and makes us more active. So, go for a walk for 20 min, skip in your room or dance, Whatever keeps you going, believe me, it's really gonna help. Will increase your concentration too!
4. Coffee.
I do not need to explain this. This is like a godsent drink!! Everyone swears by it, but honestly, whatever will help you stay up.
5. Make realistic targets.
DO NOT set your goals according to others. Forget how your roommate is studying, how the lights of the topper of your class is always turned on. You know yourself the best. Do what suits you. Set targets for yourself. Setting targets according to others will just leave you disappointed and demotivated. It's a vicious cycle. Don't do it.
6. Select a time best suited for you.
Decide if you're a morning or a night person. And stick to that. Again, do not follow others. If you're a morning person, sleep well in time and wake up as early you can. If you're a night owl, prolong your study for as late as you can. Push yourself a little. Lol, just a little though :P
7. Sleep is your best friend.
Haha. Sleep to your rescue. It has been documented that sleep is very important to convert your short term memory to long term memory, so don't shy away taking those naps! :P Lack of sleep will cause dark circles too :P
But obviously not too long, 4-5 hours is adequate during exam time :P
8. Good diet.
Last but the most important part. Keep yourself hydrated and try to have a healthy diet, something which isn't too heavy. Heavy or oily food will just make you sleepy, tired and of course gain weight. Keep drinking water and fluids. Your brain needs food to function!
Hope all these things help you guys in acing your exams!
So the next time someone calls you lazy, Be Proud ;)
Ashita Kohli
The Basics : Deviated Nasal Septum
Hello
Deviated Nasal Septum - "Abnormal and asymmetrical alignment of the nasal septum that results in acute nasal obstruction and other symptoms of upper respiratory tract."
AETIOLOGY -
1. Trauma : Abnormal pressure ( lateral or frontal ) applied to nasal septum results in its deviation to one side or another.
- The lateral blow may cause displacement of septal cartilage from the vomerine groove and maxillary crest.
- Frontal blow causes crushing injuries to the nose, usually occurs in sportspersons especially the boxers.
2. Developmental anomalies : Palate forms the base of nasal septum. Highly arched palate, cleft palate or lip, and dental abnormalities can all lead to deviation of the septum.
3. Racial factors : Caucasians have more incidence of DNS.
4. Hereditary : Familial predisposition.
TYPES of DNS -
1. Anterior dislocation : dislocation of nasal septum into one of the chambers. ( unilateral nasal obstruction )
2. C - shaped dislocation : simple curve to one side with compensatory hypertrophy of turbinates in other side. It causes unilateral nasal obstruction.
3. S - shaped deformity : causes bilateral nasal obstruction
4. Spurs : shelf - like projections may lead to headache and epistaxis. ( unilateral obstruction )
5. Thickening : due to septal hematoma
CLINICAL FEATURES of DNS mnemonic
TREATMENT - Only required if the symptoms are severe. The procedures are to be done once the patient is more than 17 years old.
- Septoplasty : The most deviated parts of nasal septum are removed and rest of the parts are surgically corrected and repositioned.
- Submucous resection ( SMR ) : Mucoperiosteal and mucoperichondral flaps that overlie one side of the septum are lifted. Most of the septum is removed and flaps repositioned.
Thats all
Hope this helped :)
- Jaskunwar Singh
Deviated Nasal Septum - "Abnormal and asymmetrical alignment of the nasal septum that results in acute nasal obstruction and other symptoms of upper respiratory tract."
AETIOLOGY -
1. Trauma : Abnormal pressure ( lateral or frontal ) applied to nasal septum results in its deviation to one side or another.
- The lateral blow may cause displacement of septal cartilage from the vomerine groove and maxillary crest.
 |
| Groove on which septal cartilage sits ( encircled ) - lateral view Diagram by IkaN. |
- Frontal blow causes crushing injuries to the nose, usually occurs in sportspersons especially the boxers.
2. Developmental anomalies : Palate forms the base of nasal septum. Highly arched palate, cleft palate or lip, and dental abnormalities can all lead to deviation of the septum.
3. Racial factors : Caucasians have more incidence of DNS.
4. Hereditary : Familial predisposition.
TYPES of DNS -
1. Anterior dislocation : dislocation of nasal septum into one of the chambers. ( unilateral nasal obstruction )
2. C - shaped dislocation : simple curve to one side with compensatory hypertrophy of turbinates in other side. It causes unilateral nasal obstruction.
3. S - shaped deformity : causes bilateral nasal obstruction
4. Spurs : shelf - like projections may lead to headache and epistaxis. ( unilateral obstruction )
5. Thickening : due to septal hematoma
CLINICAL FEATURES of DNS mnemonic
TREATMENT - Only required if the symptoms are severe. The procedures are to be done once the patient is more than 17 years old.
- Septoplasty : The most deviated parts of nasal septum are removed and rest of the parts are surgically corrected and repositioned.
- Submucous resection ( SMR ) : Mucoperiosteal and mucoperichondral flaps that overlie one side of the septum are lifted. Most of the septum is removed and flaps repositioned.
Thats all
Hope this helped :)
- Jaskunwar Singh
External Carotid Artery branches mnemonic
Hello
External Carotid Artery branches mnemonic - Seven Angry Ladies Fighting Over PMS
External Carotid Artery branches mnemonic - Seven Angry Ladies Fighting Over PMS
Cranial nerve III damage (Oculomotor nerve damage mnemonic)
Hello!
The CN III has both motor (central) and parasympathetic (peripheral) components.
Which fibers get affected in diabetes?
Which would lead to loss of pupillary light reflex?
Which fibers are compressed first?
Which would cause the down and out pupil?
Don't know? Check the video out!
The CN III has both motor (central) and parasympathetic (peripheral) components.
Which fibers get affected in diabetes?
Which would lead to loss of pupillary light reflex?
Which fibers are compressed first?
Which would cause the down and out pupil?
Don't know? Check the video out!
Mnemonic : Deviated Nasal Septum clinical features
Hey Awesomites
The clinical features ( s/s ) that are presented by a patient with DNS are : NOSE MASH
NO - Nasal Obstruction
S - Septal cartilage and bone deformity
E - Epistaxis
M - Middle Ear infection
A - Anosmia
S - Sinusitis
H - Headache
- Jaskunwar Singh
The clinical features ( s/s ) that are presented by a patient with DNS are : NOSE MASH
NO - Nasal Obstruction
S - Septal cartilage and bone deformity
E - Epistaxis
M - Middle Ear infection
A - Anosmia
S - Sinusitis
H - Headache
- Jaskunwar Singh
C Peptide levels : An Overview
Hello everyone!So I ended up uttering 'C peptide' recently in my Medicine Viva and my professor screwed me over it.
(Clearly I didn't C it through :'D )
So I thought of doing a brief summary on it.
Here goes.
1. What is C peptide ?
- When pro- insulin is cleaved , it gives insulin and C peptide.
- C peptide in general has a longer half life than insulin and is easier to detect.
- The pathway is something like this :
Pre proinsulin produced in Rough Endoplasmic Reticulum of Pancreas --> Transported to the Golgi apparatus and cleaved to form Proinsulin --> Packed into secretory granules --> In these granules proinsulin is converted to : Insulin and C peptide.
- Traditionally it is said to have no intrinsic activity but recent studies say it might have anti oxidant and anti inflammatory properties.
2. What does it indicate ?
- So , its presence indicates presence of Insulin in the body in a proportionate amount.
- Hence in a case of Hypoglycemia if C peptide levels are high, it's likely to be due to increased endogenous Insulin levels.
3. C peptide levels increased in -
- Insulinoma
- Sulfonylurea induced Hypoglycemia ( As they are Insulin Secretagogues)
- Type 2 Diabetes Mellitus ( Hyperinsulinism due to resistance)
- Insulin Resistance states like Obesity , PCOS , Cushing's.
4. C peptide levels reduced in -
- Type 1 Diabetes as Insulin secretion is reduced
- Latent Autoimmune Diabetes of Adult (LADA )
- Factitious hypoglycemia - Due to excess exogenous Insulin administration.
- Hypoglycemia due IGF secreting tumors.
So if you get a patient with Hypoglycemia with elevated insulin levels , C peptide levels help you decide if due to exogenous Insulin , or Endogenous Insulin ( Sulfonylurea induced or Insulinoma).
Hope this helped !
Stay awesome.
Happy studying!
~ A.P Burkholderia.
Monday, April 24, 2017
The Basics : Middle Ear
Hey Awesomites
In this post, I will be talking about the middle ear structures and its relations with its neighbors ( just a summary ).
The Middle Ear is an air filled and bilaterally compressed/ concaved cavity lined by mucous membrane located in between the external and internal parts of ear. It is divided into:
- Epitympanum or the Attic ( 6mm ) - lies above pars tensa and medial to pars flaccida
- Mesotympanum ( 2mm ) - lies opposite to pars tensa
- Hypotympanum ( 4mm ) - lies below the level of pars tensa
BOUNDARIES of the middle ear ( homologous to structure of a cube ) :-
Roof : Tegmen tympani - a thin bony plate that is a part of petrous part of temporal bone, separates the middle ear cleft from middle cranial fossa.
- Infection in the middle ear may spread superiorly and lead to formation of abscess in the meninges ( especially Extradural abscess ), meningitis or if severe, it may even lead to abscess formation in the temporal lobe.
Floor : Jugular bulb - The middle ear cavity is separated from jugular bulb by a thin piece of bone that if deficient may lead to formation of a layer of fibrotic tissue and mucous membrane in between. The contents of jugular bulb are:
- Internal Jugular vein
- Glossopharyngeal nerve ( IX )
- Vagus ( X )
- Accessory nerve ( XI )
The tympanic branch of glossopharyngeal nerve enters the middle ear at the junction of the floor and medial wall to play an important role in formation of tympanic plexus.
Anterior wall : The upper part of the narrow anterior wall has two openings or tunnels for - ( mnemonic : TEA )
- Canal for Tensor tympani muscle
- Pharyngotympanic ( or Eustachian ) tube
The lower part of anterior wall is separated from the Internal Carotid Artery by a thin plate of bone. The ICA is surrounded by a plexus of sympathetic nerves that enter middle ear through openings in this bony plate to form tympanic plexus.
Posterior wall : Posteriorly, it is related to middle ear cleft ( Aditus, Antrum and mastoid air cells )
- Infection in this region may spread posteriorly into the sigmoid sinus ( in posterior cranial fossa ) and cause thrombophlebitis !!
Medial wall : Medially the middle ear cavity is related to the promontory, oval and round window
Lateral wall : Tympanic membrane separates the middle ear from the external ear.
A brief about the functions of middle ear:
On the incoming of sound waves, the tympanic membrane oscillates and these oscillations are sensed by the strongly attached and faithful middle ear ossicle, the Malleus. The sound energy is transmitted as such by the ossicles ( Malleus - Incus - Stapes ) to the internal ear for further processing.
The major function of these ossicles is amplification of sound waves - Tympanic membrane is 17 times larger than the oval window - So that means the sound energy is picked up by the larger area ( TM ) and impinged over a much smaller area ( oval window ) thus amplifying it 17 times.
In addition, the lever action of the ossicular chain is approx. 1.3 units. Thus the intensity ( force ) of sound waves/ vibrations changes ( increased by ~20 times ) and not the frequency !! If the sound waves are not amplified ( in case OC is removed ), the Air Conduction would be lost. So BC > AC and thus hearing would then be poor.
Thats all
Hope this helped :)
Stay Awesome!
- Jaskunwar Singh
In this post, I will be talking about the middle ear structures and its relations with its neighbors ( just a summary ).
The Middle Ear is an air filled and bilaterally compressed/ concaved cavity lined by mucous membrane located in between the external and internal parts of ear. It is divided into:
- Epitympanum or the Attic ( 6mm ) - lies above pars tensa and medial to pars flaccida
- Mesotympanum ( 2mm ) - lies opposite to pars tensa
- Hypotympanum ( 4mm ) - lies below the level of pars tensa
BOUNDARIES of the middle ear ( homologous to structure of a cube ) :-
Roof : Tegmen tympani - a thin bony plate that is a part of petrous part of temporal bone, separates the middle ear cleft from middle cranial fossa.
- Infection in the middle ear may spread superiorly and lead to formation of abscess in the meninges ( especially Extradural abscess ), meningitis or if severe, it may even lead to abscess formation in the temporal lobe.
Floor : Jugular bulb - The middle ear cavity is separated from jugular bulb by a thin piece of bone that if deficient may lead to formation of a layer of fibrotic tissue and mucous membrane in between. The contents of jugular bulb are:
- Internal Jugular vein
- Glossopharyngeal nerve ( IX )
- Vagus ( X )
- Accessory nerve ( XI )
The tympanic branch of glossopharyngeal nerve enters the middle ear at the junction of the floor and medial wall to play an important role in formation of tympanic plexus.
Anterior wall : The upper part of the narrow anterior wall has two openings or tunnels for - ( mnemonic : TEA )
- Canal for Tensor tympani muscle
- Pharyngotympanic ( or Eustachian ) tube
The lower part of anterior wall is separated from the Internal Carotid Artery by a thin plate of bone. The ICA is surrounded by a plexus of sympathetic nerves that enter middle ear through openings in this bony plate to form tympanic plexus.
Posterior wall : Posteriorly, it is related to middle ear cleft ( Aditus, Antrum and mastoid air cells )
- Infection in this region may spread posteriorly into the sigmoid sinus ( in posterior cranial fossa ) and cause thrombophlebitis !!
Medial wall : Medially the middle ear cavity is related to the promontory, oval and round window
Lateral wall : Tympanic membrane separates the middle ear from the external ear.
A brief about the functions of middle ear:
On the incoming of sound waves, the tympanic membrane oscillates and these oscillations are sensed by the strongly attached and faithful middle ear ossicle, the Malleus. The sound energy is transmitted as such by the ossicles ( Malleus - Incus - Stapes ) to the internal ear for further processing.
The major function of these ossicles is amplification of sound waves - Tympanic membrane is 17 times larger than the oval window - So that means the sound energy is picked up by the larger area ( TM ) and impinged over a much smaller area ( oval window ) thus amplifying it 17 times.
In addition, the lever action of the ossicular chain is approx. 1.3 units. Thus the intensity ( force ) of sound waves/ vibrations changes ( increased by ~20 times ) and not the frequency !! If the sound waves are not amplified ( in case OC is removed ), the Air Conduction would be lost. So BC > AC and thus hearing would then be poor.
Thats all
Hope this helped :)
Stay Awesome!
- Jaskunwar Singh
Craniopharyngioma mnemonic
The C's of Craniopharyngioma
Children
Calcification
Cholesterol crystals
Cyst formation
Central diabetes insipidus
Compresses chiasm, can't C (see, because butemporal hemianopia)
CR: CRAniopharyngioma RAthkes pouch remnant
Yup. That's all!
-IkaN
Sunday, April 23, 2017
'A' wave in JVP : Mnemonic and explanation
Hi everyone. So JVP is one of the most theoretical clinical signs I've ever studied. And though parts of it are logical , I find it tedious to memorize all causes for a particular finding.
So I've prepared a Mnemonic for prominent a waves.
Here goes.
The A wave is a positive wave of the JVP.
It represents the Right Atrial pressure during systole.
Causes of a prominent a wave
Remember :
CRePT's
C - Cor Pulmonale
R - Right heart Failure
P - Pulmonary stenosis
T - Tricuspid stenosis
S - The S tells you it's Stenosis for P and T.
The a wave essentially represents the pressure in the Right atrium during systole.
So any condition that causes this pressure to increase would cause a prominent A wave.
Cor Pulmonale and RVF are basically congestion in RV causing elevation of pressure in the RV.
This means the atrium needs to pump with greater force into the Ventricle for the venous return to enter the Ventricle. This increases the RA pressure causing prominent a wave.
Pulmonary Stenosis leads to accumulation of blood in the RV and this follows a similar fate as the above mentioned causes.
Tricuspid stenosis causes obstruction to the flow of blood from RA to RV. Thus accentuating the pressure in the RA.
That's the Prominent a wave for you !
~~~~~~~~~~~
Now there's something called the Cannon a wave.
These represents contraction of the RA against a closed Tricuspid valve.
The causes of this include -
A- V dissociation.
Heart blocks.
Ventricular arrhythmias - V tach , Ventricular premature complexes and Ventricular pacing.
~~~~~~~~~~~
The a wave would be absent in Atrial fibrillation as the atrium is functionally not pumping at all , and just vibrating.
These are the a wave findings for you !
Hope this helped
Stay awesome.
~ A.P. Burkholderia
Number needed to treat and number needed to harm mnemonic
Hello!
Number needed to treat = 1 / Absolute risk reduction
Mnemonic: TARR - Treat Absolute Risk Reduction
Number needed to harm = 1 / Attributable risk
Mnemonic: HARM - Harm Attributable Risk M
That's all
-IkaN
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