Acute Kidney Injury due to Anticancer drugs

Hey guys, there are multiple causes of acute kidney injury in a cancer patient, namely sepsis, metastasis, tumor lysis syndrome, etc. But there is another reason which we often overlook, which is drug-induced.

1. Thrombotic microangiopathy: Associated with agents targeting vascular endothelial growth factor(VEGF), eg., Ranibizumab, Bevacizumab. These drugs also block the angiogenesis in the glomerular vasculature, such that the injured endothelium isn't replaced, leading to multiple foci of platelet aggregations just like in TTP and HUS.

2. Focal segmental glomerulosclerosis: Associated with tyrosine kinase inhibitors are the most common and are frequently associated with acute kidney injury.

3. Acute Interstitial Nephritis:
The checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab activate host T cells to enhance tumor killing by preventing tumor ligand binding to cytotoxic T-lymphocyte antigen 4 and programmed death 1 receptors, which deactivate T cells. However, this effect causes loss of self-tolerance (and perhaps tolerance to other drugs), leading to various forms of autoimmune injury, including acute interstitial nephritis, which is associated with moderate-to-advanced-stage acute kidney injury.

That's all!

-VM

Submissions: Syndromes associated with pheochromocytoma

Submitted by Vivek on the study group =)

Gross motor milestones mnemonic

Hello!

In this video, I talk about gross motor milestones from the age one to five years of age.

Source: Nelsons textbook of pediatrics.

Mumps complications mnemonic

Here's a short post on complications of Mumps!

Here's Jaskunwar Singh's mnemonic on comps of mumps. It's more extensive, mine just covers the important stuff. 

M - Meningitis

U - Urogenital infection (Orchitis, Oophoritis)

M - Male infertility

P - Pancreatitis

S - Salivary glands affected 

Also more M's:

M - Miscarriage in pregnant women (12 - 16 weeks)

M - Myocarditis

That's all!
-IkaN 

Maternal factors for IUGR mnemonic

Hello

The maternal factors that increase the risk of Intrauterine Growth Restriction ( IUGR ) in unborn babies ( small - for - dates ) include : MATERNAL RISK

M - Malnutrition / Multiparity
A - Anaemia ( severe )
T - Toxaemias of pregnancy
E - Excess physical activity
R - Raised blood pressure
N - Narrow birth spacing
A - Alcohol intake ( excess ) / Age ( young )
L - Low socio - economic scale

R - Recreational drug use
I - Infections
S - Smoking / Short stature
K


Thats all
- Jaskunwar Singh

Kangaroo mother care mnemonic

Hello

Components of Kangaroo mother care mnemonic : Baby Kangaroo HOPS in its mother's pouch ;p

H - Healthy diet provision ( breast - feeding )
O - Outpatient care ( due to early discharge )
P - Positioning of baby close to mother's chest
S - Support to mother and family


Thats all
- Jaskunwar Singh

Uric acid and struvite stones mnemonic

Well, urine is largely water which *can* be considered as transparent. That's why, uric acid stones don't show up on X-rays.

Struvite or triple phosphate stones have Proteus has the causative factor. Remember p for p

That's all!

-Sushrut Dongargaonkar

Drugs causing gingival hyperplasia mnemonic

Hello!

It's important to know drugs causing hypertrophy of the gums for exam purposes.

Auditory Transduction simplified

Basics of auditory transduction simplified by Chaitanya Inge in his first awesome video! Check it out! :D

Pigment producing mycobacteria mnemonic

There are these two mycobacteria which produce pigments- M. gordonae and M. szulgai in the dark. How to remember them?

1. A garden contains flowers which
are colourful. So you can remember M. gordonae that way.

2. Szulgai matches 'Nilgai' which is an Indian local word for the Indian
bluebuck/Indian blue bull. So the  involvement of a color in the name can be correlated with pigment production.

That's all!

-Sushrut Dongargaonkar
   

Addisons disease mnemonic

Hey!
Do you have a mnemonic for adrenal insufficiency?

Cryptococcus neoformans notes and mnemonics

Hello!

This post is on cryptococcus neoformans.

Easy way to memorise Organ of Corti

Hello Everyone!

               Here is a easy way to memorise the Organ of Corti structure.

We've also upload a video explaining the same. Check it out =) 

Thank you,

Chaitanya Inge

Beta blocker intoxication

Hello!
This is a short blog on beta blocker
intoxication.

Beta blockers acting on beta receptors have wide range of actions and uses.

Most common complication of beta blocker overuse is Cardiovascular depression like hypotension and bradycardia, impaired atrioventricular functions.
Can we give adrenergic drugs to reverse this action?
No, we can't .
Prolong use of beta blockers leads to upregulation of the beta receptors. Beta Agonists will further aggravate the adrenergic actions.
Which may cause tachycardia even arrhythmias.
Even Atropine is inconsistent in reversing the side effects

So the alternative used is Glucagon -
It stimulates cAMP synthesis independently of beta adrenergic receptors.
It has positive ionotropic and chronotropic action, thus it reverses the cardiovascular depression without causing tachycardia or other adrenergic effects.

It can also be used in calcium channels blocker overuse.
Glucagon therapy still dont have enough evidence to prove its efficiency.

Hence Judicious use of drugs is must.
Stay awesome!

~Khush

Effects of cholinergics and anticholinergics on the bladder mnemonic

In this video I talk about:

Cholinergics, bethanechol, diabetes mellitus, denervation and overflow incontinence.

Anticholinergics, oxybutynin, urge incontinence.

And mnemonics. Enjoy!

Risperidone mechanism of action mnemonic

Hello! This post is about the atypical antipsychotic - Risperidone!

Risperidone is a second-generation antipsychotic that has affinity for D2, 5-HT2A, alpha 1, alpha 2 and H1 receptors.

The mechanism of action of risperidone is not fully understood, current theories focus mainly on its ability to block D2 and 5-HT2A receptors.

Hard time remembering this? I've got a solution!

IPC 176 177 178 179 mnemonic

Shilika strikes back with a video! :D

Initiation factors in eukaryotic translation mnemonic

Hello Everyone,

Lets discuss Initiation factors today. Here's the the mnemonic:

1. elF-1: 1 looks like i . So it causes Dissociation of 80 S

2. eLF-2: Two- Formation of Ternary complex. Also GTP needed

3. eLF-3: 3 looks like B. hence it causes Breakdown(dissociation of 80 S)

4. elF-4:   

cap binding protein complex elF-4F=  elF-4E + elF-4G+ elF-4A . Binds to 5’End of mRNA through elF-4E  

elF-4A and elF-4B: A has helicAse activity.Makes use of ATP 

                                B makes things Better. :)

                                Both help  reduce complex secondary structure of 5’end of m-RNA.                                                                                                           (A+B=reduce Complexity)

5. eLF-5: 5 looks like S. So it causes: 

      1. releaSe of initiation factors

      2. aSSociation of 40S and 80S Subunits

Here are some diagrams that will help you:

That’s all,

Thank you,
Chaitanya Inge

Rubeola vs Rubella mnemonic

Hello!

RubeOla - Ordinary measles ( kOplik spots on buccal mucosa are pathognomic )

RuBella ( German measles ) - Well, I remember Bella B. Felsenheimer, a German musician and drummer ( Foschheimer spots on the soft palate are characteristic ).


Thats all
- Jaskunwar Singh

Torres bodies mnemonic

Okay, to be honest this one is not quite a very good mnemonic but I like to remember Torres bodies in yellow fever by the footballer Fernando Torres wearing his club jersey in yellow color, even if he doesn't. Well, yeah, that's about it! :-p

-Sushrut Dongargaonkar

Diagnostic Enzymes in Myocardial Infarction

   

Hello Everyone,

Here’s a quick mnemonic on Sequence of elevated enzymes in myocardial infarction. I got it from https://imgusmlestep1.blogspot.in. Originally it was  like this Time to CALL 911. I have modified it. It goes like this

                             Time to CALL 12 24 30 48.

The numbers represent time of peak elevation of the enzymes.

Sequence of elevated enzymes are:

        Troponin: Cardiac Troponin I and Cardiac Troponin C (12 hours)

        Creatine Phosphokinase (MB) (24 hrs)

        Aspartate Transaminase (30 hrs)

        Lactate Dehydrogenase 1 (48 hrs) 

Important Facts:

Cardiac troponin I (cTnI) is highly sensitive and specific for damage to cardiac tissue. cTnI appears in plasma within 4–6 hours after an MI, peaks in 8–28 hours, and remains elevated for 3–10 days.Elevated cTns, in combination with the clinical presentation and characteristic changes in the electrocardiogram, are currently considered the “gold standard” in the diagnosis of a MI.

Creatine Phosphokinase (MB):Appearance of this hybrid isoenzyme in plasma is virtually specific for infarction of the myocardium .Following an acute MI, CK2 appears approximately 4–8 hours following onset of chest pain, reaches a peak of activity at approximately 24 hours, and returns to baseline after 48–72 hours.

A quick comparison between Cardiac troponin and Creatine Phosphokinase:

Troponin is more sensitive than CK-MB because more troponin is found in the heart per gram of myocardium and that a greater percentage depleted from the heart by cardiac injury arrives in the blood 

With regard to specificity, troponin elevations are almost always specific for cardiac injury, except for the infrequent analytical false positives caused by fibrin interference and/or cross-reacting antibodies. CK-MB is not specific for cardiac injury, as a small amount is found in skeletal muscle.

I am very thankful to IkaN for helping me with Troponin and CK-MB.  :)

Thats all,

Thank you

Chaitanya Inge