Submissions: Crohn's disease mnemonic

This was submitted to us by Subbiah. Thanks!

Submissions: Anastomosis around the Scapula

This was submitted to us by Aparna. Thanks, girl!

Submissions: Anticoagulants mnemonic

This awesome mnemonic on Anticoagulants was submitted by Dr Vinayak Hiremath.

Hidden bleeds

So this is what my fellow asked me today: Say, there is a patient whose hemoglobin is dropping, dropping, dropping and he has barely any significant signs or symptoms.. Besides the GI tract, where else can you have a significant bleed which can be hidden? There are three such places.

Guess before you read the answer! :D

In my words: Diagnosing a PE

I was reading about Pulmonary Embolism for USMLE Step 2 CK and started typing notes for myself to refer. I thought I'd upload it for you guys to read as well.

Disclaimer: I am talking to myself in the blog. I hope it makes sense.

I'll be talking about two scenarios -
High pretest probability scenario: Dude who sat in a 24 hour flight, smokes a lot, is taking OCP's, got his hip replaced and can't move at all.
Low pretest probability scenario: Dude who is dyspneic, hypoxic and has a normal chest x-ray.

Let's start with scenario #1 - The high pretest probability:

If there's a high index of suspicion and a treatment option is given in the options, choose the treatment one because you don't want to waste time in imaging.

If there's a high index of suspicion and a treatment option is not given in the options, they want you to choose a diagnostic modality. The "next best step" in the diagnosis. What do you choose?

Why does oxygen cause hypercapnia in COPD?

In medical school, we learnt that oxygen administration in patients with chronic obstructive pulmonary disease (COPD) induces hypercapnia through the 'hypoxic drive' mechanism. I had talked about this in my previous blog here.

Today, I found out that it is a myth. Well, sort of. It has a minor role. At least, in COPD.

Studies found out that the minute ventilation had a limited effect on PaCO2 :/

So... What caused the CO2 increase then?

How would you look upside down?

Hey everyone!

I attended a conference of aging of the face two weeks back. Did you know that aging of the face can be related to gravity? Yep it is.

Well, here's what's REALLY interesting: To reinforce this theory, they found out that inversion photographs of aging patients (either in a supine or Trendelenburg position) demonstrate an appearance consistent with that of photographs taken approximately 10–15 years prior.

Here's a picture:

Antipseudomonal antibiotics mnemonic

Hope you're having a good day!

"CP cover Crazy Pseudomonas."

Cephalosporins (Like Ceftazidime, cefepime, cefoperazone, cefpirome)
Ciprofloxacin (Fluoroquinolones)
Carbapenems (Meropenem, Doripenem)
Colistin
Polymyxin B
Piperacillin tazobactam (Anti pseudomonal penicillins)

I also remember that antibiotics that have the letters "AZ" cover Pseudomonas.

Organisms covered by Azithromycin mnemonic

Hey!

Today, during rounds, I was asked which organisms does Azithromycin cover that ceftriaxone doesn't and I kinda blanked out :(

PS: They were talking in context to community acquired pneumonia (CAP) and so does this post.

So.. Mnemonic!

Phagocytes, Monocytes, Macrophages, Histiocytes?! What's the difference between them?

Hey guys!

If you've always found it difficult to make a distinction between those terms about wha they mean then this post is for you. Let's  just settle it once and for all.

Study group discussion: Lipid Metabolism Deficiency Enzymes

Hey guys, this is a minor post about Lipid Metabolism Deficiency enzymes we talked about in Medicowesome Whatsapp Group. (If you want to join our group, please email us!)

DNA viruses mnemonic

DNA is the blueprint of biological life as we know. 

Viruses contain either DNA or RNA, they NEVER contain both. Now whether viruses containing DNA makes them superior to there only-RNA containing counterparts..that is debatable.

Medical humour: Face-lift

"Face-lift is like a prolapse repair of the face."

- Sim, my medical friend rotating in urology talking about plastics.

Mnemonics - Dermatomal distribution easiest way to remember

Hey people,

I don't know if you struggled remembering the dermatomal distribution but I always had a tough time with it. 

Starting off: The sensory distributions always overlap with the adjacent ones. So there is no hard and fast rule. The zones that have sole supply from one nerve are known as Autonomous Sensory zones. Which are helpful in identifying the nerve lesion. C1 segment has no sensory supply, only motor supply.

Mnemonic for the layers of the skin (Epidermis)

Hey guys! 

Here's an easy mnemonic to remember the layers of the epidermis and some other fun facts.

The Epidermis consists of 5 layers (From base to top)

- Stratum basale
- Stratum spinosum
- Stratum granulosum
- Stratum lucidum
- Stratum corneum

Mnemonics

Top to Bottom:

Come Lets Get Sun Burnt                                            
Bottom to Top:

Britney Spears Glows Like Candy (If  you like her!)

Britney Spears Grows Like Cancer (If you don't like her :P )

Stratum Basale (as it is the basal layer) :

Columnar epithelial cells. 
These cells multiply and produce the keratinocytes which move up the layers. 
Melanocytes are present in this layer which produce melanosome (melanin packed in granules) and ship them to the keratinocytes in other layers  through their dendrites. 

Stratum Spinosum / prickle cell layer (contains desmosomal bridges which look like spines.) :
Polygonal cells.
Connected to each other by the aforementioned desmosomal bridges.

Stratum Granulosum (contain keratohyaline granules) :
Diamond shaped cells. 
Granules contain protein filaggrin (filament aggregation) which is responsible for the aggregation of keratin filaments. 

Stratum Lucidum:
Flat cells. 
Present only in palms and soles.

Epidermis in rest of the body has only 4 layers.

Stratum Corneum (horny layer) :
Most superficial layer. 
Cells are fully keratinised and end up as anucleate dead cells which later desquamate. 

Basale, spinosum and granulosum together are called as the living layer. 
Corneum is called as the dead layer. 

Dermis consists of the superficial papillary dermis and the deep reticular dermis.

Fun facts:
Skin is the largest organ in the body.
Keratin is synthesised in the Spinosum layers but accumulates in the granulosum layer.
The migration of cells from basal layer to desquamation is known as the Turn over Time which is normally 4-5 weeks.
Merkel cells(sensory end organ) present in the basal layer are responsible for the touch sensation.

P.S. The image has been taken from another site.

- Ved

Signs seen in Aortic regurgitation mnemonic

Hello! In this post, I talk about the signs seen in Aortic regurgitation and share a few mnemonics with you. I also inserted some gif images to make it fun.

I recommend using mnemonics for the signs you can't remember after learning them thoroughly than trying to memorize the mnemonics first :)

Let's get started :D

de Musset's sign: Rhythmic nodding or bobbing of the head in synchrony with the beating of the heart.

Mnemonic: Imagine a musketeer, raising his hat and then bowing his head stylishly.

Quincke's sign: Regurgitant blood flow into a dilated left ventricle during diastole leads to a decrease in diastolic pressure and a consequent increase in stroke volume, resulting in blanching and flushing, respectively, of the nail bed.

PS: They are pulsations which are SEEN, they are NOT FELT.

Quincke's pulse is the capillary pulsations and any thing that demonstrates these pulsations may be known as Quincke's sign. (I don't know for sure though.)

Other ways to see Quincke's pulse:

- While drawing the thumb nail sharply across the forehead, one can cause a red mark, which can be seen paling and flushing with each beat of the heart.

- When pressing a glass slide on the inner part of the lower lip, the same capillary pulsation will be seen. 

So these two can also be called Quincke's signs! :)

Mnemonic: I honestly don't have a mnemonic for this one. Uhh.. How about.. "Quickly keep Quiet with Quincke's finger on your lips?" The Q's to remind you of Quincke. Finger for nail bed. Lips for the glass slide thingy.

Causes of inverted T waves

Causes of inverted T waves :

1. Normal in lead V1 , V2 and V3 ( V3 only in blacks )  , normal in avR too

2. Ventricular hypertrophy

3 . ischemia / infarction

4. Digoxin toxicity

5. Bundle branch block

Written by Huzaifa Bhopalwala (Previously known as mist amidst)

ST elevation other than MI

Causes of ST elevation other than MI:

1. Prinzmetal angina
2. Hyperkalemia
3. Acute pericarditis and myocarditis
4. Brugada syndrome
5. Arrhythmogenic RV cardiomyopathy
6. PE (Pulmonary embolism )
7. LBBB
8. And Normal variants ( high Take off and early repolarization )

Written by Huzaifa Bhopalwala (Previously known as mist amidst)

Zika-The next Ebola?

Zika virus is a member of the flavivirus group currently spreading wildly across the Americas, especially the Latin America.

Okay, it's just another virus.Who cares?
Zika virus spreads by a mosquito bite,Aedes aegypti. 80% of the affected population are asymptomatic. Its manifests itself as a fever, headache,  joint pains and rarely conjunctivitis just like any other flu. Basically you don't know you have it.

A headache and joint pain epidemic? Stop kidding me. 

Is diarrhoea really that bad?

Hello,

Since I haven't found a solid topic to post on I'll be doing this bit.
Remember that dreaded diarrhea which struck when you were traveling off on a trip far from home and you thought you could trade your life for a toilet? That might be a saviour though.

Whaaa? Stop that Shit? No really. Read on.
Serotonin is primarily produced by enterochromaffin cells in the crypts of Leiburkuhn. These are

Mnemonic for the laryngeal muscles and their actions

Hey people,

We've all tried to remember the laryngeal muscles time and again but it just doesn't stick right?
I devised an easy way which helped me.

Mnemonic: Organisms penetrating an intact Cornea

The organisms affecting the cornea(like pneumococcus) usually do so if there is a preexisting injury especially a breach in the basement membrane of the epithelium.
But some do so despite it being intact, by creating a CHNL.

Hypoxia and radiotherapy

What effect do you think hypoxia would have on radiotherapy?

Okay I know this. Hypoxia kills cells so it should help right?
I'm afraid you couldn't be more wrong.

Mnemonic for Vit B complex

Hey guys, Jay here! These days we are having Nutrition subject and we were studying Vitamin B complex recently. Since it's confusing to me I made a mnemonic using the names of my class mates :P

With all due respect to my classmates who are future physicians, here is my mnemonic! :)

What is the difference between Vegetarianism and Veganism?

Hey guys Jay here once again. Today I thought to talk about a subject matter discussed in our Nutrition class. That is about Vegetarianism and Veganism.

Many think these both terms are interchangeable, but in fact it is NOT!!!

So let us compare Vegetarianism and Veganism...

Dextrorotary or levorotatory and D or L forms

Greetings readers!

Dextrorotary or levorotatory and D or L forms - We hear these terms, especially, in biochemistry of chiral carbon atoms.

Now, I always thought in D-glucose, the D is for dextrorotary. But I was wrong.

Time management and avoiding silly mistakes in exams

"Hello there! Do you have any tips to stay focus and manage my time while doing a paper? I tend to rush and didn't read the questions properly which caused me to make stupid mistakes!" - Asked on Tumbr

Divide number of questions by number of minutes. Have some spare time at the end.

How to keep up with medical school

"I was wondering if you have any tips on how to study daily and not fall behind in med school?" - Asked on Tumblr

“He who fails to plan, plans to fail.”

How to Behave like a Good Doctor? (Part 1)

                     Anybody with a hard earned MD/DO or MBBS(MBChB/BM/MBBChir etc all fall here) can be a doctor. But not every doctor is a good doctor. Not every good doctor can present themselves well and behave as a doctor.

Hello awesomites, I’m Jay here, once again with some insights on How behave as a Doctor in a Clinical setting. Today we had a discussion in our Medical History Lecture about this, I’m basing the article on that. This part 1.

1. Attitude

You should have a proper attitude as a doctor. In front of your patient, you should look confident. You should not be

Electives

Hey guys!

As you all know, I'm preparing for USMLE and I wish to do an Internal Medicine residency in the USA. A part of the process for international medical students requires electives, which is, clinical experience in the US.

I am in Cleveland, Ohio in the months of January - April 2016 for my electives.
I will also be coming to Houston, Texas for my USMLE Step 2 CS exam.

If you're around at that time, I would love to meet you. Please come say hi.

For those of you who have been to the US for electives, please let me know do's and dont's. Anything you wish someone had told you prior to the experience.

I will also be blogging about every tiny detail - From preparation to what I experienced - So that it helps someone like me in the future :)

That's all!

Wish me luck and pray for me.

-IkaN

PS: I will not be disclosing the name of the hospital and specialty on the blog. Reason being patient confidentiality and privacy purposes.