Brucellosis and it's reservoirs mnemonic

Hello!

Here's a mnemonic on Brucellosis and it's reservoirs! :)

Catalase positive organisms mnemonic

Hello!

Here's a mnemonic on Catalase positive organisms :)

Video by Huzaifa Bhopalwala

Enzymes requiring thiamine mnemonic

Can you enlist the enzymes requiring thiamine?

If you can, give yourself a pat on the back and don't read further.

If you can't, give yourself a pat on the back, because you are going to learn how to remember it! :D

Causes of elevated JVP mnemonic

Hey Awesomites

Jugular vein is on a high and stretching out on the RAPs of  "the CREST" .. wohhooo.. :D

R- Right ventricular failure
A- Atrial septal defect (with mitral valve disease)
P- Pericardial compression/ tamponade

C- Circulatory overload
R- Renal failure
E- Excess fluid administration
S- Superior vena cava obstruction
T- Tricuspid stenosis


Hope you enjoy the crest too ;p

- Jaskunwar Singh

Difference between Caput Succedaneum and Cephalhematoma

Hello everyone!
Lemme tell you the difference between Caput Succedaneum and Cephalhematoma today! :)

Bishops score and Manning score mnemonic

Another video by Shilika!

Immunohistochemistry and cytogenetics for leukemias: Part 2

Here's part 2! On Chronic myeloid, chronic lympoid and MDS!

Immunohistochemistry and cytogenetics for Non Hodgkins Lymphoma

Hello!

The Romberg's test does not test cerebellar function

The Romberg's test does not test cerebellar function.

This is a topic that most medical students discuss at some point of time. I have found myself in the midst of similar conversations over my years at medical school.

After much study, I happened to reach an understanding that clarified the purpose of the test and provided a way to understand the results as well.

It would help if you think of the cerebellum as a processor (such as a C.P.U. in a computer).
There are 3 main inputs:


Romberg's test (3 steps):
1. Ask patient to stand with feet together.
2. Ask patient to close both eyes.
3. Maintain the posture for 60 seconds.

The Romberg's test is positive if the patient cannot stand for 60 seconds with feet together and eyes closed.

It is essential to understand that without the processor, the inputs do not matter (as there will be no output and no result).
Thus in Cerebellar ataxia, the patient will be unable to perform any of the above 3 steps and thus the Romberg's test cannot be performed on this patient.

In a situation where the cerebellar function is intact and Romberg's test is performed:
The first input (Vision) is lost when the eyes are closed.
It is now unto the 2 other pathways (Proprioceptive and Vestibular pathways) to provide input to the cerebellum.

Thus the Romberg's test will be positive in cases of:
1. Proprioceptive dysfunction e.g. Sensory peripheral neuropathy & Dorsal column dysfunction
2. Vestibular dysfunction e.g. Vestibular neuritis

This was my attempt to provide a brief summary about this topic and it has been compiled to the best of my understanding. Please feel free to discuss it further, in the comments section below.

Have a great day!

- Vikramjeet Kakade

Immunohistochemistry and cytogenetics for leukemias: Part 1

Hello!

Fact of the day: Most efficient sleep position to clear the brain of waste

Your sleep position at night matters a lot. Not head-up, nor head-down, but sleeping on your side is the most efficient position to clear waste materials from the brain.

This is because the glymphatic system (exchange of CSF with the interstitial fluid to get rid of damaging brain proteins) of our brain works most efficiently in lateral position compared to supine or prone position.

Lateral position and right posture while sleeping is considered advantageous for those suffering from neurologic and psychiatric disorders due to this reason.

That's all

- Jaskunwar Singh

Spermatic Cord contents : Mnemonic

Hello. This is about the things that your thing contains if you're a guy :p

So the spermatic cord is an important content of the inguinal canal in men.

And it contains a host of things.

Remember :

Plenty of Dick Contributes To Good Sex Life

Plenty of = Pampiniform plexus
Dick = Ductus Deferens
Contributes = Cremasteric artery
To = Testicular Artery
Good = Genitofemoral Nerve (Genital br)
Sex = Sympathetic plexus
Life = Lymphatics.

So it's 3 Arteries + 2 nerves + 3 other things.

Hope you like this !
Stay awesome.

Fascia of the thigh : Mnemonic

Hi everyone. This is a short post where I tell you about the thigh fascia.

So fascia of the thigh is super important during surgery , and we are expected to know its layers.
So it's got 2 layers : Camper's and Scarpa's.
Now which is outer and which is inner ?

Remember :

OC IS  good.

So OC = Outer Camper
       IS  = Inner Scarpa

Hope you liked this!
Stay awesome.

Schistosoma mansoni and Schistosoma haematobium mnemonic

Here is the video :)

East African Sleeping Sickness and West African Sleeping Sickness mnemonic

Here is the video :)

Naked RNA viruses mnemonic

Here is the video!

Side effects of anti-glaucoma drugs mnemonic

Here's the video!

Bacteriophages coding for toxins mnemonic

Video is up :)

Naked DNA viruses mnemonic

Here is the video!

Uses of tetracyclines mnemonic

Write Tetracycline as TetraCycLyne -

Fact of the day: Most common causes of non gonococcal urethritis

MCC of NGU in decreasing order are:

Dermatophytes mnemonic

Let's learn a lil mycology today!

Lesions of small pox and chicken pox mnemonic

Same stage vs different stages of development!

Structure and properties of poxviruses mnemonic

Hello!

So we will be learning about the structure and multiplication of poxviridae today from the mnemonic: “Pox is in a big box”

Excited?

Memory aid for urease positive organisms

Hailo!

Here's a little memory aid for urease positive organisms.

Alcohol and Drug Interactions: 4th Part

Hii friends...

This is the last post in the series: Alcohol and Drug Interactions. The previous posts in this series were Disulfiram-like Reaction, 2nd Part, and 3rd Part.

With Warfarin

1. Binge drinking- Leads to inhibition of warfarin metabolism by CYP450 enzyme system. So it can precipitate warfarin toxicity with increased bleeding tendency in the body.

2. Chronic Alcohol consumption- Leads to induction of CYP450 enzyme system, so increases metabolism of Warfarin in the liver. So higher than usual dose of warfarin is needed to exert appropriate anticoagulant action in the patient.

With Opioids

Alcohol increases the sedative effects and also increases the risk of respiratory depression. It also attenuates cough reflex and gag reflex, so the patients have a higher risk of getting food stuck in their respiratory tract, remember Cafe Coronary.

With NSAIDs

1. NSAIDs have been implicated in an increased risk of ulcers and gastrointestinal bleeding in elderly
people. Alcohol may exacerbate that risk by enhancing the ability of these medications to damage the
stomach mucosa.

2. Alcohol also potentiates the antiplatelet actions of Aspirin, hence increase the risk of bleeding in the patients.

3. Intake of alcohol with acetaminophen can increase the risk of acetaminophen-related toxic effects
on the liver. Acetaminophen breakdown by CYP2E1 (and possibly CYP3A) results in the formation of a toxic product(NABQI) that can cause potentially life-threatening liver damage. As mentioned earlier, heavy alcohol use enhances CYP2E1 activity. In turn, enhanced CYP2E1 activity increases
the formation of the toxic acetaminophen product. In people who drink heavily or who are fasting
(which also increases CYP2E1 activity), liver injury may occur at doses as low as 2 to 4 grams per day.

That concludes this series. I hope it will help you to guide your patients towards drinking alcohol more judiciously. :p

-VM

Alcohol and drug interactions: 3rd part

Hey, guys.....

This is the third post in the series, Alcohol and drug interactions. The other posts are Disulfiram-like Reaction, 2nd Part and 4th Part.

With Antihistaminics

Alcohol increases the risk of sedation, drowsiness and falls, especially in the elderly population and with the 1st gen antihistaminics.

With Barbiturates and Benzodiazepines

Alcohol acts synergistically with them to increase their sedative effects and memory-impairing effects( This memory-impairing effect is misused in Date Rape drug, Flunitrazepam(Rohypnol)). Besides it also inhibits their metabolism in the liver, hence, increasing the drug's levels in the blood.

With H2-Receptor Antagonists

These agents(eg., Cimetidine, Ranitidine) inhibit the action of Alcohol dehydrogenase(ADH) present in gastric mucosa.  Cimetidine may also increase the rate of gastric emptying hence increasing the absorption of alcohol. So both of these effects contribute to increasing the Blood Alcohol levels.

With Muscle Relaxants

Several muscle relaxants (e.g., carisoprodol, cyclobenzaprine, and baclofen), when taken with alcohol, may produce a certain narcotic-like reaction that includes extreme weakness,
dizziness, agitation, euphoria, and confusion. For example, carisoprodol is a commonly abused and readily available prescription medication that is sold as a street drug. Its metabolism in the liver generates an anxiety-reducing agent that was previously marketed as a controlled substance (meprobamate). The mixture of carisoprodol with beer is popular among street abusers for creating a quick state of euphoria.

That's all!

-VM

Alcohol and Drug Interactions: 2nd part

Hey guys,

This is a continuation of the previous post on Disulfiram-like Reaction.

Let us start with a basic info. Pharmacokinetic drug interactions with alcohol are only seen in heavy drinkers whereas Pharmacodynamic drug interactions can be seen in moderate drinkers and even after a single episode of drinking. 

With Antibiotics

As already mentioned, the Disulfiram-like reaction can occur with Isoniazid, Cefotetan, Cefamandole, Cefoperazone, Chloramphenicol, Sulfamethoxazole, Sulfisoxazole.

Besides patients on Isoniazid should abstain from drinking alcohol since isoniazid is hepatotoxic and the liver damage can be exacerbated by concurrent alcohol consumption

With Antidepressants

1. With TCAs: Alcohol increases the sedative action of TCAs, especially Amitriptyline, Doxepin etc.
Alcohol also impairs the first-pass metabolism of Amitriptyline in the liver causing increased bioavailability of the drug. Excessive increase in levels of TCAs in the blood can precipitate convulsions and cardiac arrhythmias.

2. Among SSRIs, all are relatively safer with alcohol; the safest being Fluoxetine.

3. With MAOIs(eg., Phenelzine, Tranylcypromine): There can be severe high BP(cheese reaction) if taken together with red wine which contains Tyramine.

That's all! :)
Do go through the subsequent posts in this series, 3rd Part and 4th Part.

-VM

Alcohol and Drug Interactions: Disulfiram-like Reaction

Hey, guys...

So day before yesterday, there was my Forensic Medicine viva and the examiner asked me the causes of impotency. And I immediately started blabbing about Stress, Phimosis, Hypospadias, Peyronie's disease, I even mentioned Parkinson's disease. The examiner interjected me and asked the most common cause. I guessed heart disease and the related medications and he denied. Then he said it is excess consumption of alcohol and asked me not to underestimate alcohol and it's various interactions and correlations ever.
So here I am, trying to summarize the interactions of alcohol with the major classes of drugs.

Disulfiram-like Reaction

I am not going to go into the details of the mechanism. Just, in brief, Disulfiram-like reactions entails flushing(due to dilatation of blood vessels), nausea, vomiting, sweating, hypotension, so reflex tachycardia which can be deleterious to a patient of coronary artery disease(CAD).

Now let us try to use CAD as a mnemonic here while learning certain other things as well.

1. It starts with C, a lot of drugs starting with C have this reaction, like Cefamandole, Cefoperazone, Cefotetan, Chloramphenicol.

2. Patients with CAD have Pain, so let us now manage that some analgesics starting with P(for Pain), Phenylbutazone, Phenacetin.

3. Patients with CAD can have attacks of Angina, for which we give Nitrates, so let us take that. Drugs with Nitro group: Nitroglycerin, Isosorbide dinitrate, Nitrofurantoin, Metronidazole. Why leave Sulpha group behind?
Drugs with Sulpha group: Sulphamethoxazole, Sulfisoxazole.

4. CAD often co-exists with Diabetes Mellitus(DM). So let us manage that with some Sulfonylureas; Tolbutamide, Tolazamide, Chlorpropamide and even the 2nd gen drug Glyburide.

5. Patients with DM are immunosuppressed. Hence, they are predisposed to Mycoses and TB. Manage them with Griseofulvin and Isoniazid respectively.

That's all! :)
Do go through the other posts in this series, 2nd Part, 3rd Part, and 4th Part

-VM

Vibrio species: Halophilic and non halophilic vibrio mnemonic

Anyone up for a lil microbiology?