Pharmacologic treatment of pulmonary hypertension (notes and mnemonics)

Hi!

Vasodilator response: A favorable vasodilator response is defined as a fall in mPAP of 10 mm Hg or greater to less than 40 mm Hg with an unchanged or improved cardiac output, in response to an agent such as inhaled NO or IV epoprostenol.

Cardiovocal syndrome - Ortner syndrome

In 1897, Norbert Ortner described hoarseness caused by recurrent laryngeal nerve paralysis in patients with a large left atrium due to mitral valve stenosis.

Istradefylline

Istradefylline (Selective Adenosine 2A receptor antagonist), inhibits the adenosine's inhibitory effect on GABAergic transmission in direct nigro-striatal pathway while simultaneously inhibiting adenosine's stimulatory effect on GABAergic transmission in indirect nigro-striato-pallidal pathway, ultimately leading to stimulation of thalamo-stimulatory direct pathway and inhibition of thalamo-inhibitory indirect pathway.

Selinexor

Selinexor (Selective inhibitor of nuclear export) inhibits XPO1 (exporter protein 1).

XPO1 is often overexpressed in tumors leading to transport of tumor suppressor proteins like p16, p14, p27 from nucleus to cytoplasm and there by evading the apoptosis.

Luspatercept

Here is a submission by Kirtan on Luspatercept!

Luspatercept (recombinant fusion protein containing Activin receptor type IIB moeity) blocks excessive SMAD2/3 activity (Mothers against decapentaplegic homolog) lying downstream of TGF-beta signalling by binding endogenous TGF-beta family members, including Bone morphogenetic proteins (BMP), Activin, Inhibin, Lefty A/B, Artemin, Persephin, GDF, GDNF and MIS.

Acute type-II respiratory failure causes mnemonic

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Causes of Acute type-II Respiratory failure mnemonic:
DEPRESSION

Radiologic features seen in pulmonary emphysema mnemonic

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Radiologic features seen in a case of pulmonary emphysema (Chest X-ray PA view):

mnemonic: PSTR-ANTR

Clinical features of Pneumococcal Pneumonia mnemonic

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Clinical features of pneumococcal pneumonia mnemonic:

HI STREPTOCOCCUS

Risk factors for pneumococcal pneumonia mnemonic

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Risk factors for pneumococcal pneumonia mnemonic:

PNEUMONIA

Ventricular demand pacing

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I came across a patient with VVIR pacing today. I was wondering why we didn't do DDD instead. Let's learn what it is and why (In short!)

Five position code for pacemakers

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For those who don't know about pacemakers:

Mnemonic to remember colors in Doppler echocardiography

Short post :)

The mnemonic is BART:

Causes of primary hypothyroidism mnemonic

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Common causes of primary hypothyroidism:
( mnemonic: DR. HIT )

Fact of the day - BUC in UGI bleed

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Blood urea levels are positively associated with upper GI bleed. But here's the fact:

Causes of elevated serum amylase mnemonic

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Causes of elevated serum amylase mnemonic:

RAISED-AM

Causes of Acute Pancreatitis mnemonic

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Causes of Acute Pancreatitis mnemonic :

ABCDEFGHIjK

Differential Diagnosis of Acute Pancreatitis mnemonic

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Differential Diagnosis of Acute pancreatitis mnemonic:

HI-PANC

Extra - articular manifestations of RA ( Notes and mnemonic )

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Extra- articular manifestations of Rheumatoid arthritis :

( mnemonic - NOVELA is FrickiN' Hot! )

How to read CSF analysis report?

Video by Jay!

Multiple Myeloma notes and mnemonics

Hi!

Multiple myeloma - everything P

- malignant Proliferation of Plasma cells derived from a single clone.

- Immunoglobulin produced is a "ParaProtein" (M- protein)

- POEMS syndrome

BONE MARROW INVOLVEMENT

- Pancytopenia

PERIPHERAL BLOOD

- plasma cell leukemia ( greater than 2,000 per mm3 )

BONE INVOLVEMENT

- punched-out lesions in radiographs of flat bones

- bone pain

- pathological fractures

RENAL INVOLVEMENT

- Bence -Jones proteinuria

- production of excess Amyloid protein

- hyPer- calci -emia and -uria

These three result in renal damage and renal failure.

IMMUNE SYSTEM INVOLVEMENT

- prone to infections, particularly in respiratory and urinary tract.

HYPERVISCOSITY SYNDROME

( mnemonic - HPRVSCST )

- Headache

- Postural hypotension

- Retinal venous congestion

- Vertigo

- Strain (blurred vision)

- Congestive cardiac failure

- subtype IgA

- nysTagmus

CLOTTING PROBLEMS

- purpura

- profuse bleeding ( epistaxis, gastrointestinal )

NEUROLOGICAL MANIFESTATIONS

- peripheral neuropathy

- compressive myopathy

- carpal tunnel syndrome ( nerve entrapment)

- Amyloidosis.

SERUM STUDIES

- total serum protein raised

- low albumin

- high globulin ( decreased A:G ratio )

- high beta-2 microglobulin ( greater than 5.5 mg/dL means poor prognosis; stage III)

Plasmacytomas in Paraskeletal soft tissues - poor prognosis; treated by palliative radiotherapy.


That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh

How to calculate SVR and PVR using Ohm's law

Hi!

Ohms law: Current (I) equals the voltage difference (ΔV) divided by resistance (R)
Simplified, V=IR

In hemodynamics, what is voltage difference? The pressure difference or pressure gradient! (ΔP)

Drugs causing Thrombocytopenia mnemonic

Hi!

Drugs inhibiting platelet function/ causing Thrombocytopenia :-

ABCDE - HI

Obstructive Sleep Apnea features mnemonics

Hi!

Obstructive sleep apnea (OSA)

Urinary neutrophil gelatinase-associated lipocalin (NGAL)

Neutrophil gelatinase-associated lipocalin (NGAL) is an iron-transporting protein.

Mnemonic: Cerebellar Signs

Hey guys,

Here's a short and sharp mnemonic post.

Hope it helps.

Pulmonary hypertension notes

Hi!

Pulmonary hypertension (PH) is defined as a resting mean pulmonary artery pressure of 25 mm Hg or greater measured during right heart catheterization.


(How I remember the number 25 - PH: 2 letters, Hyper: 5 letters).

Classification of Pulmonary Hypertension mnemonic

"A heart lung chronic thrombotic unclarity"
1: pulmonary Arterial hypertension
2: PH due to left-sided heart disease
3: PH due to lung diseases and/or hypoxia
4: Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5: PH with unclear or multifactorial causes

The transpulmonary pressure gradient (TPG): The difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (LAP, commonly estimated by pulmonary capillary wedge pressure PCWP).

A TPG of >12 mmHg would result in a diagnosis of “out of proportion” pulmonary hypertension - suggesting intrinsic pulmonary vascular disease in patients with left-heart conditions associated with increased pulmonary venous pressure.

Will update post as I learn more... 

-IkaN

Step 3 NBME Form 4 answers explanations

Publishing incomplete post form drafts :)

Platypnea-Orthodeoxia Syndrome in interatrial right-to-left shunt

Hi everyone! This is a short post :)

Platypnea (flat breathing): Dyspnea induced by upright posture and relieved by recumbency.

Orthodeoxia: Arterial oxygen desaturation accentuated by upright posture and improved by recumbency.

Peripartum heart failure associated with prolonged tocolytic therapy

Did you know?

What's Wrong With My Gallbladder, Doc?

A quick mini-post to help you make a quick diagnosis.

[Please click on the image to enhance it]

Please remember to practise caution as the presentations may overlap.

Thank you for reading.

- Ashish Singh