Step 2 CK: Treatment of narcolepsy and cataplexy

Treatment of Narcolepsy:
Patients with sleepiness severe enough to require medication can be treated with stimulant medications.

IPC and CrPC mnemonics

Hello!
This post is for Indian medical students only.

IPC 319, 320, 323, 324, 325, 326, 334, 335 mnemonic

Hey!

Narcolepsy mnemonic

Hello!

This post is on narcolepsy.

For those who don't know, narcolepsy is characterized by:

Crown rump length and gestational sac diameter

The crown rump length in mm is calculated by subtracting 42 from the gestational age in number of days.

The gestational sac diameter in mm is calculated by subtracting 30 from the gestational age in number of days.

Step 2 CK: Treatment of bipolar disorder

For acute maniac episode:
Give antipsychotic (preferably IM) like Olanzapine, Haloperidol first because they act fast.

Long term treatment for Bipolar disorder: Mood stabilizer like lithium.

If patient is on mood stabilizer and presents with maniac episode: Give antipsychotic.

For patients who have a history of multiple recurrences or have a partial but inadequate response to a maintenance drug that is tolerated, add a second drug:

Common combinations include lithium or valproate:

- Plus  a second-generation antipsychotic, such as quetiapine, long-acting injectable risperidone, ziprasidone, or olanzapine

- Lamotrigine

- Carbamazepine

Step 2 CK: Treatment of anxiety disorders

Patient is in a panic attack:
Use benzodiazepines because they act fast.

Long term treatment for panic disorder:
SSRIs

Long term treatment for GAD:
SSRIs
Buspirone

CrPC 174 and 176 mnemonic

Hey!
Another video :)

IPC 375, 376 and 377 mnemonic

Hey!

IPC 300, 302, 307, 308 and 309 mnemonic

Hello!

Here are some Indian Penal Code mnemonics :)

Study group discussion: Bradycardia

Name the causes of bradycardia!

Physiological bradycardia is seen during sleep and in athletes.

In typhoid fever, yellow fever and brucellosis, we see relative bradycardia.

Pathological bradycardia is seen in hypothermia, hypothyroidism, raised intracranial tension & inferior wall myocardial infarction, hypertension, bradyarrhythmia, etc.

What is relative bradycardia?

Indices of obesity mnemonic

Hello!
Let's mnemonic-fy everything!

Authors diary: IkaN's real name (Meaning and pronunciation of Nakeya)

Hello!

IkaN from Medicowesome here!
This video and post is from the authors diary! :D

People have been asking me what my real name is and how I pronounce it so I thought of making a video on it.

There you go! :)

Wolff–Chaikoff effect mnemonic

Hello!

Here's an awesome mnemonic on Wolff–Chaikoff effect sent to us by Hari!

For those of you who don't know what Wolff–Chaikoff effect is, it is a reduction in thyroid hormone levels caused by ingestion of a large amount of iodine.

Treatment of post traumatic stress disorder (PTSD) mnemonic

Hello!

Here's a short post on the treatment of PTSD. It comes with a mnemonic!

Schizophrenia subtypes mnemonic

Schizophrenia types mnemonic: CURDP

Diagnosis vs. Prognosis! Which is which?

When I was in 1^st year I used to mistake these two parts of patient care very much. Let’s try to understand these concepts.

Diagnosis (Dx) – The identified disease/condition that the person has. We get to a diagnosis, after considering all the symptoms, and signs.

Prognosis – What’s going to happen in future for the patient regarding this disease.

Step 2 CK: ADHD treatment

Hello! This post is on the treatment of Attention Deficit Hyperactive Disorder (ADHD)!

Cognitive behavioural therapy is the first line of treatment for ADHD.

As for pharmacotherapy, FDA has approved two types of medications — stimulants and non-stimulants.

Bupropion mnemonic

Hello!

Watch the video to check the mnemonic out :D

Study group discussion: Dopamine, prolactin, Parkinson's disease and Schizophrenia

A schizophrenic presents with galactorrhea. The patient’s medication regimen includes haloperidol. Blockade of which  neurotransmitters is responsible for this patient's clinical presentation?

Dopamine. Since it is a Prolactin Inhibitor - Inhibition of Dopamine causes hyperprolatctinemia.

Doubt: Level of dopamine also decreases in Parkinson's disease. So can hyperprolactinemia also be seen in Parkinson's disease?

In Parkinson's, there is loss of dopamine only in the substantia niagra.

There are 4 main dopaminergic pathways in the CNS:
1. Nigrostrial pathway which is involved in Parkinson's disease.
2. Mesolimbic pathway involved in Schizophrenia.
3. Paraventricular pathway involved in satiety.
4. Tuberoinfundibular pathway involved in prolactin secretion.

Drugs can affect all pathways, that's why, the side effects. But Parkinson's only hits the nigrostrial pathway.

Study group discussion: Dead space

What is dead space?

Physiologic or total dead space is the sum of anatomic dead space and alveolar dead space. Anatomic dead space is the volume of gas within the conducting zone (as opposed to the transitional and respiratory zones) and includes the trachea, bronchus, bronchioles, and terminal bronchioles; it is approximately 2 mL/kg in the upright position. Alveolar dead space is the volume of gas within unperfused alveoli (and thus not participating in gas exchange either); it is usually negligible in the healthy, awake patient.

Flexion of the head decreases dead space. Why?

Flexion of head decreases anatomical dead space. Therefore, physiological dead space will also be decreased.

Neck extension and jaw protrusion can increase the dead space twofold.

Supine position decreases dead space and the dead space increases in upright position. Why?

In upright position, there is decreased perfusion to the uppermost alveoli.

Intubation decreases dead space by 70 ml approx. Why?

The size of the ET tube is smaller than the trachea. Therefore, reduction in the dead space.

Administration of bronchodilator increases dead space. Why?

The conduction zone, from the nose to the respiratory bronchioles, is dead space. Bronchodilators dilate the brochus and bronchioles and not the alveoli, increasing dead space.

Certain anaesthetics, like halothane and sevoflurane, cause bronchodilation. Hence, an important concept and MCQ.

The cause of increased dead space in general anesthesia is multifactorial, including loss of skeletal muscle tone and loss of bronchoconstrictor tone.

That's all!

Pray that my goals are completed on a timely basis. I need your prayers.

-IkaN

Apoptosis - Quick review

Apoptosis is ' Programmed Cell death'

It is a physiologic and a Pathologic phenomenon.

There are 2 pathways of apoptosis-
A. Extrinsic pathway- a/ w activation of caspase 8
B. Intrinsic pathway- a/w activation of caspase 9

Most striking feature- Absence of inflammation.
Earliest feature- Cell shrinkage
Most characteristic feature- Nuclear pyknosis

Diabetes Mellitus - Oral Treatment

Diabetes Mellitus (DM) is a heterogeneous group of disorders, characterised by hyperglycaemia and it's complications.

Hyperglycaemia according to American Diabetes Association is when
1. Fasting Blood Sugar level is more than or equal to 126mg/dL
2. Post prandial Blood sugar is more than or equal to 200mg/dL

The interesting part is here
DM Type 2 is either because of
i) increased glucose production by the liver ( when a person is sleeping) or
ii) impaired insulin secretion ( usually noticed after meals as insulin reserves are not sufficient or there is insulin resistance)

Let's talk of 2 scenarios,
In case i) Fasting blood glucose is high and
In case ii) Post Prandial blood glucose is high.

Now,
For case i), Metformin which is said to decrease the glucose production from liver is a better treatment option.
(Remember, Metformin also works against Insulin Resistance, so it also works in case ii !)

For case ii), since the problem is with insulin secretion or its resistance, Insulin Secretagogs work the best! Sulfonylurea increase the insulin secretion from ß cells in the pancreas, thereby tackling the problem.
Remember, Sulfonylureas are commonly used after Metformin!

If you want a super drug :P to tackle both these scenarios then Metformin and Thiazolidinediones are your best options. However, the side effect profile of the latter one is worrisome so used less often.

Here's one of my favourite quotes, Hardwork beats talent when talent doesn't work hard !
That's all!

- Rippie

Lights, Pokemon, Seizures!

Did you know light can induce seizures?

Photic-induced seizures — Photosensitivity has received considerable attention as a seizure trigger. The light stimulation may come from a natural or artificial source, in particular television shows and video games.

Deviation of the tongue, jaw, uvula and lips in cranial nerve palsy mnemonic

Hello! Long time no see (From my side :D )

So in this post, I'll be taking about what deviates where with a mnemonic! Yaay!
What? Jaw, tongue, lips and uvula.

Let's start with LMN lesions of the respective cranial nerves.

Two interesting facts.

Hey awesomites! Happened to read two interesting things today-

1. The Y sperm is relatively lighter due to the acrocentric chromosome, amounting to the relatively skewed sex ratio towards males across the globe.

2. Homeobox gene 8 controls the expression of forelimbs, messing with it causes alters the position of the forelimbs.

That's all!

Concepts vs mnemonics

"There are two ways to learn something - One is through pure logic  ie, from first principles (building up a concept). The other is mnemonics (To help retrieve info quickly... To avoid all the time and thinking taken to derive it).

The best thing is to learn both ways. If you forget the mnemonic, you can derive it from the concept. If you forget the concept, you'd at least have the mnemonic." - SG

Many people question whether mnemonics really help. This is what I have to say in explanation. Learn both like SG said. They'll help if you manage to remember, if you forget, you can use your knowledge and understanding to come to the same conclusion.

That's all!

SG is a good friend and is very philosophical on learning. These are some random thoughts that she sent and I thought of sharing them because I strongly agree!

-IkaN

Transmission of toxoplasmosis

Toxoplasmosis is transmitted through:
Cat bite
Droplets
Orofecal route
Cat scratch

This is a tricky question if you haven't revised parasitology. You'll vaguely remember the association with cats, so you'll be tempted to pick one which mentions the word cat.

Remember, toxoplasmosis is transmitted through cat feces, so orofecal route is the correct answer.

That's all!
-IkaN

Treatment of Babesiosis

Short post for the day!

Barbecue city - BBQ City
Babesia, Quinine, Clindamycin

Step 2 CK: GBS prophylaxis mnemonic

Hi!

Drugs used for GBS prophylaxis mnemonic: PACE CV
Penicillin
Ampicillin
Cefazolin
Erythromycin
Clindamycin
Vancomycin

Indications of GBS prophylaxis:
- Previous infant with invasive GBS disease.
- GBS bacteriuria / positive culture during current pregnancy.
- Unknown GBS status with:
- Delivery at < 37 weeks
- Amnionic membrane rupture > 18 hours
- Intrapartum temperature > 100.4 (38.0)

That's all!
-IkaN

Most common sites of bone tumors mnemonic

I made these mnemonics on request by an awesomite, Yashwanth.

Here's the most common sites list he sent, mnemonics follow.

SAAG mnemonic

Hello!

SAAG is serum albumin ascites gradient.

SAAG is >1.1 in portal HTN, CHF, HVT and constrictive pericarditis.

The mnemonic for this is SAAG is High in conditions with an H.

portal Hypertension
congestive Heart failure
Hepatic vein thrombosis
Heart constriction (Constrictive pericarditis)

For completion, SAAG < 1.1 is seen in nephrotic syndrome, cancer and infections (except SBP)

That's all!
Have an amazing day!
-IkaN

Lofgrens syndrome mnemonic

What is Lofgrens syndrome?

The triad of Arthritis, Erythema Nodosum & Hilar adenopathy seen in sarcoidosis.

Why smoking is protective for endometrial cancer?

Smoking is a risk factor for quite a number of cancers. But it can be protective for certain diseases as well..like ulcerative colitis.

It is also protective for endometrial carcinoma and how?
1. It reduces estrogen level
2. Decreases weight
3. Associated with early menopause.

Remember that endometrial cancer is due to excess estrogen..and even being obese or having diabetes mellitus is a well known risk factor

Irrespective smoking is bad for health. Each cigarette reduces your life span by 11 minutes or so they say.

Live happy stay healthy

-sakkan

Types of abortion mnemonic

Hello!

I'll start off the post with a mnemonic and then go on explaining what these terms mean...

Prostaglandins mnemonic for obstetrics

Hey!
Thought this will help.

Dinosaurs are Extinct. Ex-two-inct.
Dinoprostone is PGE2.

Carboprost. Carbofrost.
Carboprost is PGF2 alpha.

MIsoprostol - M flipped is E and I looks like 1.
Misoprostol is PGE1.

That's all!
-IkaN

Step 2 CK: Overflow incontinence mnemonic

Greeting everyone!

In this post, I'll be sharing a mnemonic on overflow incontinence!

McCune Albright syndrome mnemonic

Hello everyone!

McCune–Albright syndrome is suspected when two of the three following features are present:

Endocrine hyperfunction such as precocious puberty
Polyostotic fibrous dysplasia
Unilateral Café-au-lait spots

Here's a mnemonic :)

Precocious puberty mnemonics

Hi! :)

Precocious puberty in females is secondary sexual characteristics, accelerated growth in females greater than 8 years of age.

Normal pubertal landmarks mnemonic: