Virchow's Triad Mnemonic (NEW)

Hey, guys Jay here!

Virchow triad is about the 3 reasons for Deep Venous Thrombosis.

So I remember it as,

HE'S Virchow.

H - Hypercoaguability
E - Endothelial damage
S - Stasis

Many people may have many mnemonics. But this is mine. Hope you find it helpful. :)

Jay :)

Complicated vs. Non complicated appendicitis

• Complicated appendicitis has a perforated or gangrenous appendix.
• Non complicated appendicitis has a non-perforated appendix.

The treatment plans are different too!

• Non complicated appendicitis needs an immediate appendectomy
• Complicated appendicitis need to go through an antibiotic course before going to an appendectomy.

Reference : Schwartz Principles of Surgery 10E

Jay :)

Oxidase vs. Oxygenase

Another confusing yet very simple thing

• Oxidase does oxidation in Redox reactions.
• Oxygenase adds an Oxygen to the substrate

It's not that hard to remember right?

Jay :)

Neurotransmitters associated with sleep mnemonic

Neurotransmitters associated with sleep mnemonic
SAND

S- Serotonin: helps initiate sleep cycle and promotes wakefulness.
A- Acetylcholine: levels are higher during REM sleep.
N- Norepinephrine: levels are lower during REM sleep.
D- Dopamine: high levels responsible for arousal and wakefulness.

Note:
- The regulation of levels of Acetylcholine and Norepinephrine is an important biochemical trigger for REM sleep. Higher levels of Ach and lower levels of NE means there is increase in the time period of Rapid eye movement phase of sleep cycle.

- Serotoninergic neurons are present in Distal Raphe nuclei which enhances wakefulness. Thats why the 5-HT activity decreases during NREM sleep and becomes silent during REM phase.

- Dopamine agonists, such as  bromocriptine, pramipexole and others are used to treat parkinson's disease which work by acting on dopamine receptors and compensate for the lack of dopamine which the brain cells no longer produce. They are used together with levodopa. By increasing dopamine levels they restore the balance of Acetylcholine and dopamine thus increasing wakefulness.

- Antipsychotic drugs are dopamine antagonists. So they decrease wakefulness and increase sleep time of a person.

- Higher levels of Ach during REM sleep is associated with erections in men.


Thats all
- Jaskunwar Singh

Dehydrogenase vs. Dehydratase

Another simple thing that we often get confused with in Biochemistry!

• Dehydrogenase removes Hydrogen
• Dehydratase remove H2O

Simple right?

Jay 

Synthase vs. Synthetase

This is very simple guys! Synthases don't use ATP to make the new bond between substrates while synthetases need an ATP.

ok fine! How to remember it?

Think of the additional T that comes in syntheTase is from ATP! ;)

Got a way to memorize it?

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 6 : LIGASES)

Hello guys, we come to an end of this 6 part enzyme series and also this is the 500th Medicowesome post for 2016! Woohoo! :D

Ok, back to our business! Ligases, what to they do? Obvio, they LIGATE! Or simply connect! But connect what?

Think of these guys as a Plumber who connects those pipes! ;)

Major subclasses

• Synthetase - Formation of new bond between substrates using the energy from an ATP
• Synthase - Link two molecules without using the energy from ATP (Confusing with Synthetase? They use ATP. Check here for a memory aid.)
• Carboxylase - Formation of a new bond between a substrate and a CO2 using the energy from an ATP

Are we ok guys?

Jay  :) 

Enzymes and the Type of Reactions they Catalyze ( Part 5 : ISOMERASES)

Ok what are isomers? Same molecular Formula, different structure! That is an Isomer! And presumably isomerases play with these isomers. But how?

• Racemase - Conversion of D isomer to L isomer or vice versa(Read about them here more in IkaN's article)
• Mutase - Conversion of one constitutional isomer into another. They shift one functional group from one place to another place within the same molecule.

Are we clear on this? 

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 4 : LYASES)

With part 4 we come to a little confusing group of Enzymes guys! LYASES! They are called Lyases, of course because they do Lyse! :P

ok the major subclasses?

• Dehydratase - Removal of H2O from a substrate (Confusing with Dehydrogenase?Read Part1)
• Decarboxylase - Removal of CO2 from a substrate
• Deaminase - Removal of NH3 from a substrate
• HYDRATASE - ADDING of H2O to a substrate
• Aldolase - Produces Aldehydes via elimination reactions

Any questions guys? :)

Jay

Enzymes and the Type of Reactions they Catalyze ( Part 3 : HYDROLASES)

Back with Part 3 guys! It's Jay with Hydrolases! :P

There are 5 major classes of Hydrolases. They always Hydrolyse means breaking it down with the help of H2O.

• Lipase - Hydrolysis of ESTER linkages of lipids
• Protease - Hydrolysis of AMIDE linkages of proteins
• Nuclease - Hydrolysis of SUGAR PHOSPHATE ESTER linkages of Nucleic Acids. Phosphodiesterases also do the same
• Carbohydrase - Hydrolysis of GLYCOSIDIC bonds of Carbohydrates
• Phosphatase - Hydrolysis of PHOSPHATE ESTER bonds.

Also please note, that the types of bonds in CAPITAL ITALICIZED letters are the major types of bonds in those biomolecules as well as the bonds that break due to these enzymes.

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 2 : TRANSFERASES)

Hey guys, Jay here once again with Part 2. Here we will talk about Transferases!

Transferases, do Transfer! But transfer what? There are two major types of Transferases!

• Transaminase --> Transfer of an Amino group between substrates
• Kinases --> Transfer of a Phosphate group between substrates often from ATP
• Methyltranferase --> Tranfers single-carbon units between substrates
• Phosphorylase -->Transfers inorganic phosphate to a substrate

Trivia!

What does Kinase even mean? It comes from the greek work Kinein means "To move". It originally had nothing to do with Phosphates. But now we almost exclusively use this for Phosphate transfers. :)

Jay :)

Enzymes and the Type of Reactions they Catalyze ( Part 1 : OXIDOREDUCTASES)

Guys the post is quite long. So I thought to break it into 6 different parts. This post will cover Oxidoreductases.

There are 5 main types of Enzymes in this category. As the name suggests, two of them are Oxidases and Reductases. The other ones are Dehydrogenases, Oxygenases and Peroxidases.

• Oxidases --> Oxidizes a substrate
• Reductases --> Reduces a substrate
• Dehydrogenases --> A double bond is introduced to the substrate, by removal of two H atoms. The H are accepted by a Coenzyme.
• Oxygenase --> Directly incorporates Oxygen into the substrate
• Peroxidase --> Uses Hydrogen Peroxide H2O2 as an electrone acceptor

Question? Yes! Removal of Hydrogen and adding of Oxygen are also considered a type of Oxidation because it increases the oxidation number of the substrate! Pre-Med Organic Chemistry anyone? ;)

See you soon with the other categories guys!

Jay :)

P.S. - Don't confuse Dehydrogenase with Dehydratase!!! We go through that here:)

Urgent vs. Emergent Tracheostomy

In English, Urgency and Emergency almost means the same. But when it comes to Medical literature, it has a little difference.

So what are the differences of Urgent and Emergent Tracheostomy?

Night terrors vs Nightmares

Hey awesomites!

People who have night terrors are often misdiagnosed, nightmares being the most common. Post traumatic stress disorder is another common misdiagnosis (in adults).

Here's the difference between night tremors and nightmares both of these are classified under a group of disorders, the Parasomnias!

Recent research suggests that getting an extra sleep for 30- 40 minutes a night reduces both nightmares and night terrors to a great extent.

Scheduled awakening therapy-
Another treatment strategy (for night terror) is "Scheduled awakening therapy". It involves waking the person from sleep 15- 30 minutes before the episodes typically occur so that the cycle is interrupted and prevent the onset of the night terror. But the child is not to be fully awaken in the middle of the night.
Thats where the idea of sleep guardian came from. The sleep guardian plans smartly and finds a right time to partially wake up the child and vibrate each night (for less than 3 minutes). This prevents the episode of night terrors and sleep is not actually totally disturbed.
This method of prevention of night terrors has shown 90% positive results within first week with 80% fewer night terrors after four weeks of use.

Thats all
- Jaskunwar Singh

Adamantinoma

Hello awesome people !
Today's topic is - ADAMANTINOMA ! (and no it's not what would only happen to Wolverine! Haha see what I did there ?! )

1)Also known as Ameloblastoma (Ameloblasts are enamel forming cells), Eve's disease (looks like ADAM & EVE had a tiff over who'd name it, and clearly it was a draw! :p)

2) Its a benign tumor, but behaves like a malignant one, it metastasizes to lungs. (so wanna be)

3) Sites : #Mandible (most common site) (anyone else going weak in the knees seeing Hugh Jackman's jawline?, cool now you'll remember it better!)
Talking of knees, #Tibia is the 2nd most common site !
#Pituitary because the stalk of pituitary and enamel arise from oral epithelium

3) Slow growing tumor, with multiple cystic spaces...patients often complain of falling teeth or fracture mandible :(

4) X ray shows a "Honeycomb" appearence

5) Treatment? Well since this tumor is very "Adamant" simple curettage will cause recurrence, hence we do a wide excision (1cm margin)...Sometimes a Hemimandibulectomy may have to be done! (Sounds like what Wolverine would do to his enemies!)
All the Wolverine fans put your hands up and read this again !!  :p
That's about it !!
-PP

Top 10 series: Phenytoin

Hello!

Here are top 10 facts about of phenytoin.

Ulnar nerve

Ulnar nerve
Nerve root :C7-T1.
Key points :
On the back of medial epicondyle of humerus ulnar nerve can be palatable it produces tingling sensations Hence humerus is called as "Funny bone".
Ulnar nerve is not a content of Cubital fossa .
Remember:Ulnar nerve supplies total 15 muscles  in hand!
 
3 hypothenar eminence ,medial 2 lumbricals ,4 dorsal and 4 Palmer interossei and ADDuctor pollicis
Palmaris brevis
Forearm(Read carefully don't get confused)
Medial half of flexor digitorum profundus(Thinking about lateral half ??!!! Well ,it is supplied by Median nerve )
Flexor carpi ulnaris (Thinking about extensor carpi ulnaris ?! Read  carefully ,Supplied by radial nerve)
Clinical anatomy:
1)Musician nerve
2)Ulnar nerve lesion at the wrist :Ulnar claw hand which shows
a)Hyperextension at metacarpophalangeal joints and flexion at the interphalangeal joints ,involving ring and little fingers (Little finger is held in extension by extensor muscles )
b)Sensory loss is confined to the medial one third of the palm and medial one and a half fingers including nail bed .Medial half of dorsum of hands also shows Sensor loss
c)Vasomotor changes :Skin is warmer due to arteriolar dilation ,it is also drier due to absence of sweating because of loss of sympathetic supply.
d)Trophic changes:Long standing cases of paralysis lead to dry and scaly skin .The nails crack easily
It should be noted that median nerve lesions are more disabling.In contrast ,Ulnar nerve lesions leave a relatively efficient hand

Principal cell: How to remember it's function and location in the nephron

Principal cell

Top 10 series: Cyclophosphamide

And here's A. P. Burkholderias fav drug - Cyclophosphamide!

ENT instruments contents page

Hey, so because the contents page has expanded so much, I thought of making sub sections within the contents page for a few topics.

Here's the mini contents page for ENT instruments, this post is linked to the main contents page :)

Top 10 series: Rifampicin

Introducing a new series of videos :D

Hope you like them!

Chronic complications of pulmonary tuberculosis mnemonic

Chronic complications of pulmonary tuberculosis

Pulmonary complications-  HE CAL BOB
H- Haemoptysis
E- Emphysema
C- Cor pulmonale
A- Aspergilloma/ Atypical MTB
L- Lung calcification
B- Bronchiectasis
O- Obstructive pulmonary disease
B- Bronchopleural fistula

Extra- pulmonary complications- PALE
P- Poncet's polyarthritis
A- Anorectal fistula/ Amyloidosis
L- Laryngitis
E- Empyema necessitans/ Enteritis


Thats all
- Jaskunwar Singh

Herpes Zoster Ophthalmicus notes

Herpes zoster ophthalmicus

This viral infection is associated with a previous childhood exposure to varicella zoster (chickenpox) which remains hidden within and becomes active later in life when immune functions of the body weaken.

GUYS, did you check First Aid 2017? We are Super Proud of you IkaN!!!

Beloved Awesomites, I have a super-awesome announcement to make today regarding our Founder IkaN aka Nakeya Khozema Dewaswala.

She is the Image and Illustration editor in the recently released world famous medical book, First Aid 2017!!!

We are super proud of you sis, especially you being the only representative from South Asia in the book for this edition! We always knew you are an amazing medical student, but you proved you are totally exceptional with this feat.

This is another step toward your success sis. You are an inspiration to thousands and thousands of medical students around the world, and a living proof that if you want something, and if you struggle for it, you will certainly get it!

Me, myself am so lucky to have known you personally and be called as your bro, and I know, more than you have an AWESOME brain, you have an AWESOME heart! (Isn’t this why we love her a lot, Awesomites?)

Keep inspiring us sis! We at the Author Panel of Medicowesome, and the whole thousands of Medicowesome members, would like to congratulate you, and wish you all the very best in your all future endeavors!

Yours,

Jay :) 

On behalf of the Author Panel of Medicowesome

P.S. - Special thanks to Krupal Patel in Medicowesome Whatsapp group who brought picture to our attention! :) 

Restless leg syndrome notes

RLS symptoms:
Urge to move legs
Symptoms begin with rest
Relief on movement

Associated with:
Anemia
Pregnancy
Renal failure
Peripheral neuropathy

Pathogenesis:
Disordered dopamine function in association with abnormal iron metabolism

Treatment:
Sleep hygiene
Pramipexole, ropinirole
Iron for IDA

That's all!
-IkaN

Membranous and pseudo-membranous conjunctivitis notes

Pseudo-membranous conjunctivitis: mild form
Membranous conjunctivitis: severe form

Causative agents:
Corynebacterium diphtheriae
Beta- hemolytic streptococci
Streptococcus pneumoniae
Neisseria gonorrheae

Associated conditions:
Erythema multiforme
Stevens- Johnson syndrome

Pseudomembranous:
- Lid swelling
- mucopurulent bloody discharge
- white membrane
- easily peel off without bleeding

Membranous:
- Lids are hardened
- semisolid exudates: result in necrosis of conjunctiva and cornea
- difficult to peel off
- associated with bleeding from the undersurface

Important points to be noted:-
- The membrane forms more commonly over palpebral conjunctiva beginning from the edge of lid.
- There is enlarged preauricular lymph nodes with suppurative discharge.
- Marginal corneal ulcer due to secondary infection (especially streptococci).
- high risk of symblephron (adhesion between palpebral and bulbar conjunctiva)

Treatment:
- Penicillin (10,000 units/ ml) is the doc for acute diphtherial infection. Systemic administration and a quick injection of anti- diphtheritic serum (4,000- 10,000 units BD) 
- Removal of the membranes is not advised because of the risk of adhesion (symblephron).
- Local and systemic administration of bacitracin and penicillin is recommended in case of streptococcal infection.

Pseudotumor cerebri notes

Pseudotumor cerebri

Associated with:
Obesity
Vitamin A toxicity

Signs and symptoms:
Headache
Sixth nerve palsy
Visual field defects
Pulsutile tinnitus

Diagnosis:
Papilledema
To rule out space occupying lesions - CT / MRI normal
Most accurate - Lumbar puncture with opening CSF pressure measurement

Treatment:
Weight loss
Acetazolamide
Surgery

Why does increased ICP cause 6th nerve (Abducens) palsy?
Increased ICP can result in downward displacement of the brainstem, causing stretching of the sixth nerve secondary to its location within  Dorello's canal.

That's all!
-IkaN

Amaurosis fugax mnemonics

I was studying the causes of Amaurosis fugax today.. so i just made random mnemonics and thought of sharing with you guys :D

Amaurosis fugax is a transient uniocular loss of vision either due to lack of blood supply to the brain or to the retina itself.

Disease modifying therapies for relapsing forms of multiple sclerosis - MS treatment mnemonic

Hey!

I was reading treatment for MS today.

Do you want to remember the disease modifying therapies for relapsing forms of multiple sclerosis?

Here's a mnemonic! "Ms is Nat (not) glad. All terrified by mighty ox with fuming fungus."

Multiple sclerosis (Ms)
Natalizumab (Nat)
Glatiramer acetate (Glad)
Alemtuzumab (All terrified)
INF beta (By)
Mitoxanthrane (Mighty ox)
Dimethyl fumarate (Fuming)
Fingolimod (Fungus)

Remember, for acute attacks, use Glucocorticoids.

That's all!

-IkaN

Neurofibromatosis type 1 - Another mnemonic

Hey!

So I needed another mnemonic for neurofibromatosis because my first mnemonic wasn't good enough xD

This time, the mnemonic is NODES!

That's all! 

Merry Christmas everyone! 

-IkaN

Neurofibromatosis type 1 old mnemonic: http://www.medicowesome.com/2014/10/neurofibromatosis-1-mnemonic.html

Syndromic Management Of RTI/SRI

*Syndromic Management*📁📗🏳📘📕📒📓

Mnemonic :: *Great Girls Wont Buy Red Yellow Bags*

*Kit 1 - Grey*
*Kit 2 - Green*
*Kit 3 - White*
*Kit 4 - Blue*
*Kit 5 - Red*
*Kit 6 - Yellow*
*Kit 7 - Black*

*Kit 1 is GreaT*
Gonorrhea
C.Trachomatis

*Kit 2 is Green*
_*BV CA Green TV*_
Coz no self respectingan would buy a green TV...he'll buy it out of love for wife😜😜😜

Bacterial Vaginosis
Candida Albicans
Trichomonas Vaginalis

*Kit-3 is ABC*
Azithral
Benzathine penicillin

For Chancre and chancroid

Also notice C is 3rd letter and 3 letters ABC in the mnemonic for Kit 3

*Kit - 4 Remember that if you forget this then its BAD*

Blue
Azithral coz allergy to penicillin
Doxy

*Kit - 5 is Red as in Mnemonic*
Remember that Red is for love and love is *Her* eyes and smile
*Her*petic

*Kit - 6 is Yellow as in Mnemonic*

Yel *low* for *low*er abd pain
PID

*Kit - 7 is Black* coz last colour is the colour palate also BLAC

Bubo
LGV
Azithral
Chancroid

Vitamin D and multiple sclerosis

Hey awesomites!

Since I have written posts regarding the association of vitamin D deficiency with certain neurological disorders previously, I am here again with one more addition into the box (on sincere request of our main author IkaN.. :p ).

Anticholinesterase

Hey here is exclusive classification of anticholinesterase drugs !,hopefully it will be useful.

~Ojas

Hypoglycemia mnemonic

Hypoglycemia may present as a mere symptom of a disease or a life- threatening condition itself. I have made a mnemonic on the common signs and symptoms in a patient of hypoglycemia. Here it is..
METABOLISM

M- Mood swings
E- Excess sweating
T- Tachycardia
A- Adrenal fatigue
B- Blood pressure changes
O- Obesity
L- Lips tingling
I- Increased appetite/ hunger
S- Shakiness (tremors)
M- Muscle pain


That's all
- Jaskunwar Singh

Crispy C.R.I.S.P.R.!

10 years ago,only a few would have thought that a device in our pockets would be good enough to access all the information of the world, would do social networking, calls, would calculate, act as a torch and what not. 

We today are on a similar brink ofrevolution in genetic engineering, where the effects would be so magnificent that they would need to be measured on a Richter scale! 

Enter CRISPR, which is an acronym for 'clustered regularly interspaced shortpalindromic repeats', a  crispy new technology which promises to shrink the costs involved in genetic engineering by 90%, makes the procedure easier andshorter.

*What is it? 
We have managed to hack an antibacteriophage mechanism in bacteria to our advantage. 

Only a few bacteria survive bacteriophage invasion. To protect themselves from a further invasion, they store a part of the phage DNA into their archives. 

When another attack does occur, an RNA copy of the archived phage DNA is presented to what is known as a CAS 9 protein.

CAS 9 compares the two copies, one from the foreign DNA and the other from the archives, and is very precise at that. 

If it finds a 100% match, it cuts off thenew phage's DNA, thus rendering the attack a big embarrassment for the bacteriophage. :-p 

*What can we do with it? 
Oh, a lot of awesome things! 

-Pissing off viruses
In 2015, scientists armed with CRISPR achieved a significant reduction of HIV load from patiens. 
This year, in mice, they slashed off 51% HIV DNA from mice, just by a couple of shots in their tails! 

*Making cancer re evaluate its careerchoice- 
Malignant cell detection by the immune system can be enhanced. 

*Designer babies- 
A lot of desirable traits- super awesome eyesight, superman esque strength and so on, can be selected from a wide palette during embryogenesis.

*Bidding adieu to genetic diseases

*Making ourselves look hot at 120-

CRISPR holds the potential to slow and even reverse ageing! We can take a leaf off the books of certain aquatic species who already are doing that. 

.. and a lot more. 

*The last word
A few controversies sorround though.
- We don't know if any adverse 
  reactions may triggered, as our 
  knowledge is still just the tip of the
  iceberg.
- Some powers like say dictators
   might use it to gain precedence.
- The fear of genetic pollution.

Anyway, these are just hurdles which we need to plan and overcome for a glorious future for humanity! 

Source- Kurzgesagt. 


  

Symptoms of corneal disorders mnemonic

I was studying corneal disorders and dystrophies, infections, inflammations today and noticed many common symptoms in the patients.

Now since its the matter of the eye, I must tell you how much I love photography and also i used to do some painting stuff long ago. So i made a random mnemonic out of it for the symptoms of corneal disorders.. :p

DSLR Photography and Painting Workshops.

D- Decreased vision

S- Sensations (foreign body)

L- Lacrimation

R- Redness

P- Photophobia

P- Pain

W- white cornea

Thats all

- Jaskunwar Singh

Bullous skin disorders-1 pemphigus vulgaris and bullous pemphigoid

Pemphigus vulgaris

http://www.medpictures.org/pemphigus-vulgaris-pictures.html

Bullous pemphigoid

http://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1#!prettyPhoto



these two are the most commonly asked questions within bullous diseases.
the major difference you need to know is
pemphigus vulgaris- bullae are suprabasal. hence these are not tense and rupture easily..not very common in a clinical case for you to find a bulla
bullous pemphigoid- bullae are subepidermal..and hence tense.

a mnemonic..like a bull..bullae in Bullous pemphigoid are tough and stronger

-sakkan

Layers of retina

Retina consists of 10 layers of cells and their nuclei so I tried to make it easier to memorize all layers. A lame one but hope it helps.. :p

There are outer 5 layers. So the outer ones start with 'O' in the first letter. And the inner 5 layers initiate with 'I' in the first letter.

That's all

- Jaskunwar Singh

Symptoms of conjunctival disorders mnemonic

Symptoms of conjunctival disorders:-

RED AF

R- Redness

E- Edema of conjunctiva

D- Discharge

A- (a)ecchymosis

F- Foreign body sensation

That's all

- Jaskunwar Singh

Medipicsowesome: Adams Oliver syndrome

Hey everyone!

Hope you are enjoying Medipicsowesome!

Adams–Oliver syndrome (AOS) is a rare congenital disorder characterized by defects of the scalp and cranium (cutis aplasia congenita), transverse defects of the limbs, and mottling of the skin.

The baby has a defect in the frontal and parietal bone and terminal limb defects in the legs.

That's all!

-IkaN

Serological And Viral Markers Of Hepatitis B Infection Made Easy

Hello everyone
This is Shubham Patidar . Today I am posting my notes on Serological  and Viral Markers of Hepatitis B Infection  in concise and simple way. This is very important short note ask in pharmacology, pathology, community medicine, medicine , microbiology, in undergraduate theory exam . and mcq comes in post graduate medical examinations.
Enjoy Learning !
That's all !

Past Pointing Mnemonic

Hi everyone !
So this is another short post about 'Past pointing'. I hope you don't consider it pointless to discuss this. (I know, play along.)

There are a few tests called 'Finger-Nose-Finger' test and 'Finger-Nose' test. These detect how controlled and precise your movements are.
Say, for example , I ask a patient to touch my finger (which I place directly in front of him), then touch his own nose and touch my finger once again.
A normal person should be able to do this correctly and accurately.
However, in lesions of at least 2 structures of our body , the patient's finger overshoots the examiner's or can't seem to reach it correctly.
This is called 'Past Pointing' , as the patient shoots past the destination point.

2 important lesions where you get this are :
1. Cerebellar
2. Vestibular

So, in a Cerebellar lesion things are very straight forward.
You'd get pastpointing only on the side of the lesion as only that side has become stripped from the cerebellar control. The other side has intact Cerebellar control.
Cerebellum = Same side Past Pointing.
Cerebellum is Single and Lonely

The Vestibular System defects are slightly more complex and also very controversial. So irrespective of which side you try, you'd get Bilateral past pointing in a Vestibular lesion.
However,
Such a pastpointing is generally more prominent on the side of the Slow Component of the nystagmus produced (Whatt?). Yeah. Also, the Slow side of nystagmus and the side of past pointing are also the same as the side to which you'd lose your balance in a Vestibular disorder !
So Remember :
My SLOW Vestibular friend FALLS to pointy end but can Swing BOTH ways .
So Slow Component of nystagmus , and Falling during gait testing would be present and Pointing would be towards the same side too.
But Past Pointing can Bilateral (Swings both ways).

Hope this helps. Let me know how I can improve it!
Happy studying ! :)

~A.P.Burkholderia

Symptomatic variations in cough

Hey Awesomites!

Cough is a common symptom that may be associated with an infection of upper respiratory tract, which if not given attention to can progress to a life- threatening chronic disease! Normally, its just a common reflex that helps clear mucus off from the throat and the upper airways. But there are certain variations in the presence and progression of cough. So what is your cough trying to tell you about your health? Let's know about this...

Vestibular Apparatus Mnemonic

Hi everyone. This is just a short post to help you remember the functions of the Vestibular System. Memorising this always gives me a vertigo. ;)

The Vestibular System has 2 components :
1. Semicircular canals
2. Utricle and Saccule.

So the Vestibular System detects the following :

Angular Acceleration/Rotational movements.
Linear Acceleration.
Gravity.
Position of Head in space.

So the Semi circular canals are concerned with Angular Acceleration. You can remember that as :
Circle = Rotates ; So SCC detect Rotational movements or Angular Acceleration

The rest are functions of Utricle and Saccule.
Remember : GPL - Girls Premiere League.
For : Gravity, Position of Head and Linear acceleration.

Now  remember :
Saccule - NOT Sleeping line. So Vertical movements.
And
Utricle - Horizontal (since sleeping line was not Saccule it will be Utricle)
Another way would be "UHH' Utricle for Horizontal.

Hope this helped you.
Happy studying ! :)

How to apply for USMLE exams: ECFMG certification using IWA in detail

This is a continuation of the main post, How to apply for USMLE exams (http://www.medicowesome.com/2016/12/how-to-apply-for-usmle-exams.html)

Step 3 is elaborated in detail here:

Medipicsowesome: Thanatophoric dysplasia

Hello!

First post of Medipicsowesome. Yaay!

Thanatophoric dysplasia (TD) is a lethal skeletal dysplasia. It is the 2nd most common lethal skeletal dysplasia after osteogenesis imperfecta type II.

It is characterized by extremely short limbs and folds of extra (redundant) skin on the arms and legs.

Other features of this condition include a narrow chest, short ribs, underdeveloped lungs, and an enlarged head with a large forehead and prominent, wide-spaced eyes.

Type I thanatophoric dysplasia is distinguished by the presence of curved thigh bones and flattened bones of the spine (platyspondyly).

Type II thanatophoric dysplasia is characterized by straight thigh bones and a moderate to severe skull abnormality called a cloverleaf skull.

This baby seems to have type II thanatophoric dysplasia.

The condition is uniformly fatal within a few hours of birth either from respiratory failure or from brainstem compression from a narrow foramen magnum.

This baby died a few hours after birth.

Cool fact: The term thanatophoric derives from the Greek words "thanatos" meaning "death" and "foros" meaning "bearing/carrying/bringing".

That's all!
-IkaN

Medipicsowesome: An introduction

Hello!

The Medicowesome family has decided to create a library of medical pictures. Excited? =)

We are going to label all these posts as Medipicsowesome.

It'll contain pictures of specimens, diseases, instruments, etc.

Since we wish to avoid copyright issues, we will be taking permission for most pictures / giving credits from which they're taken. If a picture belongs to you and you do not wish to see it uploaded on the site, email us at medicowesome@gmail.com and we will take it down immediately.

I have taken permission from the patients for pictures clicked in my wards, explaining they'll be uploaded on the blog for medical students to learn. Only after their permission, I have uploaded the pictures. To maintain confidentiality, I will blur eyes / faces too.

If you want to share cases you've seen on Medipicsowesome, we'll be happy to upload it. Just email us the picture with a description and make sure you have the permission of the patient!
Email: medicowesome@gmail.com
Subject: Medipicsowesome submission

That's all!
The idea was come up by all authors, especially, Sakkan. Thanks for the encouragement everyone else! < 3
-IkaN

Median nerve

Median nerve
Root value :C5-T1
IMP points
1)Median nerve is most medial content of Cubital fossa
In Cubital fossa it gives 3
Branches to flexor muscles
Remember this mnemonics
Feel Climate (in) Rajasthan,Days (in) Singapore (in) PLs
Flexor carpi radialis  .(FELL CLIMATE -Rajasthan)
Flexor digitorum superficials(Days
in -Singapore) 
Palmaris Longus (PLs) .
In forearm it gives Anterior interosseous branch which supplies:-
1)Lateral half of flexor digitorum profundus (Well,medial half is supplies by ulnar nerve)
2)Pronator quadratus(my Fav!)
3)Flexor policies Longus(Extensor policies Longus and brevis both supplied by radial  nerve)
In palm ,median nerve supplies 5 muscles !
3 thenar muscles ,(Abductor pollicis brevis ,flexor pollicies brevis  ,opponens pollicis )
Lateral 2 lumbricals!
Clinical anatomy:
1)Known as labourers nerve /eye of hand
2)Pointing index finger occurs due to paralysis of long flexors of digit .
3)Ape or monkey thumb deformity if thenar muscles are paralysed
4)Must know carpal tunnel syndrome(Happens when median nerve is trapped )REMEMBER Skin over the thenar eminence is not affected as the branch of median nerve supplying it arises from forearm
5)FROMENT's.sign/Book holding test &paper holding test is done to test median nerve .
6) Complete claw hand when Ulnar and median nerves are paralysed.

~Ojas

Hyperplasia - Physiologic or Pathologic?

Hyperplasia means increase in the cell number.

It tends to occur only in organs where the cells retain the ability to divide. It can be physiologic or pathologic.

The morphology of the organ on gross or the cells on microscopy does not differ in physiologic or pathologic hyperplasia. What differentiates the two is the inciting stimulus.

for eg- Breast/ Endometrial hyperplasia is a feature of pregnancy as well as in certain hormone producing tumors of the ovary. The tissue microscopically, only shows increased number of mature cells. However, the hyperplasia that occurs due to pregnancy (physiologic) process is labelled as "Physiologic" while that which occurs due to ANY pathologic process is labelled as
"Pathologic" hyperplasia.
 

An AIDS patient with abnormal CT scan

Hey! Here's a case kinda thingy that I made up.

An HIV positive male presents with loss of recent memory and left sided paralysis. A CT scan is done. What are the differentials based on the CT findings given below?

1. Multiple ring enhancing lesions
2. Single, periventricular ring enhancing lesion
3. Cerebral atrophy with secondary ventricular involvement
4. Multiple non enhancing white matter lesions

Answers given below
.
.
.
.
.

1. Multiple ring enhancing lesions - Toxoplasmosis. TMP SMX for prevention!

2. Single, periventricular ring enhancing lesion - CNS lymphoma. Usually, positive for EBV.

3. Cerebral atrophy with secondary ventricular involvement - AIDS dementia complex. Though paralysis would not be a feature. Only defects in short term memory and executive function is seen.

4. Multiple non enhancing white matter lesions - Demyelination of subcortical white matter suggestive of progressive multifocal leukoencephalopathy is caused by JC virus.

That's all!
-IkaN