Here is the video!
Wednesday, January 4, 2017
The basics: Peptic ulcer
Peptic ulcer is excoriated area of stomach or intestinal mucosa caused by excessive gastric acid secretion or upper intestinal tract secretion .A type of peptic ulcer called as marginal peptic ulcer is caused during surgical process whenever there is opening made in between stomach and jejunum of small intestine like gastrojejunostomy.
Common site of peptic ulcer ?
Mostly on lesser curvature of antral end of stomach and rarely on lower end of stomach.
Mostly on lesser curvature of antral end of stomach and rarely on lower end of stomach.
Causes of peptic ulcer ?
1)Increase in acid secretion and peptic content in stomach .
2) Irritation to mucosa.
3)Poor blood supply .
4)Poor secretion of mucus.
5)Infection by H.pylori.
1)Increase in acid secretion and peptic content in stomach .
2) Irritation to mucosa.
3)Poor blood supply .
4)Poor secretion of mucus.
5)Infection by H.pylori.
Treatment of peptic ulcer.
We give anti-ulcer therapy for peptic ulcer treatment
Following are goals of anti-ulcer therapy
a) Relief of pain.
b)Ulcer healing.
c)Prevention of complications.(like bleeding ,perforation)
d)Prevention of relapse.
We give anti-ulcer therapy for peptic ulcer treatment
Following are goals of anti-ulcer therapy
a) Relief of pain.
b)Ulcer healing.
c)Prevention of complications.(like bleeding ,perforation)
d)Prevention of relapse.
Approach of treatment of peptic ulcer :
(I have made some lame tricks for memorising drugs name:D ,if you have some mnemonics please comment !)
1) Decrease acid secretion :It includes total 4 categories ,they are described below .
(I have made some lame tricks for memorising drugs name:D ,if you have some mnemonics please comment !)
1) Decrease acid secretion :It includes total 4 categories ,they are described below .
a) H2 Anti-histamine (They all end with -tidine)
-Cimetidine .
-Famotidine.
-Ranitidine.
-Roxatidine.
-Cimetidine .
-Famotidine.
-Ranitidine.
-Roxatidine.
b)Proton -pump inhibitor.(ends with -prazole)
-Omeprazole.
-Esomeprazole.(Read it as Es-omeprazole)
-Lansoprazole.
-Pantoprazole.
-Rabeprazole.
-Dexrabeprazole
(Read it as Dex-rabeprazole!)
-Omeprazole.
-Esomeprazole.(Read it as Es-omeprazole)
-Lansoprazole.
-Pantoprazole.
-Rabeprazole.
-Dexrabeprazole
(Read it as Dex-rabeprazole!)
c)Anti-cholinergic drugs:
-Pirenzepine .
-Propantheline.
(Read it as Propan-the-line).
-Oxyphenonium .
-Pirenzepine .
-Propantheline.
(Read it as Propan-the-line).
-Oxyphenonium .
d) Prostaglandin analogue:Misoprostol !
2)Neutralization of gastric acid secretion
(Antacids) .It includes 2 categories
a) Systemic:
-Sodium bicarbonate .
-Sodium citrate.
(Antacids) .It includes 2 categories
a) Systemic:
-Sodium bicarbonate .
-Sodium citrate.
b)Non-systemic:
-Magnesium hydroxide .
-Magnesium trisilicate.
-Aluminium hydroxide.
-Calcuim carbonates.
-Magnesium hydroxide .
-Magnesium trisilicate.
-Aluminium hydroxide.
-Calcuim carbonates.
c)Ulcer protective:
-Sucralfate.
-CBS (Colloidal bismuth subcitrate!).
-Sucralfate.
-CBS (Colloidal bismuth subcitrate!).
d)Anti-H pylori drugs:
-Amoxicillin.
-Tetracyclin.
-Clarithromycin.
-Tinidazole.
-Metronidazole.
-Amoxicillin.
-Tetracyclin.
-Clarithromycin.
-Tinidazole.
-Metronidazole.
~Ojas
Tuesday, January 3, 2017
Mental distractions
Hey Awesomites!
Let me ask you a question.. how much focused you are during your study time? Well, as a medical student you try your best to focus on what is written in the book and in making your own notes. You are not aware of your surroundings anymore. Someone comes nearby and calls you or sits just beside you but still your eyes are on those words and difficult medical terms of the diseases and syndromes and the drugs used to treat them. This is called Change blindness, a perceptual phenomenon that occurs when you don't notice a major change in the environment because you are too focused on one particular thing.
Let me give you another example. A young guy is standing in a long queue at a place while some people arrive from the opposite side. He starts staring on a cute little child who was looking at him too. They share smiles, and eye contact for several minutes while the mother carrying the child moves on. The guy just stands still there and is not aware of the surroundings when other people behind shout at him because he is not moving forward or letting them go. All of a sudden he realizes where he is and so walks ahead. This transient moment is the change blindness. :D
Note: Even maintaining an eye- contact with someone, even a child in this case may prove strenuous for the brain especially during reasoning and verbal processing and so is itself a distraction (distracting the young guy from the queue and instead focusing on that child). That is why we periodically avert our eyes during conversations.
During this particular moment this guy activated his visual association area (visual cortex) while looking at that child which meant he was just paying attention to the perceptual details (the depth of eyes of that child, cuteness, innocence, love).
On the other hand, the older adults may notice changes and patterns happening around while doing a particular task as well. Reduced focus (mental distractions) in the aging brain is responsible for the abstract thinking in them that is needed for problem solving and creative work.
In other words, the healthy aging people show thinking patterns that allow them to make connections among pieces of information that are right in front of them as well as information they have have encountered in the past. For example, an older adult involved in a conversation might pick up information on current road conditions from a television nearby, whereas a younger adult might be paying a closer attention to the conversation itself. Later on, the older adult might make use of the information from the TV broadcast while planning a route home.
The study suggests that older adults tend to have more focused attention in the morning and more of the abstract thinking later in the day. College students on the other hand tend to have their peak attention in the afternoon or evening and are less focused in mornings.
Inability to remember details of major events or just the location of objects begins in early midlife (the 40s) which does not mean the brain function is deteriorating, instead it may be the result of the changing focus of brain on the particular information during the process of memory formation and its retrieval. The experiments on this study have concluded that the middle- aged and older adults don't really show the same level of visual cortex activation as the young do when they recall the information. Instead, their medial prefrontal cortex is activated, a part of the brain that is involved in learning associations between events and the corresponding adaptive responses. The mPFC likely relies on the hippocampus to support rapid learning and memory consolidation.
Thats all
- Jaskunwar Singh
Let me ask you a question.. how much focused you are during your study time? Well, as a medical student you try your best to focus on what is written in the book and in making your own notes. You are not aware of your surroundings anymore. Someone comes nearby and calls you or sits just beside you but still your eyes are on those words and difficult medical terms of the diseases and syndromes and the drugs used to treat them. This is called Change blindness, a perceptual phenomenon that occurs when you don't notice a major change in the environment because you are too focused on one particular thing.
Let me give you another example. A young guy is standing in a long queue at a place while some people arrive from the opposite side. He starts staring on a cute little child who was looking at him too. They share smiles, and eye contact for several minutes while the mother carrying the child moves on. The guy just stands still there and is not aware of the surroundings when other people behind shout at him because he is not moving forward or letting them go. All of a sudden he realizes where he is and so walks ahead. This transient moment is the change blindness. :D
Note: Even maintaining an eye- contact with someone, even a child in this case may prove strenuous for the brain especially during reasoning and verbal processing and so is itself a distraction (distracting the young guy from the queue and instead focusing on that child). That is why we periodically avert our eyes during conversations.
During this particular moment this guy activated his visual association area (visual cortex) while looking at that child which meant he was just paying attention to the perceptual details (the depth of eyes of that child, cuteness, innocence, love).
On the other hand, the older adults may notice changes and patterns happening around while doing a particular task as well. Reduced focus (mental distractions) in the aging brain is responsible for the abstract thinking in them that is needed for problem solving and creative work.
In other words, the healthy aging people show thinking patterns that allow them to make connections among pieces of information that are right in front of them as well as information they have have encountered in the past. For example, an older adult involved in a conversation might pick up information on current road conditions from a television nearby, whereas a younger adult might be paying a closer attention to the conversation itself. Later on, the older adult might make use of the information from the TV broadcast while planning a route home.
The study suggests that older adults tend to have more focused attention in the morning and more of the abstract thinking later in the day. College students on the other hand tend to have their peak attention in the afternoon or evening and are less focused in mornings.
Inability to remember details of major events or just the location of objects begins in early midlife (the 40s) which does not mean the brain function is deteriorating, instead it may be the result of the changing focus of brain on the particular information during the process of memory formation and its retrieval. The experiments on this study have concluded that the middle- aged and older adults don't really show the same level of visual cortex activation as the young do when they recall the information. Instead, their medial prefrontal cortex is activated, a part of the brain that is involved in learning associations between events and the corresponding adaptive responses. The mPFC likely relies on the hippocampus to support rapid learning and memory consolidation.
Thats all
- Jaskunwar Singh
Classification of closed globe injuries
Closed globe injury classification:-
- Based on the mechanism of injury (type) :
A. Contusion (blunt trauma)
B. Lamellar laceration (due to a sharp object or blunt trauma)
C. Superficial foreign body (organic matter or metals)
D. Mixed (combined injuries)
- Based on the visual acuity (grade) :
A. >20/40 (0.5)
B. 20/50 - 20/100 (0.4 - 0.2)
C. 19/100 - 5/200 (0.2 - 0.025)
D. 4/200 - Light Perception (0.02 - L+ P+ )
E. No Light perception
- Based on the pupillary defect :
A. Relative afferent pupillary defect (RAPD) positive
B. Relative afferent pupillary defect (RAPD) negative
- Based on the Zones of violations :
Zone I- External (superficial injuries of bulbar conjunctiva, cornea and sclera)
Zone II- violation of the Anterior segment (structures in anterior chamber and the pars plicata)
Zone III- violation of the Posterior segment (structures posterior to the posterior lens capsule- retina, vitreous and optic nerve)
Thats all
- Jaskunwar Singh
- Based on the mechanism of injury (type) :
A. Contusion (blunt trauma)
B. Lamellar laceration (due to a sharp object or blunt trauma)
C. Superficial foreign body (organic matter or metals)
D. Mixed (combined injuries)
- Based on the visual acuity (grade) :
A. >20/40 (0.5)
B. 20/50 - 20/100 (0.4 - 0.2)
C. 19/100 - 5/200 (0.2 - 0.025)
D. 4/200 - Light Perception (0.02 - L+ P+ )
E. No Light perception
- Based on the pupillary defect :
A. Relative afferent pupillary defect (RAPD) positive
B. Relative afferent pupillary defect (RAPD) negative
- Based on the Zones of violations :
Zone I- External (superficial injuries of bulbar conjunctiva, cornea and sclera)
Zone II- violation of the Anterior segment (structures in anterior chamber and the pars plicata)
Zone III- violation of the Posterior segment (structures posterior to the posterior lens capsule- retina, vitreous and optic nerve)
Thats all
- Jaskunwar Singh
Blood Indices
Hello readers,today I am gonna tell you about some blood indices -there meaning, normal values, and units ! . Hopefully they will be useful . I always use to mess up them during my very first year :(
1)Mean corpuscular volume (MCV):It denotes the volume in a single RBC .It correspond to size of RBCs ,so when MCV is in normal range it denotes normocyte .When MCV increases , RBCs are known as macrocytic eg : megaloblastic anemia and when it decreases ,cell are microcytic eg: iron deficiency anemia.
MCV can be calculated by automated hematology analyzer or by using hematocrit value
MCV:-Hematocrit (%) ×10/RBC count
(million /cubic mm).
Unit of MCV is femtolitre(fL)
Normal value is 80-95 fL
2)Mean corpuscular hemoglobin(MCH):-
It's the quantity or amount of hemoglobin present in one RBC. It's normally expressed in picogram or microgram .
Normal range is 27-31 pg
Formula -
MCH :-Hb (gm per 100mL)/Total RBCs in blood(million per cubic mm) . I think no need to tell MCH decreases in anemia :D
3)Mean corpuscular hemoglobin concentration: It is concentration of hemoglobin in one RBC.It is actually the amount of hemoglobin expressed in relation to volume of RBC.(It's actually
Combination of above two terms )
So we express it in gram /dL
Normal value is 33-36 gm/dL
Formula :
MCHC:
Hb(g/100mL)×100/Hematocrit(%).
When RBC size decrease , RBC is known as hypochromic
In pernicious anemia RBCs are macrocytic and normochromic While in iron deficiency RBCs are microcytic and hypochromic.
We don't have hyperchromic RBC because content of RBC is limited !
~Ojas
Mnemonic for personality disorders
Hello!
Soo here's a nice memory aid I came across...
A: Mad
B: Bad
C: Sad
If you write two A's (AA) It does look like an M!
B for cluster B, B for Bad!
C and Sea sounds similar for Sad xD
Mnemonic for personality disorders
Soo here's a nice memory aid I came across...
A: Mad
B: Bad
C: Sad
If you write two A's (AA) It does look like an M!
B for cluster B, B for Bad!
C and Sea sounds similar for Sad xD
Mnemonic for personality disorders
"SPAS BAN His ACD"
Rickettsia mnemonic
We transferred this post here because we lost the diagram: https://www.medicowesome.com/2020/03/rickettsia-mnemonic.html
Here are a few things you should know about rickettsia!
Here are a few things you should know about rickettsia!
Rickettsia, are small, gram-negative, nonmotile, rod-shaped bacterium.
Monday, January 2, 2017
Nervous regulation of blood pressure
Hello awesomites ! Some days back I revised my concepts on regulation of blood pressure so would like to share with you ,so lets start it .This is short -term regulation of blood pressure.
Changes in blood pressure is normally detected by 9th cranial nerve from carotid sinus and by 10th cranial nerve from aortic arch both of them carries signal to NTS (nucleus of tractus solitarius) present in medulla oblongata which in turn co-ordinate 3 centres present in medulla oblongata.
- Cardio inhibitory centre .
- Cardio stimulatory centre.
- Vasomotor centre.
Now suppose there is increase in blood pressure ,let's see microscopically what changes we are gonna seen in nerve endings of 9th and 10th nerve.
An increase in blood pressure will stretch carotid sinus and aortic arch ,which in turn will cause stretching or spreading of nerve endings ,which will increase influx of the sodium ions . Ultimately increase in depolarisation wave will cause stimulation of NTS (Even decrease in depolarisation wave will stimulate NTS ,which happens during decrease in blood pressure).Now as we know there is increase in blood pressure , NTS-our main character in this process will control these 3 centres to control blood pressure. Let's see what it do to these three centres present in medulla oblongata.
1)Cardio-inhibitory centre : This centre will be stimulated which in turn send fibers to SA node and AV node via right and left vagus nerve respectively.Leading to decrease in heart rate ,obviously cardiac output will decrease so will be blood pressure!.
2)Cardio-stimulatory centre: This centre will be inhibited which causes decrease in heart rate and cardiac output via it's fibers (post-ganglionic) which passes to lateral horn of spinal cord and then post-ganglionic fibers goes to sympathetic ganglion from where post-ganglionic sympathetic fibers acts on heart causing decrease in heart rate and cardiac output.
3)Vasomotor centre:This centre do's more work compared to above two mentioned centres .It acts on three areas ,
Arteries
Veins
Adrenal medulla
Let's see how it reacts when there is increase in blood pressure.
a) On arteries :It causes vasodilation leading to decrease in Total peripheral resistance which is directly proportional to diastolic pressure hence causes decrease in diastolic blood pressure.
b )On veins :It causes vasodilation leading to decrease in venous return which is directly proportional to EDV and which in turn causes decrease in Cardiac output and hence decrease in systolic blood pressure.
c )On adrenal medulla: Decreases release of epinephrine and nor-epinephrine which is responsible for decrease in HR,so decrease in blood pressure.
Woahh! Was such a long blog!
I think it's not necessary to mention occlusion of carotid artery causes false phenomenon of decrease in blood pressure so opposite effects will be seen:)
~Ojas.
Levels Of Prevention & Mode Of Intervention
Hi everyone,
this is notes on community medicine topic. levels of prevention and mode of intervention.
Hope it helps.
That's all
Shubham Patidar jmc 013
Sunday, January 1, 2017
Metoclopramide
Hello awesomites ! Today I am gonna talk about a drug named as "Metoclopramide".
Basically it's a anti-emetic drug.First let us know what is emesis !.In simple words emesis means vomiting.Chemoreceptor trigger zone (CTZ) is located in area postrema and the nucleus tractus solitarius (NTS) of medulla oblongata.They both act as a important relay areas for afferent impulses arising in g.i.t.,throat and other viscera.
Metoclopramide is a Pro kinetic drug
It acts on GIT causing increase in peristaltic movement with relaxation of pylorus .
Mechanism of action includes :
a)D2 antagonism:It Decreases dopamine concentration and obviously acetylcholine concentration increases !.Which causes activation of ACh receptors leading to increase in LES tone and gastric pressure .
b)5-HT4 agonism:Activates 5-HT4 receptors on primary afferent neurons (PAN) of the ENS,via excitatory interneurons.
Gastric hurrying and LES tonic effects are mainly due to this action which is synergised by bethanechol and attenuated by atropine .
c)5-HT3 antagonism: At high concentrations it can block 5-HT3 receptors present on inhibitory myenteric interneurons and in NTS/CTZ .Increase in ACh concentration is also seen in minor condition
Long term use can cause parkinsonism-since decrease in dopamine , galactorrhea and gynecomastia .
It hastens use of many drugs like aspirin and diazepam by its action
~Jaskunwar Singh & Ojas
Triad of Charcot
Hello
Charcot's triad in acute cholangitis: FOR
- Fever
- Obstructive jaundice
- Right upper quadrant pain
Chracot's triad in multiple sclerosis: SIN
- Scanning speech
- Intention tremors
- Nystagmus
Thats all
- Jaskunwar Singh
Charcot's triad in acute cholangitis: FOR
- Fever
- Obstructive jaundice
- Right upper quadrant pain
Chracot's triad in multiple sclerosis: SIN
- Scanning speech
- Intention tremors
- Nystagmus
Thats all
- Jaskunwar Singh
Multiple sclerosis mnemonic
Hey awesomites!
Presenting to you the first post of 2017 :)
Multiple sclerosis clinical features mnemonic:
DONALD TRUMP
D- Demyelinating disease
O- Optic neuritis
N- Neuromyelitis optica
A- Autoimmune aetiology
L- Leg pain
D- Depression
R- Relapsing and remitting type (most common)
U- Uhthoff's phenomenon
M- McDonald's criteria (diagnostic)
P- P100 latency of nerves (delayed)
Thats all
- Jaskunwar Singh
Saturday, December 31, 2016
2016: the flashback
Hey all!
In this post, I just want to share a flashback to the year 2016 and what I have learnt through the journey of these 365 days.
In this post, I just want to share a flashback to the year 2016 and what I have learnt through the journey of these 365 days.
2016, you will be missed
Remember I promised 2016 was going to be awesome?
It was, it was. It was a beautiful year, personally.
Here's my year in review:
It was, it was. It was a beautiful year, personally.
Here's my year in review:
Create the change
Hello everyone
So it's the last day of 2016. And everyone is now talking about new year resolutions and stuff. But what do we want to resolve as medical students?
Remember the first day you joined the medical college? That day you promised yourself something. To be a good doctor one day and serve humanity. To study and work hard all day and night seven days a week and gain knowledge in every subject you study. You had taken your life- changing resolution on that first day itself.
I believe in change. I have always tried to explore myself and learn new things each day of my life. That's what we all should do. And not just in the initial days or weeks of the new year. Because you are known by your actions and not what you think.
So stop making resolutions and start taking your real life decisions. Change is the law of nature. Create the change in yourself each passing day for the better. That will make you feel good. And because your ultimate goal in life is not just to be a doctor but also be a good human being. Then one day you will be what you ever wanted to be.
That's all
- Jaskunwar Singh
So it's the last day of 2016. And everyone is now talking about new year resolutions and stuff. But what do we want to resolve as medical students?
Remember the first day you joined the medical college? That day you promised yourself something. To be a good doctor one day and serve humanity. To study and work hard all day and night seven days a week and gain knowledge in every subject you study. You had taken your life- changing resolution on that first day itself.
I believe in change. I have always tried to explore myself and learn new things each day of my life. That's what we all should do. And not just in the initial days or weeks of the new year. Because you are known by your actions and not what you think.
So stop making resolutions and start taking your real life decisions. Change is the law of nature. Create the change in yourself each passing day for the better. That will make you feel good. And because your ultimate goal in life is not just to be a doctor but also be a good human being. Then one day you will be what you ever wanted to be.
That's all
- Jaskunwar Singh
Friday, December 30, 2016
Ectopia lentis mnemonic
Ectopia lentis (or lens dislocation) associated conditions mnemonic.
- MarFAN syndrome (FAN is up)- Superior dislocation of the lens
- HomocystinURIA (URINE goes down)- Inferior dislocation
- WeilMARCHesani syndrome (We will march forwards)- Anterior dislocation of the lens
Thats all
- Jaskunwar Singh
- MarFAN syndrome (FAN is up)- Superior dislocation of the lens
- HomocystinURIA (URINE goes down)- Inferior dislocation
- WeilMARCHesani syndrome (We will march forwards)- Anterior dislocation of the lens
Thats all
- Jaskunwar Singh
Thursday, December 29, 2016
LAP score
Leukocyte Alkaline Phosphatase score is used to differentiate a reactive process from chronic myelogenous leukemia. Here I just mention the conditions with high and low LAP score (not a mnemonic this time :p )
High lap score:
- Neutrophilia ( as in bacterial infections)
- Polycythemia vera (neoplasm of bone marrow)
- Blast phase of XML
- Hodgkin's disease
- Leukemoid reactions
- in newborns, children and pregnancy.
Low lap score:
- Chronic Myelogenous leukaemia (chronic phase)
- Paroxysmal nocturnal hemoglobinuria
- Hereditary hypophosphatasia
That's all
Happy Medicowesome :)
- Jaskunwar Singh
High lap score:
- Neutrophilia ( as in bacterial infections)
- Polycythemia vera (neoplasm of bone marrow)
- Blast phase of XML
- Hodgkin's disease
- Leukemoid reactions
- in newborns, children and pregnancy.
Low lap score:
- Chronic Myelogenous leukaemia (chronic phase)
- Paroxysmal nocturnal hemoglobinuria
- Hereditary hypophosphatasia
That's all
Happy Medicowesome :)
- Jaskunwar Singh
Normal pressure hydrocephalus
Hey awesomites
Normal pressure hydrocephalus is a type of brain malfunction characterised by:
- Dilatation of ventricles
- Distortion of fibres in corona radiata
- Normal pressure on lumbar puncture
- And a triad of symptoms:-
- Cognitive loss (dementia)
- Apraxia of gait
- Pee problems (urinary incontinence)
I have made a mnemonic for this triad. Since cephalus in hydrocephalus means head so here's a cap to cover it. Mnemonic- CAP
The main aim of treatment in this condition is to drain the excess of CSF. Surgical installation of ventriculoperitoneal shunt is the usual method which aims to drain csf into the peritoneal lining of abdomen from where it is easily absorbed.
Thats all
- Jaskunwar Singh
Normal pressure hydrocephalus is a type of brain malfunction characterised by:
- Dilatation of ventricles
- Distortion of fibres in corona radiata
- Normal pressure on lumbar puncture
- And a triad of symptoms:-
- Cognitive loss (dementia)
- Apraxia of gait
- Pee problems (urinary incontinence)
I have made a mnemonic for this triad. Since cephalus in hydrocephalus means head so here's a cap to cover it. Mnemonic- CAP
The main aim of treatment in this condition is to drain the excess of CSF. Surgical installation of ventriculoperitoneal shunt is the usual method which aims to drain csf into the peritoneal lining of abdomen from where it is easily absorbed.
Thats all
- Jaskunwar Singh
Seasonal affective disorder
Hey awesomites
Seasonal affective disorder (SAD) is common in winters months when days are short and nights are long. It is caused by abnormal melatonin metabolism and the patient presents with acute depressive and atypical symptoms.
Here's a mnemonic for atypical symptoms of Seasonal affective disorder.
SAD
S- Sleepiness
A- Appetite increase
D- Decreased energy
Note: Treatment of this disorder includes exposure to bright light therapy. Melatonin tablets should not be prescribed in such cases.
That's all
- Jaskunwar Singh
Seasonal affective disorder (SAD) is common in winters months when days are short and nights are long. It is caused by abnormal melatonin metabolism and the patient presents with acute depressive and atypical symptoms.
Here's a mnemonic for atypical symptoms of Seasonal affective disorder.
SAD
S- Sleepiness
A- Appetite increase
D- Decreased energy
Note: Treatment of this disorder includes exposure to bright light therapy. Melatonin tablets should not be prescribed in such cases.
That's all
- Jaskunwar Singh
Wednesday, December 28, 2016
Vogt's triad in tuberous sclerosis mnemonic
Vogt's triad in tuberous sclerosis mnemonic:
EpiLoiAs
Epi- Epilepsy
Loi- Low IQ
As- Adenoma sebacum
- Jaskunwar Singh
EpiLoiAs
Epi- Epilepsy
Loi- Low IQ
As- Adenoma sebacum
- Jaskunwar Singh
Vogt's triad in congestive glaucoma mnemonic
Vogt's triad in acute congestive glaucoma:
GAP
G - Glaucomflecken
A - Atrophy of iris stroma
P - Pupil dilatation
Also, check out the Vogt's triad in tuberous sclerosis mnemonic here
- Jaskunwar Singh
GAP
G - Glaucomflecken
A - Atrophy of iris stroma
P - Pupil dilatation
Also, check out the Vogt's triad in tuberous sclerosis mnemonic here
- Jaskunwar Singh
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 :)
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 :)
Jay :)
Oxidase vs. Oxygenase
Another confusing yet very simple thing
It's not that hard to remember right?
Jay :)
- 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
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 :)
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
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?
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.
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!
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 :)
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.
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:)
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?
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).
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
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
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
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
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 :)
Here's the mini contents page for ENT instruments, this post is linked to the main contents page :)
Tuesday, December 27, 2016
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
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
Monday, December 26, 2016
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.
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! :)
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.
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
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