Hello everyone !
Another short post on a very important triad. Cushing's!
Cushing's reflex
It occurs in response to raised Intracranial Pressure (ICP/ICT)
Mnemonic :
HIB
H - Hypertension
I - Irregular Breathing
B - Bradycardia
Mechanism :
So just imagine :
Due to some reason you develop an increase in the ICT.
We know that blood flows from High Pressure to Low Pressure. Generally , the CSF pressure is lower than the BP.
However after a point , the ICT is bound to become equal to or even more than the systemic BP!
If that happens , the blood flow to the brain is decreased and the Brain can get ischemic (cause the Cranial pressure would be higher. So the body won't be able to pump the blood into it.)
Thus, in order to compensate for this , the sympathetic system is activated. The body's peripheral vessels undergo constriction to raise the BP. This would keep them at a higher pressure than the Cranium thus keeping the blood flow intact for a while at least. This causes the Systemic Hypertension.
In a way it's the last ditch effort to save the brain!
Due to sympathetic stimulation the respiratory centers get stimulated too and it's all weird so it causes Irregular Respiration.
Now you'd expect Tachycardia when there is so many Sympathetic juices flowing through your body.
But no. Things aren't as simple as that.
The aortic baroreceptors sense the increased BP and end up decreasing the Heart Rate. Resulting in Bradycardia. So in a way that's the 2nd phase of this Reflex!
The Reflex serves as a marker of raised ICT as that is the event that puts the whole cycle into place.
This generally occurs as the body's last resort to restore blood to the brain.
What a wonderful Homeostatic mechanism !!
Hope this helped !
Stay awesome !
Hello everyone !
Here's a way to remember the D/D's of Nodules at the Limbus.
Mnemonic :
Please Please Please ! Eat Spicy MCDonald's Tortilla.
Please - Pterygium.
Please - Pinguecula.
Please - Phlycten.
Eat - Episcleritis.
Spicy - Scleritis.
M - Melanoma.
C - Choristoma
Donald - Dermoid.
Tortilla - Trachoma. Tranta spots.
1. Out of these Pterygium , Pinguecula and Phlyctens are Conjunctival lesions.
Pterygium is a fold of conjunctiva that encroaches towards the pupil.
It can be vascular and nodule like. Can cause Foreign body sensation and decreased vision if it covers the pupil.
It may also cause Diplopia and a Squint due to its traction over the eye.
A pinguecula is milky like nodular swelling of the conjunctiva.
A Phlycten is a lesion in Phlyctenular Conjunctivitis which is an allergic or Hypersensitivity response to Tuberculin or staph Antigens. There is intense itching , discharge and nodules in the eye - called Phlyctens.
2. The lesions of Episcleritis and Scleritis are similar. They're both associated with systemic disease like Rheumatoid Arthritis , SLE, Sarcoidosis etc.
Scleritis is a more severe one of the two. There's marked redness and congestion of the eye along with multiple vascular nodules. The eye is very inflamed. There is intense pain and watering. It needs urgent treatment. It may causes various types of staphylomas.
Episcleritis is a more benign form. There is intense itching , nodular vascularity and discharge with some amount of congestion.
3. Tumors like Choristoma , Dermoid tumor and Melanoma mainly arise from the uvea. They're not very common.
4. Trachoma : presence of lesions in trachoma at the nodule may be prominent. You may also get 'Horner Tranta spots' in Vernal Keratoconjunctivitis which is an allergic Conjunctivitis.
Hope this helped !
Stay awesome !
Happy Studying!
Hello everyone ! I'm back with a short and sweet post on Argyll Robertson Pupil.
Mnemonic for Argyll Robertson Pupil (ARP) :
ARP Accomodation reflex present
PRA Pupillary reflex absent.
It's seen in conditions like Neurosyphilis for which it is extremely specific.
You could also see it in some form of strokes or Diabetic Neuropathy.
Another similar Pupillary reaction is Aedes pupil. The difference is Aedes is a dilated pupil while Argyll's is constricted. How to remember this ?
Mnemonic : AeDes.
So Aedes is tonically Dilated.
Hope this helped !
Stay aweosme.
Thanks.
Hello readers, here is the continuation of the previous topic, Immunohemolytic anemias. Today we will discuss the next two types, its more like winter special.
B) Cold agglutinin type- Cold agglutinin derives their name from the fact that they show maximal activity at temperature lower than normal body temperature.
It is present in low titres in healthy individuals.
Physiological cold agglutinin develops naturally after birth as a result of change in expression of Red cell antigens and reacts maximally at 4°C.
While pathological cold agglutinin maximally reacts at around 28-31° C and tend to occur at very low titres.
Mnemonic is "Cold MILL"
C - Complement mediated hemolysis.
M - IgM is the causative antibodies
I - Cold agglutinin antibodies appear
transiently following Infections
[Mycoplasma pneumoniae, EBV,
HIV, influenza virus, CMV]
- I antigen is the most common
target
L - Chronic cold agglutinin AIHA is
associated with Lymphoid
neoplasm
(esp B cell neoplasm), leukemias
like CLL
Mechanism- IgM binds to red cell where the temperature may fall below 30°C. It agglutinates red cells, and fixes complement rapidly. As blood recirculates and warms, IgM is released,but sufficient deposition of complements leads to phagocytosis of affected red cells in spleen, liver, bone marrow.
Clinical presentation- Exerts their pathological effects either via hemolysis and red cell destruction in RE system predominantly liver or by vaso occlusion due to agglutination.
-Mild anemia, purplish discoloration of fingers, toes, earlobes [ Acrocyanosis], mild hepatospleenomegaly,
Raynaud phenomenon in peripheral cold exposed parts.
C) Cold hemolysin type -
Also known as paroxysmal cold hemoglobinuria.
It's a rare fatal disorder causing intravascular hemolysis and hemoglobinuria when auto antibodies binds to P blood group antigens in cool, peripheral regions of body.
Paroxysmal Cold HemoGlobinuria:
P- P blood group antigens
C- Complement mediated lysis occurs.
IgGs auto antibodies binds to red cell in
cool peripheral regions, Complement
mediated lysis occurs when affected
red cell recirculates to warm regions,
because complement cascade
functions
more efficiently at 37°C
H- Hemoglobinuria
G - Auto antibodies belong to class IgG
Symptoms of the patients aggravates on exposure to cold.
Winter is coming, we know what's coming with it.
Stay warm :)
Hello awesomites!
This is my very first post, so am starting with my favorite subject Hematology.
Today's post is about Immunohemolytic anemias, commonly ignored type of anemia
Also referred as Autoimmune hemolytic anemias(AIHA)
Where antibodies are responsible for premature destruction of red blood cell.
Types- warm antibody type
- cold agglutinin type
- cold hemolysin type
Warm antibody type - It is the most common type of AIHA.
you can remember it by mnemonic
" WARM GRILLED "
W - Warm because, antibodies are active
at 37°C
A - Associated with other Autoimmune
disorders ( secondary causes like
SLE)
R - Red cell hemolysis is mainly
extravascular
M- Moderate spleenomegaly due to
hyperplasia of splenic phagocytes
G- Ig G class - most common causative
antibodies ( IgA sometimes too)
R- Rh blood group antigens are the main
target
I- 50% primary cases are Idiopathic
Secondary causes can be
L- Lymphoid neoplasm
ED- Exposure to Drugs.
Examples - penicillin, cephalosporins, quinidine, methyl dopa etc
Mechanism - A) Antigenic drugs-
Drugs such as penicillin binds to red cell membrane and they are recognized by the antidrug antibody. The antibody either recognizes the drug and bind to it or both drug and membrane protein,ultimately results in hemolysis.
B) Tolerance breaking drugs- In drugs such as methyl dopa, antibodies are formed against red cell antigens particularly Rh antigens.
Stay awesome✌️
0Hello readers! Being in medical field we are quite acquainted with the word "Stress out" .Todays article is just about a simple nasal spray that can prove to be a boon to entire human kind.(I think specially our field ! :p)
Everything in a brain is carried out by special substances called as "Hormones" .Even the simplest change in mood is concerned with hormonal changes.For example in first trimester of pregnency a rapid rise in estrogen and progesterone can cause mood swings in woman.Similary when there is depletion of hormones or its metabolites or less production of hormone this can leads to depression ,low -emotional state ,anxiety etc.Suicide can be triggered by serious illness ,can also be triggered by low self-esteem or emotional pain .
Scientists are developing a nasal spray that can prevent suicides! .This nasal spray consists of Thyrotropin releasing hormone(TRH) also known as thyroliberin . Thyrotropin is actually hormone released by hypothalamus ,it actually stimulate release of thyrotropin and prolactin from anterior pituitary.Recent findings have found out that TRH also shows anti-depressant and anti-suicidal effects.Thus preventing suicidal behaviour and depression.Researchers want to figure out ,a way to deliver it to a brain when it is given through nose .Brain is protected by Blood brain barrier (BBB),which is acting has a hinderence to pass TSH to brain.
Clinically it is related in spinocerebellar degeneration and disturbance of consciousness in humans.Pharmacological form is known as protirelin.
I hope scientists find it soon how to cross BBB :p
Exams are near and I am already freaking out :p
Keep smiling :)
Have a day with high level of TSH in brain :)
~Ojas
Hello awesomites !Today's topic is short ,simple and easy to understand.
Cancer is basically a disease where there is abnormal growth of cells in body and sometimes it is also malignant that is ,it can spread from one organ/site to another.These newly formed cells can disturb normal cycle of other cells .When a cell suffers DNA damage from cancer,a virus or radiation a group of protein complex MRN is sent to repair DNA.MRN is protein complex ,it consists of Mre11,
Rad50 and Nbs1 .In eukaryotes initial processing of double strand DNA breaks prior to repair by homologus recombination or by non-homologus joining.
When a DNA virus is present in the cell,MRN instead focuses on removing it.
If both DNA damage & a DNA virus are present in a single cell .The MRN complex is unable to manage both threats at once and ends up ignoring the virus .
These new findings imply that scientist might be able to form a virus that targets and kills only cancer cells.
Keep smiling:)
Good day:)
Hello readers ,Here is something new information about human saliva !.
Human saliva and pain killer :-
Human saliva contains a painkiller that is naturally produced by human body .It is called as -"Opiorphin" in very low concentration.
Opiorphin's role:-
Opiorphin prevents the breakdown of chemicals called as enkephalins . Apart from this opiorphin inhibits 3 protease.-
a)Ecto-endo peptidase.
b)Ecto-amino peptidase .
c)Dipeptidyl peptidase.
This extends the duration of enkephalins.
The enkephalins activates opiate receptors .Activated opiate receptors blocks pain signals from reaching brain!!. opiorphin is 6 times more potent than morphine .Unlike morphine opiorphin is not addictive and prolonged use may not lead to tolerance .
Current status in research:
Painkiller was successfully tested on rats.Further research is still needed before it's use on humans .Research include modifying molecular structure to avoid rapid degeneration in intestine and it's poor BBB(Blood brain barrier !).Modification includes transformation of N-terminal glutamine into pyroglutamate .
~Ojas
Hello awesomites ! Today's blog is about new drug -Tideglusib.
Tideglusib is actually Alzheimer's drug and is also used in paralysis of supranuclear palsy!
However this drug is currently in news because of its ability to stimulate repair of teeth .
Use of this drug can cause end of dental fillings .
Mechanism of action of drug
The mechanism is roughly known .It acts in 2 ways
1)It stimulates stem cells in the pulp of the teeth to generate new dentine and heal small cavities.(Dentine is hard dense bony tissue that forms your teeth)
2)Inhibits an enzyme called as GSK-3 which prevents formation of dentine !,
Progress in research:
Drug is successful tested on mice .They soaked biodegradable sponges in the drug and then placed them in cavity .The sponges melts away over time,leaving only the repaired tooth but for use in humans ,the drug is still under research.
Keep smiling :)
Happy day:)
~Ojas
Hello awesomites ,really tired of all the bookish knowledge so for time being I switched my self to internet,and came across some of the rarest and the most interesting diseases of all the time !
Here is the first one -Ectopic cordis.
What is -Ectopic cordis?
It is the disease where the heart is located at abnormal position that is places other than thorax or sometimes partially at thorax.It is a congenital disorder
Cause :-
It is caused due to improper maturation of the mesoderm and ventral body wall durig embryonic development.Lateral wall is responsible for fusion at midline to form ventral wall any change in this process may lead to -Ectopic cordis.
Types:-
Depending upon situation of the heart in patient ,ectopic cordis is classified into 4 parts :-
1)Thoracic.
2)Cervical.
3)Thoracoabdominal.
4)Abdominal.
Defects seen:-
1) Ventricular septal defect .
2)Atrial septal defect.
3)Absence of tricuspid valve.(Tri-cuspid atresia)
4)Fallots tetralogy. (http://www.medicowesome.com/2017/01/teratology-of-fallot.html)
Treatment:
Unfortunately the only treatment is surgery !
Not all the surgeries are successful .
Patients of ectopic cordis hardly can live for long years as there are more chances of infections to heart .
That's it for today.
Internet is interesting:)
~Ojas
Hello readers today's blog is small one -Fallot's tetralogy .
What is Fallot's tetralogy?
It is a congenital disorder of heart .It is caused to foetus may be because of alcoholic mother or who has diabetes or may be due to rubella infection caused during pregnancy.It is caused due to deletion of chromosome 22
Signs and symptoms:-
As the name suggest ,there are four signs
All four of them are related to heart .
Mnemonic is PVR -f cinema.
-Pulmonary stenosis
-Ventricular septal defect .
-Right ventricular hypertrophy
-Over-riding of aorta ,due to which blood from both the ventricles may enter aorta.
Due to defect in heart ,there is low oxygen supply to tissue this may lead to cyanosis when there is high amount of pulmonary stenosis but when there is moderate amount of pulmonary stenosis this may lead to pink tit that is pinkish colouration of skin.There is also clubbing .
Treatment:
Open heart surgery is only treatment for fallots tetralogy .
The appropriate time for surgery depends on the pulmonary stenosis .
However patient should be on life long medication for healthy life
That's all :)
Have a happy day.
~Ojas
Hey,Hello! awesomites ,this blog is just a small review of some old and new things I learned about Parkinson's disease.
The very first thing I learned is:- parkinson's disease and parkinsonism are two different terms !!!.
-Parkinsonism is a complex term it includes many symptoms while parkinson's disease is a progressive neurodegenerative disorder .
-Parkinosons disease is actually cause of parkinsonism .
Let's start with Parkinson's disease
-Main cause is decrease dopamine secretion in body mainly due to injury to substantia nigra which sends dopamine secreting nerve fibers to caudate nucleus and putamen.
Signs and symptoms:
- Characteristics features is tremors .Tremors occurs during all walking hours and therefore it is a type of involuntary tremor in case of cerebellar disease there is an intension tremor because tremors are seen when patient perform any work.
-Also festinant gait is found
-Akinesia is also seen
-Lead-pipe rigidity is seen earlier in hands and legs followed by neck and trunk.
Causes:
-Any serious injury that affects dopamine secretion !
-Also some medication which decreases dopamine secretion or blocks dopamine receptors.
-Apart from that certain drugs also induces Parkinson's disease like drugs used to treat schizophrenia and other neuroleptic drugs like
Clozapine.
Risperdal.
Quetiapine.
Apart neuroleptic drugs,others drugs like prochlorperazine,metoclopramide.
Also calcuim channel blockers causes Parkinson's
Drug induced Parkinson's remains same ,it doesn't progress
Categories of drugs used for treatment of parkinsonism:-
-Dopamine agonist.
-Anticholinergic.
-COMI inhibitors.
~Ojas
Today I am gonna give some brief review about how to treat constipation .So let's start with basics
Why constipation occurs ?
-Water serves as a transporter of stools ,decrease in concentration of water in intestine can lead to constipation ,it may be either due to increase absorption from the extracellular space or decrease water content in body.
-Decrease bowel moment
How to treat constipation?
-As now we know cause of the constipation ,we can treat constipation either by :-increasing water content or decrease loss of water from intestinal lumen
And also by increasing bowel moments so less water or salts are absorbed (Yet some drugs uses another mechanism.)
Drugs used :-
1)We can use Dietary fibers which will just form a bulk in intestine and will increase water content of faeces ,also due to bacterial degradation some osmotic active substances are produces which further increases water content Hey but there is one drawback ,it may causes gas :D.
2)Stool softeners:
-They permit water and lipid to penetrate stool .
-They are either given orally or rectally!
(Yes a drug acting on intestine can also given rectally)
-Again there is one drawback ,prolong use can cause impair absorption of fat soluble vitamins ( A,D,E,K)
3)Osmotic laxatives (Laxative is term used for drugs for treatment of constipation)
-Colon can neither concentrate /dilute fecal fluid so fecal fluid is isotonic throughout the colon
-Generally we use non-absorable sugars /salts eg:-Magnesium citrate & sodium phosphate.
-Osmotic laxatives are commonly used but should not be used in patient with renal insufficiency.
-But patient using sodium phosphate must take adequate water to compensate fluid loss due to it
,It may causes hyperphosphatemia,hyper natremia , hypocalcemia,hypokalemia.
-So should not be used in cardiac patients
4)Stimulant laxatives
a) Anthraquinones:It after hydrolysis produces bowel moment in 6-12hrs if given orally or within 2 hrs if given rectally.!
-It may causes melanosis coli.
b)Diphenylmethane derivatives : It increases bowel moments in 6-10hrs when given orally and in 30-60mins when given rectally.
-It has minimum systemic absorption
5) Opioid receptor antagonism
-Now this is an interesting type of drug mechanism rather than increasing motility it "decreases" motility .
Confused ?!!
Still it is used in prevention of constipation ?!
Yes ,by decreasing motility it prolonges the transient time required for absorption of water and salts from surrounding
Eg:-Methylnaltrexone & alvimopan.
~Ojas
