Heme Synthesis Mnemonic

Hello Everyone!

Lets discuss heme synthesis today.  Here's the Pathway:

That's all,
Thankyou
 -Chai

Post - intubation Cardiac Arrest : possible mechanisms

Hey Awesomites

Early post - intubation Cardiac Arrest ( within 10 minutes ) is a serious major complication of emergency intratracheal intubation associated with high in - hospital mortality, and occurs with approximately 2% frequency in the ED.

Various retrospective and case- control studies have been well designed to establish the connection and factors associated in the causation. One of the studies by Heffner et al. found that a higher pre - intubation shock index ( PISI ), that is defined as heart rate divided by systolic BP, and a higher weight of the patient are independently associated with post - intubation CA.

Systolic hypotension ( BP less than 90 mmHg ) is independently associated with post - intubation CA.

Emergency intubation can cause hypotension potentially as a consequence of actual intubation acting as a sympatholytic stimulus, mechanical ventilation ( positive pressure ventilation with subsequent fall in venous return ), and/ or the induction agents used.

Also important to note is that the association between pre - intubation hypotension and post - intubation progressive decline in BP and subsequently pulseless electrical activity arrest raises the question of whether treatment of hypotension before intubating by fluid resuscitation and vasopressors can decrease the rate of post - intubation CA.

That's all
- Jaskunwar Singh

Fact of the day : Easier approach shot to the pouch of Douglas

Hey Awesomites

The posterior fornix of the vagina is separated from the peritoneal cavity by a single layer of peritoneum and the posterior vaginal wall. Therefore, vaginal approach from its posterior aspect for evacuation of pus in the pouch of Douglas can be done without much difficulty.

On the other hand, approach to uterovesical pouch ( anterior relation ) is much more difficult from the vaginal route and consists of a series of steps :
- Incise the vagina
- separate bladder from cervix
- Traverse the vesicocervical space ( till the uterovesical fold of peritoneum is reached )

This difference is due to the normal physiological position of the uterus that is anteverted and anteflexed; the direction of external os being downwards and backwards.


That's all
- Jaskunwar Singh

Basic modalities of Transitional Zone

Hey Awesomites

Squamocolumnar junction ( the transitional zone ) is a junction formed by merging of squamous epithelium of the vagina with the columnar epithelium of endocervix.

Squamous non keratinized epithelium lining the vaginal mucosa has three distinct layers -
- Basal layer of cuboidal cells
- Middle layer of prickle cells
- Superficial layer of cornified cells

Embryologically, the junction consists of columnar epithelium that spreads over the external os and only the basal and middle layer of squamous epithelium lining the vaginal mucosa.

After attaining puberty, hormonal effects of oestrogen and progesterone induce metaplastic changes in columnar epithelium. Therefore, the squamous epithelium comes in close vicinity to the external os.

During reproductive age, growth of uterus, hypertrophy of cervical cells and associated hormonal changes and in females exposed to DES in utero, the transitional zone extrudes well out of the external os.

Due to high cellular activity and sensitivity to certain irritants and mutagens, there is high risk of dysplastic changes in the squamocolumnar epithelium and eventually carcinoma cervix. So, scrapings for PAP smear are done without difficulty from this exposed area to screen the patients.

In menopausal women, the atrophy of cervix leads to in drawing of SCJ into the canal. Hence the junction is not easily accessible and this ill exposure is the reason for high rates of false negative findings in PAP smear in older women! Hormonal therapy in such patients improves the positivity of results.


That's all
Jaskunwar Singh

Types of tympanic membrane perforation

Hello Awesomites ! :D

There are different types of perforation of tympanic membrane. We name it on the basis of :-

1. Size of perforation

2. Site of perforation

So, let us begin.

ACCORDING TO SIZE OF PERFORATION,

1. Pinhole :- 1-2 mm in size.

2. Small :- Area involving one quadrant or <10% of pars tensa.

3. Medium :- Area involving 2-3 quadrant or 10-40% of pars tensa.

4. Subtotal :- Area involving the pars tensa >75% and does not involve the annulus.

5. Total :- A total perforation is present in tympanic membrane. Tympanic membrane is essentially absent and involve annulus also. 

ACCORDING TO SITE OF PERFORATION,

1. Anterior 

2.Posterior

3.Inferior

4.Central

OR,

1.Central :- A simple perforation in pars tensa with intact annulus. 

                   Perforation is surrounded all around by pars tensa.

2. Marginal :- Perforation in the pars tensa surrounded partly by pars tensa and partly by bone.

3. Attic :- Perforation in pars flaccida.

I found this topic very confusing in my exams.

I hope it helped. :D

Have a great day ahead.
-Upasana Y. :) 

Corpus Callosum - Let's connect

Hey Awesomites
Jas here
I am back :)

Let's talk about the largest connective pathway in the brain, the Corpus Callosum that is made up of more than 200 million nerve fibres, connecting our left brain to the right.

Rotator Cuff muscles and their actions (mnemonic)

To remember the actions of Rotator Cuff muscles ( Supraspinatus, Infraspinatus, Teres Minor and Subscapularis), just remember the following:

1- The mnemonic for the muscles is: SITS
2- We will start with ABDuction and finish with ADDuction
3- The vowels in English can be remembered by AEEIou ( shout to remember better :P )
4- Now just match letters from the 2 mnemonics in the same order they are written in
 as you can see in the table:

So S goes with A...I goes with E...T goes with E and the last S goes with I.

Never forget the action of Rotator Cuff muscles again :)

-Murad

Echinocandins: Mechanism of action, side effects and orgranisms affected (mnemonic)

To easily remember anything related to Echinocandins (eg: Caspofungin, Micafungin) , just think of the letters "C, A and N"  => CAN :D

=> EchinoCANdins.
=> Inhibit synthesis of B-gluCAN. 
=> Used in CANdida and a thing that CAN invade your body (invasive aspergillosis).
=> CAN make you flush ( due to histamine release).

-Murad

Joll's triangle in thyroidectomy

Hello friends,

This post is about the importance of Joll's triangle in thyroidectomy.

Joll's triangle is used to identify external laryngeal nerve during thyroidectomy.

Boundaries of this triangle are :
Laterally: Upper pole of thyroid gland and superior thyroid vessels.
Superiorly: Attachment of strap muscles and deep investing layer of fascia to hyoid.
Medially: Midline of neck.
Floor: Cricothyroid muscle.

This triangle contains superior laryngeal nerve which gives rise to external laryngeal nerve.

Given below is the diagram of this triangle:

Mnemonics for Modified Jones Criteria

Modified Jones Criteria is used  for diagnosis of Acute Rheumatic Fever.

Mnemonic - "JONES CAFE PAL"

MAJOR CRITERIA :-
Joint involvement (polyarthritis)
O 'O' looks like a heart - myocarditis
Nodules subcutaneous
Erythema Marginatum
Sydenham Chorea

MINOR CRITERIA :-
CRP elevated
Arthalgia
Fever
ESR elevated

Prolong PR interval
Anamnesia of Rheumatism
L eukocytosis

Presence of  either
- 2 major criterias or
- 1 major criteria + 2 minor criteria

Is considered to diagnose patient positive.

Written by,
Pratheek Prabhu

SIADH vs Diabetes Insipidus, Osmolarity and Sodium levels in urine and serum in both (mnemonic)

Serum and urine findings in SIADH and  Diabetes Insipidus can really mess up our brains :S

A nice mnemonic to memorize SIADH is to recall the letters as  :
 "S"odium "I"s "A"lways "D"own "H"ere (by here: I mean serum) =>
so in SIADH:
=> low Na in serum
=> high Na in Urine & high Urine Osmolarity

Now ...just think of the opposite and you ll get Diabetes Insipidus
so in DI:
=> high Na in serum /high serum osmolarity
=> low Na in Urine

-Murad

Chronic Renal Failure : Indications for dialysis.

Hello guys!

In this post I am going to list down the Indications for dialysis in patients of Chronic Renal Failure.

Absolute Indications :
1. Volume overload not responding to medication.
2. Refractory hypertension.
3. Hyperkalemia unresponsive to medications.
4. Severe metabolic acidosis unresponsive to medications.
5. Uremic pericarditis
6. Neurological signs and symptoms of Uremia.
7. Plasma creatinine more than 1060 umol/l or BUN more than 36 mmol/l

Relative Indications :
1. Anorexia
2. Severe anemia unresponsive to erythropoietin.
3. Persistent severe pruritus.
4. Restless legs syndrome.

That's all.
Thank you

MD Mobarak Hussain (Maahii)

Some thalamic nuclei and their function (mnemonic)

Thalamic nuclei can really cause a headache if no mnemonics are used while studying them :O

The following mnemonics may be used to associate the nuclei with their functions:

1- Ventral Postero-Lateral nuclues  (VPL) => Very Painful Leg
This nucleus has input (pain, temperature, pressure, touch, vibration and proprioception) from Spinothalamic and dorsal columns/medial lemniscus ( Lower Limbs and Upper Limbs).

2- Ventral Postero-Medial nucleus (VPM) => Very Painful Mouth
This nucleus has input (face sensastion and taste) from trigeminal and gustatory pathway).

3- Lateral Geniculate Nucleus  (LGN) => Looking Good Naked :O
This nucleus has input (part of the visual pathway) from the optic nerve.

4- Medial Geniculate Nucleus (MGN) => Making Good Noise
This nucleus has input (part of the hearing pathway) from superior olive and inferior colliculus of tectum.

& that's it! :)

-Murad

Relation between Type I, Type II errors and Null hypothesis (mnemonic)

Biostatistics can really be dry and hard to engulf sometimes. 

One of the things that always confused me was when to accept and when to reject the null hypothesis. 

Since  mnemonics are one of the best things ever, here you go:

Type ONE error:
You use a verb with ONE consonant => reJect => so you reJect Null hypothesis

Type TWO error:
You use a verb with TWO consonants => aCCept => so you aCCept Null hypothesis

& that's it! :)

-Murad

Bacterial exotoxins that work via overactivating Adenylate Cyclase, a mnemonic

There are many bugs which have many exotoxins - to memorize those that have an exotoxin which work through overactivating Adenylate Cyclase therefore increasing cyclic AMP (+ cAMP) => just remember the letters of the word: CAMP

=> the bugs are:
Cholera (Vibrio Cholera)
Anthrax (Bacillus Anthracis)
Moctezuma's revenge (a fancy name of heat labile entertotoxigenic E.coli, ETEC)
Pertussis (Bordetella Pertussis)

-Murad

Chromosomes affected in syndromes that sound similar, a mnemonic

Hello everyone!

Wilson's disease, Williams syndrome and Wilm's tumor are confusing since they all start with "Wil". This is how I remember them and differentiate which chromosome number is affected in which disease. 

Wilson's disease: (for Dr. House fans)
Remember Dr. House, Wilson and Thirteen?

So that's how I remember that in Wilson's disease chromosome 13 is affected. 

William syndrome:
If you read the 2nd part of the word William, it is: I AM. When you re-arrange it: I AM WILL. 

Remember Will Smith and his famous movie - Seven Pounds? 

William syndrome => chromosome 7 affected. 

Wilm's tumor:
Just write the I and L as 11 so it is W11m's => Chromosome 11 is affected.

-Murad

Trinucleotide repeats mnemonics

In Friedreich Ataxia, patients have problems in their gait => GAAAAAAAAAAAit :D
so the trinucleotide repeat is: GAA

In Fragile X syndrome, patients have problems in their testicles (large testes among other things) so they  "Can't Get it Going" :P  => the trinucleotide repeat is: CGG

-Murad

Renal stones and pH of urine mnemonic

Hello!

Here's a post on the association between renal stones and pH of urine.

Which stones form in acidic urine?

Mnemonic: It's pretty simple, stones which have "weak acids" as a component.

Uric ACID
Calcium oxalate (Oxalic ACID)
Cysteine (Which is an Amino ACID)

PS: This is just a mnemonic.

Which stones form in alkaline urine?

Calcium Phosphate
Magnesium Ammonium Phosphate

That's all!

-IkaN

SERM for vulvovaginal atrophy mnemonic

Which of the following is a selective estrogen receptor modulator (SERM) that is prescribed mainly for treatment of genitourinary syndrome of menopause (vulvovaginal atrophy)?

A.) Bazedoxifene
B.) Raloxifene
C.) Phentermine
D.) Lasofoxifene
E.) Ospemifene

Atherosclerosis location mnemonic

Atherosclerosis location mnemonic

"A Cholesterol Plaque In Circles"

Most commonly involved vessels in decreasing order is:

Abdominal Aorta (especially around ostia - openings of major branches)
Coronary Artery
Popliteal Artery
Internal Carotid (especially at carotid sinus)

- Submitted by Murad

Medicollabowesome: Does long-term coffee intake reduce type 2 diabetes mellitus risk?

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Ocular toxoplasmosis and HIV

Here are some fun facts about Ocular Toxoplasmosis and HIV!

Ocular toxoplasmosis usually causes a retinal lesion with inflammation, giving the classical "headlight in the fog"  appearance.

Headlight is the lesion and the fog is due to the inflammation (WBCs).

HIV being an immunodeficient condition, there are lesser number of WBCs and hence there's no fog - Just the headlight.

The drug of choice for treatment of ocular toxoplasmosis is pyrimethamine.

However, it is contraindicated in pregnancy and HIV due to the risk of megaloblastic anemia and neural tube defects, respectively.

In pregnancy, spiramycin is preferred.

In HIV, the preferred drugs are clindamycin, azithromycin or quinolones.

- Written by Dr²

Medicollabowesome: Topic of the month - Diabetes Mellitus

AAMC ERAS: How to assign LoRs quickly to 100+ programs

Since the bulk assign option isn't available before 15th September:

Enucleation, Evisceration & Exenteration

In this post, we will look at the definition, indications and some few details regarding these 3 ophthalmologic surgeries. 

Cytochrome P450 3A4

Hello everyone!

Today lets discuss the Cytochrome P450 3A4

It is the microsomal enzyme involved in metabolism of xenobiotics. Maximum number of drugs are metabolised by CYP 3A4 in our body.

Here’s how you  remember the substrates and the inducers of the enzyme:

“In emergency Straightaway give a CPR and ACT SaNely

The inducers are:

S: St John Wort

CPR: Carbamazepine, Phenytoin, Phenobarbitone, Rifampicin

The substrates are:

ACT SaNely

A-Amiodarone

A-ACT drugs(Anti Histamines) 

*A-Astemizole
 *C-Cisapride

*T-Terfenadine

C- Cyclosporine

T- Tacrolimus

S- Statins
N-Navirs (protease inhibitors)

And how do we remember the inhibitors?

Shout “Fire in the Hole!”

Fluconazole   Ketoconazole

and Ritonavir and Erythromycin

Also you can have some grapefruit juice to chill out! Grapefruit juice is also a Inhibitor of CYP3A4.

That’s all

Thank you,

Chaitanya Inge

Drug interaction

Hello :)

Definition:-
Modification of response  to one drug by another drug or non drug (like food ,beverages like alcohol,smoking) when they are administered simultaneously or in quick succession  .


Factors for drug interactions:-
1.Multiple drugs for same disease.
2.Multiple prescribers.
3.Multiple diseases.
4.Poor patient compliance .
5. Drug factors like it is not palatable or too many in frequency .
6.Multiple unknown action of drugs.
7. Most imp is patients age .

Effects of drug interaction:-
1.Quantitative i.e Increase  or decrease the response intensity.
2. Qualitative:- abnormal /different type of response.

Mechanism of drug interaction :-
A.Pharmacokinetic interactions include,
 1.Absorption (either complex formation ,pH change ,or alteration in motility of GIT.)

2. Distribution:- (displacement from plasma protein binding site + inhibition of metabolism /or excretion)

3. Metabolism:- ( induction of enzymes or inhibition of enzymes or hepatic blood flow)

4.Excretion:- ( alteration in urine pH, Competition for active secretion ,renal blood flow)

B. Pharmacodynamic drug interactions include,
1.Antagonism
2. Summation
3.synergism

C.Drug interaction before administration:-
Either mixing before administration.
Or, exposure to light in some cases. (Like sodium nitroprusside).


-Upasana Y.

Blood retinal Barrier

Hello :)

There are two blood retinal Barrier (BRB) :-

1. Outer blood retinal Barrier - Formed by tight junction of retinal pigmented epithelium.

2. Inner blood Retinal Barrier - Formed by Muller cells and pericytes surrounding the lining of microvasculature.

That's all for today.
-Upasana Y. :)

Medicollabowesome: HIV epidemiology

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NPH and hypoglycemia mnemonic

Mnemonic is NPH.

USMLE Step 3: CCS pregnancy case checklist

Hello!

Here are things to do for a CCS pregnancy case -

MIL: Lichen Planus

Read more about Medicowesome Image Library (MIL) here.

Image: Plaques of Lichen Planus

Submitted by: Dr. Manasi Shirolikar

Immunology question

Hola awesomites!!

So, this is answer of our previous question. Lets have a look into it.

Q1)Which of the following features is not shared between T cells and B cells
a)Antigen specific Receptors
b)Class 1 MHC expression
c)Positive selection during development
d)All of the above

Answer is
C) Positive selection during development

Explanation:

Positive selection:
Site is thymic cortex.
-T cells having affinity for MHC molecules are selected since T cells having affinity for MHC molecules can interect with APC  and one who don't have recognisation is killed

Negative selection:
Site:Thymic medulla
Selected T cells are sent to medulla,where there affinity for self antigens are tested.If the have affinity they are programmed to death.

Incase of B cells,if they recognize self antigens they do not undergo death instead there receptors are changed by the process called as "Receptor editing" .If receptor editing dose not take place,then apoptosis takes place.This is negative selection of immature B cells. B cells negative selection occurs in the bone marrow

Both T-cell and B-cell have TCRs and BCRs respectively.
Class I MHC is expressed on both T cells and B cells..

Stay awesome:)

~Ojas

Opioids analgesics classification + NEET notes

Hello awesomites so here is my " Single page notes" on opioid analgesics.
Lets begin.

Let us know the difference between opiates and opioids. 

Chemicals derived from opium or related to morphine chemically are called opiates.

And those having morphine like structures, irrespective of chemical action are called as opioids.

Opioid analgesics are classified as follow

1) Natural opium alkaloids

     - Morphine, Codeine.

 Morphine
 A) Acts on Mu(Causes dependency-Euphoria) , kappa(Dysphoria - Psychomimetic) and delta receptors as agonist. Hence used as supraspinal and Spinal analgesic.
 B) Treatment of poisoning: Naloxone 0.4-0.8 mg i.v. repeatedly for 2-3 minutes.
 C) Can be administered through oral, rectal, i.m, i.v, intrathecal, epidural routes. Used as preanaesthetic medications
 D) Useful in MI and acute pulmonary edema(Both by i.v. route)
 E) Contraindicated in head injury, hypothyroidism patient, pregnancy.

Codeine.
 A) Partial agonist at mu receptor.
 B) 1/10th analgesic of morphine and less efficacious.

2)Semi-syntheic opioids :

Diacetyl morphine(Heroine), Pholcodine, Ethylmorphine.

Heroine:Three time more potent than morphine.

Codeine, pholcodeine, dextromethopran and noscapine are cough suppresants.
Dextromethopran is devoid of constipating action.

3) Synthetic opioids:

-Pethidine(Meperidine):
 A) To control shivering after anesthesia
 B) Used during labour as analgesic
 C) Safer in asthma.
 D) Pethidine and pentazosin both are anticholinergics. Hence they causes tachycardia. Perhaps, they are contraindicated in MI but useful in biliary colic

-Fentanyl:

 A) Causes truncal rigidity due action on mu receptor.
 B) Can be given as transdermal patch and as well as buccal transmucosal

-Methadone 

 A) Agonist action on mu receptor + blocks NMDA reuptake of monoamines and hence useful in neuropathic and cancer pain (Not controlled by morphine)
 B) Can be given by oral, rectal, i.v, s.c, routes.
 C) Long plasma half-life hence less dependency and tolerance. Therefore used as maintenance therapy in opioid dependency

-Dextropropoxyphene

 A) At high doses it causes seizures.

-Tramadol

 A) It is a weak mu receptor agonist and decrease reuptake of NA and 5-HT hence used as analgesia. This is abolished by Ondasteron.

By ojas 

MIL: Impetigo

Read more about Medicowesome Image Library (MIL) here.

Image: Impetigo contagiosa

Submitted by: Sagar

MIL: Polar cataract

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Image: Polar cataract

Submitted by:  Sushrut

MIL: Rhabdomyosarcoma of the Right Eye

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Image: Rhabdomyosarcoma of the Right Eye

Submitted by: Does not wish to reveal identity

MIL: Psoriasis

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Image: Plaques of psoriasis

Submitted by: Dr. Manasi Shirolikar

Introducing Medicowesome Image Library (MIL)

Hello everyone!

I wish to create a visual learning experience by adding images and videos along with what we write.

But since most images on Google have copyright issues, the Medicowesome authors can't use them :(

That is why, I'm asking medical students, residents and acquaintances to send me images of what they see to help create the Medicowesome Image Library (MIL).

It can be anything - a histology slide, a microbiology agar, a pathology specimen, a rash, an instrument, an x-ray - anything!

Treatment of streptococcal tonsillopharyngitis: Important points for USMLE

Hello!

Here's a quick post of treatment of "strep throat" (my slang for "Tonsillopharyngitis due to Streptococcus pyogenes, also known as group A Streptococcus.")

Question on sedative-hypnotics

Hello awesomites! Let us discuss about our previous question.

Question) Which of the following statement(s) is/are true regarding benzodiazepines?
A) It acts as GABA agonist
B) Diazepam is a short acting benzodiazepine
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver
E) Diazepam has higher abuse potential than midazolam
#Pharmacology
#Medicowesome

So here is answer of our previous pharmacology question
Correct answer is C and D.
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver.

Explanation:
BZDs has facilitatory action. They are not a GABA agonist.
Diazepam has rapid onset of action but prolonged action due to formation of active metabolite.
BZDs like nitrazepam, flurazepam etc are metabolised in liver by dealkylation and hydroxylation.
The dependence producing liability of BZD is low. They are Infrequently used now.

-Ojas

Classification of sedatives & hypnotics + notes for NEET

Hello awesomites!! So, here are my "Single page notes" on sedative-hypnotics. To the end of this post I have uploaded picture of my notes. So lets begin.

Classification:It is classified into 3 categories.

1)Barbiturates

Key points : 
a) No antidote.Poisoning treated by gastric lavage, symptomatic treatment and forced alkaline diuresis
b) Steep curve dose.
c) Inhibits all areas of CNS. Most sensitive is reticular system
d) It inhibits all areas of CNS. Mostly reticular system which leads to inability to maintain wakefullness.
e) May cause "Hyperalgesia".
f) Duration of REM sleep and stage 3, 4 of sleep cycle decreases
g) Contraindictated in acute intermittent porphyria
i) Hangover is common
                       
Barbiturates are further classified into three types. 

A) Long acting  
Phenobarbitone.

B) Short acting.
Butobarbitone
Pentobarbitone.

C) Ultra short acting
Thiopentone.
Methohexitone.

2)Benzodiazepines

Key points:
a) Antidote:Flumazenil is competitive antagonist. It takes 30-60 minutes for its action.
b) Flat dose curve.
c) Duration of REM sleep decreases but frequency increases.
d) Hangover less common
                
They are further classified into three categories

A) Hypnotics

-Diazepam:Causes analgesia(Barbiturates causes hyperalgesia as mentioned earlier.) and it also causes muscle relaxation
-Flurazepam :Paradoxical simulation and increase nightmare
-Nitrazepam:Increase REM sleep (Rest decreases)
-Temazepam
-Flunitrazepam : Tasteless BZD called as "
" Date rape drug"
-Midazolam:Causes blackouts and ataxia.
-Alprazolam
-Triazolam:Responsible for paranoia and other psychiatric disturbances.

B)Anti-anxiety

Remember OLA-CD

-Oxazepam
-Lorazepam:Absorption from intramuscular site is regular for other drugs its irregular.
-Alprazolam
-Chlordiazepoxide.
-Diazepam.

C) Anti-convulsants :

-Diazepam
-Lorazepam
-Clonazepam
-Clobazam

Remember: EasT LOT
E=Estazolam
T=Temazepam
L=Lorazepam
O=Oxazepam
T=Triazolam

These drugs directly conjugated without metabolism to active products. These are short acting and can be used in liver failure

3)Newer non-benzodiazepine hypnotics:

-Zopiclone:

a) Increases stage 3 and stage 4 duration

b) Indicated for patients BZDs for induction of sleep
c) Less rebound insomnia and hangover.
b) Active metabolite is eszopiclone.

-Zolpidem
a) Lacks anti-anxiety, muscle relaxants, and anti-convulsants actions.
b) Use in short term treatment of insomnia.
c) No rebound insomnia and hangover.

-Zaleplon
a) Decreases sleep latency without affecting sleep time.

-Suvorexant:
a) Its is Orexin antagonist. Orexin is wake-fullness receptor.

Ojas

Medicowesome secret project: Red

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Medicowesome secret project: Addictions

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Medicollabowesome: What is HIV PrEP and PEP?

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Image Based MCQ on Instruments

Hello awesomites!
Yesterday we posted an Image based MCQ on Instruments and here is the answer to the question.
#Image_based
#Instruments
Q. What is the inner diameter of the device shown in the picture if it is to be used in adults?

A. 2-3 mm
B. 8-9 mm
C. 12-15 mm
D. 21-23 mm
The correct answer is B. 8-9 mm. The image given shows an Endotracheal tube that is available in different sizes for different age groups.
Internal diameter 3mm - 6mm is used for Paediatric cases.
Typically, an 8.0 or 8.5 mm for adult men and 7.5 to 8.0 mm for adult women is an ideal choice.

Thanks for your active participation in the question.

MD Mobarak Hussain (Maahii)

Cushing Vs Curling Ulcer

Hello!

Its time to differentiate between two confusing ulcers - Cushing and Curling.

What is Cushing Reflex?
It is a triad of Bradycardia, Hypertension and altered respiration following Head injury.

What is Cushing Ulcer?
Stress Ulcer following Head injury.
Most common site - Acid producing area of Stomach.

What is Curling Ulcer?
Stress Ulcer following Burn.
Thomas Blizzard Curling.
Reduced plasma volume leads to ischemia and cell necrosis of the mucosa.
Most common site - 1st part of Duodenum.
cURling = bURn

This may help you to remember the difference between these two.

Thanks

MD Mobarak Hussain (Maahii)

Latanoprost and Pilocarpine never go together

Latanoprost increases the uveoscleral outflow of the aqueous humor. Pilocarpine has a constrictive effect on the ciliary body as a whole. Hence, when the two are used together, their effects end up getting nullified with the physician bungling to achieve the target IOP.

That's all!

-Sushrut Dongargaonkar

Medicollabowesome: ENT Manifestations of HIV Infection

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Medicollabowesome: Neurological Diseases in HIV patients

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