A compilation of similarities between corneal dystrophies

Many dystrophies have commonalities. Following are enumerated as under-

1. Associated with TGF Beta1 mutations-

       - Epithelial basement membrane dystrophy

       - Reis- Bückler's 

       - Thiel- Behnke 

       - Lattice and granular(type1) dystrophies

2. Associated with mutations on 5q31 locus-

         - Reis- Bückler's

         - Lattice and granular(types 1 and  2)

3. Autosomal recessive -

          - Gelatinous drop like

          -.macular

          - Congenital hereditary endothelial( type 2)

4. X linked- 

           - Lisch ( X linked dominant) 

-All others are autosomal dominant. 

5. Chromosome 12- Meesman's, congenital 

                                     hereditary stromal.

6. Chromosome 20- Posterior polymorphous, 

                                    congenital hereditary 

                                     endothelial.

7. Chromosome 1- Gelatinous drop like,

                                   posterior polymorphous.

8. Amyloid deposition is seen in- 

                   - Gelatinous drop like

                   - Lattice

                   - Granular (type2) 

                   - Congenital hereditary endothelial.

9. Bowman's membrane is lost in- 

                   -Gelatinous drop like

                   - Reis-Bückler's (replaced by irregular

                       material

                   - Thiel-Behnke's ( replaced by a

                       fibrocellular layer)

10. Recurrence after keratoplasty-

                    -  Reis-Bückler's

                    -. Lattice, granular, and macular

                    - Schynder 

                     -  Congenital hereditary stromal.

11. Association with glaucoma and keratoconus-

                    - Posterior polymorphous

                    - Fuch's endothelial. 

Now don't blame me for the list being too exhaustive 🙄

Source- Postgraduate ophthalmology by Zia Chaudhari and M Vanathi 

-Sushrut 

Corona virus

Corona virus:
A) Virology:
1) Coronaviruses are classified as a family within the Nidovirales order, viruses that replicate using a nested set of mRNAs. The coronavirus subfamily is further classified into four genera: alpha, beta, gamma, and delta coronaviruses. 
2) Positive mRNA strand virus. It is largest known RNA strand.

B) Routes of transmission — Respiratory coronaviruses probably spread in a fashion similar to that of rhinoviruses, via direct contact with infected secretions or large aerosol droplets. Immunity develops soon after infection but wanes gradually over time.

C) Clinical Manifestation:
Characterized by
1) Upper respiratory tract infections
2) Acute otitis media
3) Pneumonia
4) Temporarily linked to asthma attacks in both adults and children
5) The idea that coronaviruses produce diarrhea in humans is intriguing because of their clear intestinal pathogenicity in animals
6) Gastrointestinal manifestations -diarrhea, vomiting, nausea, and abdominal pain.
7) There is one reported case of encephalitis due to corona virus
8)Also seen in association with Kawasaki disease.

D) Diagnosis:
Until recently, no sensitive, rapid method existed to detect all of the known human coronavirus strains. Rapid techniques that can be used to detect coronaviruses from nasopharyngeal samples include reverse-transcriptase polymerase chain reaction (RT-PCR) and immunofluorescence antigen detection assays.

E) Treatment:
1) There is currently no treatment recommended for coronavirus infections except for supportive care as needed
2) Chloroquine has shown some activity against cultured cells.

F)Prevention:
1) Preventive measures are the same as for rhinovirus infections, which consist of handwashing and the careful disposal of materials infected with nasal secretions. Several antiseptic/disinfectant solutions used commonly in hospitals and households, including chloroxylenol, benzalkonium chloride, and cetrimide/chlorhexidine, have been shown to be ineffective against coronaviruses

That's it!

Source: Up-to-date.

Correct order of Stage of Death

Proposed by Kubler Ross 

" Mnemonic = DA BudDhA "

D Denial = Refuse to believe Dx 

A Anger = Frustrated , Ask "Why Me ? "

B Bargaining = in return for a cure , they promise to fulfill one or many pledges ( Charity ) 

D Depression 

A Acceptance = Realize that death is inevitable

Thank you 

By Drashtant 

Advice to young doctors

It is okay to disagree with another physician and acknowledge differences in the style of practicing medicine. Medicine is not black and white. Develop your own preferences based on evidence and experience.

A truly experienced physician understands the intricacies of medicine and will not criticize another physician for a decision they made under a different clinical circumstance with the information they had available.

A physician who second guesses themselves and critically analyzes their decisions retrospectively and prospectively are better than those who are over-confident about their diagnosis and management. Think about the decisions you make.

If you ever come across a bad patient outcome, yourself or your colleagues, do not jump to conclusions. There may be other factors, that you do not have knowledge of, which may have played a role.

When feedback is given, don't take it personally. Learn from the experience objectively and detach yourself from it. This way, you will learn more instead of getting offended and defensive about it.

To not get emotionally involved takes time. Give yourself time. Change the voice of the conversation in your head.

I am still learning.

Sincerely,
A young doctor.

Facebook: Wolffian duct

Q1) Ejaculatory duct in males develops from 

A) Ureteric bud

B) Mesonephric duct

C) Wolffian duct

D) Paramesonephric duct

#Medicowesome

#Gynaecology

Answer to this question is Option C) Wolffian duct.

But isn't Wolffian duct also called as Mesonephric duct ? So can you pick option B instead of option C?

Well, unless your exam allows multiple answers to be correct, do not pick 'Mesonephric duct'. Here is why?

The mesonephros gives mesonephric duct which opens in the Urogenital Sinus and forms trigone of the bladder. Mesonephric duct also gives ureteric bud to the Metanephros to form Renal system.

Now after this has happened, the Mesonephric duct will be called as Wolffian Duct which forms the internal genital organs and in females, disappears.

That's it!

Demotional bloke

Mnemonic for head posture in A-V pattern squints

Chin up in what? Chin down in what? The vexing never ends. Well, as it turns out, the word 'vex' itself is here to save the day.

Chin up- V exotropia (VEx). Remember that squint is very 'vexing'. So you stare in the sky to remember at least a fraction of what you stuffed in your brain the day before. 

Other will be A esotropia. By exclusion, it's easy to remember. 

Chin down- V esotropia or A exotropia. Again, by exclusion, these get placed naturally under this heading.

So, just remember 'VEX' and you won't be vexed anymore! 

-Sushrut 

Mnemonic for Drug induced Cardiomyopathy

Hello everyone ....

Aunty is cycling 🚴‍♀️ on paved trails to protect her heart 💓 

Aunty = Anthracycline = Doxorubicin, Daunorubicin , Mitoxantrone 

Cycling = Cyclophosphamide 

paVEd = VEGF Inhibitors = Bevacizumab 

Trails = Trastuzumab

Facebook: PFT-1

Q1) Which of the following is/are not a contraindications of performing PFT(Pulmonary function test)? 

A) MI within one year

B) Unstable angina

C) Recent thoraco-abdominal surgery

D) Recent ophthalmic surgery

E) Past history of pneumothorax

So correct options are - A and E

Following are contraindications to perform pulmonary function test. 

Mnemonic: UR IRcTC

U- Unstable angina

R- Recent thoracoabdominal surgery

I- Myocardial infarction within the last month

R- Recent ophthalmic surgery

T- Thoracic or abdominal surgery 

C- Current pneumothorax

That's it! 

-Demotional bloke. 

Parasitic infections and Asthma

In parasitic infection, polyclonal IgE produced by body occupies the receptor produced by mast cells. This leads to decrease action of specific IgE required for asthma. 

This mechanism is probably the cause of decrease prevalence of asthma in tropical population. 

That's it 

-Demotional bloke

Choristomas Vs Hamartomas

I get super confused with both the following terms, so I made a lame technique to remember both of them. 

Choristomas:

It sounds more like a Christmas. So Christmas tree is usually not grown in India but we do keep it as a sign of Christmas. 

So Christmas tree is normal, but the site (India or any other habitat) is not the usual site of tree, so let's say abnormal. 

So Choristomas is normal tissue at abnormal anatomical sites.

Example - Normal pancreatic cells under the small bowel mucosa.

They are not considered as neoplasm.

Hamartomas:w

'Hamara' in Hindi means 'mine'. 

Remember: this place is mine. So here, place is normal and tissue is abnormal!

That is, abnormal tissue at normal anatomical sites.

Example - Lung hamartomas exhibit cartilage, bronchi, and blood vessels. 

They are considered as neoplasm.

That's it! 

-Demotional bloke

Areas devoid of pain fibres

Areas devoid of pain fibers 

Mnemonic: BED PACK

B- Brain parenchyma

E- Ependyma

D- Duramater (Neither covering blood vessel or forming dural venous sinus) 

P- Pia mater

A- Arachnoid mater

C-Choroid plexus

That's it 

-Demotional bloke

Areas devoid of BBB

Area devoid of BBB 

Mnemonic: MAP SNOW
M- Median eminence
A- Area postrema
P- Pineal gland
S- Subfornical organ
N- Neurohypophysis
O- OVLT- Organum vasculosum laminer terminalis 

That's it 

- Demotional bloke

Egg shell calcification

Following are the cases in which we get eggshell calcification of lympho nodes on radiography. 

Mnemonic:

SSRI Love Hitting BAT

(Lame? I know!) 

S-Silicosis

S-Sarcoidosis

R- After Radiotherapy

I L- Post irradiation lymphoma

H- Histoplasmosis

A- Amyloidosis

T- Tuberculosis

That's it ! 

- Demotional bloke

Ocular Alzheimer's disease

A paper published in 2003 has dubbed glaucoma as 'ocular Alzheimer's disease' because some of the pathophysiological elements are similar.

Cataract in Rubella- interesting fact

The progressive nuclear cataract in Rubella may harbor live virus particles.

Psychiatry MCQ-1

So here are two multiple choice questions, whose answer changes with options. 

Q1)Most common psychiatric disorder is :-

A) Anxiety

B) Depression

C) Phobia

D) Schizophrenia

Here answer is A) Anxiety

Most common psychiatric disorder is 

A) General Anxiety disorder

B) Panic anxiety disorder 

C) Phobia anxiety disorder 

D) Depression

Here answer is D) Depression. 

Reason for such variation is that Anxiety is not just a single disease like depression.

Infact it is group of disorders. 

So Depression is the single most common psychiatric disease whereas Anxiety is the most common psychiatric disease. 

GANGLION (Last minute revision)

Hello Awesomites !

These are point on parasympathetic ganglion.

-Upasana Y.

Spherocytosis

Hello Awesomites !

The future blogs will be on confusers.

Q. On peripheral blood smears there is presence of spherocytes. What are the differentials and the test to identify the same?

Most of you have prompted it as hereditary spherocytosis.
 Let see.

Ans. DIFFERENTIALS :- 

• HEREDITARY SPHEROCYTOSIS
• AUTO-IMMUNE HEMOLYTIC ANEMIA

 Best next step is to do DIRECT COOMBS TEST to rule out autoimmune hemolytic anemia.
For hereditary spherocytosis go for osmotic fragility test.  


 So spherocytosis doesn't means Hereditary, it could be acquired, usually preceded by an infection.

HAPPY STUDYING :) 
-Upasana Y.

Integrating Trendelenburg

This blog will compel all the signs /symptoms Or test related to 'Trendelenburg'. Let us know if you know more of the 'Trendelenburg' in the comment section so we can integrate it here. 

Trendelenburg's gait: 

A child with unilateral dislocation of hip lurches on the affected side while bearing weight on it. Seen in DDH, poliomyelitis, Superior Gluteal nerve palsy.
Trendelenburg's gait is also known as Abductor gait or lurching gait.

Trendelenburg's test:

Trendelenburg's surgery/procedure:
It is done in GSV and SFJ incompetence. Here flush ligation of SFJ is done. Flush ligation means vein is ligated as close as possible.
Six tributaries also need to be ligated to reduce recurrence rate.
Laterally: Superior circumflex iliac.
                  Superior epigastric vein.
Medially: Superior external pudendal
                   Deep external pudendal
Distally: Accessory anterior saphenous vein
                Posterior medical thigh vein

Stripping is an additional surgery. Should be done till knee, not below knee to avoid Saphaneous nerve.

Brodie Trendelenburg's test: 

It is done to determine the incompetency of the sapheno-femoral valve and incompetency of the communicating vein.
In both the tests, patient is first placed in the recumbent position and his legs are raised to empty the veins. The sapheno-femoral junction is now compressed with the thumb or a torniquet can be used.
1) To check sapheno-femoral valve incompetency, patient is asked to stand up quickly and pressure is released. If varices fill quickly by a column of a blood from above, it indicates incompetency of the sapheno-femoral valve. This is called Trendelenburg test.
2) To test communicating system, pressure is not released but maintain for 1 min. Gradual filling of the veins indicates incompetency of communicating veins.

That's it

-Demotional bloke. 

AVPU Scale

Hello Awesomites !

LONG TIME .

AVPU scale is like glasgow coma scale to determine the level of responsiveness.

A=ALERT AND AWARE

• Eyes open 
• Knows name,date,time,place

V=RESPONDS TO VERBAL STIMULUS 

• Not oriented to time and place
• Responds in a meaningful way
  

P=RESPONDS TO PAINFUL STIMULUS 

• Eyes do not open

• Responds when trapezium muscle is pinched

U=UNRESPONSIVE

• Eyes do not open
• Does not respond to pinching of muscles 

Best (A) to Worst (U)

Happy Studying :)
 -Upasana Y.  

Types of glare and mnemonic

There are 4 different types of glare-

1. Direct glare- When the source of light is placed in the same or nearly the same direction as the object of fixation.

2. Discomfort glare- Glare which produces discomfort without interfering with vision. One experiences it when the overall illumination of the surroundings is too bright. 

3.Indirect glare- When an intense light source is placed in a direction other than the object of fixation.

4. Disability glare- Glare which reduces visual performance without necessarily causing discomfort. It refers to the reduced visibility of a target due to the presence of light elsewhere in the visual field. Contrast is reduced, and thus the visibility of the target. 

Now. How to remember all four? 

You are familiar with direct and indirect ophthalmoscopes. 

Suppose an ophthalmologist begins with direct ophthalmoscopy, which causes discomfort, both, to the patient as well as himself, because it involves going too close to the face. The ophthalmologist then starts using an indirect ophthalmoscope with the patient in a supine position, but after a while ends up having cervical spondylosis. Thus, getting a disability.

That's all!

-Sushrut 

Mnemonic for GOLD classification for COPD severity

Hello,

In this video, Drashtant talks about the GOLD classification for COPD.

Draw the human heart with me

Hi everyone!

I just created a spontaneous draw with me video.

NEET - THE EXAM. THE MYSTERY. THE CLOWN

Mnemonic for ocular axes and angles

This one is for the PGs. The 4 axes and 3 angles are pretty confusing to remember plainly. Here's how I do it.

Authors' diary: Mercy

Today, when I walked into a patients room to talk to him, he said, "Mercy."

I wasn't sure if this 90 year old male with dementia said what he said.

I asked him, "Did you just say mercy?"

He said yes and nodded. It broke my heart. 

It's sad that aggressive treatments have come to this. When families want "Everything done" they don't see what we actually do.

There comes a point in life when it is okay to refuse treatments, not because you're negligient and ignorant about your health, but because it is the right thing to do.

With all our technological advancements in medicine, we can keep a body alive. We can have a ventilator with tracheostomy breathe for the patient, we can feed through a PEG tube, we can replace the kidney with dialysis, we can keep the blood pressure up with pressors. Sometimes, we can even bypass the heart and lungs through extra corporeal membrane oxygenation (ECMO). But just because we can do it, doesn't mean we should do it. What about quality of life? 

Medicine can only do so much. There comes a point in the natural course of human life when the body can't heal anymore. That's when it's okay to say, "No more." It's time for comfort care and hospice. 

Fortunately, for my patient, the physician explained about end of life to the decision makers and the family understood the goals of care. The patient was discharged to hospice. 

Contents page for Medicowesome secret project on Depression: Let's talk

Secret projects on Let's talk about depression - WHO day theme

What is the "Let's talk" project? How can I talk about mental illnesses?

Whatsapp group for medical professionals struggling with mental health issues

Hello, medicowesomites!

The Medicowesome admins had a recent discussion on depression and anxiety among health care professionals. We decided to create something like a support group on Whatsapp for those interested.

Pressure half time in aortic regurgitation notes

Hello! This post may be relevant to IM residents and cardiology fellows.

Olanzapine dose in CINV

Hi!

Olanzapine, an anti-psychotic, has been used in the patients of cancer for its beneficial effects on chemotherapy-induced nausea and vomiting (CINV) at a dose of 10 mg due to its anti-emetic action (neurotransmitter blockade at serotonin and dopamine receptors).

But due to its major adverse impact of daytime sedation, recent studies and randomized controlled trials have concluded its revised dose to be 5 mg for CINV.

To be noted here that the anti-emetic use of olanzapine is still off label, an unlicensed drug used for this purpose.

That's all

- Jaskunwar Singh

Mnemonic for Cherry 🍒 Red spots in Eye

Hello everyone….

" Story of Cherry 🍒 from farm to crowd "

From Farmer ( Mr.Tay Sachs ) 

Quintal of GM Cherry 🍒 storage (GM = Genetically modified ) 

Picked up 

By Dapper Gentleman (Mr.Sandhoff ) 

for selling to 

Crowd 

In Berlin 

(Like Cherry blossoms in Berlin... Google it.. ) 

Mnemonic for Antibodies in SLE & it's Clinical Importance

Hi everyone!

Here is a hack.

ANA = All Negative Absent = All Positive identified = Highest Sensitivity ( So best Screening Test ) 

Anti dsDNA = Disease Severity 

Anti Sm = Specific Most

Anti RNP = Raynaud & Polymyositis ( MCTD )

Mnemonic for Dawn & Somogyi phenomenon

Hello everyone....

A diabetic patient who is taking NPH insulin regularly at early evening time presents with early morning headache. He also feels very stressed & tiredness. 

I have checked that he is hyperglycemic.

Suddenly I think about Dawn & Somogyi phenomenon. But I have a confusion between that 2 terms.

So I make a mnemonic…

Here it is ..

Dawn & Somogyi phenomenon

In both Early Morning High Glucose 

= Due to ⬆️ GH & Cortisol Surge 

What is the difference ??

Sonographic diagnostic features of monochorionic monoamniotic twin pregnancy

1. Absence of dividing amniotic membrane

2. Presence of single placenta

3. Same gender fetus

4. Adequate amniotic fluid around each fetus

5. Both fetus moving freely 

Indications of long‐term oxygen therapy

Hi!

I was discussing the indications of long‐term oxygen therapy with a friend today...

Long‐term continuous oxygen therapy, ideally for ≥18 h/day is indicated when:

1. Daytime partial arterial oxygen concentration (PaO2) is ≤ 55 mm Hg at rest or a pulse oxygen saturation (SpO2) less than or equal to 88 percent.

2. Daytime PaO2 is 56–59 mm Hg and there is evidence for hypoxic organ damage (right heart failure, pulmonary hypertension or polycythaemia)

Fact of the day: AHN in old age

Hi!

Fact: New neurons proliferate as we age, in both physiologically and pathologically aging brains, even in the ninth decade of life.

Authors' diary: Battling jealousy

Hi!

I read comment on YouTube recently, "There are people who don't even share their notes and there are people like you who help others with their work..."

I know that feeling. It stems from a number of negative emotions. One of them is jealousy or envy - The intolerance in seeing someone else succeed more than you.

Treatment resistant depression notes

Hi! Quick notes for a friend :)

Treatment resistant depression: Major depressive episodes that do not respond satisfactorily to at least two trials of antidepressant monotherapy.



Things to consider:
Assess adherence
Identify comorbidities
Reassess diagnosis

Treatment strategies:
Augmentation (adding a treatment)
Switching treatment

Important Mnemonics for Oral hypoglycaemic drugs in Diabetes

Hello everyone .. 

I make mnemonics for some important side effects of oral hypoglycemic drugs. 

You must know that because you may prescribe it for 1 out of 11 adults in whole population the of world….!!

Side effects of Oral hypoglycaemic drugs along with it's class & mechanism of action 

#Mnemonic 1

Big Men ForminG Poor Diabetic neuropathy ( D/Dx B12 Deficiency ➡️ confirmed by doing  B12 LAB test.)

Biguanide = Metformin 

Inhibit mGPD 

It causes Vitamin B12 Deficiency & Lactic Acidosis (LA) 

#Mnemonic 2 

1st Key to SUccess is Lord "Ram"

1st Gen SUlfonylureas

Closes K+ Channel 

Ram = Disulfiram like reaction….

#Mnemonic 3 

Paragliding makes your heart failed or maybe a fracture or bladder injury 

Para = PPAR Y

Gliding = Glitazone activates it...

#Mnemonic 4

"Rosy red Blood don't reach to heart (MI) but goes into Pee = Red Pi ( Pee = Urine in Bladder Cancer )

MI (rosiglitazone) 

Bladder cancer (pioglitazone)

#Mnemonic 5

“Change your Daily Personal Passivity (DPP) otherwise your heart fails” 

DPP  = DPP-4 inhibitors 

#Mnemonic 6

“Candid Status is Very Good in Love Test”

SGLT-2 inhibitors can cause Vulvovaginal Candidiasis 

Drugs category & their Suffix 

Pramlintide = Amylin Analogue 

1st gen Sulfonylureas = “Amide”

2nd gen Sulfonylureas = “Ride” & “Zide”

Meglitinides = “Nide”

DPP-4 Inhibitors = “Gliptin”

Glitazones / thiazolidinediones = “Zone”

SGLT -2 Inhibitors = “Flozin”

#Mnemonic 7

Alpha glucosidase inhibitors = "Please Side your Car & Pay Toll"

Acarbose & Miglitol 

#Clinical Pearls 

Weight neutral = DPP 4 & Alpha Glucosidase inhibitors 

SGLT2 inhibitors & GLP-1 = Used in CVD

( Cardiovascular diseases) patients

In case of Renal failure you can only give 2 type of drugs orally = DPP 4 inhibitors & Glitazones 

Injectables can be given in renal failure.

3 times / day dosing = Pramlintide , Alpha Glucosidase inhibitors & Glinide 

Regular Insulin ( Short acting ) is preferred for 

DKA ( IV)

Hyperklaemia (Add Glucose)

Stress Hyperglycemia

Thank you :)

- Dr. Drashtant Prajapati

Therapeutics in Sickle Cell Anemia

Apart from Hydroxyurea, Analgesics and vasodilators like phosphodiesterase inhibitors, certain tantalizing novel drugs have been approved for Sickle cell anemia.... Let's take a closer look at them.

(1) Voxelotor (HbS polymerization inhibitor) binds covalently to N-terminal valine of alpha chain of HbS (around 30% of HbS in individual cell) stabilizing it's oxygenated form and causing left ward shift of dissociation curve without impairing oxygen delivery to tissues.

Consistently reduces hemolysis and viscosity with in 2 weeks of administration... FIRST EVER therapy targeting core defect.

Benign vs Malignant pulmonary calcifications mnemonic

A nice mnemonic to differentiate benign and malignant pulmonary calcifications is:

Malignant calcifications are ***SuPER bad*** :P
S: Spiculated
P: Punctate
E: Eccentric
R: Reticular

I use those 3 starts (***) to remind me of punctate.(vs the other P of Popcorn in the benign lesions)

Bening ones are the rest:
Popcorn, laminated, concentric and diffuse homogeneous

-Murad

NB: these calcification types suggest benign vs malignant lesions and are not diagnostic per se.

Check the other amazing mnemonic by Drashtant in the comments section below  :)

Inferior wall MI treatment mnemonic

Inferior wall MI is different than other MIs . It is associated with sinus bradycardias and AV block.

Lower back pain notes

Hello!

Here are my quick and dirty notes on Low back pain (LBP) mostly seen in ambulatory medicine! I will not be going into evidence-based medicine (EBM) physical examination (PE) findings but I have put a quick note for conditions you can test on PE so you can look them up.

Hepatorenal Syndrome: An Overview

Hello good folks! Let's discuss HepatoRenal Syndrome (HRS) in brief.

Cirrhosis + Ascites + Renal Failure = HRS, after excluding other causes of kidney damage.

How common is HRS?
1 in 10 patients of advanced cirrhosis or acute liver failure develop HRS.

How does HRS happen?
Abnormal haemodynamics, that's how. Pathogen, faulty immune system and mesenteric angiogenesis result in splanchnic and systemic vasodilation but renal vasoconstriction. Other factors maybe contributory.

Types and management
Type 1: Rapidly progressive, median survival about 2 weeks. Haemodialysis may be required.

Type 2: Slowly progressive, median survival about 6 months. Transjugular Intrahepatic Portosystemic Shunt (TIPS) maybe required.

Liver and/or kidney transplant maybe considered for both types.



Thanks for reading.
- Ashish Singh.

Dihydropyridine vs non-Dihydropyridine CCBs mnemonic

Dihydropyridine vs non-Dihydropyridine CCBs were always a struggle to me because they are both CCBs but at the same time they have some differences.

I hope that the following mnemonic will help in reminding you which one is Dihydro and which one is not :D :

The mnemonic (remember DIE HARD movie and Bruce Willis)

I am a DIe Hard FAN

DIHydropyridine CCBs:
FAN
F- felodipine
A- amlodipine
N- nicardipine

So non-Dihydropyridine CCBs are Verapamil and Dilitazem.

The original FAN mnemonic was posted here:
http://woanchyi818.blogspot.com/2015/03/calcium-channel-blockers-ccbs.html

good luck :)

Murad

Topical vs Oral antifungal mnemonic

Hey my friends, a common question in qbanks is when to use topical vs oral antifungals in Tinea infections.
Well, you can use the following mnemonic:

Tinea CAPitis => Imagine a CAP covering your head/scalp so you need a systemic treatment => Oral treatment (eg: Terbinafine) to reach it.
Scientifically, the systemic/oral treatment is needed to reach the hair shaft.

Tinea Corporis: Since Tinea Capitis is the oral one, Tinea Corporis is the topical one :)


Murad :)

Classification and causes of hyponatremia mnemonics + notes

Hi!

Classification and causes of hyponatremia mnemonics + notes:

1. Hyponatremia with low osmolality :

     (i) reduced effective blood volume

              (A) increased ECF volume -

                               - Edematous kidney (nephrotic syndrome)

                               - Cirrhosis of liver

                               - Failure of heart

              (B) REduced ECF volume -

                                - Renal loss of Na ( Diuretics, Ketonuria, Addison's disease)

                                - Extrarenal loss of Na ( sweating, diarrhea, vomiting, peritonitis, pancreatitis)

    (ii) Normal/ increased EBV

                - Inadequate ADH syndrome

                - Constant thirst

                - Renal failure (chronic)

2. Hyponatremia with raised osmolality :

( H & M)

- Hyperglycemia 

- Mannitol administration 

Note -

- Hyponatremia per se does not produce any significant clinical features. The low osmolality that it causes is responsible for various features.

- Slow correction of hypotonicity produces gradual rise in osmolality without any significant risk. But rapid correction of hyponatremia produces loss of brain water resulting in brain damage!

- The rate of correction should be around 0.6 mEq/L/hr. In severely symptomatic patients, total correction in a day should not exceed 8-10 mEq/L/hr.

That's all

Hope it helps

- Jaskunwar Singh

Attrition

In simple words, Attrition is the loss of tooth structure occlusally due to excessive forces by the occluding teeth, grinding of teeth, deep bite.

Aurora kinases

Hello friends, Let's talk about Aurora kinases today.... Aurora sounds so beautiful, right ?

Aurora kinases represent serine threonine kinases with instrumental role in cell division.

Specifically, Aurora kinase A is required for duplication and separation of centromere, and Aurora B is required for attachment of microtubules to centromere.

They are often over expressed in tumors resulting in defective cytokinesis during cell division, eventually causing aneuploidy and driving the carcinogenesis.

Now, it really gets interesting; usually when functioning of microtubules are perturbed say by paclitaxel, then spindle check point inhibitor is activated leading to cell demise by upregulation of P53, PUMA and other mediators.

But in case of Aurora kinase inhibition, cells keep on dividing especially in case of P53 mutated cells. Since centromeres will not segregate, it ultimately leads to tetraploid genome and four centromeres in a cell, causing catastrophic mitosis in subsequent cell cycle effectively tearing apart the genome.

They are significant because often when other tyrosine kinase inhibitors targeting EGFR, VEGFR, FGFR are used, tumors over express Aurora kinases, there by over riding the inhibition mediated by tyrosine kinase inhibitors.... So targeting them is key to maintain remission in patients already on kinase inhibitors.

Few examples of drugs in trials: Monastrol, Hesperidin.

It's called Aurora because of the similarity between the appearance of microtubule spindles during cell division and Aurora Borealis.

Pretty Majestic, right?

Submitted by Kirtan Patolia 

Risk factors for puerperal sepsis mnemonic

Hi!

Risk factors for puerperal sepsis mnemonic:
PUERPERAL SEPSIS