Tuesday, June 9, 2015

Antibiotic associated diarrhea mnemonic

Clostridium difficile is the most common cause of antibiotic associated diarrhea.

How do I remember this?

"Difficile grows when the normal flora are deficient."

Antibiotic associated diarrhea is treated with metronidazole.

How do I remember this?

"Definitely treat difficile with metrodiffizole."

That's all!

-IkaN

Study group discussion: Suprapubic cystostomy experience

So last night, in the emergency department, comes a 65 yr old male complaining of difficulty in passing urine.
On examination: His lower abdomen is distended. A pyriform shaped swelling reaching the umbilicus.

He was having acute retention of urine. Tried introducing a 16 fr catheter. But failed. Next step?

You try intorducing a 10 fr paediatric catheter.

But we didn't have one to our dispense. So we did supra pubic.

What is the procedure?
Palpate and percuss first. Then insert the catheter directly at 90 degree.

The moment I did.. The patient heaved a sigh of relief. On further work up, it was a case of BPH.

How do you make sure you don't injure inferior epigastric vessels?

Midline 4 cm above pubic symphysis. Inferior epigastric vessels are more lateral.

Does dopamine cause vasoconstriction or vasodilation?

Is dopamine a vasoconstrictor or a vasodilator?

Both! It depends on the rate of infusion.

At low rates of infusion (0.5 to 2 mcg/kg/min), dopamine causes vasodilation that is presumed to be due to a specific agonist action on dopamine receptors in the renal, mesenteric, coronary and intracerebral vascular beds.

At higher rates of infusion (10-20 mcg/kg/min), there is some effect on alpha- adrenoceptors, with consequent vasoconstrictor effects and a rise in blood pressure. The vasoconstrictor effects are first seen in the skeletal muscle vascular beds, but with increasing doses, they are also evident in the renal and mesenteric vessels.

Immunology emoticon game answers

Here are the answers!

Monday, June 8, 2015

Immunology emoticon game

And it's back again! Except, it is more tougher conceptually.

We figured guessing words out of emoticons is too lame and easy for you medicos and thought we'd add questions to make it more fun!

Immunology emoticon game

Friday, June 5, 2015

Study group experience #17


We did a massive change in all 4 groups, we clubbed Asians in two groups and Non Asians in two groups. Now the groups are segregated time zone wise, leading to better fruitful discussions! Though we do a bit of a mix and match here and there.

Also, we recently made group 5. It's a lot of discussions to take it for people who are in all 5 groups!

Study group discussion: T4 level

Studying the anatomy of the thorax.. Does anyone know the events occurring at T4 level?

At t4 level:
- Arch of aorta starts and ends at this level
- Azygous vein ends here to join SVC
- Trachea divides into primary bronchi

Study group discussion: Food, pain and ulcers

How does food relieve pain in duodenal ulcer and aggravate pain in stomach ulcer?

Food reaching stomach causes acid secretion. Therefore, pain increases.

In case of duodenal ulcer, eating causes pyloric spincter contraction, acid is prevented from reaching the duodenum
Therefore, pain is relieved.

Thursday, June 4, 2015

Beckwith-wiedemann syndrome mnemonic

"Becky is big."
Beckwith-wiedemann syndrome mnemonic

"Big body"
Macrosomia

"Big tongue"
Macroglossia

"Big abdomen"
Omphalocele

"Big pancreas"
Hyperinsulinemia -> Hypoglycemia

"Big organs"
Visceromegaly

"Likes to get bigger"
Associated with Wilms tumor, gonadoblastoma and neuroblastoma


That's all!

-IkaN

Monday, June 1, 2015

Study group discussion: Pheochromocytoma and eleven

What is rule of 11 for pheochromocytoma?

11% are extra-adrenal
11% are bilateral
11% are malignant
11% are found in children
11% are familial
11% are not associated with hypertension
11% contain calcification