Friday, September 18, 2015

Constitutional pancytopenia mnemonic

Constitutional pancytopenia mnemonic

Rich in name, poor in cells.

"I fancy this carat (gold), diamond and silver man. He is a mega rich noob down here!"

Fancy: Fanconi syndrome
Dis (Dys) Carat: Dyskeratosis congenita
Diamond silver man: Shwachman Diamond syndrome.
A mega: Amegakaryocytic thrombocytopenia
Noob: Noonan syndrome
Down: Downs syndrome

That's all!

The mnemonic is just as hard xP

-IkaN

Thursday, September 17, 2015

Study group discussion: Drunken crab syndrome

Which parasite causes the drunken crab syndrome?

Paragonimus westermani.

Drunken crabs, because man gets infected with it by eating raw crabs. In Taiwan, these crabs are marinated in wine. Hence, the name!

Also called kejang.

Wow I didn't know this.

Nice to know, I was formulating all sort of weird possibilities for symptoms based on that.

I thought of a motion abnormality.. Since crabs can walk sidewise.

When I first came across this... Even I thought that the person would have a drunken gait or something!

Wonder how a crab would walk in cerebellar ataxia.. Considering they have a cerebellum.. Or not!

Lets talk about crabs!

Crabs is also slang for STD.
It's not slang, my bad. It's lice in pubic hair. Also known as crab lice.

CRAB is used for Multiple Myloma symptoms too.
CRAB:
C = Calcium (elevated),
R = Renal failure,
A = Anemia,
B = Bone lesions

And then there's Krabbe's disease, some sort of leucodystrophy.

Lame mnemonic for drunken crab.. Our teacher said -- Mr. Krabs gets drunk in Taiwan .. Because he found out.. His daughter "P"earl  (paragonimus) is a man (westermanii)

Nice mnemonic!

Typhoid: Leukopenia, chronic carrier state and cancer (Why does typhoid fever cause leukopenia?)

I see a lot of patients with typhoid in the casualty and usually, they all have leucopenia. So I wondered - Why does the WBC count decrease in typhoid or enteric fever? Why does the WBC count become low unlike other infections?

After loads and loads of Googling, I found the answer to my question.

Study group discussion: Acromegaly

What is the most common cause of death in patient with acromegaly?

Cardiomyopathy leading to heart failure.

Why is diabetes more common in acromegaly?

GH has anti insulin effect.

Cool fact: GH increases insulin production. But at the same time causes insulin resistance.

How can you find out by giving glucose that patient has acromegaly or not?

Normally, growth hormone should be suppressed by giving glucose. Suppression of GH by giving glucose excludes acromegaly.

What is the treatment for acromegaly?

Pegvisomant - GH receptor antagonist.
Transsphenoidal removal of pituitary tumor.

Study group discussion: HSV encephalitis and musical hallucinations

Fun fact: HSV encephalitis is associated with musical hallucinations.

It's due to disruption of connections between the sensory cortex and reticular formation.

Is that specific for HSV only? Like the way auditory hallucinations is characteristic of schizophrenia?

No, it occurs in epilepsy, intoxication and other focal brain lesions as well.

I've heard that musical hallucinations occurs in people who listen to music for long periods of time. Not sure if it's true.

JVP in pericardial tamponade

Greetings everyone!

Today, I was reading about JVP in pericardial tamponade. I started explaining a few concepts to myself and then I thought maybe everyone would like to know about this! So I wrote them down for you guys to read.

Why is y descent absent in JVP in pericardial tamponade? 
Y wave is due to ventricular relaxation. The ventricles can't relax when the pericardium is full of fluid, leading to the absence of y descent.

JVP in pericardial tamponade
Why is there a prominent x descent in JVP of pericardial tamponade?

Pharmacological agents that relax lower esophageal sphincter mnemonic

Pharmacological agents that relax lower esophageal sphincter mnemonic

ABCDEF MINTS

Alcohol
Anticholinergics like Atropine
Barbiturates
Benzodiazepines like Diazepam
Caffeine or coffee
Chocolate (My favorite!)
Dopamine
E (Prostaglandin E1 & E2)
Fat
Meperidine
Nitrates
Theophylline
Smoking
Peppermint (mints)

That's all!
-IkaN

Wednesday, September 16, 2015

Cirrhosis of liver: Concepts, mechanism and pathophysiology

Hello everyone! 

In this really long post, I'll be discussing the pathophysiology of some of the signs, symptoms and conditions seen in chronic liver failure / alcoholic liver disease. We are going to focus on the WHY.

Let's get started ^__^

Why is gynecomastia, testicular atrophy and female pubic hair distribution seen in males with chronic liver failure?
Physiology:
- Liver metabolizes estrogens.
Pathology:
- In cirrosis, estrogen degradation is decreased, so estrogen concentration are elevated causing testicular atrophy, gynecomastia & changes in pubic hair.
- Estrogen also induces SHBG production and this further reduces the free testosterone levels.

Stigmata of diseases

What does stigmata mean?

Stigmata means some lesion, mostly skin, which is visible, showing the patient is suffering from that particular disease.
In some diseases, like leprosy and tuberculosis, the patient may not want to reveal the condition because of the stigmata associated with the disease in society. But due to certain signs, the disease gets revealed. (These diseases were considered a disgrace in earlier days.)

Examples - 

Sunday, September 13, 2015

Thyroid carcinoma mnemonic

Hello! 
I made a real easy way of remembering thyroid tumors :)

Papillary carcinoma mnemonic:
Popular (Most common thyroid cancer)
Palpable lymph nodes (Lymphatic metastasis is common)
Positive I (131) uptake
Post radiation in head and neck (One of the causes)
Pops out of the capsule (Usually encapsulated but invades capsule)
Pops everywhere in the gland (Multifocal)
Positive, pleasing, perfect, parexcellence, peerless prognosis
(Excellent prognosis because it's slow growing)
[Another mnemonic is PG - Papillary, Good prognosis =D ]
Histology:
Popping eyes (Clear nuclei, Orphan Annie Eyes)
Papillary pattern
Psammoma bodies
Pseudoinclusions (Intranuclear cytoplasmatic inclusions)

Saturday, September 12, 2015

Study group discussion: Why more phenytoin is prescribed at night

Why do we give phenytoin in 1-0-2 dose after discharge? Why two tablets at night?

Phenytoin causes marked drowsiness that can confound the mental status (read GCS) exam in medicated patients, most critically those who have had neurosurgery and are given phenytoin for postoperative seizure control. In an outpatient being prescribed phenytoin one would plausibly order more to be taken when the patient is likely to be asleep instead of when they're awake.

Thank you for sharing this with us.

One article says, previously, we used to give 300 mg once daily. After chronic use, patients started developing adverse reactions of drug. It was then decided to start using phenytoin in divided doses. (100 mg TID).

Also remember that gingival hyperplasia is a very important and distinctive secondary effect of phenytoin, my teachers say that it stays even if you stop the medicine, but I'm not sure of that since I have not read that anywhere else.

Tuesday, September 8, 2015

Difference between smooth ER and Rough ER mnemonic

Hello! Hope you're having a good day =)

In today's post, I'll be sharing how to remember the difference between rough endoplasmic reticulum and smooth endoplasmic reticulum.

Monday, September 7, 2015

von Willebrand disease mnemonic

Greetings everyone!

As you all probably already know, I've been studying loads of hematology this week. Here's another compilation of facts + mnemonic on  von Willebrand disease!

Saturday, September 5, 2015

How to remember gene for differentiation of gonads

Hello!

How to remember gene for differentiation of gonads

Mnemonic: Why (Y) are you Sorry (SRY)?

Y chromosome contains SRY gene which differentiates gonads to testes.

Daxone (DAX1) went for (WNT-4) double X (XX) .

Genetic factor DAX1 and signaling molecule WNT-4 are necessary for development of ovary.

That's all!

-IkaN

Wednesday, September 2, 2015

Normal values of Calcium, Phosphate, PTH and Alkaline phosphate mnemonic

Hey!

Here are a few mnemonics on how to remember the normal range of calcium, phosphate, PTH and Alkaline phosphate.

You may need to memorise these values for time restricted exams where wasting time looking up tables for normal values may cost you a few points.

Tuesday, September 1, 2015

Studying Biochemistry

"Just came across your blog. I must say you are very inspirational. I am first year medical student but I find it hard to study biochemistry. I would like to know if there is a good way to learn it. Any tips?" -Asked by email

How to speed read

I have modified a lot of general principles of speed reading for us, medical students, because we need to understand what we read.

Causes of macrocytic anemia mnemonic

Hello.

We all know that vitamin B9 and B12 causes macrocytic anemia but do you know the OTHER causes of macrocytic anemia?

They are:
Orotic aciduria
Thiamine deficiency
Hypothyroidism
DysErythropoietic anemia

Mnemonic: OTHEr

That's all!

-IkaN