Dextrorotary or levorotatory and D or L forms - We hear these terms, especially, in biochemistry of chiral carbon atoms.
Now, I always thought in D-glucose, the D is for dextrorotary. But I was wrong.
Hey guys!
As you all know, I'm preparing for USMLE and I wish to do an Internal Medicine residency in the USA. A part of the process for international medical students requires electives, which is, clinical experience in the US.
I am in Cleveland, Ohio in the months of January - April 2016 for my electives.
I will also be coming to Houston, Texas for my USMLE Step 2 CS exam.
If you're around at that time, I would love to meet you. Please come say hi.
For those of you who have been to the US for electives, please let me know do's and dont's. Anything you wish someone had told you prior to the experience.
I will also be blogging about every tiny detail - From preparation to what I experienced - So that it helps someone like me in the future :)
That's all!
Wish me luck and pray for me.
-IkaN
PS: I will not be disclosing the name of the hospital and specialty on the blog. Reason being patient confidentiality and privacy purposes.
Why do patients with multiple sclerosis experience worsening of neurological symptoms after heat exposure, that is, after taking a hot bath or after exercise?
It's known as Uhthoff's phenomenon.
Uhthoff's phenomena is due to ion channel modifications, in conjunction with thermoregulatory derangements that occur in MS, transiently altering the conduction properties of demyelinated axons.
This is from uptodate:
Heat sensitivity — Heat sensitivity (Uhthoff phenomenon) is a well-known occurrence in MS; small increases in the body temperature can temporarily worsen current or preexisting signs and symptoms.
This phenomenon is presumably the result of conduction block developing in central pathways as the body temperature increases. Normally, the nerve conduction safety factor decreases with increasing temperature until a point is reached at which conduction block occurs; this point of conduction block is reached at a much lower temperature in demyelinated nerves.
(This was discussed on our study group.)
Study group discussion: Why does ciprofloxacin cause tendinitis or tendon rupture?
The exact pathophysiology of FQ-induced tendinopathy remains elusive; however, some concepts have been suggested:
FQ: Fluoroquinolones
1. FQs are synthetic antibiotics that act by inhibiting bacterial DNA gyrase (topoisomerase II). DNA gyrase is directly involved in DNA replication and cell should not exert a negative effect on human cell lines because the affected bacterial enzymes have little homology with mammalian DNA gyrase. However, it is possible that FQs have a direct cytotoxic effect on enzymes found in mammalian musculoskeletal tissue.
2. FQs have chelating properties against several metal ions (e.g., calcium, magnesium, aluminum), and have been known to cause direct toxicity to type 1 collagen synthesis and promote collagen degradation.
3. Animal studies have shown that FQs cause cartilage damage by inducing necrosis of chondrocytes (36 hours after treatment), disruption of the extracellular matrix, and formation of vesicles and fissures at the articular surface.
(This was discussed in our study group)
Some review questions on drug induced pancreatitis!
Which diuretics can lead to pancreatitis?
Thiazides and furosemide
Which Antiretroviral drugs can lead to pancreatitis?
Didanosine and stavudine
Which antibiotics can lead to pancreatitis?
Metronidazole and tetracyclines
Seizure med leading to pancreatitis?
Valproate
Immunosuppressive drugs leading to pancreatitis?
Azathioprine
L asparaginase
Ok the last one.. Drugs for treatment of IBD leading to pancreatitis?
Sulfasalazine
5-ASA
(Mnemonic, if you need one)
FAV DAM - ATiTiS
Furosemide, Azathioprine, Valproate
Didanosine, Asparginase, Metronidazole
ASA, Tetracycline, Thiazides, Stavudine, Sulfasalazine.
Hello everyone!
I see a lot of patients in the casualty with fever, chills & thrombocytopenia but to my surprise, they've been diagnosed with malaria (Instead of dengue). I was wondering what the mechanism is.
The speculated mechanisms leading to thrombocytopenia are: coagulation disturbances, splenomegaly, bone marrow alterations, antibody-mediated platelet destruction, oxidative stress and the role of platelets as cofactors in triggering severe malaria.
In uncomplicated cases of malaria, thrombocytopenia is the result of splenic pooling of platelets aggravated by a moderate decrease in platelet life span.
That's all!
-IkaN
Mini bacteriology post! Yaay!
In which Lancefield group does Streptococcus pyogenes and Streptococcus agalactiae belong? How do you remember them?
Streptococcus Pyogenes belongs to Lancefield Group A mnemonic:
I remember GAP jeans (Because of the gap company manufactures amazing clothes) - Group A Pyogenes.
Streptococcus Agalactiae belongs to Lancefield Group B mnemonic:
Remember B for Baby. Streptococcus Agalactiae causes meningitis in babies and belongs to Lancefield Group B. Babies also love Galaxy chocolates and stars.
That's all!
-IkaN