Heyde's syndrome mnemonic

Greetings! Short post for the day about Heyde's syndrome!

The mnemonic is: Heydes' hidden bleeding heart.

Pathophysiology of achalasia mnemonic

Hello!

This post is about the pathophysiology of achalasia!

In achalasia, there is loss of NO and VIP releasing inhibitory neurons. Thus, the loss of the inhibitory innervation in achalasia results in the manometric consequence of failure of LES relaxation as well as loss of esophageal peristalsis.

Classification of enzymes mnemonic

Hello!

This mnemonic on classification of enzymes was submitted by Mohd. Ayub Ali.

The mnemonic is, "On The Himalayas, Lyf (life) Is Lightened."

Intermediates in Gluconeogenesis mnemonic

Hi guys!

So today I wanted to talk to you about Gluconeogenesis.

The first thing is that gluconeogenesis takes place in the mitochondria.

Now when anyone says, "mitochondria", I (and probably all of us) immediately jump to, "mitochondria is the powerhouse of the cell".

Why does Digoxin toxicity result in increased automaticity?

Hey everyone!

Digitalis and other cardiac glycosides are known to cause an AV nodal delay.

Then why does too much Digoxin result in some arrhythmias that are due to increased automaticity? Brady arrhythmias are explainable. But why tachy arrhythmias?

Atrial fibrillation in WPW syndrome

Random fact that I learnt today!

If a patient with WPW syndrome develops symptomatic atrial fibrillation, what is the drug of choice?

Answer is procainamide.

Stable patients suspected of having WPW with atrial fibrillation should not receive agents that predominantly block atrioventricular conduction, but they may be treated with procainamide or ibutilide.

Why?
Because if you block the AV node using beta blockers, calcium channel blockers or digoxin, you will favour conduction to the accessory pathway. This will worsen the arrhythmia.

That's why, in stable patients, chemical cardioversion is preferred.

If instability is present, electrical cardioversion is required.

That's all!
-IkaN

Related post: Supraventricular tachycardia mnemonic

Organisms covered by Ampicillin mnemonic

So here it is...

Ampicillin HELPS to clear Enterococci!

Haemophilus influenzae
E. Coli
Listeria monocytogenes
Proteus
Salmonella

Ps: Gram-negative organisms have 'porin' channels in their outer lipid membrane through which the Beta-lactam antibiotics enter the cell. Also the lipopolysaccharide layer that contains endotoxins! (Gram-positive organisms do not have such things in their cell wall)
The only exception is Listeria monocytogenes that has little amounts of such endotoxins, inspite of being Gram-positive bacteria!

That's all!

-JasKunwar Singh

Interesting facts about testing 9th, 10th and 11th Cranial nerves

Hey guys!
So here's my first blog! Hope you like it!

Did you know that when 11th cranial nerve is involved on one side, you check for turning of head to opposite side and shoulder shrugging on the same side?

But when involved bilaterally, the patient can't turn their head.

So to test bilateral sternocleidomastoids, you ask the patient to sit up from sleeping position. He'll have head lag!

Here's another interesting fact:
Gag reflex is involved in 9th or 10th cranial nerve nerve palsy... This specifically localises lesion at medulla because both nerves originate there.

That's all!
Thanks ☺

-Rippie

Viral hepatitis - A histologic clue to the causative virus

Viral hepatitis is predominantly caused by hepatotropic viruses, although others like EBV, CMV are also implicated in the causation. Though serological markers serve as a gold standard for diagnosis, the following histologic clues help a pathologist to suspect the causative virus.

HAV - The portal tracts show a large amount of plasma cell infiltrates.

HBV - Presence of Ground Glass cytoplasm

HCV- Lymphoid aggregates in the portal tracts with macrovesicular steatosis of hepatocytes (most marked with Type 3)
Steatosis in zone 1 is mainly due to HCV while steatosis in zone 3 is mainly due to metabolic causes or alcohol.
EBV - Beads on a string pattern of sinusoidal infiltrates of Atypical lymphocytes.

CMV- Formation of microabscesses with intracytoplasmic and intranuclear inclusions.

Herpes virus- Nonzonal punched out necrosis with nuclear ground glass (Cowdry A) inclusions.

Thus, a good pathological suspicion would add to the confirmatory serological reports.

How to write for Medicowesome (And instructions for new authors)

Hello!

You can write for Medicowesome and share your awesomeness with everyone around the world! It goes on the "Submissions" page. If you want me to share your notes / knowledge / mnemonics on Medicowesome, email them to me (medicowesome@gmail.com) and I'll post it for you!

If you wanna be an independent author at Medicowesome, here's what you need to do:

Email me your id at medicowesome@gmail.com asking that you want to write for Medicowesome. I'll say yaay! Of course, yes! :D (You could also send a few sample blog posts and a fancy CV. jk.)

Make a blogger account (blogger.com) using your Gmail account.

Send me your email address. I will send you an author invitation, you must accept it within 24 hours.

Caffeine in Migraine!

Does Caffeine play a role in therapy of migraine? Or does it cause migraine?

Asking a doctor, he said yes caffeine heals pain in migraine attack. OK yea fine. But it can cause an attack too!! This is what I found something Amazing!

Migraine is a disorder characterised by acute pulsating headache, usually restricted to one side of head. Pulsatile dilatation of cranial blood vessels is the immediate cause of pain.

But we know headache is usually caused by vasoconstriction of cranial vessels and not vasodilation!
Actually, excess vasoconstriction or vasodilation, both cause less blood to reach brain parenchyma. This makes brain tissue cry for its necessary nutrients from blood!

In migraine there's excessive vasodilation of the vessels. So is the cause of acute pain. Caffeine constricts cranial blood vessels ( all other systemic vessels are dilated ). It is a CNS stimulant. (That's why we have more coffee at night while studying). :p

Now here comes the point. 1-2 cups of coffee (100-200mg) heal the pain by vasoconstriction. More than this will tend to decrease blood flow and so less supply to brain tissue.
That's why some people, who are in a habit of taking excess coffee or soft drinks, are more prone to headaches!

》 Caffeine is one of the constituents of medicines specific for treating migraine.

• MIGRIL: Ergotamine 2mg, Caffeine 100mg, cyclizine 50mg tab.

• VASOGRAIN: Ergotamine 1mg,  Caffeine 100mg, Paracetamol 250mg, Prochlorperazine 2.5mg tab.

• CAFERGOT: Ergotamine 1mg tab. + Caffeine 100mg.

Other medicaments-
• Crocin Pain Relief: Paracetamol 650mg + Caffeine 50mg tab.
• Micropyrin: Aspirin 350mg tab. + Caffeine 20mg

PS: Remember, the moment you feel migraine symptoms, have coffee. It is the best and most effective way to heal pain, without significant side effects.

That's all
Thanks :)

Bromocriptine in Type-2 Diabetes Mellitus

Type-2 Diabetes Mellitus is a chronic metabolic disorder characterised by Hyperglycaemia, Insulin-resistanthe state, increased lipolysis, and high risk of cardiovascular disease! We all know that. And much more to it..
But how can Bromocriptine be used to control blood glucose levels in diabetics??

Increased sympathetic activity in diabetics leads to breakdown of fats and high levels of free fatty acids in blood, which makes them obese! Insulin resistance in turn activates endogenous glucose production cycles which  results in glucose intolerance and high risk of cardiovascular diseases, hepatic failure, kidney problems and other systemic abnormalities!

Bromocriptine-
• An ergot derivative
• Acts as a potent agonist of dopamine D2 receptors.

• Intracerebral injection of 0.8mg Bromocriptine mesylate- quick release formulation, in Insulin-resistant state, is given after first meal in morning within 2-hours of awakening.

• It acts in the Supra-Chiasmatic and Ventro-medial nuclei of hypothalamus and regulates circadian rhythm of Insulin sensitive-resistant cycles and controls Dopaminergic-Serotonergic neurotransmitter activity.

• Simply saying, Bromocriptine reverses circadian rhythm from insulin-resistant state back to insulin-sensitive state, thus decreasing blood glucose levels back to normal.

• It reduces blood glucose levels, but does not bring back to normal. That's why it is prescribed as an add-on drug with insulin or sulfonylureas. This makes an additive effect in the anti-diabetic therapy!

That's all!
Thanks :)

Hypertrophy- is it just all about size?

Hypertrophy is a form of cellular adaptation mainly seen in the nondividing tissues of the body. It simply means increase in the individual cell size. But, is this all about hypertrophy?