Biotin mnemonic |
Sunday, July 10, 2016
Biotin deficiency mnemonic
Study group discussion: A case of vitamin deficiency
Tuesday, July 5, 2016
Order of decision making
However, this may not be possible on every occasion and it is the physician's responsibility to ensure that a decision is made that would be what the patient would have wanted (if the patient does not have the capacity to make the decision himself/herself).
Monday, July 4, 2016
Apoptosis genes mnemonic
So we basically have bcl 2 , bcl XL, mcl-1, Bax, bak, bcl -xs genes which influence apoptosis.
Now let's imagine a cell committing suicide which is apoptosis.
Sunday, July 3, 2016
Dysphagia
Hi everyone!
So, here's what I found interesting today!
Dysphagia is awareness of something sticking in the throat or retrosternally during swallowing.
Whereas, odynophagia is pain as food or drink descends the esophagus. It almost always implies an infection of esophagus e.g.candida esophagus in HIV patients.
Remember, dysphagia often has a significant cause which can be malignant and almost always needs investigation!
Can there be different patterns of dysphagia?
Yes.
It can be more for solids than liquids.
When it is rapidly progressive, look out for a malignant cause! When it's fairly less rapid in progression, suspect a benign stricture (rarely an esophageal pouch)!
Or, it can be more for liquids than solids.
This usually is the case in neurogenic dysphagia and can be sometimes associated with aspiration or coughing.
That's all!
- Rippie
Saturday, July 2, 2016
Monday, June 27, 2016
Cyanosis
So, I found a few interesting things about cyanosis.
Cyanosis is bluish discolouration of skin and mucous membranes.
Reason?
It occurs when amount of reduced Hemoglobin is more than 4g/dl. (Harrison's, 19E)
Even small amounts of methemoglobin (1.5g/dl) and sulphmethemoglobin (0.5g/dl) can evoke cyanosis!
(Just remember, bigger the name lesser the amount required :P)
Types?
Central and Peripheral cyanosis
What happens in both of them?
Central cyanosis has either i) low arterial oxygen saturation or ii) abnormal Hemoglobin derivatives so skin as well as mucous membranes are involved!
Peripheral cyanosis is due to either i)increased oxygen extraction or ii)reduced amount of blood reaching periphery (simply, vasoconstriction [so you may find cold skin] or reduced cardiac output =D) so only skin is involved.
Where to check for cyanosis?
Lips, nail beds, ears and malar eminences.
Fun facts:
1. Cyanosis in heart failure can be mixed i.e. Central plus peripheral
2. "Differential cyanosis" is when lower limbs are cyanosed and NOT the upper limbs! It happened when there's a Patent Ductus Arteriosus (PDA) with Reversal of shunt!
3. So can cyanosis of only upper limbs happen? Yeah, if there's a PDA with Reversal of shunt with Transposition of great vessels!
Most interesting one:
4. In PDA with reversal of shunt with Pre-ductal coarctation of aorta all limbs except for Right Upper Limb can be cyanosed! If you're wondering why, then the answer is that if the coarctation is before the origin of left Subclavian Artery you may find its blood supply being hampered and so the cyanosis of left upper limb. Both the lower limbs get its blood supply from arteries after the level of coarctation, so it's invariably going to be cyanosed!
Quite a lot, right?
That's all!
-Rippie
Saturday, June 25, 2016
Evolution, transposons, retrotransposons.
We all like to think mutation as a random occurrence, an occurrence only due to chance which is mostly harmful and may be evolutionary significant once in a blue moon.
There are actually, contrary evidences to all that. Evidences which will force us to rethink all our notions and accept Jean Baptiste Lamarck as our hero(yeah the Giraffe-neck guy).
How,do you ask? Well, we'll have to begin by learning what 'junk' DNA is. Junk DNA (better call it noncoding DNA) is a vast amount of nucleic acid lying unused in the nucleus. Actually, only 3% of the 'normal' DNA codes at a given time. Rest of it lies unused.
With me still here? Great. Now, we come to 'jumping genes' or 'transposons'. What initially was considered as a rigid blueprint, the DNA is so not like it. In fact, its a dynamic entity. Genes moving here and there, cutting,copying, and pasting themselves within the strands.
These frisky genes are the transposons. In experiments conducted by Barbara MC Clintock, it was discovered that when corn plants were subjected to environmental stresses, the genes arranged themselves so as to confer them with a survival benefit. Yes, a sort of intentional mutation was done by the plant itself!
Later, in experiments conducted by Harvard researcher John Cairns on certain lactophobic strains of E coli, where the bacteria were deprived of all the nutrition except for lactose, it was observed that those bugs lost their milk fear rather readily, quicker than mere chance would have allowed to mess with their genetics.
Lamarck doesn't sound too stupid now, does he?!
And now, coming to the most interesting part, does all this magic occur in us, as well? Hell yeah. And wait till I mention the name of the partner in crime - Retroviruses.Yep.You read that right.
These are the viruses which can penetrate the Weissman barrier - a barrier which prevents traits acquired by the parent's somatic cells to pass to the germ cells.The idea is to prevent harmful acquired traits like radiation induced DNA damage from passing to the offspring.
Coming to viruses again,we all know how they work their charm. Using the host machinery and then in the process, sometimes ending up as a part of our own DNA- the junk DNA about which I wrote earlier.Today,it is a known fact that at least 8% of our DNA can be traced back to retroviruses. With this vast noncoding (junk) DNA, the space to play for the jumping genes opens up many folds, and hence a higher number of permutations and combinations become available for an acceptable mutation to occur.
Now what the hell are 'retrotransposons' in the title? Well, a subtype of jumping genes. Normal transposons work by cutting and pasting within the genome, while these retrotransposons are copy pasters.
But more interestingly, their work resembles very, very close to retroviruses. A retrotransposon initially copies itself on an RNA strand, travels,and uses reverse transcriptase to paste itself into a new location on the DNA strand. Does this mean retrotransposons are descended from retroviruses?! You bet!
This has led many to theorize that viruses have actually accelerated human evolution by endowing us with acres of junk DNA and retrotransposons, while we continued to provide them a warm, cozy environ.
Some thought innit?
Tuesday, June 21, 2016
LDL Cholesterol- The 'bad' turns good
Monday, June 20, 2016
USMLE STEP 1: Psychiatry: Malingering and Factitious disorders.
So whenever you come across a clinical vignette in which the patient comes with UNEXPLAINED symptoms or complaints and doesn't seem to have an actual illness, but is either faking it or creating it, the patient is either MALINGERING or has a FACTITIOUS DISORDER.
Friday, June 17, 2016
Wednesday, June 15, 2016
Stress and epilepsy
MAC prophylaxis mnemonic
Clinical and radiological features of rickets mnemonic
So I had created this video long back but just realized I never uploaded it on the blog. Here it is! :)
Tuesday, June 14, 2016
Study group discussion: White jaundice
Can anyone explain about what is white jaundice?
I think it refers to cholestasis syndrome (obstruction of bile outflow)
Jaundice (Increased conjugated bilirubin)
Acholia (Pale stools, thus "white jaundice")
Choluria (Dark urine)
May have generalized pruritus (Due to cholesterol)
Here's what someone else wrote:
White Jaundice is not a separate disease, it is a very old term for jaundice.
Jaundice is a condition in which bilirubin, which is a yellow coloured pigment, accumulates in the body and causes the skin to turn bright yellow. In severe cases, the skin can appear brown.
To confirm that someone is jaundiced, and not just dark-skinned, the whites of the eyes are examined, yellow colouration here is a clear sign of jaundice, hence the old expression "white jaundice".
Migraines linked to Vitamin D deficiency
A new study suggests that migraine attacks are linked to vitamin deficiencies.
The question is - 'Could supplements be the key to fight such attacks?'
Vitamin D in Type - 2 Diabetes Mellitus
Why does acute promyelocytic leukemia (M3) cause DIC?
Monday, June 13, 2016
Indications of hypertonic saline
The only indications of hypertonic saline is when there is hyponatremia in the body severe enough to cause symptoms like mental status changes.
Oral hypoglycemic drugs used for diabetes mellitus mnemonic
So whenever there is a LOT of things to remember, like a lot of drug classes or a lot of microorganisms, I personify them. I make them real life characters and give them creep personality traits.
Here's a mnemonic kinda thingy on drugs used in diabetes mellitus aka oral hypoglycemics!