Patau syndrome notes

These were submitted by Yeswanth Gopisetti

Montegia and galezzia fractures mnemonic

Hello everyone! 

In today's post, I'll be sharing a mnemonic on Monteggia and Galezzia fractures! 

U for ulna in Monteggia  

R for radius in Galezzia 

Also, U in Monteggia is at the Upper end of ulna. 

R in Galezzia is at the lower end of radius. 

Another mnemonic is M for Monteggia, M for the medial bone, which is ulna! 

Submitted by DoctorWizard 

Ketamine- A new antidepressant!

Hello!

Remember those conventional classes of drugs used for treating major depressive disorders?? Well, now I have a better one. Ketamine!
Haha yea trust me... this commonly used anaesthetic, analgesic, hallucinogenic drug has got its place in another class of drugs- The anti-depressants. :D

#AnswerTime: Female with weakness of lower limbs

Okay so answer tim! 

I posted a quiz time question here: http://www.medicowesome.com/2016/07/quiztime.html?m=0

Here's the solution to it. 

Sorry this got so late, I've had exams -.-

The IMNCI problem - Solved. (Mnemonic)

Hi everyone !
So I was just studying Pediatrics and sometimes they expect us to remember how to fill the IMNCI form 😭 #SoCruel.
So here's a mnemonic I made for the headers :

For a child below 2 months -->
Bl*w Job TDM

So
Bl*w= Bacterial infection
Job= Jaundice
T=Temperature (hypothermia)
D= Diarrhea
M= Malnutrition

__________________________________
For a child above 2 months -->
3 Di*ks in FEMAles Is Fun

So 3 D*cks are  :
Danger signs
Diarrhea
Dypnea /difficult breathing /cough.

FEMAles  :
  F = Fever
  E = Ear problem
  M = Malnutrition
  A = Anemia

Is = Immunization

Fun = Feeding .

Hope you find this one helpful.
Will continue with the GI hormone series once exams are done.  :p
Bye.

Solitarius and ambiguus

Vagal nuclei was a hated subject to me..so bad that I would turn the page if I ever came across it.

This thing helps keep my facts straight when it comes to these horrid nuclei.. hopefully it will help you too.

Ambiguous in a literal meaning is to outshine everyone else. There are many ways to do that. The most everlasting impression you leave is how you interact to people..what to say and when to say.

That's what nucleus ambiguous helps you to achieve..these are the neurons controlling the palate, pharynx and larynx. Hence, the controller of speech :)

its the vagus, the glossopharyngeal and spinal accessory that share this nucleus

Nucleus Solitarius is for taste sensation and for the supply of carotid and aortic body chemoreceptos
Hence, it's the facial, glossopharyngeal and vagus nerve that share this particular nucleus

Psst- let me know of your way to remember this. Our ideas may be solitary..but let's make it ambiguous together :D

Sticks like a gum

I am generally against the idea of using mnemonics.. but this particular one is a life saver for me.. though stupid :D

Think of a chewing GUM, think of the times when it was stuck to your fingers..and you struggled to get rid of it.

That's how valgum..when things stick to each other.

No more worries as to what is genu valgum and genu varus.

Additional mnemonic by Subbiah: After K is L, by alphabetical order. Hence Knock knees is vaLgum.

Antibodies to stop Heart disease!

Hello everyone!

Cardiovascular disease is one of the most leading causes of death in the world today, with major risk factors not merely high cholesterol and high blood pressure but also the actual lesions being directly responsible for the disease- Atherosclerotic plaques.
Antibodies that help the immune system remove dead and dying cells have been shown to reduce atherosclerosis. 
Read further to know the "how" of that.. :D

Why use glycine in TURP?

TURP is the current standard surgical procedure for BPH. The various irrigation fluids are

NaCl- since there is use of cautery in TURP.. NaCl can be hazardous to the surgeon as well as the patient

Distilled water- while resection of prostate tissue, there is exposure of the underlying vessels..which leads to rapid absorption of the irrigating fluid. Distilled water is highly hypotonic.. which can cause widespread hemolysis.

Glycine- currently the most preferred agent. The commonly used conc is 1.5% glycine with an osmolality of 230mosmoles(plasma 285-290mosmole) At this conc the hypotonicity is balanced with the toxicity of glycine. Though it can still cause volume overload with dilutional hyponatremia..it is not as severe as with distilled water.

Dilution hyponatremia Is a dreaded complication of TURP. The management includes I.V NaCl solution (0.9% & 3%), fluid restriction and furosemide.

Other less known solutions are- Glucose , mannitol and urea
A costly but comparatively safer option is cytal( sorbitol+mannitol)..but due to cost restriction..it's not that common.

#QuizTime: Female with weakness of lower limbs

#Quiz time

A 25 year old female who is a marathoner presented to the OPD with weakness of her lower limbs. She said she isn't able to practice as her legs feel very tired. This started with her foot , about a week back, And now her entire leg feels weak.
History is otherwise insignificant , but there is a history of mild fever with a very light maculopapular rash about 4 weeks back, within a span of 3 weeks after she returned from a Running Contest in Brazil.

GI Hormones: Cholecystokinin Pancreozymin

Hi everyone ! So this is the 3rd post in  the series of the hormones of the GIT.
Last post we discussed about the Zollinger Ellison syndrome as a result of  Gastrin.  This post we look at the 2nd member of the gastrin family. Cholecystokinin PZ
Hope you like it. ::)

⛔Cholecystokinin Pancreo-Zymin ⛔

◾Produced by : I cells in mucosa of Upper SI.

◾Physiology of secretion :
○ Acts vis CCK A receptor. (Gastrin acts via CCK-B if you recollect)
○Pre-Pro-CCK fragmented into many parts.
○Multiple AA in each for, but same 5 AA at Carboxy terminal
○Also found in distal ileum and colon + Cerebral Cortex.

◾Functions : lots.

○Gall bladder motility (contraction - kinesis)
○Stimulates pancreatic enzyme secretion ; augments secretin's actions
○Trophic action on pancreas
○Inhibits gastric emptying
○Causes contraction of pyloric sphincter -->preventing duodenal content aspiration.
○CNS --> role in regulation of satiety/food intake, Anxiety.

________________________________________

So if you notice, this does way more things than its brother Gastrin. Now it might get a little tedious to remember. So think of it this way :
Cholecysto-kinin Pancreo-Zymin. So first part of the name is cholecysto = Gall bladder. Kinin=motility. So 1. GB motility. Next is Pancreozymin. So acting on the zymogen granules in pancreas to bring about 2. enzyme secretion. Now along with causing enzyme stimulation it'll also tell the pancreas to grow up , hence exerting a 3. trophic action. So far so good?
Now for all of this gall and pancreatic fluid to reach the intestines , the barrier of the Oddi sphincter needs to be passed. So it'll 4.relax this sphincter causing the secretions to flow freely into the gut.
This causes a lot of fluid to be present in the duodenum. Since this is in proximity to the pylorus, the pyloric sphincter will  have to be shut to prevent aspiration of alkaline duodenal stuff into the stomach, hence 5.pyloric sphincter constricts.
Finally, since it's modulating so much of the digestion , it's got receptors in the CNS that 6.stimulate/depress hunger based on the CCK levels (like more CCK indicates more food being gulped down)
I have no idea about the anxiety part. So we're gonna have to go with it. Lol.

◾Regulation :

○Factors that increase -->
□Luminal  : fatty acids (>10Carbon atoms) -as lipase from pancreas acts on lipids and gall fluid contains fat digestive bile acids + AA.
□Other : CCK-Releasing peptide (intestinal mucosa) + Monitor factor (pancreatic)
+ feedback b/w degradation and secretioPZ

◾Applications
○ CCK in the injectable form can be used as a diagnostic aid to check Gall bladder motility

○ CCK Antagonists -->
□Proglumide =Non Selective. Ulceroprotective effect. (Gut action). May increase analgesic property of Opioids and help reduce Tolerance to them (CNS Action).
□Lorglumide =Selective fir CCK A type. Gut action.
□Studies are on going to harness their potential as anti-anxiety or anorectics. (CNS actions)

:)
Next post - The secretin family.
Hope you'll are finding this helpful. Let me know if you have any doubts or suggestions. Bye until then=)

-:Drug Doses:-

Hi everyone !
here is collection of drug doses according to their classification,Hope it helps you:)

Pericarditis, pericardial tamponade, X descent and Y descent

Hello everyone!

Here's another awesome mnemonic submitted by Aditi!

"cPAY TAX"

In constrictive pericarditis, prominent Y descent is seen (X descent is also prominent.

In pericardial tamponade, prominent X descent is seen (Y descent is absent).

Thank you so much for sending your mnemonics to us, girl! (=

Causes of triple deformity of the knee mnemonic

To remember the causes of TRIPLE DEFORMITY of knee, remember word "TRIPLE"

T - TB
R - Rheumatoid arthritis
I - Illiotibial band
P - Polio
E - Excessive bleeding

Submitted by Aditi Bhosale

Bone in bone appearance mnemonic

Remember mnemonic, "TOPDOG" for bone in bone appearance:

T - Thalassemia
O - Osteoporosis
P - Pyles disease
D - Diaphragmatic achalasia
O - Osteodysplasty
G - Gauchers disease

Submitted by Aditi Bhosale

Good prognostic factors in nerve injury mnemonic

Good prognostic factors in nerve injury.

Remember that, "NERVE is Good"

N-Neuropraxia
E-Early repair
R-Radial that is pure motor or poor sensory has best prognosis
V-Vascularity intact
E-End to end anastomosis
G- growing age

Submitted by Aditi Bhosale

Tuberculosis mnemonics

Hello!

Today's post is all about TB! :D

So many names to remember :/

Enterobius vermicularis notes & mnemonics

Enterobius vermicularis notes

Here are my notes for Enterobius vermicularis. Uploading so you guys can refer to them (:

GI Hormones: Zollinger Ellison Syndrome

Hi everyone ! So this is the 2nd post in  the series of the hormones of the GIT. 

Last post we discussed about the functions of the hormone Gastric.  This post we look at its applied aspects. And that's majorly looking into the Zollinger Ellison Syndrome. 

Hope you like it. ::)

⛔ZOLLINGER ELLISON SYNDROME⛔

■Etiology: sporadic or Associated with MEN1 SYNDROME (Multiple Endocrine Neoplasia syndrome)

■TRIAD : Tumor + Hypergastrinemia + Peptic ulcerations. 

↪Tumor. = Gastrinoma. 50% gastrinomas are malignant.                                                       ○MC Site is the duodenum
○(☆MC site for PUD in general is also duodenum. So it only makes sense that for the mucosa to ulcerate there must be a local gastrin supply available ).

○2nd MC site for gastrinoma = Pancreas. Originally the tumor was defined as a non Beta cell Pancreatic tumor. 😨. Now its been realised the duodenum was the culprit all along.
○PUD and Hypergastrinemia. = due to increased gastrin secretion by the tumor, gastrin exerts an increase in the acid secretion + its trophic action on gastric mucosa. This causes erosions of gastric mucosa as well as causes hypertrophy of it (paradox). Thus we get a Hypertrophic Gastropathy + PUD.

↪S/S:
○Abdominal pain is the MC symptom . Can mimic PUD.
○2nd MC symptom is Diarrhea.
May be associated with mucosal damage due to acid leading to villous atrophy (excessive acid of stomach. Pancreatic/intestinal alkalinity may be unable to counteract. Pancreatic secretions may be compromised due to tumor)
○Heartburn
○GI bleed -- hematemesis, melena. Due to ulcer-hemorrhage. 

↪Inv:
○S.gastrin levels - >100. IOC for screening
○May follow up a positive result with gastric acid function tests
○Somatostatin receptor scintigraphy.
○Evaluate for Liver /LN mmets
○S.Calcium -- associated with MEN1.

↪Rx :
○PPI. Symptomatic treatment achieved with OMEPRAZOLE and friends.
○Can use Octreotide - Somatostatin analogue. It's a generalised inhibitor of pretty much all hormones.
○Surgical Rx of tumor advised to avoid mets

☆☆☆☆☆MEN1 --> Hyper parathyroidism , pituitary tumors ,Pancreatic tumors.
(Mnemonic : All MEN like 3 things - Pus*y, Pus*y, Pus*y. = parathyroid, pituitary, pancreas) ; 

Autosomal Dominant. cause men are dominant, lol. ¤¤ 

The next post is going to be about the only  other member in the Gastrin family -CCK PZ. 

So don't fail it to check it out. ;;) 

Bye till then. :* :D

GI Hormones: Gastrin

Hi everyone, so this is my first post in the series of GI hormones!

There are 2 families of GI hormones -

1. Gastrin family (Gastrin , CCK)

2. Secretin family (Secretin, glucagon, VIP, GIP)

Others - Motilin, Peptide YY, Substance P, Ghrelin, Guanylin

In this post, I'll be talking about one of the members of the gastrin family, gastrin itself! :D


⛔⛔GASTRIN⛔⛔

I. Produced by: 

■ G cells - enteroendocrine cells located in antral gastric mucosa.

II. Physiology of secretion:     

■ Acts via CCK-B receptor

■ Progastrin is cleaved to form 3 different residues :G 14, 17,34.

■ Sulfated and carboxylated forms also exist.

■ Amidated form is more stable.

■ G17 is principal form w.r.t. GI actions.

■ G34 has longer t1/2 than others.

■ Inactivated in SI, kidneys

III. Functions: 

■ Stimulates Gastric acid and Pepsin secretion

■ Trophic action - stimulates growth of mucosa of Gut.

IV. Regulation:

A. Factors that increase secretion of gastrin: 

■ Luminal:

- Amino Acids (Aromatic) in stomach 

- Distension

Because the job of this hormone is to bring about protein breakdown via pepsin and increase pH of the stomach, Hence it is released in response to protein and other contents entering the stomach. Tells the stomach it's time to do its job!

■ Neural:

- Vagal discharge as it secretes GRP at the postganglionic fibres.

Both sympathetic and parasympathetic fibres in gut are stimulatory (dual ANS stimulation).. What can we do about it?

■ Bloodborne:

- Epinephrine

- Ca2+

Calcium is a universal stimulant of motility and exocytosis from glands; epinephrine = dual ans stimultion.

Factors that decrease secretion of gastrin:

■ Luminal:

- Acid

- Somatostatin

Acid tells the G cell to shut up. There's enough acidity. No need for stomach to yap.

Somatostatin keeps all other hormones in check!

■ Bloodborne:

- Secretin family (Secretin, VIP, GIP, glucagon) (archnemesis)

Applied aspects of Gastrin:
■ Normal S. Gastrin levels = upto 100pg/ml
■ Hypergastrinemia:
- Pathological Increase (eg. Gastrin secreting tumor)
- Compensatory Increase (eg. Pernicious Anemia i.e. Type A Gastritis; due to destruction of    acid secreting cells compensation with increased  gastrin.)
■ Hypogastrinemia:
- Antral loss eg. Antrectomy, Achlorhydria.
- H pylori associated ulcers/gastritis may show hypogastrinemia, but association is not very clearly established. 

My next post will be on Zollinger Ellison Syndrome.  Excited? :D I know I am 😎

Hope you guys like it. 

~ A. P. Burkholderia

Strongyloides Stercaralis Notes And Mnemonics

Hey everyone!
These are microbiology  notes made by me =) Hope it helps you ☺