Mini Q&A for the day!
What is the drug of choice for Listeria monocytogenes meningitis?
Ampicillin.
What is the drug of choice for penicillin allergic patients?
TMP SMX for penicillin allergic patients.
What drugs do you use empirically for treatment of meningitis? When do you use ampicillin?
Ceftriaxone
Vancomycin
Add ampicillin for Listeria monocytogenes (Especially in elderly, neonate, immunocompromised.)
Why is cefotaxime preferred over ceftriaxone in neonates and patient with liver disease?
Ceftriaxone-induced biliary sludge is a solubility problem that occurs in patients receiving high-dose treatment (greater than or equal to 2 g).
The risk of developing ceftriaxone-associated biliary "pseudolithiasis" increases with increasing ceftriaxone dose and in patients with impaired gallbladder emptying.
Cefotaxime has renal excretion and therefore preferred over ceftriaxone.
Angiotensin converting enzyme inhibitors (ACEI) are contraindicated in bilateral renal artery stenosis. Why?
In renal artery stenosis, renal perfusion is less and hence GFR is low. In such a case, nephrons adapt the filtration by causing efferent arteriolar constriction to maintain the pressure needed for filtration.
If ACEI is given, there is dilation of efferent arteriole and renal perfusion will again decrease further and GFR will become more low. Hence, contraindicated.
In bilateral renal stenosis, the effective renal blood flow is not significantly reduced but maintained at the cost of increasing the efferent artery tone. ACEI causes inhibition of angiotensin 2, leading to efferent artery vasodilation in glomerulus. This decreases intra glomerular pressure and filtration, resulting in renal function detoriation.
Q&A for the day!
Most common cause of bacterial endocarditis:
After tooth extraction -
Injection drug use -
Health care / catheter associated -
Originates from GI tract -
After genitourinary manipulation -
Answers:
After tooth extraction - Streptococcus viridans
Injection drug use - Staphylococcus aureus (Less common - Pseudomonas aeruginosa, Candida species)
Health care / catheter associated - S. aureus (Also Coagulase negative staphylococci CoNS)
Originates from GI tract - S. gallolyticus (Formerly known as Streptococcus bovis)
After genitourinary manipulation - Enterococci
That's all!
-IkaN
What a great day to study today!
In this post, I uploaded my notes on corticosteroids side effects mnemonics.
Hope you find it helpful.
That's all!
- शुभम् पाटीदार mbbs 013 बेच।
From the authors diary:
I created this image for Jason Compton. Last year, they did a play on Beta Blockers at RhinoFest and used one of my illustrations for it. Even though I couldn't attend it, I'm always glad to be a part of being a fun way of information spreading!
This year, they're doing a family (multi-generational) theme and educating about genetics, inherited traits, etc.
I created this fun image for them.
Parents "hand me down" their clothes (jeans) and genes! The blue and yellow DNA mix to form different shades of green in the children.
I hope you like this illustration and all the very best for your play! =)
-IkaN
So I thought of writing a few posts on questions that were asked to me in my vivas. You may not be asked the same questions, but these are just for you to get an idea on how it goes (:
What is the difference between orthopnea and paroxysmal nocturnal dyspnoea?
Orthopnea is dyspnea in the recumbent position.
PND is acute shortness of breath and cough, usually occurring after 1-3 hours of sleep.
Orthopnea is relieved by sitting upright, PND persists even after assuming the upright position.
Where will you check for edema in a bed ridden patient?
In the sacral area or in the scrotum.
(In ambulatory patients, check in the ankles and pretibial region.)
That's all!
I'll keep updating as and when I remember =)
-IkaN
