Sunday, January 22, 2017
Klein waardenburg syndrome mnemonic
Acute Post-hemorrhagic anemia
Today I am gonna talk about the Anemias of blood loss, particularly the acute cases of posthemorrhagic anemia.
The Basics- Anaemia
"Anaemia is defined as a decrease in the level of haemoglobin due to loss of a significant amount of red blood cells which decreases the oxygen- transporting capacity of blood."
Saturday, January 21, 2017
Post MI complications mnemonic
Complications due to an attack of myocardial infarction mnemonic: DARTH VADER (I loved his character in Star wars you know :p )
D- Dressler's syndrome
A- Arrhythmia
R- Rupture
T- Tamponade
H- Heart failure
V- Valvular defects
A- Aneurysm
D- Death!
E- Embolism
R- Recurrence
That's all
- Jaskunwar Singh
Cushing's Reflex in Meningitis : Mnemonic and Explanation
Hello everyone !
Another short post on a very important triad. Cushing's!
Cushing's reflex
It occurs in response to raised Intracranial Pressure (ICP/ICT)
Mnemonic :
HIB
H - Hypertension
I - Irregular Breathing
B - Bradycardia
Mechanism :
So just imagine :
Due to some reason you develop an increase in the ICT.
We know that blood flows from High Pressure to Low Pressure. Generally , the CSF pressure is lower than the BP.
However after a point , the ICT is bound to become equal to or even more than the systemic BP!
If that happens , the blood flow to the brain is decreased and the Brain can get ischemic (cause the Cranial pressure would be higher. So the body won't be able to pump the blood into it.)
Thus, in order to compensate for this , the sympathetic system is activated. The body's peripheral vessels undergo constriction to raise the BP. This would keep them at a higher pressure than the Cranium thus keeping the blood flow intact for a while at least. This causes the Systemic Hypertension.
In a way it's the last ditch effort to save the brain!
Due to sympathetic stimulation the respiratory centers get stimulated too and it's all weird so it causes Irregular Respiration.
Now you'd expect Tachycardia when there is so many Sympathetic juices flowing through your body.
But no. Things aren't as simple as that.
The aortic baroreceptors sense the increased BP and end up decreasing the Heart Rate. Resulting in Bradycardia. So in a way that's the 2nd phase of this Reflex!
The Reflex serves as a marker of raised ICT as that is the event that puts the whole cycle into place.
This generally occurs as the body's last resort to restore blood to the brain.
What a wonderful Homeostatic mechanism !!
Hope this helped !
Stay awesome !
Friday, January 20, 2017
Reynolds pentads
Hello readers ! Today's blog is sweet and simple.
RJ -FHC.
R-Right upper quadrant pain .
J-Jaundice .
F-Fever .
H-Hypotension.
C-Confusion .
Neonatal reflexes mnemonic
Here's a mnemonic for the reflexes seen in neonates and infants: GRASPMEN
G- Grasp reflex/ Glabellar tap
R- Rooting reflex (to assist breastfeeding)
A- Automatic walking reflex
S- Suckling reflex (during breastfeeding)
P- Plantar Reflex
M- Moro's reflex
E- Extrusion reflex
N- Neck (tonic reflex)
That's all
- Jaskunwar Singh
Tuberculosis : Ocular Manifestations
This is a short post about the manifestations of Tuberculosis in the eye.
We can classify them as :
1. Disease related.
2. Therapy related.
Eyelid - Lupus Vulgaris. Lid granuloma.
Lacrimal apparatus - TB Dacryoadenitis. Dacryocystitis.
II. Orbit :
Orbital Cellulitis.
Orbital Pseudotumor.
I. Conjunctiva -
Phlyctenular Conjunctivitis - due to hypersensitivity to Tuberculin. Seen as intense itching , discharge , redness and nodules.
Interstitial Keratitis
Granulomatous uveitis ( Chronic anterior Uveitis ). Shows Mutton Fat appearance.
Eale's disease - may be a result of Hypersensitivity to Tuberculin. Although causality is not established clearly.
Sub retinal Tubercles.
Happy studying.
Stay awesome.
~A.P.Burkholderia
Nodule at the Limbus : Mnemonic
Hello everyone !
Here's a way to remember the D/D's of Nodules at the Limbus.
Mnemonic :
Please Please Please ! Eat Spicy MCDonald's Tortilla.
Please - Pterygium.
Please - Pinguecula.
Please - Phlycten.
Eat - Episcleritis.
Spicy - Scleritis.
M - Melanoma.
C - Choristoma
Donald - Dermoid.
Tortilla - Trachoma. Tranta spots.
1. Out of these Pterygium , Pinguecula and Phlyctens are Conjunctival lesions.
Pterygium is a fold of conjunctiva that encroaches towards the pupil.
It can be vascular and nodule like. Can cause Foreign body sensation and decreased vision if it covers the pupil.
It may also cause Diplopia and a Squint due to its traction over the eye.
A pinguecula is milky like nodular swelling of the conjunctiva.
A Phlycten is a lesion in Phlyctenular Conjunctivitis which is an allergic or Hypersensitivity response to Tuberculin or staph Antigens. There is intense itching , discharge and nodules in the eye - called Phlyctens.
2. The lesions of Episcleritis and Scleritis are similar. They're both associated with systemic disease like Rheumatoid Arthritis , SLE, Sarcoidosis etc.
Scleritis is a more severe one of the two. There's marked redness and congestion of the eye along with multiple vascular nodules. The eye is very inflamed. There is intense pain and watering. It needs urgent treatment. It may causes various types of staphylomas.
Episcleritis is a more benign form. There is intense itching , nodular vascularity and discharge with some amount of congestion.
3. Tumors like Choristoma , Dermoid tumor and Melanoma mainly arise from the uvea. They're not very common.
4. Trachoma : presence of lesions in trachoma at the nodule may be prominent. You may also get 'Horner Tranta spots' in Vernal Keratoconjunctivitis which is an allergic Conjunctivitis.
Hope this helped !
Stay awesome !
Happy Studying!
How to check for the Pupils : Clinical Pearl
This is a post about how to look for a normal pupil while doing an ophthalmological examination.
So here goes :
- Relax the Patient
- Take the patient to a semi dark room.
- Make the patient Fixate on a distant point to eliminate any error that Accomodation may produce.
- Place an obstruction between the two eyes.
- Always shine your torch laterally and bring it in only from the sides to avoid light shining directly on the other eye.
Look for the following in the pupils :
- Size
- Shape ( for eg. You may get a Festooned pupil on adding your Mydriasis if the patient has adhesions)
- Number ( for eg. You may get Poly Coria which causes Diplopia )
- Location ( for eg. You may get Corectopia)
- Unless you've met the criteria above ( The setting) , you cannot say 'Direct and indirect reflex present' .
So unless you're in a semi dark room (and the other 3 criteria mentioned above) you would plainly shine the torch and look for constriction. This plainly shows the pupils are reactive to light.
- Check for your direct and consentual (indirect) reflexes in both your eyes after meeting the listed Criteria in the *Setting* !
Happy studying !
Stay aweosme.
Argyll Robertson Pupil : Mnemonic
Hello everyone ! I'm back with a short and sweet post on Argyll Robertson Pupil.
Mnemonic for Argyll Robertson Pupil (ARP) :
ARP Accomodation reflex present
PRA Pupillary reflex absent.
It's seen in conditions like Neurosyphilis for which it is extremely specific.
You could also see it in some form of strokes or Diabetic Neuropathy.
Another similar Pupillary reaction is Aedes pupil. The difference is Aedes is a dilated pupil while Argyll's is constricted. How to remember this ?
Mnemonic : AeDes.
So Aedes is tonically Dilated.
Hope this helped !
Stay aweosme.
Thanks.
Thursday, January 19, 2017
Wednesday, January 18, 2017
Diagnosis of Narcolepsy
Hello friends!!
This is the third one in the four-post series on Narcolepsy. Let's commence.
That's all! Do go through the other posts in this series.
Role of Orexins in Narcolepsy
Clinical features of Narcolepsy
Treatment of Narcolepsy
-VM
Clinical Features of Narcolepsy
Role of Orexins in Narcolepsy
Diagnosis of Narcolepsy
Treatment of Narcolepsy
-VM
Role of Hypocretins/Orexins in Narcolepsy
Hello friends!!
This is the first of the four-post series on Narcolepsy.
So let's start. The hypocretins were thought in the past to regulate feeding behaviour and energy metabolism, the word “orexin” is derived from the Greek word for appetite. But later through animal experimentation it was found that in mice, inactivation of two hypocretin receptors reproduces Narcolepsy.
First of all, let us learn that monoaminergic neuronal projections from Tuberomammilary nucleus(histaminergic), Locus Ceruleus(noradrenergic) and the Raphe nucleus(serotonergic) inhibit the Ventrolateral Preoptic Nucleus(VLPO) of hypothalamus.
Basics of Immunoglobulin G
There are two unique facts about IgG
1)It's catabolism.
2)Suppression of homologus antibody synthesis by a feedback process.
Well we can say body has complete control over the catabolism and to make it simpler let's say body and IgG both acts opposite to each other !.(Just a saying :p,Infact we know IgG works for body).For example In some diseases like chronic malaria ,kala azar or myeloma IgG level rises and as we know body has complete control and it acts against it So, IgG synthesis its gonna catabolised it rapidly !
Conversely,In hypogammaglobulinemia IgG given for treatment is metabolised slowly.
IgG has another unique property of suppressing the antibody synthesis which looks like it or performs similar kind of functions or simply homologus antibody.
Now let's say IgG is quite insecure about its true but dominating love -"Body". It doesn't want any competition so it kicks away all the antibodies which looks like it or perform similar function like him
(Such a insecure antibody it is !)and this unique property is utilised in the Iso-immunisation of a women by administration of anti-Rh(D) IgG during delivery.
It's the only maternal immunoglobulin that is transported across placenta and provides "Natural passive immunity"in new born (Not present in infants )
IgG2=23% (By the way 23 is also half life of IgG)
IgG3=8%
IgG4=4%
Immunohemolytic anemias part-2
Hello readers, here is the continuation of the previous topic, Immunohemolytic anemias. Today we will discuss the next two types, its more like winter special.
B) Cold agglutinin type- Cold agglutinin derives their name from the fact that they show maximal activity at temperature lower than normal body temperature.
It is present in low titres in healthy individuals.
Physiological cold agglutinin develops naturally after birth as a result of change in expression of Red cell antigens and reacts maximally at 4°C.
While pathological cold agglutinin maximally reacts at around 28-31° C and tend to occur at very low titres.
Mnemonic is "Cold MILL"
C - Complement mediated hemolysis.
M - IgM is the causative antibodies
I - Cold agglutinin antibodies appear
transiently following Infections
[Mycoplasma pneumoniae, EBV,
HIV, influenza virus, CMV]
- I antigen is the most common
target
L - Chronic cold agglutinin AIHA is
associated with Lymphoid
neoplasm
(esp B cell neoplasm), leukemias
like CLL
Mechanism- IgM binds to red cell where the temperature may fall below 30°C. It agglutinates red cells, and fixes complement rapidly. As blood recirculates and warms, IgM is released,but sufficient deposition of complements leads to phagocytosis of affected red cells in spleen, liver, bone marrow.
Clinical presentation- Exerts their pathological effects either via hemolysis and red cell destruction in RE system predominantly liver or by vaso occlusion due to agglutination.
-Mild anemia, purplish discoloration of fingers, toes, earlobes [ Acrocyanosis], mild hepatospleenomegaly,
Raynaud phenomenon in peripheral cold exposed parts.
C) Cold hemolysin type -
Also known as paroxysmal cold hemoglobinuria.
It's a rare fatal disorder causing intravascular hemolysis and hemoglobinuria when auto antibodies binds to P blood group antigens in cool, peripheral regions of body.
Paroxysmal Cold HemoGlobinuria:
P- P blood group antigens
C- Complement mediated lysis occurs.
IgGs auto antibodies binds to red cell in
cool peripheral regions, Complement
mediated lysis occurs when affected
red cell recirculates to warm regions,
because complement cascade
functions
more efficiently at 37°C
H- Hemoglobinuria
G - Auto antibodies belong to class IgG
Symptoms of the patients aggravates on exposure to cold.
Winter is coming, we know what's coming with it.
Stay warm :)
Tuesday, January 17, 2017
Immunohemolytic anemias part-1
Hello awesomites!
This is my very first post, so am starting with my favorite subject Hematology.
Today's post is about Immunohemolytic anemias, commonly ignored type of anemia
Also referred as Autoimmune hemolytic anemias(AIHA)
Where antibodies are responsible for premature destruction of red blood cell.
Types- warm antibody type
- cold agglutinin type
- cold hemolysin type
Warm antibody type - It is the most common type of AIHA.
you can remember it by mnemonic
" WARM GRILLED "
W - Warm because, antibodies are active
at 37°C
A - Associated with other Autoimmune
disorders ( secondary causes like
SLE)
R - Red cell hemolysis is mainly
extravascular
M- Moderate spleenomegaly due to
hyperplasia of splenic phagocytes
G- Ig G class - most common causative
antibodies ( IgA sometimes too)
R- Rh blood group antigens are the main
target
I- 50% primary cases are Idiopathic
Secondary causes can be
L- Lymphoid neoplasm
ED- Exposure to Drugs.
Examples - penicillin, cephalosporins, quinidine, methyl dopa etc
Mechanism - A) Antigenic drugs-
Drugs such as penicillin binds to red cell membrane and they are recognized by the antidrug antibody. The antibody either recognizes the drug and bind to it or both drug and membrane protein,ultimately results in hemolysis.
B) Tolerance breaking drugs- In drugs such as methyl dopa, antibodies are formed against red cell antigens particularly Rh antigens.
Stay awesome✌️
Monday, January 16, 2017
Nasal spray that prevents suicide.
0Hello readers! Being in medical field we are quite acquainted with the word "Stress out" .Todays article is just about a simple nasal spray that can prove to be a boon to entire human kind.(I think specially our field ! :p)
Everything in a brain is carried out by special substances called as "Hormones" .Even the simplest change in mood is concerned with hormonal changes.For example in first trimester of pregnency a rapid rise in estrogen and progesterone can cause mood swings in woman.Similary when there is depletion of hormones or its metabolites or less production of hormone this can leads to depression ,low -emotional state ,anxiety etc.Suicide can be triggered by serious illness ,can also be triggered by low self-esteem or emotional pain .
Scientists are developing a nasal spray that can prevent suicides! .This nasal spray consists of Thyrotropin releasing hormone(TRH) also known as thyroliberin . Thyrotropin is actually hormone released by hypothalamus ,it actually stimulate release of thyrotropin and prolactin from anterior pituitary.Recent findings have found out that TRH also shows anti-depressant and anti-suicidal effects.Thus preventing suicidal behaviour and depression.Researchers want to figure out ,a way to deliver it to a brain when it is given through nose .Brain is protected by Blood brain barrier (BBB),which is acting has a hinderence to pass TSH to brain.
Clinically it is related in spinocerebellar degeneration and disturbance of consciousness in humans.Pharmacological form is known as protirelin.
I hope scientists find it soon how to cross BBB :p
Exams are near and I am already freaking out :p
Keep smiling :)
Have a day with high level of TSH in brain :)
~Ojas
Can virus kill cancer cells ?
Hello awesomites !Today's topic is short ,simple and easy to understand.
Cancer is basically a disease where there is abnormal growth of cells in body and sometimes it is also malignant that is ,it can spread from one organ/site to another.These newly formed cells can disturb normal cycle of other cells .When a cell suffers DNA damage from cancer,a virus or radiation a group of protein complex MRN is sent to repair DNA.MRN is protein complex ,it consists of Mre11,
Rad50 and Nbs1 .In eukaryotes initial processing of double strand DNA breaks prior to repair by homologus recombination or by non-homologus joining.
When a DNA virus is present in the cell,MRN instead focuses on removing it.
If both DNA damage & a DNA virus are present in a single cell .The MRN complex is unable to manage both threats at once and ends up ignoring the virus .
These new findings imply that scientist might be able to form a virus that targets and kills only cancer cells.
Keep smiling:)
Good day:)