Wednesday, May 3, 2017

Rubeola vs Rubella mnemonic

Hello!

RubeOla - Ordinary measles ( kOplik spots on buccal mucosa are pathognomic )

RuBella ( German measles ) - Well, I remember Bella B. Felsenheimer, a German musician and drummer ( Foschheimer spots on the soft palate are characteristic ).


Thats all
- Jaskunwar Singh

Torres bodies mnemonic

Okay, to be honest this one is not quite a very good mnemonic but I like to remember Torres bodies in yellow fever by the footballer Fernando Torres wearing his club jersey in yellow color, even if he doesn't. Well, yeah, that's about it! :-p

-Sushrut Dongargaonkar


Tuesday, May 2, 2017

Diagnostic Enzymes in Myocardial Infarction

   
Hello Everyone,

Here’s a quick mnemonic on Sequence of elevated enzymes in myocardial infarction. I got it from https://imgusmlestep1.blogspot.in. Originally it was  like this Time to CALL 911. I have modified it. It goes like this
                             Time to CALL 12 24 30 48.
The numbers represent time of peak elevation of the enzymes.
Sequence of elevated enzymes are:
        Troponin: Cardiac Troponin I and Cardiac Troponin C (12 hours)
        Creatine Phosphokinase (MB) (24 hrs)
        Aspartate Transaminase (30 hrs)
        Lactate Dehydrogenase 1 (48 hrs) 

Important Facts:

Cardiac troponin I (cTnI) is highly sensitive and specific for damage to cardiac tissue. cTnI appears in plasma within 4–6 hours after an MI, peaks in 8–28 hours, and remains elevated for 3–10 days.Elevated cTns, in combination with the clinical presentation and characteristic changes in the electrocardiogram, are currently considered the “gold standard” in the diagnosis of a MI.

Creatine Phosphokinase (MB):Appearance of this hybrid isoenzyme in plasma is virtually specific for infarction of the myocardium .Following an acute MI, CK2 appears approximately 4–8 hours following onset of chest pain, reaches a peak of activity at approximately 24 hours, and returns to baseline after 48–72 hours.

A quick comparison between Cardiac troponin and Creatine Phosphokinase:

Troponin is more sensitive than CK-MB because more troponin is found in the heart per gram of myocardium and that a greater percentage depleted from the heart by cardiac injury arrives in the blood 

With regard to specificity, troponin elevations are almost always specific for cardiac injury, except for the infrequent analytical false positives caused by fibrin interference and/or cross-reacting antibodies. CK-MB is not specific for cardiac injury, as a small amount is found in skeletal muscle.

I am very thankful to IkaN for helping me with Troponin and CK-MB.  :)


Thats all,
Thank you
Chaitanya Inge  

Drugs that prolong QT interval mnemonic

Hello!

Here are drugs that can prolong QT interval and cause Torsades de Pointes! The mnemonic is TOOOOORSADES!

Cerebral ring enhancing lesions Mnemonic


Cerebral Ring enhancing lesions are a common finding in MRI based questions asked in the boards. ;)

The mnemonic to help you remember it is: Suppose there is a Dr Grams who is missing his wedding ring and is searching for it fervently. So if you're doing an MRI and you see a ring what should you do?

CAL DR GRAMS

C- Contusion
A- Abscess
L- Lymphoma

D- Demyelinating disease
R- Radiation necrosis

G- Glioblastoma
R- Resolving Haematoma
A- Abscess
M- Metastatic lesion
S- Subacute infarct

Here's a mnemonic submitted by Jaskunwar Singh. It includes Tuberculosis and toxoplasmosis!

CAL DR SMART

C - Contusions
A - Abscess
L - Lymphoma

D - Demyelinating diseases
R - Radiation necrosis

S - Subacute infarct
M - Malignancy / Metastatic lesions
A - AIDS
R - Resolving haematoma
T - Toxoplasmosis / TB

I assume that everybody knows about toxoplasmosis and tuberculosis so I didn't include them in my mnemonic. Use the mnemonic that suits you =)

That's all :)

-VM

Study group discussion: A mnemonic for yawning? (pandiculation)

Hello!

Pandiculation definition: A stretching and stiffening of the trunk and extremities, as when fatigued and drowsy or on waking, often accompanied by yawning. 

Here's a study group discussion xD

Medicowesome secret project: Segregation of waste and recycling

Monday, May 1, 2017

Vitamin B3 and pellagra mnemonics

Hello!

This post is all about niacin aka vitamin B3 and it's deficiency with loads of mnemonics. Who is excited?

1. How to remember Niacin is vitamin B3:

- You can remember the three vowels in nIAcIn, so it's vitamin B three.
- N has 3 strokes, so Niacin is B3
- NIA - B3

2. Vitamin B3 deficiency, Pellagra, is clinically manifested by photosensitive dermatitis, diarrhea, dementia.

Pellagra mnemonic:
"B3 causes D3"
Diarrhea, Dermatitis, Dementia.

3. Pellagra tends to occur in areas where people eat maize (or corn, the only grain low in digestible niacin) as a staple food.

Mnemonic: Corny people can't be nice. (Corn can't have niacin)

People - Pellagra. PP!

Corny people can't be nice and amazing! Get it? A-maize-ing! Hahahahha! I'm so pun-ny and funny!

4. The amino acid tryptophan is needed to make niacin, serotonin and melatonin.
Mnemonic: Have a nice trip to serotonin land (Serotonin rhymes with Melatonin).

Why is this fact clinically significant?
Carcinoid syndrome leads to excess production of serotonin, which depletes  tryptophan. There's not enough tryptophan to produce niacin, resulting in pellagra.

5. Isoniazid (INH) use can cause vitamin B3.

Mnemonic: INH has 3 letters. B3 deficiency!
Also, isoNIAzid. For NIAcin deficiency.

6. Lastly, you should know about Hartnups disease which is due to defective neutral amino acid transporter on renal and intestinal epithelial cells 

Here's a mnemonic by usmle1mikmonics:
HARTNUP Disease
Hartnup
Aminoaciduria
Renal (also intestinal) / Recessive
Transporter defect / Tryptophan deficiency
Neutral amino acids / Niacin deficiency / Nicotinamide supplements (Treatment)
Urine (Tryptophan lost in urine)
Pellagra / high Protein diet (Treatment)
D’s - Dermatitis, Dementia, Diarrhea

That's all!
-IkaN

Anterior Abdominal Wall : Mnemonics

Hi everyone. So I've just started Surgery and it makes me go back to Anatomy. A lot.
Here are some helpful Mnemonics on the Anterior abdominal wall

The External Oblique muscle is the SIR of  all muscles.
It's the SIR of all muscles.
Hence , This SIR forms the Superficial Inguinal Ring.
Because it's the SIR , it forms the Sir of all ligaments too - the Inguinal Ligament.

The Fascia Transversalis is a scary thing. Whenever I see it , I get DAR. ( Dar is the Hindi word for Fear)
So I get DIR when I look at it. :P
And hence the Deep Inguinal Ring is in the Fascia Transversalis.
Since this is such a scary muscle , the important artery Inferior Epigastric Pierces this muscle. Making it more DIR-avna.

Finally,
How should one remember the direction of the External and Internal oblique muscles ?
Hands in your pocket is External Oblique.
So medially and downwards.

Hands on the Tits is Internal Oblique.
So medially and upwards.

Hope these help you !
Happy Studying !
Stay aweosme.

~ A.P.Burkholderia

How is Visual Contrast achieved?

Hello everyone,
Let us discuss Visual contrast today. This question has haunted me for a long time.

Let's start with the basics, the cells in various layers of retina and their function.

Here's a quick review of things you have already read:

1. What is photoreceptor?
It is a rod or cone. It detects light.




2. What is horizontal cell?
It is present between rods and cones. It is inhibitory in function. (It is involved in lateral inhibition which we will discuss later!)

3. What is bipolar cell?
It transmits information from photoreceptor to ganglion cells.



Now, lets come to the details.







4. What are metabotropic receptors?

First of all what you must understand is Metabotropic receptors and Inotropic receptors are receptors present on bipolar cells.

They recieve stimulas from photoreceptors (mostly decreased glutamate is the stimulas).

Metabotropic receptors cause depolarisation that is excitation of centre of receptive field of bipolar cells

5.What are inotropic receptors?
They cause inhibition of centre of receptive field i.e. hyperpolarization. (remember, I for Inhibition)


6. Receptive field - What is it?
It is a region of retina where if the light falls it is going to alter the firing of neurons. (By firing I don’t mean guns :P) It means the action potentials generated and transmitted by the photoreceptors. So each cell has a characteristic receptive field. It can be as small as a dot or as large as this page itself. But don't limit this concept to a photoreceptor only. Almost all sensory cells example in somatosensory system or in auditory system possess a receptive field.

Receptive field of a bipolar cell is arranged into a central disk,
the “center” and a concentric ring, the “surround”, each region responding oppositely to light.

Coming to the crux of the topic i.e. Visual Contrast.

How do the things we have discussed so far help us achieve that?

Visual Contrast is achieved by two mechanisms:
1. Lateral Inhibition
2. Excitation of Some Bipolar Cells and Inhibition of Others — The Depolarizing and Hyperpolarizing Bipolar Cells.

1. How does lateral inhibition help?
First: It does not allow the signal to spread through the dendritic and axonic trees. Hence point to point transmission occurs.
Second: The direct and indirect pathways accentuate each other. This can be easily understood. Photoreceptor sends excitatory signals to bipolar cell. But the adjacent photoreceptor sends a inhibitory signal through the horizontal cell. Mostly these two neutralize each other so no net stimulus is transmitted to bipolar cell.
      But If the adjacent cell is  unstimulated by light, It will not inhibit the excitatory signals transmitted by the photoreceptor which is stimulated by light. Hence it will allow excitation of bipolar cell.
This allows extra excitation of bipolar cell. We get a better contrast. The area which is dark remains dark. But the area which is bright becomes even brighter. This is what visual contrast is all about.
The fun part of all this is, a lot of visual illusion make use of this principle. Do google "Simultaneous Contrast"  :) .


2. How do different Bipolar cells help?
Because depolarizing and hyperpolarizing bipolar cells lie immediately against each other, this provides a mechanism for separating contrast borders in the visual image, even when the border lies exactly between two adjacent photoreceptors.
We will take a simple example. Suppose light is striking at periphery of two receptive fields. Remember it is shaped like a disk, with a centre and periphery both opposite in nature.Suppose One is On centre bipolar cell and other is Off centre bipolar cell(On centre: Activated when light hits centre but periphery is inactivated and vice versa for Off centre). So only the Off centre bipolar cell will detect it. Hence mixing up of signals is avoided. Again what I get is a sharper border. That is what contrast is all about.

That is how it is all done.

Interesting fact: The cells in the retina don't follow the "all or none" law. Transmission is by Electrotonic conduction. From ganglionic cell onwards cells  follow all or none law.

Thats all,
Thank you,
Chaitanya Inge

Lewy body dementia mnemonic

Hey there.

Dementia with Lewy Bodies (DLB) is characterized clinically by deficits in attention and visuospatial function; fluctuating cognition; recurrent visual hallucinations; and spontaneous motor features of parkinsonism. Other associated symptoms include repeated falls, syncope, autonomic dysfunction, neuroleptic sensitivity, delusions, hallucinations in other modalities, sleep disorders, and depression.

Here are mnemonics and how I remember these points!

Lewy has halLEWYcinations.
Visual hallucinations are common.

Lewy is slowy.
Slow movements for Parkinson's disease .

Lewy is sleepy.
REM sleep abnormalities like drowsiness.

Lewy is slippy.
DLB is associated with frequent falls.

Lewy is slow-y, sleepy, slippy and sees things (halLEWYcinations)

lEwy also has an E for eosinophilic intracytoplasmic alpha synuclein aggregates.

That's all!
-IkaN

Authors' diary: Jas a year

Hello!

Our admin and author, Jaskunwar Singh, completed 1 year of writing with Medicowesome today :D

Sunday, April 30, 2017