Medicowesome

Thursday, August 31, 2017

Medicollabowesome: HIV epidemiology

What is Medicollabowesome? How can I collaborate?

USMLE Step 3: CCS pregnancy case checklist

Hello!

Here are things to do for a CCS pregnancy case -

MIL: Lichen Planus

Image: Plaques of Lichen Planus

Submitted by: Dr. Manasi Shirolikar

Immunology question

Hola awesomites!!

So, this is answer of our previous question. Lets have a look into it.

Q1)Which of the following features is not shared between T cells and B cells
a)Antigen specific Receptors
b)Class 1 MHC expression
c)Positive selection during development
d)All of the above

Answer is
C) Positive selection during development

Explanation:

Positive selection:
Site is thymic cortex.
-T cells having affinity for MHC molecules are selected since T cells having affinity for MHC molecules can interect with APC and one who don't have recognisation is killed

Negative selection:
Site:Thymic medulla
Selected T cells are sent to medulla,where there affinity for self antigens are tested.If the have affinity they are programmed to death.

Incase of B cells,if they recognize self antigens they do not undergo death instead there receptors are changed by the process called as "Receptor editing" .If receptor editing dose not take place,then apoptosis takes place.This is negative selection of immature B cells. B cells negative selection occurs in the bone marrow

Both T-cell and B-cell have TCRs and BCRs respectively.
Class I MHC is expressed on both T cells and B cells..

Stay awesome:)

~Ojas

Opioids analgesics classification + NEET notes

Hello awesomites so here is my " Single page notes" on opioid analgesics.
Lets begin.

Let us know the difference between opiates and opioids.

Chemicals derived from opium or related to morphine chemically are called opiates.

And those having morphine like structures, irrespective of chemical action are called as opioids.

Opioid analgesics are classified as follow

1) Natural opium alkaloids

- Morphine, Codeine.

Morphine
A) Acts on Mu(Causes dependency-Euphoria) , kappa(Dysphoria - Psychomimetic) and delta receptors as agonist. Hence used as supraspinal and Spinal analgesic.
B) Treatment of poisoning: Naloxone 0.4-0.8 mg i.v. repeatedly for 2-3 minutes.
C) Can be administered through oral, rectal, i.m, i.v, intrathecal, epidural routes. Used as preanaesthetic medications
D) Useful in MI and acute pulmonary edema(Both by i.v. route)
E) Contraindicated in head injury, hypothyroidism patient, pregnancy.

Codeine.
A) Partial agonist at mu receptor.
B) 1/10th analgesic of morphine and less efficacious.

2)Semi-syntheic opioids :

Diacetyl morphine(Heroine), Pholcodine, Ethylmorphine.

Heroine:Three time more potent than morphine.

Codeine, pholcodeine, dextromethopran and noscapine are cough suppresants.
Dextromethopran is devoid of constipating action.

3) Synthetic opioids:

-Pethidine(Meperidine):
A) To control shivering after anesthesia
B) Used during labour as analgesic
C) Safer in asthma.
D) Pethidine and pentazosin both are anticholinergics. Hence they causes tachycardia. Perhaps, they are contraindicated in MI but useful in biliary colic

-Fentanyl:

A) Causes truncal rigidity due action on mu receptor.
B) Can be given as transdermal patch and as well as buccal transmucosal

-Methadone

A) Agonist action on mu receptor + blocks NMDA reuptake of monoamines and hence useful in neuropathic and cancer pain (Not controlled by morphine)
B) Can be given by oral, rectal, i.v, s.c, routes.
C) Long plasma half-life hence less dependency and tolerance. Therefore used as maintenance therapy in opioid dependency

-Dextropropoxyphene

A) At high doses it causes seizures.

-Tramadol

A) It is a weak mu receptor agonist and decrease reuptake of NA and 5-HT hence used as analgesia. This is abolished by Ondasteron.

By ojas

Friday, August 25, 2017

MIL: Impetigo

Image: Impetigo contagiosa

Submitted by: Sagar

MIL: Polar cataract

Image: Polar cataract

Submitted by: Sushrut

MIL: Rhabdomyosarcoma of the Right Eye

Image: Rhabdomyosarcoma of the Right Eye

Submitted by: Does not wish to reveal identity

MIL: Psoriasis

Image: Plaques of psoriasis

Submitted by: Dr. Manasi Shirolikar

Introducing Medicowesome Image Library (MIL)

Hello everyone!

I wish to create a visual learning experience by adding images and videos along with what we write.

But since most images on Google have copyright issues, the Medicowesome authors can't use them :(

That is why, I'm asking medical students, residents and acquaintances to send me images of what they see to help create the Medicowesome Image Library (MIL).

It can be anything - a histology slide, a microbiology agar, a pathology specimen, a rash, an instrument, an x-ray - anything!

Treatment of streptococcal tonsillopharyngitis: Important points for USMLE

Hello!

Here's a quick post of treatment of "strep throat" (my slang for "Tonsillopharyngitis due to Streptococcus pyogenes, also known as group A Streptococcus.")

Question on sedative-hypnotics

Hello awesomites! Let us discuss about our previous question.

Question) Which of the following statement(s) is/are true regarding benzodiazepines?
A) It acts as GABA agonist
B) Diazepam is a short acting benzodiazepine
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver
E) Diazepam has higher abuse potential than midazolam
#Pharmacology
#Medicowesome

So here is answer of our previous pharmacology question
Correct answer is C and D.
C) Diazepam causes lesser respiratory depression than midazolam
D) Nitrazepam is metabolized in liver.

Explanation:
BZDs has facilitatory action. They are not a GABA agonist.
Diazepam has rapid onset of action but prolonged action due to formation of active metabolite.
BZDs like nitrazepam, flurazepam etc are metabolised in liver by dealkylation and hydroxylation.
The dependence producing liability of BZD is low. They are Infrequently used now.

-Ojas

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