Thursday, August 31, 2017
Wednesday, August 30, 2017
Tuesday, August 29, 2017
Saturday, August 26, 2017
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
Lets begin.
Chemicals derived from opium or related to morphine chemically are called opiates.
1) Natural opium alkaloids
- Morphine, Codeine.
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.
A) Partial agonist at mu receptor.
B) 1/10th analgesic of morphine and less efficacious.
Diacetyl morphine(Heroine), Pholcodine, Ethylmorphine.
Dextromethopran is devoid of constipating action.
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
A) Causes truncal rigidity due action on mu receptor.
B) Can be given as transdermal patch and as well as buccal transmucosal
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
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.
Friday, August 25, 2017
MIL: Rhabdomyosarcoma of the Right Eye
Introducing Medicowesome Image Library (MIL)
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
Here's a quick post of treatment of "strep throat" (my slang for "Tonsillopharyngitis due to Streptococcus pyogenes, also known as group A Streptococcus.")
Thursday, August 24, 2017
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
Classification of sedatives & hypnotics + notes for NEET
a) No antidote.Poisoning treated by gastric lavage, symptomatic treatment and forced alkaline diuresis
b) Steep curve dose.
c) Inhibits all areas of CNS. Most sensitive is reticular system
d) It inhibits all areas of CNS. Mostly reticular system which leads to inability to maintain wakefullness.
e) May cause "Hyperalgesia".
f) Duration of REM sleep and stage 3, 4 of sleep cycle decreases
g) Contraindictated in acute intermittent porphyria
i) Hangover is common
Barbiturates are further classified into three types.
A) Long acting
Phenobarbitone.
Butobarbitone
Pentobarbitone.
Thiopentone.
Methohexitone.
a) Antidote:Flumazenil is competitive antagonist. It takes 30-60 minutes for its action.
b) Flat dose curve.
c) Duration of REM sleep decreases but frequency increases.
d) Hangover less common
They are further classified into three categories
-Flurazepam :Paradoxical simulation and increase nightmare
-Nitrazepam:Increase REM sleep (Rest decreases)
-Temazepam
-Flunitrazepam : Tasteless BZD called as "
" Date rape drug"
-Midazolam:Causes blackouts and ataxia.
-Alprazolam
-Triazolam:Responsible for paranoia and other psychiatric disturbances.
-Lorazepam:Absorption from intramuscular site is regular for other drugs its irregular.
-Alprazolam
-Chlordiazepoxide.
-Diazepam.
-Lorazepam
-Clonazepam
-Clobazam
E=Estazolam
T=Temazepam
L=Lorazepam
O=Oxazepam
T=Triazolam
c) Less rebound insomnia and hangover.
b) Active metabolite is eszopiclone.
a) Lacks anti-anxiety, muscle relaxants, and anti-convulsants actions.
b) Use in short term treatment of insomnia.
c) No rebound insomnia and hangover.
a) Decreases sleep latency without affecting sleep time.
a) Its is Orexin antagonist. Orexin is wake-fullness receptor.
Wednesday, August 23, 2017
Tuesday, August 22, 2017
Image Based MCQ on Instruments
Hello awesomites!
Yesterday we posted an Image based MCQ on Instruments and here is the answer to the question.
#Image_based
#Instruments
Q. What is the inner diameter of the device shown in the picture if it is to be used in adults?
B. 8-9 mm
C. 12-15 mm
D. 21-23 mm
The correct answer is B. 8-9 mm. The image given shows an Endotracheal tube that is available in different sizes for different age groups.
Internal diameter 3mm - 6mm is used for Paediatric cases.
Typically, an 8.0 or 8.5 mm for adult men and 7.5 to 8.0 mm for adult women is an ideal choice.
Monday, August 21, 2017
Cushing Vs Curling Ulcer
Hello!
Its time to differentiate between two confusing ulcers - Cushing and Curling.
What is Cushing Reflex?
It is a triad of Bradycardia, Hypertension and altered respiration following Head injury.
What is Cushing Ulcer?
Stress Ulcer following Head injury.
Most common site - Acid producing area of Stomach.
What is Curling Ulcer?
Stress Ulcer following Burn.
Thomas Blizzard Curling.
Reduced plasma volume leads to ischemia and cell necrosis of the mucosa.
Most common site - 1st part of Duodenum.
cURling = bURn
This may help you to remember the difference between these two.
Thanks
MD Mobarak Hussain (Maahii)
Latanoprost and Pilocarpine never go together
Latanoprost increases the uveoscleral outflow of the aqueous humor. Pilocarpine has a constrictive effect on the ciliary body as a whole. Hence, when the two are used together, their effects end up getting nullified with the physician bungling to achieve the target IOP.
That's all!
-Sushrut Dongargaonkar