Tuesday, September 18, 2018
Modified Allen test
Thursday, September 13, 2018
Question: Chicken pox
#Microbiology
#PSM
2) SAR is 90%
3) Superficial rash
4) Single stage of rash
Tuesday, September 11, 2018
Question: Squint manifestations
#Ophthalmology
1) Left superior oblique
2) Left inferior oblique
3) Right superior oblique
4) Right inferior oblique
We have one last finding and that is patient's head is tilted towards right. Remember that this is compensatory method of patient for avoiding diplopia which actually suggests that patient is experiencing diplopia maximum when head is tilted towards left.
So in our last step we will be using clue as head tilted towards left! (Remember we go to maximum diplopia.)
So, this time hold your pencil in the centre of our clinical diagram and tilt it towards left. Obviously do this for both eyes individually. Simply like this
Monday, September 10, 2018
Transcription : A mnemonic to remember the RNA Polymerases
Here's a short mnemonic post for you!
Transcription is the process by which the DNA is converted into an RNA transcript ( Literally - the DNA is transcribed or written out as an RNA sequence).
The key enzyme needed for this process is RNA Polymerase.
In Eukaryotes , there are 3 different RNA Polymerases subtypes depending on which RNA they help code for.
We know that Ribo Nucleic Acids or RNA can be mRNA - Messenger RNA , tRNA or Transfer RNA , rRNA - Ribsomal RNA or one of the small nuclear RNAs - micro RNA - miRNA / siRNA.
Here's a mnemonic to memorize which RNA Polymerase codes for which of these -
Mnemonic - R MIS T5 (Read as R Mistify)
RNA Polymerase I = rRNA
RNA Polymerase II = mRNA, miRNAs , siRNAs
RNA Polymerase III = tRNA , 5S rRNA
This form of RNA specificity is not found on the Prokaryotes - and they have just one RNA Polymerase that bears it all , for all types of RNA !
This has been a quick summary of transcription and a helpful mnemonic for you!
Hope was helpful.
Stay awesome !
Happy Studying!
~ A.P.Burkholderia
Question: Dengue and eye
#Medicowesome
#Ophthalmology
Q) In Dengue, all are seen w.r.t eye except:-
1) Cataract
2) Optic neuritis
3) Vitreous hemorrhage
4) Maculopathy
So, you basically cannot solve above problem if you don't know which portion dengue affects in eye.
Dengue affects posterior portion of the eye. So accordingly answer is
Cataract-Option 1
Some basics to cover over here.
Eyeball is divided into two segments or portion.
Anterior segment: Cornea to lens.
Volume - 0.31mL of Aqueous humor.
Posterior segment: Lens to retina.
Volume - 4mL of Vitreous humor.
Anterior segment is divided into two parts:-
Anterior chamber: Cornea to iris.
Volume- 0.25mL of Aqueous humor
Posterior chamber: Iris to lens.
Volume- 0.06mL of Aqueous humor
-Demotional bloke.
Friday, September 7, 2018
Question: Diabetic 3rd nerve palsy
Question:
In Diabetic 3rd nerve palsy all are seen except
A) Pupil dilation
B) Outward and downward gaze
C) Ptosis
D) Impaired pupillary reflex
Let us start with the basic.
Mnemonic for extraocular muscles nerve supply
LR6 SO4 Rest3
Lateral rectus is supplied by 6th nerve or abducence nerve and superior oblique by 4th nerve or trochlear nerve and rest all muscles including LPS are supplied by 3rd muscle or occulomotor nerve.
In pupillary reflex,
Afferent nerve: Optic nerve
Efferent nerve: Occulomotor nerve.
So in case of 3rd nerve palsy, we will have less or no actions of all EOM except lateral rectus and superior oblique.
So we will have downward gaze (due to superior oblique) and outward gaze (due to lateral rectus) and Ptosis (because LPS is supplied by 3rd nerve! ).
Pupillary reflex is also disturbed so option 4 is also ruled out.
Here is a trick in this question. In DM and HTN, microangiopathy is seen due to which central fibers are affected.
Central part do not contribute to pupillary reflex.
This leads to no pupil dilation. In case of surgical conditions and trauma, peripheral fibers are affected which causes impaired pupillary reflex or pupil dilation.
-Demotional bloke.
Monday, September 3, 2018
Apgar score in preterm infants
This score tells you about the well being by evaluating cardiac,respiratory and nervous system of a newborn.
May be in future new components will be added to use this score in evaluation of preterm infants.
Thursday, August 30, 2018
Timeline in Psychiatry
1. Clinical presentation
2. Time
This post enlists how to make a psychiatric diagnosis in time.
Author's note: This blogpost is intended for an audience having a foundation knowledge of the subject.
It does not explain any concept or review any literature, instead serves as a quick cheat sheet for timeline required to make a psychiatric diagnosis.
[Kindly click on the image to view the table clearly]
Happy studying!
-- Ashish Singh
Wednesday, August 29, 2018
Hering's law of equal innervation
Similarly, Left IO is responsible for elevating left eye to right side.
This is Hering's law of equal innervation.
S (Superior) gets converted to I (Inferior)
O (Oblique) gets converted to R (Rectus)
R gets converted to O.
S gets converted to I.
Movements of eye muscles.
Actions are divided into three types Primary, secondary and tertiary.
1) Through diagram.
2) Trick: Recti muscles are adductors
1) Diagram off course!
2) Trick: Superior muscles are Intorters and inferior muscles are extorters.
Tuesday, August 7, 2018
Warfarin and Newer Oral Anticoagulants (NOACs) notes
These are my notes from Harrison on Warfarin and Newer Oral Anticoagulants (NOACs).
Friday, August 3, 2018
Stop Antibiotic Abuse!
Hello Everyone,
It's been really long since the last post! Well it's been hectic all the way to and through residency.
I was recently researching on the topic of antibiotics while I stumbled upon this excellent piece of information cum approach by Dr.Strong on starting Anbiotics.
Well everyone should ask themselves these 12 questions before starting any antibiotic for one's patient and trust me you'll end up choosing the most appropriate one.
This is how we don't contribute to the Antibuse- "Antibiotic Abuse"( my personal neologism)
So now coming back to the questions, ask yourself these questions before you start any antibiotics,
1) What condition is being treated?
2) What are the commonly known bacterial species causing that condition?
3) Which antibiotic group is typically active against those?
4) What are the local resistance patterns for the chose antibiotic?
5)Will there be adequate organ penetration?
6) What is the preferred route of administration?
7)Any specific contraindication of the antibiotic to look out for?
8) Any required dose adjustment for coexisting renal or hepatic diseases?
9) Any specific drug interactions to be considered?
10) When on therapy anything that needs periodic monitoring?
11) How can the therapy be narrowed once bacterial sensitivities are available?
12) What will be the anticipated duration of the therapy?
Let's take a step towards stopping the rampant Antibuse.
That's all for now.
Let's learn Together!
-Medha Vyas.
Thursday, August 2, 2018
Ring-enhancing lesion in an immunocompromised host
If it is a ring-enhancing lesion in an immunocompromised host, the most commonly seen etiologies are Cerebral toxoplasmosis (50%) and Primary central nervous system (CNS) lymphoma (30%).
But let's talk about the uncommon etiologies -
ECG quiz: ST elevation in aVR and ST depression in other leads
Sunday, July 29, 2018
Trapezius and pericarditis.
Patient explains you that the pain is radiating and he is eventually experiencing pain in to the back of this some muscle. You find out that he is pointing towards the "Trapezius muscle" .
but it never radiates to trapezius.
Upper part is supplied by the spinal accessory nerve.
Lower part is supplied by the nerves from C3 and C4 only.
Wednesday, July 18, 2018
Can you find Asterixis in Non-Hepatic disorders?
Upasana Y. :)
Thursday, July 12, 2018
Authors' diary: Ponder
Before you get a CT scan on the patient in the ER, stop and think - does the patient really need a CT scan? Will it get me the answers I'm looking for? Or will I need additional testing? Think of the harms of radiation exposure. Unless you don't want to rule out a hemorrhage that requires immediate intervention, do not order it STAT.
Tuesday, July 3, 2018
Dentinoenamel Junction
- DEJ appears as a scalloped line.
- The convexities of scallop are directed towards the dentine
- The surface of dentine appears pitted
- DEJ provides strength to the union between enamel and dentin
- Prevents shearing of enamel when functioning.
- Scalloping of the junction is seen more in the occlusal portion where masticatory stresses are high.
Enamel Lamellae
Sometimes, they penetrate towards DEJ
They consist of organic material but with a little amount of mineral content.
Types of enamel lamellae:
- Type A: Lamelle composed of poorly calcified rod segments
- Type B: Lamelle consists of degenerated cells
- Type C: Lamelle arising in erupted teeth where cracks are filled with organic material, originating from saliva
Type A is restricted to enamel
Type B and C are restricted to dentine
Clinical Significance:
- It is a site of weakness in a tooth.
- It forms a road of entry for bacteria to initiate caries.
Hunter-Schrengar bands
These bands are the functional adaptation to occlusal masticatory forces.
Alternating, light and dark bands of varying width that can be seen in longitudinal cross-section under the obliquely reflected light.
Dark bands: Parazones
Light Bands: Diazones
The angle between the bands is 40 degrees
- Written by Anisha Valli
Zone Of Weil
- Its a layer of 40um.
- It is also known as the sub-odontoblastic layer.
- It doesn't consist of cells.
- This zone is prominently seen in the coronal pulp.
- Cell-free zone decreases in size when dentin formation occurs at a rapid rate.
- The cell-free zone consists of a network of nerve fibres which lost their myelin sheath. This is known as Plexus of Rashkow.