Hi!
Extra- articular manifestations of Rheumatoid arthritis :
( mnemonic - NOVELA is FrickiN' Hot! )
Monday, November 11, 2019
Sunday, November 10, 2019
Multiple Myeloma notes and mnemonics
Hi!
Multiple myeloma - everything P
Multiple myeloma - everything P
- malignant Proliferation of Plasma cells derived from a single clone.
- Immunoglobulin produced is a "ParaProtein" (M- protein)
- POEMS syndrome
BONE MARROW INVOLVEMENT
- Pancytopenia
PERIPHERAL BLOOD
- plasma cell leukemia ( greater than 2,000 per mm3 )
BONE INVOLVEMENT
- punched-out lesions in radiographs of flat bones
- bone pain
- pathological fractures
RENAL INVOLVEMENT
- Bence -Jones proteinuria
- production of excess Amyloid protein
- hyPer- calci -emia and -uria
These three result in renal damage and renal failure.
IMMUNE SYSTEM INVOLVEMENT
- prone to infections, particularly in respiratory and urinary tract.
HYPERVISCOSITY SYNDROME
( mnemonic - HPRVSCST )
- Headache
- Postural hypotension
- Retinal venous congestion
- Vertigo
- Strain (blurred vision)
- Congestive cardiac failure
- subtype IgA
- nysTagmus
CLOTTING PROBLEMS
- purpura
- profuse bleeding ( epistaxis, gastrointestinal )
NEUROLOGICAL MANIFESTATIONS
- peripheral neuropathy
- compressive myopathy
- carpal tunnel syndrome ( nerve entrapment)
- Amyloidosis.
SERUM STUDIES
- total serum protein raised
- low albumin
- high globulin ( decreased A:G ratio )
- high beta-2 microglobulin ( greater than 5.5 mg/dL means poor prognosis; stage III)
Plasmacytomas in Paraskeletal soft tissues - poor prognosis; treated by palliative radiotherapy.
That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh
That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh
Saturday, November 9, 2019
How to calculate SVR and PVR using Ohm's law
Hi!
Ohms law: Current (I) equals the voltage difference (ΔV) divided by resistance (R)
Simplified, V=IR
In hemodynamics, what is voltage difference? The pressure difference or pressure gradient! (ΔP)
Ohms law: Current (I) equals the voltage difference (ΔV) divided by resistance (R)
Simplified, V=IR
In hemodynamics, what is voltage difference? The pressure difference or pressure gradient! (ΔP)
Friday, November 8, 2019
Drugs causing Thrombocytopenia mnemonic
Hi!
Drugs inhibiting platelet function/ causing Thrombocytopenia :-
ABCDE - HI
Monday, November 4, 2019
Sunday, November 3, 2019
Urinary neutrophil gelatinase-associated lipocalin (NGAL)
Neutrophil gelatinase-associated lipocalin (NGAL) is an iron-transporting protein.
Saturday, November 2, 2019
Pulmonary hypertension notes
Hi!
Pulmonary hypertension (PH) is defined as a resting mean pulmonary artery pressure of 25 mm Hg or greater measured during right heart catheterization.
(How I remember the number 25 - PH: 2 letters, Hyper: 5 letters).
Classification of Pulmonary Hypertension mnemonic
"A heart lung chronic thrombotic unclarity"
1: pulmonary Arterial hypertension
2: PH due to left-sided heart disease
3: PH due to lung diseases and/or hypoxia
4: Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5: PH with unclear or multifactorial causes
The transpulmonary pressure gradient (TPG): The difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (LAP, commonly estimated by pulmonary capillary wedge pressure PCWP).
A TPG of >12 mmHg would result in a diagnosis of “out of proportion” pulmonary hypertension - suggesting intrinsic pulmonary vascular disease in patients with left-heart conditions associated with increased pulmonary venous pressure.
Will update post as I learn more...
Pulmonary hypertension (PH) is defined as a resting mean pulmonary artery pressure of 25 mm Hg or greater measured during right heart catheterization.
(How I remember the number 25 - PH: 2 letters, Hyper: 5 letters).
Classification of Pulmonary Hypertension mnemonic
"A heart lung chronic thrombotic unclarity"
1: pulmonary Arterial hypertension
2: PH due to left-sided heart disease
3: PH due to lung diseases and/or hypoxia
4: Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5: PH with unclear or multifactorial causes
The transpulmonary pressure gradient (TPG): The difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (LAP, commonly estimated by pulmonary capillary wedge pressure PCWP).
A TPG of >12 mmHg would result in a diagnosis of “out of proportion” pulmonary hypertension - suggesting intrinsic pulmonary vascular disease in patients with left-heart conditions associated with increased pulmonary venous pressure.
Will update post as I learn more...
-IkaN
Platypnea-Orthodeoxia Syndrome in interatrial right-to-left shunt
Hi everyone! This is a short post :)
Platypnea (flat breathing): Dyspnea induced by upright posture and relieved by recumbency.
Orthodeoxia: Arterial oxygen desaturation accentuated by upright posture and improved by recumbency.
Platypnea (flat breathing): Dyspnea induced by upright posture and relieved by recumbency.
Orthodeoxia: Arterial oxygen desaturation accentuated by upright posture and improved by recumbency.
Wednesday, October 30, 2019
Post-LP Headache
Hey guys!
Here's all you need to you know about that nasty headache some patients get, after a lumbar puncture (LP).
How common?
Up to one-thirds of all cases.
What are the risk factors?
None. Despite years of anecdotal advice to the contrary, none of the following has ever been scientifically shown to be a risk factor: position during or after the procedure; hydration status before, during or after; amount of CSF removed; immediate activity or rest post-LP.
When does it happen?
Within 24 hours of LP.
How does it present?
Let's SOCRATES the pain here.
Site: Frontal > Occipital
Onset: Acute
Character: Dull aching
Radiation: None
Association: Mild neck stiffness, nausea
Time Course: Lasts for 2 days to 2 weeks
Exacerbating factor: Sitting upright or standing, and so the relieving factor is lying down
Severity: Varies
What is the pathology?
Thought to be continued leakage of CSF from the puncture site and intracranial hypotension. Other neuro-vascular mechanisms may be involved.
How do I prevent it?
Using the smallest practical needle and keeping the bevel facing up. Before withdrawing the needle, reinserting the stilette.
How do I treat it?
It's self limiting. Can use analgesia, as per WHO Pain Ladder. In extreme cases, can also involve an anaesthetist for an epidural 'blood patch'.
Know something you'd like to add? Let me know.
Thank you for reading. Have a nice rest of the day, you.
- Ashish Singh
Here's all you need to you know about that nasty headache some patients get, after a lumbar puncture (LP).
How common?
Up to one-thirds of all cases.
What are the risk factors?
None. Despite years of anecdotal advice to the contrary, none of the following has ever been scientifically shown to be a risk factor: position during or after the procedure; hydration status before, during or after; amount of CSF removed; immediate activity or rest post-LP.
When does it happen?
Within 24 hours of LP.
How does it present?
Let's SOCRATES the pain here.
Site: Frontal > Occipital
Onset: Acute
Character: Dull aching
Radiation: None
Association: Mild neck stiffness, nausea
Time Course: Lasts for 2 days to 2 weeks
Exacerbating factor: Sitting upright or standing, and so the relieving factor is lying down
Severity: Varies
What is the pathology?
Thought to be continued leakage of CSF from the puncture site and intracranial hypotension. Other neuro-vascular mechanisms may be involved.
How do I prevent it?
Using the smallest practical needle and keeping the bevel facing up. Before withdrawing the needle, reinserting the stilette.
How do I treat it?
It's self limiting. Can use analgesia, as per WHO Pain Ladder. In extreme cases, can also involve an anaesthetist for an epidural 'blood patch'.
Know something you'd like to add? Let me know.
Thank you for reading. Have a nice rest of the day, you.
- Ashish Singh
Monday, October 28, 2019
Ashman beat
Hello!
What's an Ashman beat?
An aberrant PVC, usually of RBBB morphology, which follows a short RR interval and is preceded by a relatively prolonged RR interval.
The mechanism is pretty cool!
What's an Ashman beat?
An aberrant PVC, usually of RBBB morphology, which follows a short RR interval and is preceded by a relatively prolonged RR interval.
The mechanism is pretty cool!
Retinoic Acid and Malignancy
Hello Awesomites !
This is going to be short post.
Relevant for exams.
All trans retinoic acid is used in APML (ACUTE PROMYELOCYTIC LEUKEMIA)
Cis retinoic acid and derivatives like 13-cis-retinoic acid (13-cRA) reduces second aerodigestive tract tumors in patients with resected head and neck cancers.
13-cis RA is used in Neuroblastoma.
Happy studying.
-Upasana Y.
This is going to be short post.
Relevant for exams.
All trans retinoic acid is used in APML (ACUTE PROMYELOCYTIC LEUKEMIA)
Cis retinoic acid and derivatives like 13-cis-retinoic acid (13-cRA) reduces second aerodigestive tract tumors in patients with resected head and neck cancers.
13-cis RA is used in Neuroblastoma.
Happy studying.
-Upasana Y.
Differentiation syndrome
Hello Awesomites !
AML (M3) also known as acute promyelocytic leukemia.
The drug is ATRA+As2o3 ( All trans retinoic acid +arsenic trioxide).
After few days from therapy :-
unexplained fever,
acute respiratory distress with interstitial pulmonary infiltrates,
and/or a vascular capillary leak syndrome
leading to acute renal failure.
Suspect :-
Differentiation syndrome (DS), formerly known as retinoic acid syndrome, is the main life-threatening complication of therapy with differentiating agents (all-trans retinoic acid [ATRA] or arsenic trioxide [ATO]) in patients with acute promyelocytic leukemia (APL).
The differentiation of leukemic blasts and promyelocytes induced by ATRA and/or ATO may lead to cellular migration, endothelial activation, and release of interleukins and vascular factors responsible of tissue damage.
Roughly one quarter of patients with APL undergoing induction therapy will develop the DS.
Treatment -
Early therapy with intravenous corticosteroids. The use of invasive diagnostic techniques, such as bronchoscopy and bronchoalveolar lavage or lung biopsy, is not usually required in patients with suspected DS and respiratory distress with lung infiltrates.
Be careful with invasive procedure as these patients have concomitant coagulopathy (DIC like state)
The early administration of high-dose dexamethasone at the onset of the first signs or symptoms of DS is crucial, since it appears to dramatically reduce mortality of this complication.
HAPPY STUDYING :)
-Upasana Y.
AML (M3) also known as acute promyelocytic leukemia.
The drug is ATRA+As2o3 ( All trans retinoic acid +arsenic trioxide).
After few days from therapy :-
unexplained fever,
acute respiratory distress with interstitial pulmonary infiltrates,
and/or a vascular capillary leak syndrome
leading to acute renal failure.
Suspect :-
Differentiation syndrome (DS), formerly known as retinoic acid syndrome, is the main life-threatening complication of therapy with differentiating agents (all-trans retinoic acid [ATRA] or arsenic trioxide [ATO]) in patients with acute promyelocytic leukemia (APL).
The differentiation of leukemic blasts and promyelocytes induced by ATRA and/or ATO may lead to cellular migration, endothelial activation, and release of interleukins and vascular factors responsible of tissue damage.
Roughly one quarter of patients with APL undergoing induction therapy will develop the DS.
Treatment -
Early therapy with intravenous corticosteroids. The use of invasive diagnostic techniques, such as bronchoscopy and bronchoalveolar lavage or lung biopsy, is not usually required in patients with suspected DS and respiratory distress with lung infiltrates.
Be careful with invasive procedure as these patients have concomitant coagulopathy (DIC like state)
The early administration of high-dose dexamethasone at the onset of the first signs or symptoms of DS is crucial, since it appears to dramatically reduce mortality of this complication.
HAPPY STUDYING :)
-Upasana Y.
Friday, October 25, 2019
Route of bisphosphonate administration mnemonic
Mini post!
IVZ: Intravenous zoledronic acid (once a year)
oRAl: Oral bisphosphonates are Risedronate and Alendronate
- IkaN
IVZ: Intravenous zoledronic acid (once a year)
oRAl: Oral bisphosphonates are Risedronate and Alendronate
- IkaN
Denosumab
Hi! Long time no see :)
This post is on Denosumab!
MOA:
- Monoclonal antibody against the receptor activator of nuclear factor κB ligand (RANKL)
- Reduces bone resorption by inhibiting the development of osteoclasts
Route: SC
Dosing: Administered twice yearly
This post is on Denosumab!
MOA:
- Monoclonal antibody against the receptor activator of nuclear factor κB ligand (RANKL)
- Reduces bone resorption by inhibiting the development of osteoclasts
Route: SC
Dosing: Administered twice yearly
Saturday, September 28, 2019
Quinsy Complication
This post is written by Sweta Senthil.
I don't know why she targeted me to make this mnemonic but it makes sense to remember the complication of Quinsy.
So mnemonic is "OJAS Pee"
Edema of larynx
Jugular Vein Thrombosis
Abscess of Lung/Pneumonitis
Septicemia, Spontaneous hemorrhage
Parapharyngeal Abscess
That's it!
Sunday, September 1, 2019
IOLs- most important optical zone
Most common answer would be the centre.
That however is not the case as the light rays pass undeviated right through the centre.
In fact, phakic IOLs have an opening right in the centre for aqueous to circulate.
The most important part is the pericentral area, as the refracted rays through this area get focussed on the macula.
-Sushrut
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