Mnemonic for Antibodies in SLE & it's Clinical Importance

Hi everyone!

Here is a hack.

ANA = All Negative Absent = All Positive identified = Highest Sensitivity ( So best Screening Test ) 

Anti dsDNA = Disease Severity 

Anti Sm = Specific Most

Anti RNP = Raynaud & Polymyositis ( MCTD )

Mnemonic for Dawn & Somogyi phenomenon

Hello everyone....

A diabetic patient who is taking NPH insulin regularly at early evening time presents with early morning headache. He also feels very stressed & tiredness. 

I have checked that he is hyperglycemic.

Suddenly I think about Dawn & Somogyi phenomenon. But I have a confusion between that 2 terms.

So I make a mnemonic…

Here it is ..

Dawn & Somogyi phenomenon

In both Early Morning High Glucose 

= Due to ⬆️ GH & Cortisol Surge 

What is the difference ??

Sonographic diagnostic features of monochorionic monoamniotic twin pregnancy

1. Absence of dividing amniotic membrane

2. Presence of single placenta

3. Same gender fetus

4. Adequate amniotic fluid around each fetus

5. Both fetus moving freely 

Indications of long‐term oxygen therapy

Hi!

I was discussing the indications of long‐term oxygen therapy with a friend today...

Long‐term continuous oxygen therapy, ideally for ≥18 h/day is indicated when:

1. Daytime partial arterial oxygen concentration (PaO2) is ≤ 55 mm Hg at rest or a pulse oxygen saturation (SpO2) less than or equal to 88 percent.

2. Daytime PaO2 is 56–59 mm Hg and there is evidence for hypoxic organ damage (right heart failure, pulmonary hypertension or polycythaemia)

Fact of the day: AHN in old age

Hi!

Fact: New neurons proliferate as we age, in both physiologically and pathologically aging brains, even in the ninth decade of life.

Authors' diary: Battling jealousy

Hi!

I read comment on YouTube recently, "There are people who don't even share their notes and there are people like you who help others with their work..."

I know that feeling. It stems from a number of negative emotions. One of them is jealousy or envy - The intolerance in seeing someone else succeed more than you.

Treatment resistant depression notes

Hi! Quick notes for a friend :)

Treatment resistant depression: Major depressive episodes that do not respond satisfactorily to at least two trials of antidepressant monotherapy.



Things to consider:
Assess adherence
Identify comorbidities
Reassess diagnosis

Treatment strategies:
Augmentation (adding a treatment)
Switching treatment

Important Mnemonics for Oral hypoglycaemic drugs in Diabetes

Hello everyone .. 

I make mnemonics for some important side effects of oral hypoglycemic drugs. 

You must know that because you may prescribe it for 1 out of 11 adults in whole population the of world….!!

Side effects of Oral hypoglycaemic drugs along with it's class & mechanism of action 

#Mnemonic 1

Big Men ForminG Poor Diabetic neuropathy ( D/Dx B12 Deficiency ➡️ confirmed by doing  B12 LAB test.)

Biguanide = Metformin 

Inhibit mGPD 

It causes Vitamin B12 Deficiency & Lactic Acidosis (LA) 

#Mnemonic 2 

1st Key to SUccess is Lord "Ram"

1st Gen SUlfonylureas

Closes K+ Channel 

Ram = Disulfiram like reaction….

#Mnemonic 3 

Paragliding makes your heart failed or maybe a fracture or bladder injury 

Para = PPAR Y

Gliding = Glitazone activates it...

#Mnemonic 4

"Rosy red Blood don't reach to heart (MI) but goes into Pee = Red Pi ( Pee = Urine in Bladder Cancer )

MI (rosiglitazone) 

Bladder cancer (pioglitazone)

#Mnemonic 5

“Change your Daily Personal Passivity (DPP) otherwise your heart fails” 

DPP  = DPP-4 inhibitors 

#Mnemonic 6

“Candid Status is Very Good in Love Test”

SGLT-2 inhibitors can cause Vulvovaginal Candidiasis 

Drugs category & their Suffix 

Pramlintide = Amylin Analogue 

1st gen Sulfonylureas = “Amide”

2nd gen Sulfonylureas = “Ride” & “Zide”

Meglitinides = “Nide”

DPP-4 Inhibitors = “Gliptin”

Glitazones / thiazolidinediones = “Zone”

SGLT -2 Inhibitors = “Flozin”

#Mnemonic 7

Alpha glucosidase inhibitors = "Please Side your Car & Pay Toll"

Acarbose & Miglitol 

#Clinical Pearls 

Weight neutral = DPP 4 & Alpha Glucosidase inhibitors 

SGLT2 inhibitors & GLP-1 = Used in CVD

( Cardiovascular diseases) patients

In case of Renal failure you can only give 2 type of drugs orally = DPP 4 inhibitors & Glitazones 

Injectables can be given in renal failure.

3 times / day dosing = Pramlintide , Alpha Glucosidase inhibitors & Glinide 

Regular Insulin ( Short acting ) is preferred for 

DKA ( IV)

Hyperklaemia (Add Glucose)

Stress Hyperglycemia

Thank you :)

- Dr. Drashtant Prajapati

Therapeutics in Sickle Cell Anemia

Apart from Hydroxyurea, Analgesics and vasodilators like phosphodiesterase inhibitors, certain tantalizing novel drugs have been approved for Sickle cell anemia.... Let's take a closer look at them.

(1) Voxelotor (HbS polymerization inhibitor) binds covalently to N-terminal valine of alpha chain of HbS (around 30% of HbS in individual cell) stabilizing it's oxygenated form and causing left ward shift of dissociation curve without impairing oxygen delivery to tissues.

Consistently reduces hemolysis and viscosity with in 2 weeks of administration... FIRST EVER therapy targeting core defect.

Benign vs Malignant pulmonary calcifications mnemonic

A nice mnemonic to differentiate benign and malignant pulmonary calcifications is:

Malignant calcifications are ***SuPER bad*** :P
S: Spiculated
P: Punctate
E: Eccentric
R: Reticular

I use those 3 starts (***) to remind me of punctate.(vs the other P of Popcorn in the benign lesions)

Bening ones are the rest:
Popcorn, laminated, concentric and diffuse homogeneous

-Murad

NB: these calcification types suggest benign vs malignant lesions and are not diagnostic per se.

Check the other amazing mnemonic by Drashtant in the comments section below  :)

Inferior wall MI treatment mnemonic

Inferior wall MI is different than other MIs . It is associated with sinus bradycardias and AV block.

Lower back pain notes

Hello!

Here are my quick and dirty notes on Low back pain (LBP) mostly seen in ambulatory medicine! I will not be going into evidence-based medicine (EBM) physical examination (PE) findings but I have put a quick note for conditions you can test on PE so you can look them up.

Hepatorenal Syndrome: An Overview

Hello good folks! Let's discuss HepatoRenal Syndrome (HRS) in brief.

Cirrhosis + Ascites + Renal Failure = HRS, after excluding other causes of kidney damage.

How common is HRS?
1 in 10 patients of advanced cirrhosis or acute liver failure develop HRS.

How does HRS happen?
Abnormal haemodynamics, that's how. Pathogen, faulty immune system and mesenteric angiogenesis result in splanchnic and systemic vasodilation but renal vasoconstriction. Other factors maybe contributory.

Types and management
Type 1: Rapidly progressive, median survival about 2 weeks. Haemodialysis may be required.

Type 2: Slowly progressive, median survival about 6 months. Transjugular Intrahepatic Portosystemic Shunt (TIPS) maybe required.

Liver and/or kidney transplant maybe considered for both types.



Thanks for reading.
- Ashish Singh.