Thursday, May 20, 2021
Types of COVID-19 antibody tests
Wednesday, May 19, 2021
Cancer Screening - US Preventive Services Task Force (USPSTF) guidelines
As the saying goes - "Awareness is Power in a world where information is everywhere", lets quickly learn the USPSTF recommended guidelines for Cancer screening
CANCER | SCREENING MODALITY | AGE GROUP |
Breast Cancer |
| Women aged 50 to 74 yrs |
Cervical Cancer |
or
or
| Women aged 21 to 29 yrs Women aged 30 to 65 yrs |
Lung Cancer |
| Adults aged 50 to 80 yrs |
Colorectal Cancer |
| Adults aged 45 to 75 yrs |
P.S. - USPSTF now recommends screening for Colorectal cancer in adults aged 45 to 75 years
- Padma Sri Katikaneni
Tuesday, May 18, 2021
Fact of the day - Athlete's heart
Hi!
Athlete's heart - physiologic eccenteric hypertrophy (cardiac remodeling) - changes include resting bradycardia, higher cardiac output with exercise, dilatation of LV cavity size with hypertrophy of myocytes compared to normal heart.
vs pathologic hypertrophy in case of systolic heart failure, aortic/mitral regurgitation, dilated cardiomyopathy(DCM) (volume overload conditions).
LV systolic ejection fraction is normal - low-normal in athletes.
(vs HCM- high, DCM- low)
HCM is a common cause of death in athletes, especially those with family history.
That's all
- Jaskunwar Singh
METABOLIC SYNDROME - MNEMONIC
BE AWARE of THE HIGH SUGARS
(3 or more of the following : diagnosis of Metabolic syndrome)
Blood Pressure >/=130/85mmHg
Abdominal obesity ( waist circumference) > 40 inches in males; >35 inches in females
Triglycerides >/=150 mg/dl
HDL cholesterol < 40mg/dl in males; < 50mg/dl in females
Fasting blood Sugars >/=100mg/dl
Hope this helps:)
- Padma Sri Katikaneni
Megalencephaly mnemonic
Monday, May 17, 2021
COMMON METASTASES - MNEMONICS
LIVER Cancer Sometimes Penetrates Big Liver
Colon, Stomach, Pancreas, Breast, Lung
BONE Permanently Relocated Tumours Like Bones
P.S. - FOUR CARCINOMAS ROUTE HEMATOGENOUSLY!
(Follicular carcinoma thyroid, Choriocarcinoma, Renal cell carcinoma, Hepatocellular Carcinoma)
Hope these mnemonics help!
Feel free to add any more fun mnemonics :)
- Padma Sri Katikaneni
Internal Medicine residency program Excel sheet (2020)
Hi guys,
I am sharing an excel sheet containing 200+ Internal Medicine residency programs. Feel free to download it and edit the information and programs according to your profile and needs. There may be a few IMG friendly programs that are missing, so do your homework and don't apply blindly. Use this as a template sheet to work on!
Kindly note, the comments are subjective, and none of the authors endorse them as proven facts. Some information may be incorrect as a lot of manual labor went into making this sheet.
Hope this helps in making the ERAS application process easier!
https://docs.google.com/spreadsheets/d/1l2Vra6wDcZX5_FMLOFcetZua64wwNsdXKDKB0saGykg/edit?usp=sharing
Sunday, May 16, 2021
HERPANGINA vs HERPETIC GINGIVOSTOMATITIS
HERPANGINA (Hand-Foot-Mouth Disease) | HERPETIC GINGIVOSTOMATITIS | |
CAUSATIVE VIRUS | Coxsackie A virus | Herpes Simplex type 1 virus (HSV-1) |
AGE | 3-10 years | 6 months-5 years |
CLINICAL PRESENTATION | Grayish Vesicles on Posterior Oropharynx (soft palate, tonsils, tonsillar pillars, Uvula)
| Clusters of vesicles on Anterior Oropharynx (Lips, buccal mucosa, tongue, gingiva, hard palate) |
TREATMENT
| Supportive management with oral hydration and analgesics | Oral Acyclovir |
Fact of the day - halothane hepatotoxicity
Hi!
A patient with biliary stones who's undergone laparoscopic cholecystectomy may develop signs of hepatotoxicity between 2 days - three weeks post-op. due to halothane. The mechanism is this anesthetic's biotransformation to reactive metabolites through P450.
At risk category of patients are females more than 40 years of age.
Labs show elevated AST and ALT.
Hepatitis is relatively rare.
Other effects:
- Cardiac arrhythmias
- malignant hyperthermia
- hypertension
That's all
- Jaskunwar Singh
Thursday, May 13, 2021
Levetiracetam - pregnancy considerations
Hi!
Levetiracetam, used primarily for seizures control, is also used off-label for SAH, status epilepticus, seizure prophylaxis in craniotomy and traumatic brain injury.
Dosing is increased in pregnancy and closely monitored regularly due to various physiologic effects, especially in third trimester. (levitate dose of levetiracetam) :-
- increased volume of distribution, Vd (increase in plasma volume, CO)
- increased renal excretion (increase in GFR; levitate the rate)
- rapid and almost complete absorption via GIT (unlike other drugs with decreased absorption in pregnancy)
- low risk of adverse effects and fetal malformations when used in monotherapy. (low with mono, high with poly)
- Levetiracetam is NOT metabolized by liver; Cyt P450 independent. Bioavailability 100%. (unlike other antiepileptics - hepatic metabolism increases in pregnancy)
Levetiracetam crosses placenta and can be detected in the newborn. (leve leaves mother)
The newborns are at greater risk of SGA and low APGAR score.
Protein-binding of the drug is low (<10%). So, decrease in albumin concentration during pregnancy does not significantly affect the drug concentration. (low pro)
That's all
- Jaskunwar Singh