Thursday, May 20, 2021

Types of COVID-19 antibody tests

Hi everyone! 

In this post, I will go over in very short the different 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

  • Biennial Mammography                                                                                            

Women aged 50 to 74 yrs 

Cervical Cancer    

  • Cervical cytology every 3yrs  


  • Cervical cytology every 3 yrs 

or

  • High risk HPV(hrHPV) testing every 5 yrs

or

  • hrHPV testing in combination with cytology every 5yrs (cotesting) 

                                                                                                               

Women aged 21 to 29 yrs 


Women aged 30 to 65 yrs   

Lung Cancer  

  • Annual Low dose CT chest (who have a 20 pack-year smoking history and currently smoke/quit within past 15 yrs)



Adults aged 50 to 80 yrs

Colorectal Cancer 

  • Colonoscopy screening every 10 yrs

  • Flexible sigmoidoscopy every 5 yrs

  • Computed tomography colonography every 5 yrs

  • High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every yr

  • Stool DNA-FIT every 1 to 3 yrs


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

Human herpes viruses (HHV) types mnemonic

Human herpes viruses mnemonic... In case you get them mixed up...


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

Hello friends! 

Here's is the simple mnemonic to remember the important causes of Megalencephaly.
CATS
Canavan's disease
Alexander disease
Tay- Sachs disease
Sandoff disease.

That's all!
Dr.Madhuri Reddy

Monday, May 17, 2021

COMMON METASTASES - MNEMONICS

SITE OF METASTASIS                              PRIMARY TUMOUR 

BRAIN                                                                    Lots of Bad Stuff Kill microGlia
                                                                                 Lung, Breast, Skin (melanoma), Kidney, GI(colon)

LIVER                                                                     Cancer Sometimes Penetrates Big Liver   
                                                                                 Colon, Stomach, Pancreas, Breast, Lung 

BONE                                                                      Permanently Relocated Tumours Like Bones
                                                                                 Prostate, Renal, Thyroid, Lungs, Breast

     

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 Oropharyn   

(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

Glomerulonephritis associated with infectious diseases mnemonic


Hepatitis B: Membranous glomerulonephritis
Hepatitis C: Membranoproliferative glomerulonephritis
HIV: Focal segmental glomerulosclerosis

By IkaN

Embryology of eye mnemonic

Hello friends!

Here's is the simplest way to remember embryology of eye.

*Out of all layers (ecto,meso, endo), the endoderm doesn't contribute to the embryology of eye.
* Mesoderm forms - extraocular muscles
* Rest of the structures are derived from ectoderm.

* Surface ectoderm forms the structures which are visible to us from outside like Corneal epithelium
Conjunctival epithelium
 Lacrimal gland
 Lens ( important)

*Neuroectoderm forms neural structures like
Retina
Ciliary body ( not muscles)
Iris - both sphincter and dilator pupillae
Optic nerve

* Neural crest derivatives are 
Meninges of optic nerve
Schwann cells
Ciliary ganglion
Ciliary muscles 

For the remaining derivatives, watch the following picture.

Thank you.
Dr. Madhuri Reddy.