Thursday, October 19, 2023

Mnemonic | Morphology of IgA nephropathy

 Morphology of IgA nephropathy will be derived from its pathogenesis and the disease name.


so the mnemonic is presented here:

Pathogenesis = indicates about role of immunoglobulins and mesangial cells

now about these 2 things take the name of the disease:

IgA = A = All 

= all main antibodies in infections (IgA, IgG, IgM) 

= all mainly possible mesangial morphologies ranging from mesangial widening, diffuse mesangial proliferation endocapillary proliferation, segmental sclerosis, , to crescentic glomerulonephritis  


(remember it by keeping in mind the structure of glomerulus in which from center to periphery comes mycangium, capillaries and then epithelium of glomerulus)


I hope it works for you all again πŸ‘½

In Sha Allah!

Thank you πŸ’“

Wednesday, October 18, 2023

Mnemonic | Uncinate Herniation / Transtentorial Herniation

The word that comes first in my mind when i see uncinate written in the book is UNCLE

I don't know why but this is what it is!

so my UnKle is PHD

U = uncinate herniation

K = Kernohan's Notch 

P = posterior cerebral artery compression

H = hemiparesis (ipsilateral)

D  = Duret hemorrhage (midbrain and pons)


  • and from posterior cerebral artery point and hemiparesis, another thing can be linked which is CN# 3 paralysis

because posterior cerebral artery supply mainly occipital lobe so some problem with eye may occur which is actually related to oculomotor nerve compression (just a linker not the actual pathophysiology)


I hope it works for you all again!

In Sha Allah!

Thank you πŸ’“

Mnemonic | Morphology of Membranoproliferative Glomerulonephritis

Here again I am back with another mnemonic to remember the morphology of Membranoproliferative Glomerulonephritis 

Pathology is fun πŸ˜­πŸ˜‚

I hope the feelings are obvious to everyone now lol 😁


this mnemonic will be mainly derived from the name of the disease:

Membrano proliferative Glomerulonephritis:

  • if I abbreviate this disease to MG (membranoproliferative glomerulonephritis), than i can make you remebr that MG is a car manufacturing company so its cars would make a tram track appearance on roads when they are driven

and then comes the breakdown of the disease name:

  • Membrano = meaning something wrong is with basement membrane of glomerular capillaries

tram track appearance 


  • Proliferative  = meaning something is proliferating 

so endothelium, mesangium is proliferating (ME from membrano)


  • Glomerulonephritis = inflammation indicates infiltration of leukocytes as it is a nephritic syndrome mainly


specific types of Membranoproliferative glomerulonephritis have these all above said features but certain differences which are mentioned in this table below:

Differences

Membranoproliferative glomerulonephritis type 1

 

Membranoproliferative glomerulonephritis type 2

(C3 glomerulopathy)

Dense deposit disease

C3 deposits

 

Deposited in irregular pattern

(subendothelial ONLY)

 

 

Waxy deposits

(mesangial, subendothelial and tubular BM)

 

Ribbon like highly dense deposits

(mesangial, subendothelial and tubular BM)

Classic complement system components

 

Present

 

Absent

 

Absent


I hope this was fun also for you like always!

I hope it works you again

In Sha Allah!

Thank you πŸ’“

feel free to ask any study related question in the comment sectionπŸ‘½

Tuesday, October 17, 2023

Mnemonic | Morphology of Membranous Nephropathy |

Morphologies are always very difficult, atleast for me and my colleagues πŸ˜₯

so I have made a mnemonic for the membranous nephropathy morphology:
I will try to keep it simple and make the name of the disease a major hint for the morphology:

4 things will get evident from the name of the disease:

1.  Word membranous indicates towards basement membrane of capillaries of glomerulus, and what can happen to it in inflammation or disease?
mostly thickening of basement membrane of capillaries

2.  M stands for Mehrab (the place where Muslim religious leader of stands to lead the prayer) - picture is shown below

   
took this image from alamy website (and these pictures are downloadable from there without any consent)

so the leader stands in it and it appears like dome if seen from outside = dome and spike pattern 

3.   next comes the dome again,  as I described the dome appearance from outside of this mehrab so if I imagine that dome being the outside of capillaries which will blink in mind the point of 
sub epithelial deposits 
(as epithelium is on the outside of capillaries in glomerulus)
   
4.  remaining morphology is same as in other nephrotic syndromes (effacement of podocytes, etc.)



I know it has got long but to remember morphologies and then forgetting is worst than understanding this mnemonic and keeping the memory long enough atleast till final exam. lol πŸ˜‚

I hope it works again for you like my other mnemonics
In Sha Allah!
Thank you πŸ’“












Monday, October 16, 2023

Roll over phenomenon | A kind of Mnemonic |

Roll over phenomenon is even though simple thing but still a good memory anchor would be beneficial in future.

so here it is a mnemonic for how to remember roll over phenomenon


what does the word indicate from roll over?

 it means roll over something or like that meaning 

now look at the picture of its graph, it also shows like as if it just rolled up the hill and then over it and then rolled down the hill  like a car. lol


so that is it, the roll over phenomenon, meaning sound intensity is best heard at the peak of the mountain and it decreases on either side of the rolled over mountain.


i hope your brain keep this anchor with it for your life long

In Sha Allah

Thank you

Saturday, October 14, 2023

Mnemonic for Incubation Period of Dengue virus

Incubation period of dengue virus is 3-10 days

How to remember this with all so many incubation periods in community medicine?😒


so the solution is in its name:


DENgue

so DEN rhymes with ten 

and look at the E in it, flip it and you get 3

so 3-10 days


and that's it πŸ™ˆ 

I hope it works for you 
In Sha Allah !
Thank you πŸ’“

Allah Hafiz!

Mnemonic for Morphology of Focal Segmental Glomerulonephritis

 Morphology of Focal segmental glomerulonephritis is derived mostly from its name and its pathophysiology.

so here it is:😍

1st word = Focal = only some glomeruli are involved (mainly juxtamedullary)

but it can extent later to whole of cortex as well

2nd word = segmental = only a portion of glomerulus is involved

but later may extend to whole of glomerulus which may extend into interstitium and ultimately tubular atrophy can occur

3rd word = glomerulosclerosis = scarring/fibrosis of glomerulus

scarring hints scarring obviously (fibrosis I mean)

and scarring links to capillary lumen obliteration of glomerulus 

(imagine a situation when glomerulus will be sclerosed, it will get contracted and so capillary lumen will also start collapsing) - now link obliteration of capillary lumen with increased mesangial matrix

for this see the diagram of glomerulus and understand that mesangial growth can also compress upon the capillary lumen and cause lumen obliteration


Pathophysiology:

link the morphology with pathophysiology if you are reading pathophysiology of FSGS from Robbins pathology then it has said that some people think that FSGS is a derivative of minimal change disease and the hall mark of minimal change disease is 

EFFACEMENT OF PODOCYTES - SO this morphology is also here

and this effacement means leakage of plasma contents seen in minimal change disease that is proteins and lipids so here we see 

HYALINOSIS AND LIPID LADEN MACROPHAGES


I HOPE IT WORKS WELL.πŸ‘€

In Sha Allah!


Monday, October 9, 2023

Mnemonic for causitive agents of Acute Postinfectious glomerulonephritis

How to remember that which organisms can be the cause of postinfectious glomerulonephritis?

Sometimes it gets very problematic, not because that is important to know, but because sometimes you just want to remember everything  from ROBINS PATHOLOGY. lol
so here it is:

BACTERIAL CAUSES:


Post infectious glomerulonephritis is also called post streptococcal glomerulonephritis and it is a quite obvious things. From this we have:
                                                                    PostSTreptococcal
the name itself indicates Streptococcus
P indicates Pneumococcus and ST for Staphylococcus 


VIRAL CAUSES:

From the name of post streptococcal glomerulonephritis, the first thing that comes to mind is some relation with children because when we studied these topics in our immunology chapters than glomerulonephritis and post infectious endocarditis were written next to each other. so children picture is now clear in our little brains, now what children do most of the time? CRY! lol And how:

MM AHu ahu....................................................aaaaaaaaaaaaaaaaaaaaaaaaaaaaa lol and mother says CHHHHH tos top him from crying (or may even slap - a vicous cycle may begin or terminate. you can relate yourself. lol - sorry for your nostalgia!)

M = mumps
M = measles
A = aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa (thats nothing. lol)
H = HBV HCV
CHHH = chickenpox

and that's it! 
I hope it works for you 
In Sha Allah !
Thank you πŸ’“


Tuesday, August 8, 2023

Lead impedance change threshold and cause

Low lead impedance 
< 200 ohms
Indicate insulation breach
Usually inner insulation in a bipolar coaxial lead

High lead impedance 
> 2000 ohms
Indicate open circuit
Lead fracture or loose set screw

Friday, August 4, 2023

Threshold for surgical repair of thoracic aortic aneurysm in patients with Marfan syndrome mnemonic

What is the threshold for surgical repair of thoracic aortic aneurysm in patients with Marfan syndrome? 

5 cm

Marfan, MarFIVE

The threshold for surgical repair in patients with Marfan syndrome is an external diameter of 5 cm. Factors that will prompt repair at a diameter <5 cm include rapid growth of >0.5 cm in 1 year, family history of aortic dissection at a diameter <5 cm, or the presence of significant aortic regurgitation.

Thursday, April 27, 2023

Dysbarism - Emergency Medicine

 Hello all !

Dysbarism: 

refers to illness that is related to pressure changes in the body , that exceeds the body's capacity to adapt to these changes 

Pathophysiology of dysbariam depends on the Boyle's law : in which pressure is inversely related to volume

When you descend e.g deep water : Pressure increases and volume decreases

When you ascend : Volume increases and pressure decreases 

I will explain the main disorders of Descent and Ascent

Disorders of descent

1. Nitrogen Narcosis 

Gas we breath contains all gases : including nitrogen.

When you descend the nitrogen gas dissolves in blood and causes the symptoms of nitrogen intoxication.

Management : Ascent

2. Barotitis

Pressure damage to the ear due to squeezing secondary to the elevated pressures

Management: Ascent , supportive treatment

Disorders of Ascent

1. Arterial Gas Embolism 

Volume expansion in every air filled areas of the body e.g GIT, Alveoli 

When it occurs in the alveoli it cause the formation of an air embolus into the pulmonary vein : which can travel to the brain - causing stroke, in the heart - causing Myocardial Ischaemia

Usually acute onset : usually within minutes of ascent (e.g from diving)

Management: involves hyperbarric treatment

2. Decompression Sickness

This is caused by formation of nitrogen gas bubbles (opposite to when you descend where it dissolves)

There are two main types of decompression sickness

i. Type 1

- Usually involving the skin and joints : painful skin and joints

ii. Type 2

- Usually involving the CNS : paraesthesia, paralysis 

Management involves : Hyperbarric treatment , Oxygen, Aspirin 

NB : patient with type 1 DS : have to avoid air travel for upto one week ,those with type 2 DS : have to avoid air travel for upto 1 month 


I hope it was helpful ! For any queries feel free to contact me 

Happy reading !


Author : Mohammad Faruk Omar

Emergency Medicine Resident 

Muhimbili University of Health and Allied Sciences, Tanzania