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101158

Spot Diagnosis Series 2

.
.
.
.
Pinealoma

The patient usually presents with paralysis of conjugate upward gaze and is known as
Parinaud's syndrome. There can be bilateral papilledema. Accommodation is intact. Absence of pupillary light reflex. This is due to lesion in superior colliculi. 


.


I found it very difficult during my usmle prep to remember the components of various bands in a muscle fiber. Even after multiple reads and memorization I still could not recall it. All that changed when I came up with a simple mnemonic .

                 
                  I act at 5am hence my sleepiness



I = I band
act = actin
at = A band
5 am =  actin + myosin
hence = H zone
my sleepiness =  myosin



Autosomal dominant diseases visual mnemonic
Click on image to enlarge.



Preparing for exams involving Biochemistry and Genetics can be tough as plethora of facts needs to be committed to memory. This is especially true when you are preparing for your USMLE Step 1 exam. Hopefully, the following visual mnemonic will help ease down your memorization process for remembering major Autosomal dominant diseases.

If you commit this statement listed below in your mind with the image to help you guide through, you will never have a hard time recalling the major Autosomal dominant diseases:

Osler Family is Hyper because Mary Huntington Von Turbo Sphereing MEN Across Hill.
  1. Osler-Weber-Rendu syndrome (Osler)
  2. Familial hypercholesterolemia (Family Hyper)
  3. Marfan's syndrome (Mary)
  4. Huntington's disease (Huntington)
  5. Von Recklinghausen's Disease (Von)
  6. von Hippel-Lindau disease (Von)
  7. Tuberous sclerosis (Turbo)
  8. Hereditary spherocytosis (Sphereing)
  9. Multiple endocrine neoplasias  (MEN)
  10. Achondroplasia (Across)
  11. Hypokalemic periodic paralysis (Hill)
  12. Autosomal dominant polycystic kidney disease (ADPKD)
The picture shows a young Mary Huntington sphereing a globe full of MEN across a hill and she appears to be winning or probably have just won (Von), which makes the Osler Family very mad and hyper. Also note that the whole sphereing event is hosted by the ADPKD foundation. 

By the way, sphereing or zorbing is a recreational activity/sport of rolling a transparent plastic spherical orb with passenger(s) down the hill.

I made this mnemonic myself to recall the autosomal diseases effectively and quickly. It works like a charm for me. Hope it helps you too.



Stem Cell Wisdom Medical Humor



Spot Diagnosis Series 1
.
.
.
.

Achalasia 

This barium swallow is characteristic of achalasia. The esophagus is dilated proximally and distally “bird beak” is seen which is the smoothly tapered distal portion.



Many at times students come across questions in USMLE regarding baroreceptors, their location and their innervation. At times questions focus on the loss of innervation and its resultant effects on the body and its very critical to remember which baroreceptors are innervated by which nerves.

Arterial baroreceptors are located in the aortic arch and the carotid sinuses of the right and left carotid arteries. The baroreceptors found within the aortic arch monitor the pressure of blood delivered to the systemic circuit, and the baroreceptors within the carotid arteries monitor the pressure of the blood being delivered to the brain.


The glossopharyngeal nerves transmits impulses from carotid sinuses whilst the vagus nerves transmits impulses from the aortic arch. A simple mnemonic to remember this is:

                                     

GLOSSY CAROTID VISITS AORTA IN VEGAS

Innervation of baroreceptors



MedPrepOnline Qbank
Question: Which of the following drugs is useful in the treatment of angina pectoris?
a. Digoxin
b. Quinidine
c. Quinine
d. Salbutamol
e. Propranolol


Correct answer: (e)

Propranolol is a non-selective beta-blocker. It blocks beta-1 and beta-2 receptors. By blocking beta-1 receptors, it decreases the heart rate and leads to decreased oxygen demand by the cardiac cells which prevents angina from occurring.

Digoxin (a) increases contractility; hence, increasing oxygen demand and precipitating angina.

Quinidine (b) is a derivative of quinine (c) which is an antimalarial and has no role in angina. Itself it is a class Ia anti-arrhythmic that blocks Na+ channels and prolongs the action potential duration. It has no role in angina.

Salbutamol (d) is a beta-2 agonist and has no role in angina. Beta-2 receptors are present on the bronchioles.


Yo Dawg Villi Medical Meme



Medical Teaching Hospital Hierarchy



CNS lymphoma
Image Copyright of Radiological Society of North America
Question: A 36 year old male presented with seizures and motor deficits. MRI scan of his brain revealed a homogeneously enhancing mass in the frontal lobe. Histological examination of the mass revealed it to be a B cell lymphoma. The most useful investigation in this patient would be to test for?

a. Epstein-Barr virus
b. Cytomegalovirus
c. Herpes simplex
d. HIV
e. Respiratory syncytial virus


Correct answer: (d) HIV

Immunocompromised patients are found to have a primary CNS lymphoma and 90% of such lymphomas are associated with EBV infection. In the above stated causes, HIV is a common cause of immunodeficiency. EBV (a)  itself does not lead to a primary CNS lymphoma unless the patient is immunodeficient in the first place.

Cytomegalovirus (b) or CMV is associated with retinitis and/or interstitial pneumonia. It is not associated with lymphoma.

HSV (c) and RSV (e) are not associated with lymphomas.


Spot Diagnosis Series 2

.
.
.
.
Pinealoma

The patient usually presents with paralysis of conjugate upward gaze and is known as
Parinaud's syndrome. There can be bilateral papilledema. Accommodation is intact. Absence of pupillary light reflex. This is due to lesion in superior colliculi. 


.


I found it very difficult during my usmle prep to remember the components of various bands in a muscle fiber. Even after multiple reads and memorization I still could not recall it. All that changed when I came up with a simple mnemonic .

                 
                  I act at 5am hence my sleepiness



I = I band
act = actin
at = A band
5 am =  actin + myosin
hence = H zone
my sleepiness =  myosin



Autosomal dominant diseases visual mnemonic
Click on image to enlarge.



Preparing for exams involving Biochemistry and Genetics can be tough as plethora of facts needs to be committed to memory. This is especially true when you are preparing for your USMLE Step 1 exam. Hopefully, the following visual mnemonic will help ease down your memorization process for remembering major Autosomal dominant diseases.

If you commit this statement listed below in your mind with the image to help you guide through, you will never have a hard time recalling the major Autosomal dominant diseases:

Osler Family is Hyper because Mary Huntington Von Turbo Sphereing MEN Across Hill.
  1. Osler-Weber-Rendu syndrome (Osler)
  2. Familial hypercholesterolemia (Family Hyper)
  3. Marfan's syndrome (Mary)
  4. Huntington's disease (Huntington)
  5. Von Recklinghausen's Disease (Von)
  6. von Hippel-Lindau disease (Von)
  7. Tuberous sclerosis (Turbo)
  8. Hereditary spherocytosis (Sphereing)
  9. Multiple endocrine neoplasias  (MEN)
  10. Achondroplasia (Across)
  11. Hypokalemic periodic paralysis (Hill)
  12. Autosomal dominant polycystic kidney disease (ADPKD)
The picture shows a young Mary Huntington sphereing a globe full of MEN across a hill and she appears to be winning or probably have just won (Von), which makes the Osler Family very mad and hyper. Also note that the whole sphereing event is hosted by the ADPKD foundation. 

By the way, sphereing or zorbing is a recreational activity/sport of rolling a transparent plastic spherical orb with passenger(s) down the hill.

I made this mnemonic myself to recall the autosomal diseases effectively and quickly. It works like a charm for me. Hope it helps you too.



Stem Cell Wisdom Medical Humor



Spot Diagnosis Series 1
.
.
.
.

Achalasia 

This barium swallow is characteristic of achalasia. The esophagus is dilated proximally and distally “bird beak” is seen which is the smoothly tapered distal portion.



Many at times students come across questions in USMLE regarding baroreceptors, their location and their innervation. At times questions focus on the loss of innervation and its resultant effects on the body and its very critical to remember which baroreceptors are innervated by which nerves.

Arterial baroreceptors are located in the aortic arch and the carotid sinuses of the right and left carotid arteries. The baroreceptors found within the aortic arch monitor the pressure of blood delivered to the systemic circuit, and the baroreceptors within the carotid arteries monitor the pressure of the blood being delivered to the brain.


The glossopharyngeal nerves transmits impulses from carotid sinuses whilst the vagus nerves transmits impulses from the aortic arch. A simple mnemonic to remember this is:

                                     

GLOSSY CAROTID VISITS AORTA IN VEGAS

Innervation of baroreceptors



MedPrepOnline Qbank
Question: Which of the following drugs is useful in the treatment of angina pectoris?
a. Digoxin
b. Quinidine
c. Quinine
d. Salbutamol
e. Propranolol


Correct answer: (e)

Propranolol is a non-selective beta-blocker. It blocks beta-1 and beta-2 receptors. By blocking beta-1 receptors, it decreases the heart rate and leads to decreased oxygen demand by the cardiac cells which prevents angina from occurring.

Digoxin (a) increases contractility; hence, increasing oxygen demand and precipitating angina.

Quinidine (b) is a derivative of quinine (c) which is an antimalarial and has no role in angina. Itself it is a class Ia anti-arrhythmic that blocks Na+ channels and prolongs the action potential duration. It has no role in angina.

Salbutamol (d) is a beta-2 agonist and has no role in angina. Beta-2 receptors are present on the bronchioles.


Yo Dawg Villi Medical Meme



Medical Teaching Hospital Hierarchy



CNS lymphoma
Image Copyright of Radiological Society of North America
Question: A 36 year old male presented with seizures and motor deficits. MRI scan of his brain revealed a homogeneously enhancing mass in the frontal lobe. Histological examination of the mass revealed it to be a B cell lymphoma. The most useful investigation in this patient would be to test for?

a. Epstein-Barr virus
b. Cytomegalovirus
c. Herpes simplex
d. HIV
e. Respiratory syncytial virus


Correct answer: (d) HIV

Immunocompromised patients are found to have a primary CNS lymphoma and 90% of such lymphomas are associated with EBV infection. In the above stated causes, HIV is a common cause of immunodeficiency. EBV (a)  itself does not lead to a primary CNS lymphoma unless the patient is immunodeficient in the first place.

Cytomegalovirus (b) or CMV is associated with retinitis and/or interstitial pneumonia. It is not associated with lymphoma.

HSV (c) and RSV (e) are not associated with lymphomas.


 
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