Kerley lines are a sign seen on chest radiographs with interstitial pulmonary edema. They are thin linear pulmonary opacities caused by fluid or cellular infiltration into the interstitium of the lungs. They are named after Peter Kerley.
Types
Kerley A lines
Longer (at least 2cm)
Unbranching lines
Coursing diagonally from the periphery toward the hila in the inner half of the lungs. Caused by distension of anastomotic channels between peripheral and central lymphatics of the lungs.
Kerley A lines are less commonly seen than Kerley B lines.
Kerley A lines are never seen without Kerley B or C lines also present.
Kerley B lines
These are short parallel lines at the lung periphery.
These lines represent interlobular septa
Usually less than 1 cm in length
Parallel to one another at right angles to the pleura.
They are located peripherally in contact with the pleura, but are generally absent along fissural surfaces.
They may be seen in any zone but are most frequently observed at the lung bases at the costophrenic angles on the PA radiograph, and in the substernal region on lateral radiographs.
Kerley B lines are seen in Congestive Heart Failure (CHF) and Interstitial Lung Diseases (ILD).
Kerley C lines
Least commonly seen of the Kerley lines.
Short, fine lines throughout the lungs, with a reticular appearance leading to spider web appearance.
They may represent thickening of anastomotic lymphatics or superimposition of many Kerley B line.
GLP agonists bind to a membrane GLP receptor.[2] As a consequence of this, insulin release from the pancreatic beta cells is increased. Endogenous GLP has a half life of only a few minutes; thus an analogue of GLP would not be practical.
Exenatide (also Exendin-4, marketed as Byetta) is the first GLP-1 agonist approved for the treatment of type 2 diabetes. Exenatide is not an analogue of GLP, but rather a GLP agonist.[20][21] Exenatide has only 53% homology with GLP, which increases its resistance to degradation by DPP-4 and extends its half-life.[22] Typical reductions in A1C values are 0.5-1.0%.
These agents may also cause a decrease in gastric motility, responsible for the common side effect of nausea, and is probably the mechanism by which weight loss occurs.
Amylin agonist analogues slow gastric emptying and suppress glucagon. They have all the incretins actions except stimulation of insulin secretion. As of 2007[update], pramlintide is the only clinically available amylin analogue. Like insulin, it is administered by subcutaneous injection. The most frequent and severe adverse effect of pramlintide is nausea, which occurs mostly at the beginning of treatment and gradually reduces. Typical reductions in A1C values are 0.5-1.0%.
The Enneking system for the surgical staging of bone and soft-tissue tumors is based on grade (G), site (T), and metastasis (M) and uses histologic, radiologic, and clinical criteria.
Grade
In the Enneking system, bone tumors are graded as follows:
G0 - Benign lesion
G1 - Low-grade malignant lesion
G2 - High-grade malignant lesion
Surgical grade generally follows histologic grade; however, a higher surgical grade may be applied if the radiographic features and clinical behavior of a lesion indicate an aggressiveness that is incompatible with its benign histologic features.
Site
In the Enneking system, the site and local extent of bone tumors are classified as follows:
T0 - A benign tumor that is confined within a true capsule and the lesion's anatomic compartment of origin (ie, a benign intracapsular, intracompartmental lesion)
T1- An aggressive benign or malignant tumor that is still confined within its anatomic compartment (ie, an intracompartmental lesion)
T2 - A lesion that has spread beyond its anatomic compartment of origin (ie, an extracompartmental lesion)
Metastasis
Metastatic classification in the Enneking system is as follows:
M0 - No regional or distant metastasis
M1 - Regional or distant metastasis
Benign: 1 Latent G 0 T 0 M 0 2 Active G 0 T 0 M 0 3 Aggressive G 0 T 1-2 M 0-1
Enneking's Staging System of Malignant Bone Tumors Ia Low grade, intracompartmental G 1 T 1 M 0 Ib Low grade, extracompartmental G 1 T 2 M 0 IIa High grade, intracompartmental G 2 T 1 M 0 IIb High grade, extracompartmental G 2 T 2 M 0 IIIa Low or High grade, intracompart. G 1-2 T 1 M 1 w/ metastases. IIIb Low or High grade, extracompart. G 1-2 T 2 M 1 w/ metastases.
The Enneking classification correlates the tumor stage with the excision margins as follows:
Benign tumors
Stage 1 tumors - Intracapsular excision (or curettage) is adequate.
Stage 2 tumors - Extracapsular excision passing through the reactive zone is needed.
Stage 3 tumors - Wide margins of resection are required in stage 3 lesions (aggressive benign tumors). In areas that are not amenable to wide excision, marginal excision together with adjuvant treatment (eg, radiation therapy) may be acceptable.
Malignant tumors
Stage IA - These tumors are treated with wide excision and are usually amenable to limb salvage procedures.
Stage IB - Such tumors may be treated with wide excision, but the choice between amputation and limb salvage depends on the estimated amount of residual tumor left behind after a limb salvage procedure.
Stage II - These tumors are high grade, are usually extracompartmental, and have a significant risk for skip metastases. They usually are not amenable to limb salvage operations and require radical amputation or disarticulation in most patients. However, bone tumors responsive to chemotherapy may be treated successfully using wide excision and adjuvant therapy.
Stage III - Tumors at this stage are responsive to chemotherapy and may be treated with aggressive resection. Those that are not responsive to adjuvant therapy should be treated with palliative resection.
Phaechromocytoma is a rare tumor. It is the tumor of the adrenal medulla of adrenal glands. It produces epinephrine and/or norepinephrine. Approximately 90% of the tumor arise from the adrenal glands itself while the restoccur at extra adrenal.
ANALGIN: This is a pain-killer. Reason for ban: Bone marrow depression. Brand name : Novalgin __________________________________________________ _________ CISAPRIDE: Acidity, constipation. Reason for ban : irregular heartbeat Brand name : Ciza, Syspride __________________________________________________ __________ DROPERIDOL: Anti-depressant. Reason for ban : Irregular heartbeat. Brand name : Droperol __________________________________________________ ____________ FURAZOLIDONE: Antidiarrhoeal.. Reason for ban : Cancer. Brand name : Furoxone, Lomofen
__________________________________________________ ___________ NIMESULIDE: Painkiller, fever. Reason for ban : Liver failure. Brand name : Nise, Nimulid __________________________________________________ ______________________
NITROFURAZONE: Antibacterial cream.
Reason for ban :Cancer.. Brand name : Furacin __________________________________________________ ______________________
PHENOLPHTHALEIN: Laxative. Reason for ban : Cancer. Brand name : Agarol __________________________________________________ ______________________ PHENYLPROPANOLAMINE: cold and cough. Reason for ban : stroke. Brand name : D'cold, Vicks Action-500 __________________________________________________ ______________________ OXYPHENBUTAZONE: Non-steroidal anti-inflammatory drug. Reason for ban : Bone marrow depression. Brand name : Sioril __________________________________________________ _____________________ PIPERAZINE: Anti-worms. Reason for ban : Nerve damage. Brand name : Piperazine __________________________________________________ ______________________ QUINIODOCHLOR: Anti-diarrhoeal. Reason for ban : Damage to sight. Brand name : Enteroquinol
Friday, September 17, 2010
EPONYMS NAMED AFTER JEAN MARTIN CHARCOT: 1) Charcot-Leyden crystals- Synonyms: Asthma crystals, Charcot-Robin’s crystals The crystals: Double-pointed, colourless, hexagonal andoften needle-shaped phosphate crystals (the crystallizedmembrane-associated eosinophil enzyme lysophospholipase) found in sputum of patients suffering from bronchial asthma or stool of patients with acute amoebic dysentery and ulcerative colitis. The crystals were first noticed by Friedreich Albert von Zenker in 1851, and then described by others. Other persons associated: Ernst Viktor von Leyden,Charles-Philippe Robin
2) Charcot’s joint- Synonym: Neuropathic joint The joint: Non-inflammatory, painless, disorganized or destroyed, hypermobile, huge swelling of joints(especially knee) with crepitus felt on joint movement due to presence of loose bodies. There is marked instability of the joint. The condition may be seen in diabetes mellitus, leprosy, syringomyelia or tabes dorsalis.The posterior column sensations are lost in patients with Charcot’s joint.
3) Charcot-Neumann crystals- The crystals: it is the phosphate crystals present in semen Other person associated: Franz Ernst Christian Neumann
4) Charcot’s triad I (cerebral triad)- The triad: The combination of intention tremor,nystagmus, and scanning or staccato speech, which is very often seen in multiple sclerosis.
5) Charcot’s triad II (biliary triad)- The triad: Recurrent pain in right upper abdomen or biliary colic, fluctuating jaundice, and intermittent spiking fever with rigors seen in patients with stone in common bile duct.
6) Charcot’s intermittent hepatic fever- The fever: This is in continuation of Charcot’s triad II,where there is pyrexia due to cholangitis, and associated with jaundice and upper abdominal discomfort.
7) Charcot-Bouchard aneurysm- Synonym: Charcot’s artery of cerebral haemorrhage (i.e.,the lenticulostriate branch of middle cerebral artery) The aneurysm: Microaneurysm of small cerebral perforated vessels, rupture of which may result in intracerebral bleeding. Other person associated: Charles-Joseph Bouchard
8) Charcot’s oedema- The oedema: A local and very painful oedema with a bluish appearance of the extremities, seen in hysterical paralysis.
9) Charcot’s disease- Synonym: Charcot’s sclerosis, Lou Gehrig’s disease,tabes spasmodica The disease: It is a rare disorder of nervous system with degeneration of nerves conducting signal to muscles.There is early asymmetrical weakness of limb muscles, followed by fatigue, cramps, wasting and fibrillation of the upper extremity, and spasticity of the lower limbs. It usually affects adults over 50 years of age but may occur in younger persons with a M:F ratio of 2:1. The entity is now known as amyotrophic lateral sclerosis, and commonly known to media as Lou Gehrig’s disease, after Henry Louis (Lou) Gehrig, an American baseball player who died from it in 1941.
10) Charcot’s vertigo- Synonym: Cough syncope The entity: An attack of violent coughing may result in laryngeal spasm or glottic closure, which ultimately leads to intense vertigo or syncope
11) Charcot’s-Marie-Tooth disease- Synonym: Charcot’s-Marie-Tooth-Hoffmann disease, Tooth’s syndrome, peroneal muscular atrophy The disease: It is the commonest disease within a group of conditions known as Hereditary Motor and Sensory Neuropathies (HMSN). There is slowly progressive weakness as well as wasting of distal muscles of legs and arms, resulting from degeneration of the peripheral nerves, nerve roots, and even the spinal cord. The patient is usually a young one who develops foot drop, highstepping gait and ‘inverted champagne bottle’ appearance of the legs. The affected person has normal intelligence with normal life span. The disease was first described by Friedreich Schultze in 1884 but the work of Charcot threw light over the disease with a new concept that it is a neuropathy, rather than being a myopathy. Other persons associated: Pierre Marie, Howard HenryTooth, Johann Hoffmann
12) Charcot’ zones- The zones: Hysterogenic zones in the human body
13) Charcot-Wilbrand syndrome- The syndrome: A neuro-ophthalmic syndrome, resulting in visual agnosia and inability to revisualise images due to occlusion of the posterior cerebral artery of the dominant hemisphere. The condition is sometimes associated with Gerstmann’s syndrome. Other person associated: Hermann Wilbrand
14) Erb-Charcot paralysis- The paralysis: a rare syndrome comprising of spinal syphilis with paraesthesia, spastic weakness, sphincteric disorder, brisk deep reflexes, muscle atrophy, sensory disturbances, and paraplegia. Other person associated: Withelm Heinrich Erb
15) Charcot’s angina cruris- Synonym: Charcot syndrome I, intermittent claudication, intermittent limping syndrome The disease: It is an intermittent gait disturbance caused by obliterative angiopathy with diminished circulation of muscles of legs. There is appearance of pain, discomfort, cramp and weakness of legs, most commonly developing after physical effort/walking and disappearing after rest. The condition is symptomatic of a variety of vascular disease, including Buerger’s disease. The term coined at the title is no longer used for intermittent gait disturbances.
16) Charcot-Joffroy syndrome- Synonym: Spiller’s syndrome, epidural ascending spinal paralysis The syndrome: A syndrome characterized by sensorydisturbances of lower limbs, localized or diffuse pain in the back/legs/chest, followed by weakness of knees, and transverse myelitis There may be presence of hyperaesthesia, vasomotor and sphincteric disturbances, resulting from thrombophlebitis of the meningorachidian veins with subacute/chronic pachymeningitis. In 1911, Spiller first reported two cases. Other persons associated: William Gibson Spiller, Alexis
17) Souques-Charcot syndrome- A variant of Hutchinson-Gilford syndrome (premature aging in younger children with dwarfism) consisting of eunuchoid habitus, mental subnormality, loose-shinydry skin with subcutaneous atrophy. Other associated person: Alexandre-Achille Souques,Sir Jonathan Huchinson
18) Charcot-Weiss-Baker syndrome- Synonym: Carotid sinus hypersensitivity syndrome,tight collar syndrome, vagal syncope. The syndrome: Transient attacks of syncope associated with bradycardia and hypotension, resulting from application of strong pressure on the neck over the bifurcation of common carotid artery, or by sudden turning of head, or wearing a tight collar. This syndrome was first described by Johann Nepomuk Czermak in 1866. Other persons associated: Soma Weiss, James Porter Baker
Auscultatory areas starting from left 2nd intercostal space:
Remember: All Patients Take Medicines
Aortic - Pulmonary - Tricuspid - Mitral
Note:
Only Aortic area is on left ; Remember that ALL stands for aortic area - read as Aortic Left Left ; Why 2 lefts? Because it's in 2nd IC space )
If you want to remember the other intercostal spaces where the auscultatory areas on right are situated just imagine a patient in Room no.245 - Right 2, 4, 5 IC spaces in that order for Pulmonary, Tricuspid, Mitral in that order of All Patients Take Medicine.
Confusion buster: Please note that Aorta arises from left ventricle, but auscultatory area is on right side. Note the same problem with Pulmonary artery.
Ortholani's and Barlow's tests detect DDH. You might confuse between the two tests or you may feel that both are the same. First, here is what the tests are:
Barlow's test: The maneuver is performed by adducting the hip while applying light pressure on the knee, directing the force posteriorly. If the hip is dislocatable, the test is considered positive. The Ortolani maneuver is then used, to confirm that the positive finding (i.e., that the hip actually dislocated).
Ortholoni's test: It is performed by gently abducting the infant's leg using the examiner's thumb while placing anterior pressure on the greater trochanter using the examiner's index and forefinger. A positive sign is a distinctive 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum.
Now here's how to remember the two tests:
Barlow's test - you feel the Dislocation - so Barlow's test is Bad test as you are dislocating from joint.
ORTHOlani - you try to feel the Reduction - like ORTHOpedicians reducing all fractures and dislocations.
The stethoscope's diaphragm is larger than the bell. So remember - diapragm (LARGER) picks up HIGH pitched sounds; Bell (SMALLER) picks up LOW pitched sounds.
AeGophony- like bleating of A Goat ; Ask the patient to say 'A', you hear 'E' (AEgophony)
Bronchophony - spoken from the EARpiece (BEAR).
sIbiliant rhonchi is hIgh pitched; sOnorous- lOw pitched
List of Microbes which may not gram stain well:
Remember: " These Microscopic Rascals May Look Colourless "
Treponema
Mycobacteria
Rickettsia
Mycoplasma
Legionella
Chlamydia
In case the attending nurse sees a patient with chest pain, she should MOVE the patient to emergency care unit:
Remember MOVE:
Monitor (cardiac monitor) connect
Oxygen administration
Venous access with large bore canula
ECG to be taken
In Good Pasture's syndrome, there is auto antibodies against Glomeruli (causing Glomerulonephritis ) & Pulmonary basement membrane ( causing Pneumonitis )
To remember the named signs, it would be better to know a little bit of history. There might be an interesting incident related to a person who gave the name of the sign / syndrome. One such interesting case is how Sister Mary Joseph node got it's name. Also called Sister Mary Joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen.
To remember this sign better, let's go back to history. Imagine these events:
Scene: St. Mary's Hospital in Rochester; Dr. Mayo is taking rounds with Sr. Mary Joseph, his surgical assistant helping him.Sr. Mary drew Mayo's attention to the phenomenon, and he published an article about it in 1928.
Some signs can be better understood and remembered by knowing the meaning of word. Of course, most of the signs are named after people, but we are lucky to have few signs otherwise. For example, when I asked one medical student why Puddle's sign is named so, he told me that it was named after Dr. Puddle and he didnot remember what the sign was about.
So what's a puddle? A puddle is a small collection of liquid, usually we refer to a puddle of water in the ground after a rain etc. This is used to detect minimal fluid collection in the abdomen i.e. minimal ascitis.
Now to remember, you have the picture given below. There's a puddle, a sign board reading 120 ml and a Gorilla. Puddle sign can detect ascitis as less as 120 ml. What's the Gorilla doing there? The Gorilla's position is the position we use to elicit puddle sign. To make this more clear, let us see how to elicit this sign.
Let patient lie prone for 5 minutes, after which he/she has to rise on his/her elbow and knees (that's like the Gorilla!) and by the method of auscultatory percussion you find that there is resonant note in the flanks and dull note towards the center of abdomen i.e. the puddle forms at the central part of abdomen.
Which anticoagulant can be used in pregnancy? Heparin or Warfarin?
Answer is Heparin. WARfarin SHOULD NOT BE used. Remember: There SHOULD NOT BEWAR IN pregnancy.
Ricketsial POX : R. AKArI (see the picture above - AKAI)
ePidemic typhus : R. Prowazekii
Rocky mountain spotted fever : R. Riketssi
Q - Fever : COXiella BURNetti ( Imagine Camel & OX walking in a queue i.e. "Q" in a BURNing desert)
Srub typhus : R. TSUTSUgamushi (Imagine the sound while scrubbing - TSU TSU TSU TSUgamushi; alternatively remember only SUsugamushi, with "t" silent for ScrUb). SCRub typhus causes eSChaR
Remember this with the formula D / R for paucibacillary and DC / RC for multibacillary Explanation: The denominator is the monthly drug to be taken. In case of multibacillary leprosy, note that the dose of Clofazamine, be it monthly or daily, is half the dose of other drug taken along with it ( 100 / 2 = 50, 600 / 2 = 300 ). Duration of treatment is 1/2 yrs and 2 yrs for Pauci & Multibacillary leprosy respectively.
Which of these is a bio indicator of past pollution with fecal matter?
a) Faecal Streptococci b) Clostridium perfringens c) both d) none
The answer is b.
How to remember:
Cl. perfringes is an indicator of past water pollution
Also remember that the indicator of recent water pollution is Faecal Streptococci ( Recent = Short term - Streptococci )
Remember Rajasthan Transport Development Corporation Board (RTDCB):
Roots join to form Trunks
Trunks join to form Divisions
Divisions join to form Cords
Cords join to form Branches
Branches
Alternatively, remember Real Teenagers Drink Cold Beer
Other alternative mnemonics sent by Mr. Frank Hopkins made with his mnemonic generating software:
Uses 1st Two Letters of Each Term
Romanian Troops Diverted Combat Brigade
Round Trembling Divas Cold Breasts
Uses 1st Letters Only
Real Tight Dollar Closed Banks
Raining Twenty Days Collapsed Bridge
Real Tequila Drinker Charlie Boozer
Remember That Dudes Chick's Bootie
Raise The Dead Crying Behold!!! (This has a more religious tone to it)
Many of the medical names are derived from latin. If you study a bit of latin or greek you will find medical terms getting simpler. Below is a picture depicting how few bones got their names (Starting from the first picture row wise):
ACETABULAM
In Latin, acetum = vinegar and -bulum, a suffix signifying the instrument. Acetabulum was thought to resemble a small vinegar cruet of roman times.
TIBIA
In Latin means a flute. Yes, a tibia after removal of external fixators looks like a flute :-)
PATELLA
In Latin means a little plate. So next time have food in a big patella !
SKULL
In Anglo Saxon means a bowl. Eat brain from the bowl !
OLECRANON
In Greek, olenokranon, from olene = elbow and kranos = helmet. In other words, the protector of the elbow. Elbow's helmet !
COCCYX
In Greek, kokkyx = cuckoo. This bone looks like the beak of a cuckoo. Huh?
PELVIS
In Latin, pelvis means basin.
CLAVICLE
In Latin, clavicula, diminutive of clavis = a key. Clavicle resembled those old keys. Anyway, don't use your clavicle to open your door :-)
tRIcuspid valve is in RIght atrium
Bicuspid valve in Left atrium ( Remember BiLe)
Bicuspid valve is also called MitraL valve. So mitraL is on Left
If you know what is a "mitre", then you can easily remember that bicuspid valve is mitral. "Mitre" is the hat that you see often worn by bishops. It has 2 leafs resembling the cusps. See picture below.
Alternatively, imagine a RAT in LAB; Right Atrium Tricuspid, Left Atrium Bicuspid.
If you know Hindi, remember DoMitr (Two friends) Bicuspid valve = Mitral valve by
Anatomy was very confusing, especially relative position of structures. One constant confuser was the position of Aorta and Venacava as they descend into thorax.
I remembered that the AoRTa is RighT .
Here's another way to remember : Both a-o-r-t-a and r-i-g-h-t have 5 letters; v-e-n-a and c-a-v-a and l-e-f-t have 4 letters.
CONTRIBUTED BY MR. KAMAL A.P. Remember FEAR: (The manipulation of shoulder has to be carried out in this sequence)
Flexion
Extension
Abduction, followed by Adduction ( Remember Ab comes before Ad in dictionary)
Rotations (Internal & external)
The factors consumed in clot are 1, 2, 5, 8. You can remember this by imagining a watch showing the time as 12:58 - 1,2,5,8 ; Also imagine CFC (Clotting factors consumed) written on the watch.
Another mnemonic was sent by our reader Mr. Shiva; Shiva just keeps singing 1,2,5,8 what do we appreciate? clots!
There are 2 types of Amyloidosis of spleen - Sago spleen and Lardaceous spleen
What is the difference between the two?
Remember - Super Fast bus has Less Passengers (SF-LP)
Sago spleen - Amyloid deposit in Follicles
Lardaceous spleen - Amyloid deposits mostly inPulp
In NPH, there is
Abnormal P,H ( P = Pee problems = urinary incontinence; H = Head problem = dementia )
Ataxia
Absent signs of raised intracranial tension ( like headache, vomiting )
Here's how to remember the KTC = Kreb's or TCA or Citric acid cycle:
Remember "Citric Acid Is Kreb's Starting Substrate For Mitochondrial Oxidation"
These stands for the substrates in order:
Citric acid
Iso-Aconitase
Iso-citrate
Alpha-Ketoglutarate
Succinyl CoA
Succinate
Fumarate
Maleate
Oxaloacetate
To remember the vitamin K dependent factors, try to memorize this picture. They are factors 2, 7, 9, 10. The story behind the picture mnemonic. In year 2K ( = 2000 = factor 2 is K dependant ), a pregnant lady after carrying her child for 9 months, caring all 7 days a week, gave birth to a child. The child grew up, got 10 upon 10 marks.
UV rays from sun act on skin, convert Cholecalciferol (CC) --> 25 Hydroxy CC in liver --> 1,25 Di Hydroxy CC in kidney.
So there are two hydroxylation reactions, first in Liver, second in Kidney. Remember this: You have 1 liver, 2 kidneys; So hydroxylation 1st reaction in your 1 liver and 2nd hydroxylation in 2 kidneys.
First Generation Cephahlosporins - Remember this story:
Mr. Fazol (ceFAZOLin) is a Lorry Driver (cephaLORIdine). He works very hard and has become Thin (cephaloTHIN) He has a "Rad" Watch on his hand (cephRADine) and a "Lux" soap (cephaLEXin). He wears a bright green Drawer {i.e trousers} ( cefaDROxil)
Route of drug administration: He will put the Lux soap in his Drawer - (Cefalexin & Cefradine are given orally. The latter can also be given i.v. /.i.m.. All others- i.v. /.i.m)
Second Generation Cephalosporins: Remember FOX, FUR, FAC - ceFOXitin, ceFURoxime, ceFAClor
Third Generation Cephalosporins - The story goes thus:
Mr. Aziz (ceftAZIdime) is taking an Ox (ceftizOXime, cefpodOXime) in a Taxi (cefoTAXIme) for slaughtering, i.e. an Operation (cefOPERAZONE). For this purpose he is taking Three Axon blades (cefTRIAXONe). He will Fix (ceFIXime) the ox for dinner (cefDINIR) in a short time!
Route of drug administration: Fix the price and eat (only Cefixime is given oral: all others im/iv).
ADRs: Operation will cause bleeding (Cefoperazone cause bleeding)
Fourth Generation Cephalosporins:
My wierd dream: QUEEN of ROME who FLEW to OZONE layer, fell down and was made IP (Inpatient) by ME. Helps you to remember fourth generation cephalosporins - Cefquinome, Cefpirome, Cefluprenam, Cefozopran, Cefipime.
Remember the REP ( Medical representative ) offering you an iPod. Let us name him as iREP ( REP offering iPod ). He tells you, " give me 5, 10, 15, 20 - 35 prescriptions to get an iPod ".
Here's the interpretation:
iREPS stands for
i - INH - 5mg/kg
R - Rifampicin - 10mg/kg
E - Ethambutol - 15mg/kg
P - Pyrazinamide - 20-35mg/kg
S - Streptomycin - 20-35mg/kg
Their dosages per kg are 5, 10, 15, 20-35, 20 - 35 respectively.
Which of these are Bacterocidal?
Of these, the ones that RIPS bacteria are the R, I, P, S.
To remember certain striking side effects see below:
INH - I Have Neuritis
Rifampicin - Red man syndrome
Ethambutol - Eye affected ( Retrobulbar neuritis )
Streptomycin - Song is difficult to hear ( Oto toxicity)
Erb's - Upper trunk ( C5, C6 ) {See the picture mnemonic above - imagine the '6' to resemble 'b' of erbs ; 's' resembles '5' }
Klumpke's - Lower Trunk ( C7, C8, T1 )
Remember 'E' comes before 'K' in alphabetical order, so Erb's is upper and Klumpke's lower trunk.
Now Klumpke's start with C7. Note that K-L-U-M-P-K-E is 7 letters.
Wegener's granulomatosis affects the upper and lower respiratory tracts and the kidney. As depicted in the visual mnemonic, URTI, LRTI, Epistaxis, Hemoptysis, Glomerulonephritis are few of the manifestations of this disease. It is C-ANCA positive. Treatment is with antibiotics, corticosteroid, Azathioprine, Cyclophosphamide etc.
This visual mnemonic gives you the clinical features of Kawasaki disease. Imagine a Child on Kawasaki bike with red lips, tongue, body rash with cervical lymphadenopathy having a heart thrash ( Coronary aneurysm ) seeing a beautiful nurse who has the treatment needed for him. Note that Kawasaki disease is C- ANCA +ve as painted on the bike. The clinical features are depicted as a song, which you can try to sing in the tune of Titanic's song, "my heart will go on...."
Endodermal pouches form the following organs / glands:
You have 1 tongue and 2 tonsils
So from Ventral part of 1st Endodermal pouch forms the tongue
From ventral part of2nd Endodermal pouch forms tonsils
From THIrd endodermal pouch forms THymus and Inferior parathyroid
Note that superior parathyroid and follicular C - cells of thyroid forms from the 4th endodermal pouch (The superior and more complicated one arises from the fourth)
The above picture gives mnemonic for Ewing's tumor. First let us analyse the picture. Note the chick and swelling of Diaphysis of Tibia with the onion. Chick says VAC VAC VAC VACA, VAC VAC VAC AV / CV. The chick has fat and hence PAS stain positive. Note the moon and star at the top, Radio streaming music and chick fluttering it's wings up and down to the music as represented by 2 arrow marks at the left side. See the melted snow below the bone and a blood vessel from the side ( left corner )
Now, this is what the picture says: Ewings - the chick with wings; Arises from Diaphysis, most common bone is Tibia. Seen in children as represented by the chick. Onion represents the onion peel appearance in X-rays. The wings going up and down ( arrows ) represent that the size of tumor increases and decreases ( H/O Exacerbations and remissions ). The moon & star represents the clinical feature that pain is worse at night. Radio represents that the tumor is extremely radiosensitive - therefore melts like snow. Spread is by blood vessels and lymphatics. And what the chick says is the chemotherapy regimen - VAC ( Vincristine, Adriamycin, Cyclophosphamide ), VACA ( VAC + Actinomycin ), AV alternating with CV.
To remember the structures of anatomical snuffbox, look at your right hand and extend your thumb. You see three prominent tendons. The tendon in between is a brevis tendon - Extensor policis brevis. The tendon that meets it from the extensor surface is therefore extensor policis longus. The remaining tendon going in different direction of Extensor Policis Brevis is Abductor Policis Longus. Note that the longus goes parallel and brevis converges on both ends.
Kerley’s A lines (arrows)
