Tones of Pictures, Most Commons and Mnemonics

Tuesday, August 28, 2007

NAC

The use of N-acetylcysteine=NAC:

N-->Nephropathy prevention(when use contrast for CT scan in patients with renal insufficiency)
A-->Acetaminophen toxicity
C-->Cystic Fibrosis (mycolitic agent)

Friday, August 24, 2007

Oxygen Dissociatin Curve


This tool is very helpful to understand better the O2 dissociation curve.
The full text with explanation of O2Hb dissociation curve here.

Monday, August 13, 2007

Mnemonics

I found Tommyk's notes 2 weeks ago and I can tell that there is a lot of very useful information like this one for example.

The NBME will ask a lot of questions about serum electrolytes and DIURETICS. This is come up over and over and over again!
LISTEN, for FHA (Acronym Federal Housing Authority). (which stands for Furosemide, HCTZ, and Acetazolamide), YOU LOSE K (cash) FROM THE SERUM!!!!!!!!! (Hypokalemia results) (Think of mnemonic, if the FHA comes, you likely have no Kash!)
LISTEN, if your patient wants a H (HI)- Fidelity (F) stereo, he has to BUY IT UP (B=Bi-carbonate) (Hydrochlorothiazide and Furosemide stands for the H and F), then you must BUY IT UP! ("Buy" sounds like Bicarbonate, and BUY IT UP means the "Buy"carbonate HCO3 levels in your blood will increase!) (LINK:metabolic alkalosis)
LISTEN, all Diuretics lower Magnesium, so THINK that if you sit down to pee (diuretic), you will also have a big MASSIVE GLOB of poop. The M in Massive and the G in Glob of poop stands for Mg coming out. (hypomagnesium)
LISTEN, ALL Diuretics raise uric acid in serum, lowering it in the renal tubules. This mnemonic is easy...DIURETIC SOUNDS LIKE URIC ACID both have "UR". Say it fast. then you will connect! And Diu"r"etic has "r" for raise in serum. (This is of clincal importance as Thiazide Diuretics are used to treat uric acid stones because while serum levels stay high, renal tubule levels remain low!)
LISTEN, the acronym ASA stands for aspirin, and aspirin Overdose is acidic. So the A (Amiloride), the S (Spironolactone), and A (Acetazolamide) . An aspirin Overdose gives you metabolic acidosis!!!!!!!
Also KNOW the connection that the K sparing diuretics STAys in serum. (S=spironolactone, T-triamterene, A-amiloride) (Usually, I found it helpful to recall that H and K stay together usually...) HCO3 leaves in the urine...
LISTEN, for Calcium ions it is tougher. But this works for me. I think of a S-Ca-fFold falling down a building. (You know, for painters). So, Calcium administration makes S (Spironolactone) and F (Furosemide) "fall" out of your urine! See the Ca in word S-Ca-Ffold!!!! (This is clincially important because LASIX or furosemide is given to CHF patients every second which predisposes them to Ca stones in kidney!
REPEAT THIS HIGH YIELD CONCEPTs UNTIL IT STICKS!!!!!! BEcause you will likely be asked this on your test because of the relation to renal stones....Ca for e.g. causes stones. Hypokalemia, Hyperacidosis...And this is SO IMPORTANT, you must repeat my mnemnoics over and over. They worked for a lot of people! And I spent a long time making up these memory mnemonics. Don't let them go to waste! Someone told me my mnemonics saved them! Thanks but please they are for everyone and they are useless unless you repeat them. Please e-mail me if you like the mnemonics. If they are bothersome, I will stop submitting them!!!!!

Saturday, August 11, 2007

Pulmonary artery hypertension


Theca and Granulosa cells


LH stimulate Theca cells to produce androstendione, which inturn is given to Granulosa cells
FSH stimulate Granulosa cells conversion of androstendione to estradiol by aromatase

Theca cells-->Theca lutein cells---------->Progesterone, Androgens

Granulosa cells-->Granulosa lutein cells------ >Progesteron, Estrogen
The corpus luteum is formed by both granulosa cells and thecal cells after ovulation has occurred. The wall of the follicle collapses into a folded structure, which is characteristic for the corpus luteum. Vascularization increases and a connective tissue network is formed. Theca interna cells and granulosa cells triple in size and start accumulating lutein (Which hormone stimulates this process? Where is this hormone produced?) within a few hours after ovulation. They are now called granulosa lutein cells and theca lutein cells and produce progesterone and oestrogens.
Hormone secretion in the corpus luteum ceases within 14 days after ovulation if the oocyte is not fertilised. In this case, the corpus luteum degenerates into a corpus albicans - whitish scar tissue within the ovaries.
Three major types of ovarian neoplasms are described, with epithelial cell tumors (70%) comprising the largest group of tumors. Germ cell tumors occur less frequently (20%), while sex cord–stromal tumors make up the smallest proportion, accounting for approximately 8% of all ovarian neoplasms.
Granulosa-theca cell tumors, more commonly known as granulosa cell tumors (GCTs), belong to the sex cord–stromal group and include tumors made up of granulosa cells, theca cells, and fibroblasts in varying degrees and combinations. GCTs account for approximately 2% of all ovarian tumors and can be divided into adult (95%) and juvenile (5%) types based on histologic findings.
Both subtypes commonly produce estrogen, and estrogen production often is the reason for early diagnosis.

Cryptosporidiosis



Cryptosporidium sp., an intracellular protozoan parasite. Using a modified cold Kinyoun acid-fast staining technique, and under an oil immersion lens the Cryptosporidium sp. oocysts, which are acid-fast stain red, and the yeast cells, which are not acid-fast stain green(picture1).
It exists in either the free-swimming (trophozoite) form or the oocyst (dormant) form. Cryptosporidium parvum is now recognized as a human pathogen which can cause severe diarrheal illness.
Big problem for immunocompromised patients (AIDS).