This article is in response to the request made by a reader in the comment section. Today, we will try to simplify the biliary tree cancers. Classification of Cholangiocarcinoma Second-order bile ducts act as the separation point between intrahepatic and extrahepatic cholangiocarcinoma. A. Inhtrahepatic – 10 to 20% B. Extrahepatic…
Author: Epomedicine
PGMEE, MRCS, USMLE, MBBS, MD/MS
Most Important Urinary Buffer: Phosphate or Ammonia?
There are multiple choice questions (mcq) which asks: What is the most important urinary buffer? And the choices include both the phosphate and ammonia. Different textbooks on physiology and biochemistry have different opinions. Some say that the most important is Phosphate and the others say Ammonia is more important. So,…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Rosettes in Pathology
Rosette refers to a decoration or pattern resembling a rose. In pathology, rosette refers to aa halo or “spoke-wheel” arrangement of cells around a central structure especially in neoplasms of neuroblastic or neuroectoderma origin. The central structure can be: a. Empty lumen: True ependymal rosette Well differentiated ependymomas (minority of cases)…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Purine and Pyrimidines : Structure, Synthesis and Metabolism
Purines and Pyrimidines Bases Purines = 2 rings Adenine Guanine Hypoxanthine (Deaminated Adenine) Adenine to Hypoxanthine deamination is mediated by Adenosine deaminase which is decreased in Autosomal recessive SCID. Accumulated dATP inhibit ribonucleotide reductase leading to deficient synthesis of other deoxyribonulceotide precursors for DNA synthesis. Xanthine (Deaminated Guanine) Mnemonics: Pure…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Trinucleotide Repeat Disorders and Anticipation Mnemonics
Anticipation in genetics refers to an increase in severity and decrease in age of onset in successive generations, most likely due to increased size of trinucleotide repeats. Paternal anticipation: Huntington’s disease, Friedreich’s Ataxia Maternal anticipation: Myotonic dystrophy, Fragile X syndrome Diseases Trinucleotide Repeat Affected gene Chromosome Fragile X syndrome CGG…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Solving Pedigree Analysis in 3 steps
First: Look for Mitochondrial Inheritance Female transmits disease to all the offsprings (both males and females). Male doesn’t transmit the disease and only the females transmit the disease. If Mitochondrial inheritance is absent, go to second step. Second: Look if the gene is Dominant, Recessive Dominant: Atleast one member in…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Glucose 6 Phosphate : Central to Glucose Metabolism
Glucose-6-Phosphate central to the 4 major metabolic pathways of glucose, i.e. glycolysis, gluconeogenesis, glycogenesis, glycogenolysis and HMP shunt (Pentose phosphate pathway). Glucose is immediately phosphorylated inside the cells to Glucose-6-Phsophate to trap them inside cell and prevent diffusion out of the cell. Glucose-6-Phosphate is the key intermediate to understand the…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Granular contents of Neutrophils and Platelets
Neutrophil Granules Azurophilic (Primary) Granules These are lysosomes that occur in all granulocytes, as well as in lymphocytes and monocytes. In addition to expected lysosomal hydrolases, they also contain peroxidases (used to demonstrate azurophilic granules chemically). Develop earlier than specific granules. Stains blue/purple by Romanowsky stain. Mnemonic: ABCDE MnOP Acid hydrolase…