Author: Epomedicine

PGMEE, MRCS, USMLE, MBBS, MD/MS tb vs sarcoidosis

Difference between Sarcoidosis and Tuberculosis

Epomedicine,

Sarcoidosis and tuberculosis are both granulomatous disease with similar constitutional symptoms, respiratory symptoms and multiple organ involvement with hilar and mediastinal lymph node involvement. Hence, the diagnosis of one from the other may pose significant difficulties. Sarcoidosis vs Tuberculosis (TB) IFN-gamma release assays (IGRA)Tuberculosis can be reliably excluded if both…

Clinical Skills and Approaches opioid algorithm

Prescribing Opioids for Chronic Pain

Epomedicine,

Recommendations for Prescribing Opioid in Chronic pain 1. 1st line of therapy in chronic pain outside of active cancer, palliative or end of life care must be nonpharmacologic therapy and nonopioid pharmacologic. Consider opioid therapy in combination with nonpharmacologic or nonopioid pharmacologic therapy if benefits outweighs risk. 2. Ordinarily 2…

Emergency Medicine nstemi algorithm

NSTEMI : Early Medical Management Pearls

Epomedicine,

Antiplatelet therapy Aspirin 2-4 non-enteric coated chewable baby aspirins (81 mg each) – buccal absorption is the fastest for platelet inhibition. Initial dose: 150 mg – 325 mg Daily dose: <150 mg For patients unable to take oral medications: Rectal suppository 325 mg Avoid in acute MI: Enteric coated preparations…

PGMEE, MRCS, USMLE, MBBS, MD/MS antidepressant side effects

Antidepressants Made Easy

Epomedicine,

Tricyclic Antidepressants (TCA) Mnemonic: -pramine, -triptyline, -pin Secondary amines: predominantly norepinephrine reuptake inhibitors Nor-triptyline Desi-pramine Tertiary amines: Ami-triptyline Imi-pramine Clomi-pramine Doxe-pin Irreversible MAO Inhibitors Mnemonic: TIPS Non-selective MAO inhibitors: Tranylcypromine Isocarboxazid Phenelzine Selective MAO-B inhibitor: Selegiline (transdermal patch) Reversible Inhibitor of MAO-A (RIMA) Moclobemide Tolaxatone Tetracyclic Antidepressants Nonselective inhibitor of…

PGMEE, MRCS, USMLE, MBBS, MD/MS steroid leukocytosis mechanism

Steroid Induced Leukocytosis

Epomedicine,

Mechanism of Steroid Induced Leukocytosis There are 3 major mechanisms responsible for corticosteroid induced granulocytosis: 1. Demargination of neutrophils from endothelial cells (60% of the rise): Recall the leukocyte adhesion cascade in the chapter of inflammation. L-selectins are present in leukocytes that mediates their rolling on the endothelial lining of…

Case Reports small cell lung cancer approach

Extensive Small Cell Lung Cancer

Epomedicine,

Short Case Summary 74 years old smoker, male patient presented with significant weight loss, productive cough and abdominal discomfort of short duration. Patient was icteric with stable vitals. On examination of chest, there was decreased air entry over right lung field. On examination of abdomen, liver was palpable with hard,…