Cerebrospinal Fluid (CSF) Production and Absorption CSF is produced by the choroid plexus that lines the ventricles. Choroid plexus = Infoldings of blood vessels of piamater + Modified ciliated ependymal cells Tight junctions of the choroid plexus cells form Blood-CSF barrier. CSF is reabsorbed by arachnoid granulations to enter dural…
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics
He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music.
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Answering Techniques for Surgery Papers
How to answer definitions ? Definitions are often asked in the exams – both in theory exams and viva-voce. As the content is vast, mugging them up is not a good idea. If you have a good understanding over the topic, you can write down a good definition by including…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Thalamic Connections Mnemonic
Structure of Thalamus A vertical “Y” shaped white mater – internal medullary lamina divides thalamus into: In anatomical position: Pulvinar = Posterior end or posterior pole of thalamus Thalamic Connections Picture mnemonic Remember the schematic diagram drawn below showing important parts of thalamus in an anticlockwise fashion: Now, we assign…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heme Synthesis and Defects Simplified
Structure of Heme Heme is a ferro-proto-porphyrin. Heme = Protoporphyrin IX ring + Iron (Fe) in center Protoporphyrin IX = porphyrin with attachment to 4 Methyl, 2 Propionyl and 2 Vinyl groups. Porphyrin = Cyclic structure with 4 pyrrole rings Pyrrole rings are derived from Porphobilinogen (PBG) Hydroxymethylbilane = Linear…
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Medical Humanities in Nepal
The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. – Mark E Silverman Shapiro et.al. defined medical humanities with characteristic features: Use of methods, concepts, and content from one or more…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Cholesterol Synthesis Mnemonic
Liver as a hub of cholesterol metabolism All nucleated cells have the capacity to synthesize cholesterol from acetyl-CoA (like most biological lipids). 90% of synthesis occurs in liver and intestine. The cholesterol biosynthesis pathway involves enzymes that are in the cytoplasm, microsomes (ER), and peroxisomes. Liver obtains cholesterol from 3…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Inheritance of Disease – Mnemonics
Lets work with some generalizations 1. X-linked dominant, mitochondrial and Y-linked conditions are rare. You need to remember them. 2. Usually inherited in autosomal dominant pattern are: Mostly mutations in non-enzymatic structural proteins (e.g. collagen, fibrillin, cytoskeletal proteins of RBC) or in membrane receptors (e.g. LDL receptor) Diseases due to diminished…
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Why to not defibrillate Asystole ?
What is asystole? Asystole is a state of no cardiac electrical activity. It is seen as a “flat-line” in ECG monitor. However, other possible causes of flat-line should be ruled out before calling it asystole. They are: Loose or disconnected ECG leads Loss of power to ECG monitor Once, asystole…