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
Prescribing Opioids for Chronic Pain
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 : Early Medical Management Pearls
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
Apoptosis (Caspases and Genes) : Mnemonics
Caspases (Pro-apoptotics) Initiator caspases: Executioner caspases: 3 and 7 Pro-apoptotic genes Mnemonic: “B” followed by a vowel Anti-apoptotic genes Mnemonic: Contains “L” or “XL” Other: Inhibitor of Apoptosis (XIAP) How all these genes and molecules work together to complete apoptosis? Find it here.
PGMEE, MRCS, USMLE, MBBS, MD/MS
Opioid Receptors Mnemonic
Opioid receptors are a group of inhibitory G protein-coupled receptors with opioids as ligands. Mu (µ) Receptor (MOP) Mnemonic: MU CARDS Miosis eUphoria Constipation Analgesia (Supraspinal + Spinal) Respiratory depression Rigidity (truncal) Dependency Sedation µ1 mediates supraspinal analgesia, and most of other effects including spinal analgesia is mediated by µ2. Kappa…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Antidepressants Made Easy
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…
Emergency Medicine
Supraventricular Tachycardia vs Sinus Tachycardia
Yesterday, I had encountered a tachycardic patient with heart rate 160/min. Somewhere in medical school, I was taught that the sinus tachycardia with heart rate >160/min must be considered as a Supraventricular tachycardia (SVT). With such misinformation, it was easier for me to overlook the fact that the patient was…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Steroid Induced Leukocytosis
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…