ASBURY CRITERIA FOR GUILLAIN BARRE SYNDROME (GBS) Required Criteria Mnemonic: AIDP 1. Areflexia 2. Include in differential and rule out other causes 3. Duration < 4 weeks 4. Progressive weakness of 2 or more limbs due to neuropathy Supportive criteria Mnemonic: AIDPS 1. Afebrile 2. Involvement: Mild sensory involvement Facial…
Emergency Medicine 
Severe Malaria : Quick revision
Criteria for Severe and Complicated Malaria Positive peripheral blood smear for P.falciparum + ≥1 of the CHAPLINS (Mnemonic) Convulsions: >2 in 24 hour Cerebral edema (Consciousness impaired) Hypoglycemia (glucose <40 mg/dl) Hemorrhage (DIC) Hemoglobinuria (Black water fever) Anemia (hemoglobin <5 gm/dl or PCV <15% in children; hemoglobin <7 gm/dl or…
Emergency Medicine 
Short Approach to SVT and AVNRT management
This is an ECG from a patient who came with a complaint of palpitation: Analyze the ECG: Rhythm: Regular Heart rate: Around 170/min QRS: Around 0.08 s i.e. ≤0.1 s (narrow QRS complex) ECG diagnosis: Regular Supraventricular Tachycardia (SVT) Now, look for P waves – There are no P waves In…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Antigenic Shift and Drift
Antigenic Drift Nature of antigenic variation: Minor Mechanism: Gradual accumulation of amino acid substitutions due to point mutation in the hemagglutinin (H) and neuraminidase (N) genes. As mutations accumulate, antibodies generated by exposure to previous strains do not neutralize current strains to the same extent, resulting in only limited or…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Bedside Cold Agglutinin Test for Mycoplasma
Definition of Cold Agglutinin Cold agglutinins are polyclonal IgM that have specificity against the I-antigen on red cells, and often there is light chain restriction, with kappa being predominant. The infections associated with cold agglutinins are: Mycoplasma pneumoniae Epstein Barr virus Cytomegalovirus HIV Rubella Steps for Bedside Cold Agglutinin Test…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Rickettsial Diseases Made Easy
Important features of Rickettsia and Rickettsial Diseases Obligate intracellular parasites like Chlamydia – can survive only in host cells Cannot produce their own ATP, so they utilize the ATP of a host cell Gram negative coccobacillia, and short bacilli that grow strictly in eukaryotic cells (unable to grow in cell…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Ethambutol Induced Optic Neuropathy
Mechanism of Ethambutol induced optic neuropathy Ethambutol is metabolized to a chelating agent. The chelating agent formed then may impair the function of metal-containing mitochondiral enzymes, such as the copper containing cytochrome-c oxidase of complex IV and the iron containing NADH:Q oxidoreductase of complex I. These mitochondrial respiratory chain play…
Blog 
Human Growth Hormone – Elixir of youth?
Human Growth Hormone (HGH) also known as somatotropin is synthesized and secreted by the acidophilic cells of pituitary gland in response to Growth hormone releasing hormone (GHRH). HGH is a protein (peptide) hormone composed of a chain of 191 amino acids. HGH production is inhibited by another hormone known as…