Cyberchondria

Med Student Syndrome without all the nuisance of going to medical school. ---- I do not take credit for any images or other content unless noted.

[neuromaencer]

[xiphoidprocess]

Image: Osteoporosis in vertebra showing 3 microfractures Dr. Michael Klein University of Alabama, AL Polarized light, 15x Objective

[nychealth]

Today is World Hepatitis Day!

The Health Department, the Fund for Public Health in New York and five community partners – the Mount Sinai School of Medicine, Montefiore Medical Center, Cornell Medical College, VNSNY Choice and HealthFirst – announced today that they have received a $10 million Health Care Innovation Award from the Center for Medicare & Medicaid Services to focus on hepatitis C (HCV).

Project INSPIRE NYC (Innovate & Network to Stop HCV & Prevent complications via Integrating care, Responding to needs and Engaging patients & providers) aims to achieve:

Better care, by increasing the number of patients starting hepatitis C therapy, strengthening management of behavioral health problems, reducing hospitalizations and emergency department visits, and maintaining a high level of satisfaction among enrollees;

Better health, with increased hepatitis C cure rates, fewer hepatitis C-related complications, and increased screening for depression and alcohol abuse; and

Lower costs, by reducing expenses from preventable hospitalizations, emergency department visits, and complications of hepatitis C infection.

Hepatitis C Facts:

An estimated 146,500 New Yorkers have chronic hepatitis C, though about half do not know that they are infected.

Hepatitis C is a liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

Hepatitis C is usually spread when blood from a person infected with hepatitis C enters the blood stream of someone who is not infected. Today, people most often become infected with hepatitis C by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions.

Most people living with hepatitis C have few symptoms of illness until 10 to 30 years after initial infection, when life-threatening complications can develop. People with hepatitis C are at risk for developing cirrhosis, liver cancer, and other types of liver damage.

Given unprecedented advances in hepatitis C treatment, a cure has become achievable for most. Treatment is now shorter, less toxic, and more effective than in the past.

NYC Health is releasing a number of new resources including an updated website and site locator, informational video, Risk Assessment postcard, Hep C Facts booklet, and a City Health Information Bulletin for primary care providers, as well as a mobile app. New Yorkers can also text LIVER to 877877 to be connected with Hepatitis C testing and care services.

Read our Press Release for more information and the full resource list.

[actgnetwork]

May is Hepatitis Awareness Month! Check out this info graphic from Whitman-Walker Health in DC about the different types of hepatitis and the treatments available. Check out the CDC’s website to find a testing center near you.

[artsciencenursing-blog]

Source

[marianxtina]

Cranial Nerves by number :)

I used to use this trick to memorize the cranial nerves. Haha. Useful! ;)

[orqueen]

Hemopericardium: Caused by bleeding into the pericardial sac. The cause of this may be penetration by a sharp object or projectile, blunt chest trauma, rupture of the heart wall as a result of mitral valve problems or damage to the myocardium following a heart attack and rupture of an aneurysm or dissection of the aorta.

[medicalschool]

Transverse section through the middle of the first lumbar vertebra, showing the relations of the pancreas

[fuckyeahnarcotics]

Abdominal ectopic pregnancy.

Full case.

[suckingoncolorforms]

A simulated image of scintillating scotoma

[medxclusive]

Fungi causing Cutaneous Mycoses.

- Crush Step 1

[sevenintelligences]

Major Classes of Antibiotics - The Longitude Prize

There is still time to enter the Longitude Prize… I might do so, just for the hell of it! The theme was: to create a cheap, accurate, rapid and easy-to-use point of care test kit for bacterial infections. Point-of-care test kits will allow more targeted use of antibiotics, and an overall reduction in misdiagnosis and prescription. Effective and accurate point of care tests will form a vital part of the toolkit for stewardship of antibiotics in the future. This will ensure that the antibiotics we have now will be effective for longer and we can continue to control infections during routine and major procedures. The issue is that we cannot outpace microbial evolution. A new broad-spectrum antibiotic, if applied with current methods, would eventually meet new forms of resistance. The overall solution involves a long-term path towards a more intelligent use of antibiotics enabling a future of more effective prevention, targeted treatments and smart clinical decision support systems.

Beta-Lactams

Beta-lactams are a wide range of antibiotics, the first of which to be discovered was penicillin, which Alexander Fleming identified in 1928. All beta-lactam antibiotics contain a beta-lactam ring; they include penicillins, such as amoxicillin, and cephalosporins. Bacteria can develop resistance to beta-lactams via several routes, including the production of enzymes that break down the beta-lactam ring. In the NHS, penicillins are the most commonly prescribed antibiotics, with amoxicillin being the most common in the class.

Sulfonamides

Prontosil, a sulfonamide, was the first commercially available antibiotic, developed in 1932. In the present day, sulfonamides are rarely used, partially due to the development of bacterial resistance, but also due to concern about unwanted effects such as damage to the liver of patients.

Aminoglycosides

Aminoglycosides inhibit the synthesis of proteins in bacteria, eventually leading to cell death. In the treatment of tuberculosis, streptomycin was the first drug found to be effective; however, due to issues with toxicity of aminoglycosides, their present day use is limited.

Tetracyclines

Tetracyclines are broad-spectrum antibiotics, active against both Gram-positive and Gram-negative bacteria. Their use is decreasing to increasing instances of bacterial resistance; however, they still find use in treatment of acne, urinary tract, and respiratory tract infections, as well as chlamydia infections.

Chloramphenicol

Another broad-spectrum antibiotic, chloramphenicol also acts by inhibiting protein synthesis, and thus growth and reproduction of bacteria. Due to the possibility of serious toxic effects, in developed countries it is generally only used in cases where infections are deemed to be life-threatening, although it is a much more common antibiotic in developing countries due to its low cost and availability.

Macrolides

Macrolides’ effectiveness is marginally broader than that of penicillins, and they have been shown to be effective against several species of bacteria that penicillins are not. Whilst some bacterial species have developed resistance to macrolides, they are still the second most commonly prescribed antibiotics in the NHS, with erythromycin being the most commonly prescribed in the class.

Glycopeptides

Glycopeptides include the drug vancomycin – commonly used as a ‘drug of last resort’, when other antibiotics have failed. There are strict guidelines on the circumstances in which vancomycin can be used to treat infections, in order to delay the development of resistance. The bacteria against which glycopeptides are active are otherwise somewhat limited, and in most they inhibit growth and reproduction rather than killing bacteria directly.

Oxazolidinones

Oxazolidinones are active against Gram-positive bacteria, and act by inhibiting protein synthesis, and hence growth and reproduction. Linezolid, approved for use in 2000, was the first marketed antibiotic in the class, and resistance seems to be developing relatively slowly since its introduction.

Ansamycins

This class of antibiotics are effective against Gram-positive bacteria, as well as some Gram-negative bacteria. A subclass of antibiotics, rifamycins, are used to treat tuberculosis and leprosy. Uncommonly, ansamycins can also demonstrate anti-viral activity.

Quinolones

Quinolones are widely used for urinary tract infections, as well as other hospital-acquired infections where resistance to older classes of antibiotics is suspected. Resistance to quinolones can be particularly rapid in its development; in the US, they were the most commonly prescribed antibiotics in 2002, and their prescription for unrecommended conditions or viral infections is also thought to be a significant contributor to the development of resistance.

Streptogramins

Streptogramins are unusual in that they are usually administered as a combination of two antibiotic drugs from the different groups within the class; combined they have a synergistic effect and are capable of directly killing bacteria cells. They are often used to treat resistant infections, although resistance to the streptogramins themselves has also developed.

Lipopeptides

Discovered in 1987, lipopeptides are the most recent class of antibiotics. Daptomycin is the most commonly used member of the class; it has a unique mechanism of action, disrupting several aspects of cell membrane function in bacteria. This unique mechanism of action also seems to be advantageous in that, currently, incidences of resistance to the drug seem to be rare – though they have been reported.

[mynotes4usmle]

SPINAL CORD LESIONS

[modernathenamd]

@

[md-admissions]

I just want to thank whoever made this beautiful table

[radiopaedia]

What’s your diagnosis for this slow growing pulsatile mass?

ANSWER: http://goo.gl/bbsJAZ

[brainsandbodies]

From Daily Anatomy

Incredible view of the Corpus callosum!  "The cerebral hemispheres are divided right down the middle into a right hemisphere and a left hemisphere. Each hemisphere appears to be specialized for some behaviors. The hemispheres communicate with each other through a thick band of 200-250 million nerve fibers called the corpus callosum. (A smaller band of nerve fibers called the anterior commissure also connects parts of the cerebral hemispheres.) It connects the left and right sides of the brain allowing for communication between both hemispheres. The corpus callosum transfers motor, sensory, and cognitive information between the brain hemispheres. As a last resort, the corpus callosum can be severed so that communication between the cerebral hemispheres is interrupted in cases of severe intractable epilepsy, but of course you can imagine that this is accompanied by strong neuropathological symptoms!” Image found on bobschuster.com

[mynotes4usmle]

ANTIBIOTICS CHEAT SHEET :)

Also, REMEMBER!!!!

* Sulfonamides compete for albumin with:

Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies

Warfarin: increases toxicity: bleeding

* Beta-lactamase (penicinillase) Suceptible:

Natural Penicillins (G, V, F, K)

Aminopenicillins (Amoxicillin, Ampicillin)

Antipseudomonal Penicillins (Ticarcillin, Piperacillin)

* Beta-lactamase (penicinillase) Resistant:

Oxacillin, Nafcillin, Dicloxacillin

3°G, 4°G Cephalosporins

Carbapenems 

Monobactams

Beta-lactamase inhibitors

* Penicillins enhanced with:

Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)

Aminoglycosides (against enterococcus and psedomonas)

* Aminoglycosides enhanced with Aztreonam

* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)

* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)

* Both inhibited by Probenecid during tubular secretion.

* 2°G Cephalosporines: none cross BBB except Cefuroxime

* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.

* Cephalosporines are ”LAME" bc they  do not cover this organisms 

L  isteria monocytogenes

A  typicals (Mycoplasma, Chlamydia)

M RSA (except Ceftaroline, 5°G)

E  nterococci

* Disulfiram-like effect: Cefotetan & Cefoperazone (mnemonic)

* Cefoperanzone: all the exceptions!!!

All 3°G cephalosporins cross the BBB except Cefoperazone.

All cephalosporins are renal cleared, except Cefoperazone.

Disulfiram-like effect

* Against Pseudomonas:

3°G Cef taz idime (taz taz taz taz)

4°G Cefepime, Cefpirome (not available in the USA)

Antipseudomonal penicillins

Aminoglycosides (synergy with beta-lactams)

Aztreonam (pseudomonal sepsis)

* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

* Covers VRSA: Linezolid, Dalfopristin/Quinupristin

* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.

* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)

* Phototoxicity: Q ue S T  ion?

Q uinolones

Sulfonamides

T etracyclines

* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides

* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis

* Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.

* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.

* Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.

* QT prolongation: macrolides, sometimes fluoroquinolones

[themedicalstate]

Hacking The Brain

Abuse of these mind hacking drugs is one of the fastest growing problems of our generation. As long as doctors keep prescribing these harmful drugs to too many youngsters the problem will continue to grow. Although some children really do need these drugs to function regularly, my personal opinion is that the requirements and potency of these drugs should wait until the patient is of age – the same as tobacco or alcohol. The availability of these drugs to young Americans needs to diminish if the trend of usage wants to decrease.

- By AllTreatment

[pubhealth]

Cryptosporidium (also known as “Crypto”)

Causal Agent and Life Cycle (above):

Many species of Cryptosporidium exist that infect humans and a wide range of animals. Although Cryptosporidium parvum and Cryptosporidium hominis (formerly known as C. parvum anthroponotic genotype or genotype 1) are the most prevalent species causing disease in humans, infections by C. felis, C. meleagridis, C. canis, and C. muris have also been reported.

Follow steps in graph above:

Sporulated oocysts, containing 4 sporozoites, are excreted by the infected host through feces and possibly other routes such as respiratory secretions . Transmission of Cryptosporidium parvum and C. hominis occurs mainly through contact with contaminated water (e.g., drinking or recreational water). Occasionally food sources, such as chicken salad, may serve as vehicles for transmission. Many outbreaks in the United States have occurred in waterparks, community swimming pools, and day care centers. Zoonotic and anthroponotic transmission of C. parvum and anthroponotic transmission of C. hominis occur through exposure to infected animals or exposure to water contaminated by feces of infected animals . Following ingestion (and possibly inhalation) by a suitable host , excystation occurs. The sporozoites are released and parasitize epithelial cells (, ) of the gastrointestinal tract or other tissues such as the respiratory tract. In these cells, the parasites undergo asexual multiplication (schizogony or merogony) (, , ) and then sexual multiplication (gametogony) producing microgamonts (male) and macrogamonts (female) . Upon fertilization of the macrogamonts by the microgametes (), oocysts (, ) develop that sporulate in the infected host. Two different types of oocysts are produced, the thick-walled, which is commonly excreted from the host , and the thin-walled oocyst , which is primarily involved in autoinfection. Oocysts are infective upon excretion, thus permitting direct and immediate fecal-oral transmission. Note that oocysts of Cyclospora cayetanensis, another important coccidian parasite, are unsporulated at the time of excretion and do not become infective until sporulation is completed. Refer to the life cycle of Cyclospora cayentanensis for further details.

(From CDC)