DreamingRealist

Ilham Alia. 23 and young. pursuing MBBS degree and His love :)

[usmlepathslides]

Gout  Note large tophus on malleolus and along margin of the foot, sign of chronic gout, composed of crystalline material (H and E shows multinucleated giant cell reaction to the MSU crystals)

[mynotes4usmle]

Hyperuricemia

Older men

Deposition of urate monophosphate crystals.

Negative birefringency, needle shaped crystals, neutrophils in joint aspiration

1° = 90%, idiopathic, 2°= 10% leukemia, polycethemia vera, renal failure, Lesch-Nyhan Sd ( HPRT1 deficiency, X linked, mental retardation, self mutilation, hyperuricemia, spasticity)

Affects: big toe (podagra, painful), heel, ankle, wrist

Big toe, very very painful, skin ulceration and joint destruction and deformity.

Complications: uric acid calculi (radiolucent), renal failure.

Tx: NSAIDs, colchicine, allopurinol (xantine oxidase inhibitor), probenecid (helps eliminate uric acid by the kidney)

[mynotes4usmle]

Acute attack

NSAIDs: best initial tx

Steroids: Triamcinolone, oral (multiple joints) or injection (single joint). When pt doesn’t respond to NSAIDs or are CI.

Colchicine: CI of NSAIDs or steroids. SE: white cell suppression, diarrhea

If pt is already on Allopurinol, continue.

Chronic

Allopurinol: best initial tx. SE: hypersensitivity, Toxic epidermal necrolysis, Stevens-Johnson sd.

Febuxostat: if pt can’t tolerate Allopurinol

Pegloticase: for refractory disease

Probenecid, Sulfinpyrazone: rarely used

Decrease: alcohol, meat, seafood, weight.

Avoid: thiazides, aspirine, niacin. Losartan first if HTN

Colchicine: prevents second attacks

[just-shower-thoughts]

Maybe tea became a popular home medicine, throughout history, because people automatically sterilized the water in the process of making it.

[just-shower-thoughts]

Do anti-vaxers get their pets vaccinated? Are they worried that it will make their pets autistic?

[just-shower-thoughts]

Shopping malls are dying, global temperatures are rising, let’s start housing communities in the shells of malls

[the-movemnt-deactivated20170912]

Royal Jordanian Airlines’ compelling ad shows what it’s like to be Arab on an airplane

follow @the-movemnt

[seranavolkihars2]

Important to the Medblr and Nurblr community - as well as the other hardworking women who are both a mother and a professional.

You don’t have to feel guilty about pursuing your passion while raising a family.

[drveebs]

😭

[aspiringdoctors-blog]

This is why the Cabbage is so great.

[just-shower-thoughts]

A common lie I tell myself is, “I don’t have to write that down, I’ll remember it”

[lulliloolala]

Yup now I'm struggling to recall what Mr Adham told us regarding shoulder examination,which I never perform my entire life. *Sighhhhh

[just-shower-thoughts]

A common lie I tell myself is, “I don’t have to write that down, I’ll remember it”

[lulliloolala]

Yup now I'm struggling to recall what Mr Adham told us regarding shoulder examination,which I never perform my entire life. *Sighhhhh

[heyitsthatalmostdoctor]

Evolution of a medical student

MS1: wow what did I do in college I know literally nothing. Next year will be so much better because at least I’m finally learning stuff that I’m gonna use for the rest of my life!

MS2: the workload literally doubled? I’m already taking a board exam? Step 1 kill me pls. Next year will be so much better because I’ll actually be in the hospital and talking to patients and playing doctor!

MS3: wow I still know literally nothing, I think I might actually know less than before, and everyone treats us like the actual scum of the earth why am I here again? Next year will be better because I won’t be a stupid third year and I can do electives in the field I actually wanna go into!

MS4: fucking stay tuned.

[lulliloolala]

Sooooo relatable 😂😂😂

[bananatwinky]

[iloveyoursoul]

[allahaljalil]

❤️❤️❤️

[dxmedicalstudent]

A junior doctor is nothing without the tools of their trade. You’ll be surprised how much you can get into a tiny, tiny handbag, or the pockets of a pair of trousers… I’ve been asked too many times by male colleagues just what is in my little handbag; usually it’s the same things they carry around in all their pockets then leave lying around the wards.

[docinlimbo]

[earthnation-deactivated20131010]

what did one cell say to his sister cell that stepped on his toe

[earthnation-deactivated20131010]

mitosis

[katara-deactivated20130617]

i want to die 

[littlemissruntofthelitter]

The struggle 😂😂

[flyonthewallmedstudent]

Sounds about right. I learned that the OR is a great place to study for exams. Take pocket sizes notes with you. 

[ziyadnazem]

The 12 Cranial Nerves and Starbucks

When you walk into Starbucks and you..

I. Smell the coffee aroma (olfactory)..

II. Read the order menu from about 20 feet away (optic) then you..

III.  Pupils constrict as you look at items, such as muffins, closer (oculomotor)..

IV.  You look up at salesperson then down at your money as you pay (trochlear)..

V. You clench your teeth and touch your face when they called your drink (trigeminal)..

VI. You look side-to-side to see if anyone else has ordered the same drink (abdsucens)..

VII. You smile because you realize this IS your drink (facial), then..

VIII. You hear someone say “You can sit here, we are leaving” (auditory). As you sit..

IX. You taste the sweet whipped cream on the top of your drink (glossopharyngeal)..

X. You say “Ahhhh this is good!” (vagus)..

XI. You look at the person next to you because they heard you and then you shrug your shoulders (spinal accessory)..

XII. When they look away you stick your tongue at them (hypoglossal)!

[esltun]

★ advice about how to start study