祝日 / Permanent Vacation
he wasn't even looking at me and he found me
noise dept.
almost home
Three Goblin Art
trying on a metaphor
todays bird
dirt enthusiast
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cherry valley forever
Claire Keane
ojovivo
Peter Solarz
Keni
Kiana Khansmith
izzy's playlists!
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Jules of Nature
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@medbeyondwords
WHY IS NOBODY TALKING ABOUT THE BIGGEST RAINFOREST IN THE WORLD BURNING?!!!!!!
The Amazonia Rainforest (Amazonas) is the largest rainforest in the world, and is on fire right now. There’s no media coverage, and it’s been burning for at least 3 weeks!! The president hasn’t even done anything. Fuck.
Guys! the National Health Care Provider Solutions is offering FREE ACLS, BLS, PALS, CPR and First Aids and Bloodborne Pathogens CERTIFICACTIONS
Just click the link bellow and get your certification :)
https://nhcps.com/mexico/
Cell Cycle - Cancer
Quiescent/ senescent
Gap 0/G0
A resting phase where the cell has left the cycle and has stopped dividing.
Interphase
Gap 1 / G1
Cells increase in size. The G1 checkpoint control mechanism ensures that everything is ready for DNA synthesis.
DNA Synthesis / S
DNA replication occurs during this phase.
Gap 2 / G2
During the gap between DNA synthesis and mitosis, the cell will continue to grow. The G2 checkpoint control mechanism ensures that everything is ready to enter the M (mitosis) phase and divide.
Cell division
Mitosis / M
Cell growth stops at this stage and cellular energy is focused on the orderly division into two daughter cells.
A checkpoint in the middle of mitosis (Metaphase Checkpoint) ensures that the cell is ready to complete cell division.
Cyclins
family of proteins control cells through the cell cycle by activating cyclin-dependent kinases (CDKs).
G1 /S cyclins – essential for the control of the cell cycle at the G1/S transition, Cyclin D/ CDK4, Cyclin D /CDK6, and Cyclin E / CDK2 – regulates transition from G1 to S phase.
G2 /M cyclins – essential for the control of the cell cycle at the G2/M transition (mitosis). G2 /M cyclins accumulate steadily during G2 and are abruptly destroyed as cells exit from mitosis. Cyclin B / CDK1 – regulates progression from G2 to M phase
Klinefelter Syndrome (XXY)
It is a chromosomal condition that affects male physical and cognitive development. It occurs when a male is born with an extra X chromosome (XXY).
Clinical Features
Small testes that do not produce as much testosterone as usual.
Breast enlargement (gynecomastia)
Reduced facial and body hair
Infertility
May have learning disabilities and delayed speech and language development.
Diagnosis
It is not often made until a man is evaluated for inability to concieve.
Low serum testosterone
Karyotype 47 XXY
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Hello there! What medical school do you go to and does it accept international students?btw love your blog😍
I’m really sorry for late reply!
I went to Universidad Autónoma de Chihuahua, in México! And yes we do! We have had students from all over the world, it’s always fun and a great experience :) and thank you!
Osler - Weber - Rendu Syndrome
Also known as Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder of development of the vasculature, caused by a mutation in several genes, including ACVRL1, ENG, SMAD4, and GDF2.
Clinical Features
Epistaxis and telangiectases of the lips, tongue and skin occur in 80-99% of patients.
Arteriovenous malformations (AVMs) in the brain, lungs, liver, GI tract.
Diagnosis
Require the presence of 3 of the following 4:
Recurrent epistaxis
Visceral AVMs (seen on MR or CT arteriography)
Mucocutaneous Telangiectases
Near relative of an affected individual
Mutation analysis can be used for presymptomatic diagnosis.
Treatment
Embolization of all treatable pulmonary AVMs
Anti-estrogenic agents (eg. tamoxifen)
Anti-vascular endothelial growth factor agents (eg. bevacizumab)
Gaucher Disease
Gaucher disease is a rare genetic disorder (autosomal recessive) resulting from a deficiency of the enzyme glucocerebrosidase, in which Glucocerebroside is deposited in cells of the macrophage-monocyte system as it isn’t broken down by the enzyme. The buildup of Glucocerebroside (a fatty substance) in certain organs, particularly spleen and liver, causes these organs to enlarge and can affect their function.Build up can also occur in bone tissue, weakening the bone and increasing the risk of fractures. If the bone marrow is affected, it can interfere with the blood’s ability to clot. An inherited disorder, Gaucher disease is most common in Jewish people of Eastern and Central European descent (Ashkenazi). Symptoms can appear at any age.
Signs and symptoms
Most patients present with:
Abdominal complaints, painfully distended.
Skeletal abnormalities. Gaucher disease can weaken bone, increasing the risk of painful fractures. It can also interfere with the blood supply to bones, which can cause portions to die.
Blood disorders decrease in healthy red blood cells (anaemia) can result in severe fatigue, also affects clotting, which can cause easy bruising and nosebleeds.
Type 1 - Nonneuronopathic Gaucher disease
painless splenomegaly
anemia, thrombocytopenia
chronic fatigue
hepatomegaly (enlarged liver - with or without abnormal liver function test findings)
bone pain, or pathologic fractures
Type 2 - Acute neuronopathic Gaucher disease
at birth or during infancy with
increased tone
seizures
strabismus (cross eye), oculomotor apraxi
organomegaly
failure to thrive
swallowing abnormalities
hepatosplenomegaly (enlarged spleen and liver)
In addition to organomegaly and bony involvement, individuals with type 3 (chronic) disease have neurologic involvement.
Diagnosis
Measurement of glucocerebrosidase activity in peripheral blood leukocytes - less than 15% of mean normal activity. Minor elevations of liver and angiotensin-converting enzyme levels are common. DNA analysis is also being used to establish the presence of two mutant alleles, especially in diagnostic panels.
Management
Enzyme replacement therapy replaces the deficient enzyme with artificial ones. Intravenouslyin high doses at two-week intervals.
Miglustat (Zavesca) oral medication appears which interferes with the production of the Glucocerebroside. Diarrhoea and weight loss are common side effects.
Eliglustat (Cerdelga) as above, Possible side effects include fatigue, headache, nausea and diarrhoea.
Osteoporosis drugs help rebuild bone weakened by Gaucher disease.
Doing the entire EKG series by DrNajeeb with Boots…because break is for cooking, skiing and Najeebing😉⛄️
Stages of decubitus ulcers
Decubitus ulcers (or pressure sores or bed sores) are preventable injuries to skin tissue. These pressure sore injuries open the body up to further infection and disease, often resulting in death or amputation. Pressure sores are broken down into 4 stages:
Stage1: Still intact, they are not open wounds. While the skin remains intact, there may be painful bruising underneath.
Stage2: Pressure wounds are open painful sores caused by unrelieved pressure. It can look like an abrasion, blister, or a shallow crater in the skin.
Stage3: Pressure sore burrows deeper. The bedsore is open but the muscle, tendon and bone are not visible at this stage of the sore. A patient’s fatty tissue surrounding the pressure sore may be exposed.
Stage4: Deepest most traumatic stage. There is deep damage to skin tissue in the affected area and often damage to the surrounding joints and tendons.
Osteomyelitis, infection of the bone, or Sepsis, blood infection, are often complications of an open Stage 4 decubitus ulcer.
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Abdominal aorta and branches
The main branches are:
Celiac trunk: mainly responsible for the blood supply to the stomach and spleen except the head
Superior mesenteric artery and inferior mesenteric artery that are responsible for the blood supply to the small and large intestines, head of the pancreas and upper part of the rectum
Gonad arteries (Testicular or ovarian)
Renal arteries, and common iliac artery.
It is important to remember at which level every and each artery lies.
Please note that the bifurcation of aorta occurs at L4, and the division of the common iliac artery is at the level of L5-S1.
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β-blocker, is a class of medications that are particularly used to manage cardiac arrhythmias, and to protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention). They are also widely used to treat hypertension, although they are no longer the first choice for initial treatment of most patients.
Adverse drug reactions: nausea, diarrhea, bronchospasm, dyspnea, bradycardia, hypotension, heart failure, heart block, sexual dysfunction, alteration of glucose and lipid metabolism, etc.
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Alzheimer’s Disease
Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.
7 stages of the disease: (The stages don’t always fall into neat boxes, but they can be a guide and help you plan for your relative’s care.)
-Stage 1: Normal Outward Behavior Asymptomatic. Only a PET scan can reveal whether he’s got Alzheimer’s.
-Stage 2: Very Mild Changes At this stage, subtle symptoms of Alzheimer’s don’t interfere with daily tasks. This could include forgetting a word or misplacing objects.
-Stage 3: Mild Decline: It’s at this point that you start to notice changes in one’s thinking and reasoning, such as: Forgets something he just read Asks the same question over and over Has more and more trouble making plans or organizing Can’t remember names
-Stage 4: Moderate Decline Problems in thinking and reasoning get more obvious, and new issues appear. Forget details about himself Forget what month or season it is Have trouble cooking meals or even ordering from a menu
-Stage 5: Moderately Severe Decline The person might start to lose track of where he is and what time it is. Trouble remembering his address, phone number, or where he went to school. Confused about what kind of clothes to wear.
-Stage 6: Severe Decline He might recognize faces but forget names. He might also mistake a person for someone else, for instance, thinking his wife is his mother. Delusions might a set in. They might need help to go to the bathroom.
-Stage 7: Very Severe Decline Many basic abilities, such as eating, walking, and sitting up, fade during this period. Many people at this stage can no longer tell when they’re thirsty.
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Clinical Case
An otherwise healthy 33-year-old male presents with innumerable asymptomatic fleshy papules on the mucosal surface of his lips. A biopsy of one of the lesions demonstrates focal epithelial hyperplasia, consistent with Heck disease.
What virus is associated with Heck disease?
A. Coxsackievirus
B. Epstein-Barr virus (EBV)
C. Human papillomavirus (HPV)
D. Herpes simplex virus (HSV)
Answer: C. Human papillomavirus (HPV)
Focal epithelial hyperplasia is an oral infection caused by HPV types 13 and 32. The papules are typically asymptomatic and recede with time, often over the course of a few months.
Source
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Jaccoud’s arthropathy
It is a chronic non-erosive (contrary to rheumatic arthritis) reversible joint disorder caused by inflammation of the joint capsule and subsequent fibrotic retraction, causing ulnar deviation of the fingers.
Typically affects the metacarpophalangeal (MCP) joints but can also affect the proximal interphalangeal (PIP) joints of the hands, wrists and knees.
It is presented with hand deformities, including swan neck deformity, Z deformity of the thumb, and ulnar deviation.
Traditionally described as occurring post rheumatic fever. It is also seen in association with systemic lupus erythematosus (SLE) and other rheumatic conditions.
The deformities result mainly from soft-tissue abnormalities, such as laxity of ligaments, fibrosis of the capsule, and muscular imbalance, rather than from destruction of the bone of joints, as occurs in rheumatoid arthritis.
Treatment focuses on alleviating pain and in maintaining functionality through use of nonsteroidal anti-inflammatory drugs, corticosteroids, antimalarial drugs and physiotherapy.Surgery is also a possibility.
Spinal Cord Anatomy: The Basics
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Chest X-Rays (CXR) Interpretation
DRSABCD is a familiar acronym for those who have undertaken First Aid/Basic Life Support courses. Now DRSABCDE can used as a simple, yet comprehensive, approach to CXR interpretation.
Normal CXR
D – Details:
Patient name, age / DOB, sex
Type of film – PA or AP, erect or supine, correct L/R marker, inspiratory/expiratory series
Date and time of study
R – RIPE (assessing the image quality)
Rotation – medial clavicle ends equidistant from spinous process
Inspiration – 5-6 anterior ribs in MCL or 8-10 posterior ribs above diaphragm, poor inspiration?, hyperexpanded?
Picture – straight vs oblique, entire lung fields, scapulae outside lung fields, angulation (ie ’tilt’ in vertical plane)
Exposure (Penetration) – IV disc spaces, spinous processes to ~T4, L) hemidiaphragm visible through cardiac shadow.
S – Soft tissues and bones (it is common to leave it until the end)
Ribs, sternum, spine, clavicles – symmetry, fractures, dislocations, lytic lesions, density
Soft tissues – looking for symmetry, swelling, loss of tissue planes, subcutaneous air, masses
Breast shadows
Calcification – great vessels, carotids
A – Airway & mediastinum
Trachea – central or slightly to right lung as crosses aortic arch
Paratracheal/mediastinal masses or adenopathy
Carina & RMB/LMB
Mediastinal width <8cm on PA film
Aortic knob
Hilum – T6-7 IV disc level, left hilum is usually higher (2cm) and squarer than the V-shaped right hilum.
Check vessels, calcification.
B – Breathing
Lung fields
Pleura: reflections, thickenning
Vascularity – to ~2cm of pleural surface (~3cm in apices), vessels in bases > apices
Pneumothorax – don’t forget apices
Lung field outlines – abnormal opacity/lucency, atelectasis, collapse, consolidation, bullae
Horizontal fissure on Right Lung
Pulmonary infiltrates – interstitial vs alveolar pattern
Coin lesions
Cavitary lesions
C – Circulation
Heart position –⅔ to left, ⅓ to right
Heart size – measure cardiothoracic ratio on PA film (normal <0.5)
Heart borders – R) border is R) atrium, L) border is L) ventricle & atrium
Heart shape
Aortic stripe
D – Diaphragm
Hemidiaphragm levels – Right Lung higher than Left Lung (~2.5cm / 1 intercostal space)
Diaphragm shape/contour
Cardiophrenic and costophrenic angles – clear and sharp
Gastric bubble / colonic air
Subdiaphragmatic air (pneumoperitoneum)
E – Extras
CVP line, NG tube, PA catheters, ECG electrodes, etc
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Migraine
It’s a genetic neurological disease, characterized by episodes often called Migraine attacks. They are quite different from regular headaches. Migraine sufferers may have moderate or severe pain and usually can’t participate in normal activities because of the pain.
They last for at least 4 hours or may last for days.
The most common symptoms are:
Throbbing, pulsating pain – 85%
Light sensitivity - 80%
Sound sensitivity – 76%
Nausea – 73%
Pain on one side – 59%
Vision changes, blurred vision – 44%
Aura – 36%
Vomiting – 29%
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