December 28, 2013

Politeness is Poison!

Last week, during the bedside teaching one of my classmate, T, wasn't able to see what the professor was inspecting on the patient. There was a significant finding and the professor was going on and on about it. I know how it feels when everyone is craning their necks to see what they can see but you can't see even the patient's clothes or feet or even the bed in which the patient is lying. When you can hear clearly, but what you hear makes no sense to you. That particular day, from the place where I was, I could clearly see the patient's significant finding. Having been in T's shoes, I knew how it felt. So I thought of giving him some space so that he too could take a look. But, my my! Bhalai ka to koi zamana hi nae raha (You should not speak of kindness) !! He stood in my spot there for the entire class. It was like Sheldon got his spot back by depriving other Sheldon of the same spot!


May be, I should learn something from the crayons. Some are sharp, some are pretty, some are dull, some are bright, some have weird names. But, we have to learn to live in the same box!

October 4, 2013

Swayambhu, Nepal

I'm leaving for a short trip to my birth-city and my mother's place in West Bengal, India. Hoping to see some beautiful Durga Puja Pandals there. Happy Dashain!

Swayambhu Stupa

September 29, 2013

Beautiful Nepal

I stumbled and spent hours upon a blog which had amazing photos. And I suddenly had this thought of making my blog a little less boring and monotonous by incorporating pictures in it from in and around the valley of Kathmandu and other stuff and other places. I was running out of posts to make anyway. I'm not a pro in photography but it won't hurt to try amateur photography to test my skills. I'll get started soon.

August 17, 2013

Mitral Stenosis X- Ray Findings

Radiological signs seen in mitral stenosis are:

§  Backward displacement of esophagus by enlarged left atrium (in lateral view X-ray). Also the earliest sign.

§  Straightening of left heart border due to enlarged left atrium.

§  Double shadow due to enlarged left atrium. Dense right atrial shadow superimposed within fainter left atrial shadow that touches the diaphragm.

§  Splaying of carina (The left main bronchus is lifted up by the enlarged left atrium)

§  Prominent upper zone pulmonary veins (Inverted moustache sign /  Antler’s horn sign / Cephalisation pulmonary of blood flow)

§  Enlarged pulmonary trunk (This occurs following the development of pulmonary hypertension)

§  Kerley B lines (indicating fluid collection in the interlobular septa. 1-2 cm in length lines in lung peripheries perpendicular to and extend out to pleural surfaces.)


NOTE: Here is a chest radiograph exhibiting classic findings of chronic mitral stenosis.

Are you interested in knowing the Peripheral signs in Aortic Regurgitation? Click here.

August 15, 2013

Gunnerhoea

Had a bad-day- Surrounded by gunners everywhere. To my front, to my back, to my right, to my left. All trying to outgun each other.

They don't let anyone get close to them! Anyone!!!

August 4, 2013

Cookies & Explorer

Few days after my last post, I updated Chrome. It asked something about some cookies' settings. I have no idea about the internet cookies. I may have selected options which I shouldn't have. And BOOM! Blogger doesn't work in Chrome anymore.

So, I took weeks to figure out what to do. And with no options remaining, here I am, posting my first blog from explorer and will continue to do so. Yeah yeah! I know I have lots of patience.

June 1, 2013

Incorrect Answers!

Professor: So, what do you think is the complication of thyroglossal cyst?

Me *In Volume 3- audible in a half-a-meter diameter area, basically in a self-mumbling volume* : Kind of Regurgitation of ingested things like um..food and water.

Bench-mate *staring at me for infinity*

Me: You know..you eat stuffs and it slips through that hole and collects in that cyst. After over-filling it regurgigates..Oh yeaaa! Even if it does over-flow, it'll slip baccck towards the oropharynx. *sheepish grin*

Bench-mate *wide eyed* : If you don't know the answer, it's you better don't speak.

Me: I was not sure that's why I was mumbling *you idiot*!

Bench-mate *rolling her eyes*

Me *THE whatever look*

I like expressing what comes to my mind while answering. My brain is in automatic mode of processing the questions to get the answers. It's not a nice habit to say incorrect answers. Mistakes matter. But making mistakes when learning is a natural part. And expressing is a bigger satisfying achievement than sitting quiet with the fear of making mistake.

May 28, 2013

Causes of Cyanotic Heart Disease

Causes of Cyanotic Heart Disease: the five "terrible T's" and one "S"
1. Transposition of the great vessels
2. Total anomalous pulmonary venous return
3. Tetralogy of Fallot
4. Truncus arteriosus
5. Tricuspid atresia
6. Severe pulmonic stenosis

May 25, 2013

Causes of Altered Mental Status in Neonates: THE MISFITS

Causes of Altered Mental Status in Neonates can be remembered by the mnemonic: THE MISFITS

Trauma
Heart disease, Hypoxia and Hypovolemia
Endocrine (e.g. Congenital Adrenal Hyperplasia , Thyrotoxicosis)
Metabolic ( Electrolyte Imbalance)
Inborn Errors of Metabolism
Sepsis (e.g. Meningitis, Pneumonia, UTI)
Formula Mishaps ( under or over- dilution)
Intestinal Catastrophes (e.g. Volvulus, intessuseption)
Toxins and Poisons
Seizures

May 16, 2013

Untitled

With the start of neonatology unit yesterday, I guess  our good days are back for few days. Being tired of taking history every single day (even if it makes us the better and more expert at it) today was like a bliss. Like getting an umbrella in scorching sunlight. Whatta big relief!! After forgetting what interest is, today we were kids again. Learning something new with lots of interest.

1. Learnt how to put on sterile gloves. I succeeded with no laughs on me.

2. Learnt handwashing. Yeyyy me! I wont have to post a post during surgery rotations on how i was standing without any idea on what scrubbing is :D One less post to write during winters! 

April 24, 2013

Exposure to experience

My clinical rotations had started long long ago. I mean 7 weeks back. 7 weeks of my 12 weeks pediatrics posting have finished already. These 7 weeks have taught me things equivalent to 2 years of basic science combined.

1. Don't show off. Show up!

2. Be in the cockpit
You cannot learn how to fly by sitting at the back. You have to be in the cockpit- watching and learning from the pilot. Being in the cockpit and carrying a book on how to fly a plane won't help either.

3. Patients can teach you a lot!
Learn from every patient you see. In our clinical postings, each one of us is assigned 2 inpatient beds with real kids. Real, sick kids patients. If a patient stays in a bed for a week. You get more or less 24 patients in 12weeks. Plus 2/3 cases are taught everyday for around 3 weeks. Almost 36 more patients to learn from. 60 chronic diseases to learn from in 10 weeks (2 weeks of neonatology out of 12) is a great achievement!

4. Learn to say 'I don't know.' but make sure you look it up later.

5. Do not stress.

6. Enjoy the holidays while you can. You never know what turn your life might take. May be the rules of your clinical rotations change tomorrow and you stop getting the much needed and much awaited holidays. I thank god for starting my clinicals with pediatrics and not surgery where we get no government holidays except saturdays. And my fellow mates have to reach 1 hour before the scheduled time. 12 free days in 12 weeks! Oh lord! Save my soul during winters!


April 13, 2013

Causes of common drops

Wrist drop : Radial Nerve
Foot drop : Common Peroneal nerve
Eyelid Drop : Trigeminal nerve
Uvula drop : Vagus nerve
Shoulder drop/ upper limb (whole) drop : Brachial Plexus Injury
Lower limb drop (whole) : Sciatic nerve injury

April 11, 2013

Ectopia lentis

Ectopia lentis (Dislocation of lens) is seen in Marfans syndrome & Homocystinuria , but in one the dislocation is up (and outward) while in the other it goes down (and inward).
Remember that " urine goes down and into closet ". So lens get displaced down and inward in Homocysteinuria. And lens get displaced up and outward in Marfans syndrome (Opposite of above).

April 5, 2013

Blood disorders: Male vs Female

HE (male) gets:
HEmophilia (X-linked)
HEinz bodies (G6PD deficiency, causing HEmolytic anemia: X-linked)
HEmochromatosis ­ (male predominance)
HEart attacks (male predominance)
HEnoch-Schonlein purpura (male predominance)

SHE (female) gets:
SHEehan's syndrome

March 19, 2013

A New Name

I guess people have ups and downs during their blogging and I think I'm in that down phase. Hats off to those extra- ordinary people who do this blogging thing day in and day out.

With my unusual blogging rhythm I thought of using a pen- name (which suits me better) rather than my original name in my blog. What word can match my blogging and real life better than a Pulse's Pulsatile nature.

February 21, 2013

Diaphragm apertures- AEIOU

AEI- OU
Aorta : T12
Esophagus: T10
Inferior Vena Cava: T8

OU can be used to remember that it is On moving  Up from T12.

February 20, 2013

Meckel's Diverticulum- Rule of 2

Di representing 2 - Diverticulum has its features in 2s. So, Meckel's diverticulum follows the "Rule of 2".
2 inches long
2 feet from end of ileum
2 times more common in men
2% occurance in general population
2 types of tissues may be present.

February 16, 2013

Inferior Vena Cava tributaries

"I Like To Rise So High" to the heart

Iliac
Lumbar
Testicular
Renal
Suprarenal
Hepatic

TAILOR

Testicular
Azygos
Inferior phrenic
Lumbar
Ovarian
Renal

February 15, 2013

Causes of Thrombocytosis

MAKE MAPS

Myeloproliferative disorders
Acute hemorrhage
Kawasaki Syndrome
Essential thrombocytosis

Malignancy
Acute/ chronic Inflammation
Post- operative
Splenectomy

February 13, 2013

Side Effects of Phenobarbitone

Remember:
1. Children are annoying-
          hyperkinesia, irritability, insomnia, aggression
2. Adults are dosy/ lazy-
          sedation, dizziness, drowsiness
         

February 12, 2013

Atherosclerosis- Pathological changes and Complications

Pathological changes that can occur in an atherosclerotic plaque (atheroma) are: CURE

Calcification
Ulceration
Rupture
Erosion

The complications that can develop as a result of the changes are: HEAT

Hemorrhage (into the plaque, due to rupture of fibrous cap covering)
Emboli formation
Aneurysm (due to weakening of arterial wall)
Thrombosis

February 11, 2013

Adverse Effects of Aspirin

ASPIRIN

Asthma
Salicylism
Peptic ulcer/ Premature close of PDA
Intestinal blood loss
Reye's Syndrome
Idiosyncracy
Noise ( Tinnitus)

February 10, 2013

Bronchiectasis: Causes

A SICK AIRWAY

Airway lesion (chronic obstruction)
Sequestration
Infection, Inflammation
Cystic fibrosis
Kartagener's syndrome
Allergic bronchopulmonary aspergillosis
Immunodeficiencies (myeloma, lymphoma, hypogammaglobinemia)
Reflux inhalation injury
Williams Campbell Syndrome
Aspiration
Young's Syndrome

February 9, 2013

Alzheimer's disease: Features

RONALD (In memory of Ronald Readen, former US president. who was victim of AD)

Reduction of acetylcholine
Old Age
Navigational difficulties, Neurofibrillary tangles
Atrophy of cerebral cortex
Language impairment
Dementia

February 8, 2013

Foramen Ovale, Rotundum, Spinosum

Structures passing through Foramen Ovale: MALE

Mandibular nerve
Accessory meningeal artery
Lesser petrosal nerve
Emissary veins

Foramen Rotundum is MAXimally rounded

  • Foramen Rotundum is round or circular in adults
  • Maxillary nerve is the structure that passes through it

Foramen Spinosum is located adjacent to the spine of sphenoid.

February 6, 2013

Beta- blockers A/E and C/I

ADVERSE EFFECTS OF BETA BLOCKERS:
BBC Rocks - All Loving Viewers

B- Bradycardia
B- Bronchoconstriction
C- Claudication (Lameness)
R- Rebound hypertension
A- Angina esp. Variant
L- Lipid Profile altered, Libido loss
V- Vivid dreams/ Nightmares


CONTRAINDICATIONS OF BETA BLOCKERS: ABCDE

A- Ashmatics
B- Bradycardia, Block (complete/partial heart block)
C- COPD
D- Diabetes
E- Electrolyte disturbances (hyperkalemia)


February 5, 2013

Adverse Effects of Phenytoin

Adverse Effects of Phenytoin

P:  P-450 interactions

H: Hirsutism, Hypersensitivity, Hyperglycaemia

E: Enlarged gums

N: Nystagmus

Y: Yellow-browning of skin

T: Teratogenicity

O: Osteomalacia

I:  Interference with folic acid absorption (hence anemia)

N: Neuropathies: vertigo, ataxia, headache

February 4, 2013

Cephalosporins

Having trouble remembering cephalosporins according to generation? Here's a small tip to remember some of them (helpful specially for the objectives)


4th generation- think of 4th 'P'lace. All of them have a 'P' in them AFTER the first syllable.
                    CefPime
                    CefPirome

3rd generation- think of 3 for 'T'hird. Almost all of them have a  'T' in them AFTER the first syllable.
                    CefTriaxone
                    CefTazidime
                    CefTibuten
                    CefTizoxime
                    CefoTaxime


2nd generation- think of a Fox having Furry Face i.e. ceFOXitin, ceFURoxime ceFAClor

1st generation is thought of, when you come first in a game. That means you are 'IN Luck'. All of them end in 'IN' and have a 'L' in them.
                    Cephalothin
                    Cefazolin
                    Cefhalexin
                    Cephradine

Adverse Effects of Cephalosporins


"DDT HAPeNS"

D- Diarrhoea

D- Disulfiram like reaction

T- Thrombophlebitis

H- Hypoprothrombinemia

A- Allergy(hypersensitivity)

P- Pain(severe)

N- Nephrotoxicity

S- Super infections with fungi

P.S. I would like to thank the genius mind who made this mnemonic. 

February 3, 2013

Urease Positive Microorganisms

PUNCH

Proteus
Ureaplasma urealyticum
Nocardia
Cryptococcus
Helicobacter pylori

February 2, 2013

Placenta-crossing organisms and Drugs C/I during breastfeeding

PLACENTA-CROSSING ORGANISMS- STARCH
Syphilis
Toxoplasmosis
AIDS (HIV)
Rubella
CMV
Herpes/ Hepatitis

DRUGS CONTRAINDICATED DURING BREASTFEEDING-  BREAST

B= Bromocriptine/ Benzodiazepines

R= Radioactive isotopes/ Rizatriptan

E= Ergotamine/ Ethosuximide

A= Amiodarone/ Amphetamine

S= Sex steroids/ Stimulant laxatives

T= Tetracycline/ Tretinoin

February 1, 2013

Catalase Positive Microorganisms

SPACE
Staphylococci
Pseudomonas aeroginosa
Aspergillus fumigatus
Candida
Enterobacteriaceae

CATaLaSE
Cornybacterium
Aspergillus
Tuberculosis (Mycobacterium tubeculosis)
Legionella pneumoniae
Staphylococcus
Enterobacteriaceae

NOTE: None of the anaerobes are catalase positive. Worth to remember obligate anaerobes are ABC

Actinomyces
Bacteroides
Clostridium

January 30, 2013

Assortment of Dissection Feelings #2

#When the anatomy professor compliments me on my dissection

I'm like:

#Anatomy First Cut Feeling


# When it's time to crack out the bonesaw in anatomy


# When I finish a dissection early. 

I'm like:




January 12, 2013

How to date a doctor

Stumbled upon this article in foxnews.

Dating a med student? Check out these tips for a "healthy" relationship.

1. Don't expect to see them. Ever.
2. Accept the fact they will have many affairs. With their books.

3. Learn to hide your “ew, gross” reactions when they tell you all the stuff you never wanted to know about your bodily functions.
4. Support them when they come home after each test, upset because they failed—and gently remind them after they get their well above passing grade how unnecessary the “I’m going to fail out of medical school and never become an MD” dramatics are.
5. Each week they will have a new illness. Some will be extremely rare, others will be more mundane. Doesn’t matter. They will be certain they have it (no second opinions necessary.) Med school can, and will, turn even the sanest into a hypochondriac. Date them for long enough, and you’ll become one too.

6. There will be weeks you'll forget you even have a boyfriend—friends will ask how he is and you'll say, “What? Who? Oh....right. He's well...I think.”
7. They'll make you hyper-aware that germs are everywhere and on everything. Even though you used to walk into your home with your shoes on, and sit on your bed in the same clothes you just wore while riding the subway, or sat on a public bench in, you'll become far too disgusted to ever do it again. Believe me, it's going to get bad...you'll watch yourself transform into the anal retentive person you swore you'd never become. And when you witness others perform these same acts that, before you began dating your med student, you spent your entire life doing too, you'll wince and wonder, “Ew! How can they do that? Don't they know how many germs and bacteria they're spreading??!”

8. Romantic date = Chinese take-out in front of the TV on their 10 minute study break.
9. A vacation together consists of a trip down the street to Walgreens for new highlighters and printer paper.
10. Their study habits will make you feel like a complete slacker. For them, hitting the books 8-to-10 hours a day is not uncommon, nor difficult. You'll wonder how you ever managed to pass school on your meager one hour of studying per night.
11. They're expected to know everything. Everything! The name of the 8 billion-lettered, German sounding cell that lives in the depths of your inner ear, the technical term for the “no one's ever heard of this disease” disease that exists only on one foot of the Southern tip of the African continent. But ask them if your knee is swollen, or what you should do to tame your mucous-filled cough, or why the heck your head feels like someone's been drilling through it for oil for two weeks straight, and they won't have a clue.

12. “My brain's filled with so much information, I can't be expected to remember THAT!" will be the standard excuse for forgetting anniversaries, birthdays, and, if you get this far, probably the birth of your first-born.
13. You'll need friends with unending patience who pretend never to get sick of listening to your endless venting and complaints. Or, you'll need to pay a therapist who will pretend never to get sick of listening to your endless venting and complaints.

But take this all with a grain of salt. It's not like I'm speaking from experience or anything...

Also, don't forget to check the post on Reasons why you should date a doctor

January 1, 2013

Flashback!

Even though people say not to look back, I couldn't resist looking back... As I look back, the biggest blog achievement of 2012- I finally reached my first blog benchmark of 500 views. Being just a beginner at blogging and with just an year old blog and irregular posts, I'm super happy. I don't know if I have any regular viewers, but if there are any, I assure you to update my blog often the next few months. Ooh and yeah! The medlife achievement- I'm just a week from completing my 2nd year. Cheers!

I just finished my major two exams and have practicals coming up the next week. I'll be back with a bang after the exams. There are many things to add in this blog.
First thing- I created this blog with the aim to supply med students important websites. I haven't quite stuck to it. But, before that I need to take care of my blog name. I myself find the name of my blog to be misleading and I can't think of any other better name. So as of now, describing about the medicine system in Nepal is one of the major task lying ahead of me. It's complicated but I'll take time and try my best to help fellow people(who are interested in studying here) to know the system here.
Also, I'll add on as many mnemonics that I know. It's my personal interest to share the mnemonics I know, even though there already are many websites for mnemonics. I hope you'll find some mnemonics that you haven't seen anywhere or are better than the ones you have come across. I can't remember of anything more important than these two major additions to this blog.

As I look ahead...I can see.. Exams and the pre-exam panic attacks. But, I'll try to update often. And, no resolutions this year. Had I kept all those resolutions over the past decade, I would be rich, thin, fit, healthy, smarter and organised. But, my life is good just the way it is :) Happy New Year People!!