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MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) MEDICAL STUDENT REVIEW: 2017 a globulin is a globular protein there's alpha ones, gamma ones, and probably a bunch of other ones. gamma globulins are mostly immunoglobulins, but not all gamma globulins are immunoglobulins SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. PEUTZ-JEGHERS SYNDROME AND OSLER-WEBER-RENDU (AND JUVENILE versus So at first, they look pretty similar, right? dots on the skin, near and around the mouth. However, the subtleties make all thedifference.
THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: 2019 AKA the Ovarian Cancer edition 1 Niraparib for patients with newly diagnosed ovarian cancer 2 Veliparib + chemo for maintenance & first line therapy in ovarian cancer 3 Olaparib + bevacizumab as first-line maintenance in ovarian cancer 4 M72/AS01E trial for TB vaccine 5 Projected adult Obesity in the US at a state level 6 Care of Transgendered people 1 PolyADPribose polymerase inhibitor SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) MEDICAL STUDENT REVIEW: 2017 a globulin is a globular protein there's alpha ones, gamma ones, and probably a bunch of other ones. gamma globulins are mostly immunoglobulins, but not all gamma globulins are immunoglobulins SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. PEUTZ-JEGHERS SYNDROME AND OSLER-WEBER-RENDU (AND JUVENILE versus So at first, they look pretty similar, right? dots on the skin, near and around the mouth. However, the subtleties make all thedifference.
THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: 2019 AKA the Ovarian Cancer edition 1 Niraparib for patients with newly diagnosed ovarian cancer 2 Veliparib + chemo for maintenance & first line therapy in ovarian cancer 3 Olaparib + bevacizumab as first-line maintenance in ovarian cancer 4 M72/AS01E trial for TB vaccine 5 Projected adult Obesity in the US at a state level 6 Care of Transgendered people 1 PolyADPribose polymerase inhibitor MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. HODGKIN LYMPHOMA NON HODGKIN LYMPHOMA, ABVD AND CHOP Unless you're seeing it all the time because you're reading a bunch of articles about lymphomas, it can be tricky to differentiate CHOP and ABVD as well as knowing what they stand for. MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: 2017 a globulin is a globular protein there's alpha ones, gamma ones, and probably a bunch of other ones. gamma globulins are mostly immunoglobulins, but not all gamma globulins are immunoglobulins TREATING PRESSURE ULCERS IN THE ELDERLY... OR ANYONE You can see that there are 4 layers before the bone. Each layer that is "messed up" is the stage of the ulcer. In stage 1, it is non blanchable because the pressure has messed up the blood supply so that when you press down, you're ot re-occluding any vessels that will fill up once the pressure is released. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. GARDNERELLA VAGINALIS We're going to go over some of the more interesting parts of gardnerella an important cause of vaginosis. Gardnerella is the key identifying organism for vaginosis. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG.BIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diab SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG.BIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diab MEDICAL STUDENT REVIEW: 2019 AKA the Ovarian Cancer edition 1 Niraparib for patients with newly diagnosed ovarian cancer 2 Veliparib + chemo for maintenance & first line therapy in ovarian cancer 3 Olaparib + bevacizumab as first-line maintenance in ovarian cancer 4 M72/AS01E trial for TB vaccine 5 Projected adult Obesity in the US at a state level 6 Care of Transgendered people 1 PolyADPribose polymerase inhibitor MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) MEDICAL STUDENT REVIEW: 2017 a globulin is a globular protein there's alpha ones, gamma ones, and probably a bunch of other ones. gamma globulins are mostly immunoglobulins, but not all gamma globulins are immunoglobulins CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
MEDICAL STUDENT REVIEW: THE FRENCH, DUTCH, OR RAYNAUD? Primary = idiopathic Secondary = seen with other conditions CREST, MCTD Treatment is tough because first li MEDICAL STUDENT REVIEW Medical Student Review MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diab SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
ALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. EMULSIFICATION PH, PKA, BILE SALTS/ACIDS AND THE emulsification pH, pKa, bile salts/acids and the enterohepatic circulation. when the pH is less than the pKa, the protonated form predominates. from the stomach to the small intestine, the pH increase significantly, reaching a physiological pH of 7.4 in the ileum. when the liver shoots out its bile acids into the gallbladder, which then SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
ALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. EMULSIFICATION PH, PKA, BILE SALTS/ACIDS AND THE emulsification pH, pKa, bile salts/acids and the enterohepatic circulation. when the pH is less than the pKa, the protonated form predominates. from the stomach to the small intestine, the pH increase significantly, reaching a physiological pH of 7.4 in the ileum. when the liver shoots out its bile acids into the gallbladder, which then SYMPATHETIC, PARASYMPATHETIC, SOMATIC INNERVATION PRE AND I like to remember 6 different innervations Parasympathetic (1) Sympathetic (4) and Somatic (1) Parasympathetic preganglionic axons are long, postganglinic axons are short. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 1... THE The innate immune system is the answer to “how do you protect yourself IN GENERAL” from things: you have your skin that forms a protective barrier, cells that gobble up anything remotely suspicious MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . TAKEAWAYS FROM NEJM... JANUARY 09 2020 Title 1 Early surgery v conservative care for asymptomatic aortic stenosis 2 rivaroxaban after transcatheter aortic valve replacement 3 reduced leaflet motion after transcatheter aortic valve replacement 4 Luspatercept in patients witih low-risk myelodysplastic syndromes 5 Detection of Donor HIV in HIV postive kidney transplant recipient Summary 1 145 asymptomatic patients with aortic CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it HODGKIN LYMPHOMA NON HODGKIN LYMPHOMA, ABVD AND CHOP Unless you're seeing it all the time because you're reading a bunch of articles about lymphomas, it can be tricky to differentiate CHOP and ABVD as well as knowing what they stand for.ALTITUDE AND OXYGEN
If you've ever been hiking or have been up really high, you might have noticed that you run out of breath faster. Maybe your dad or one of your friends put his hands on his hips and stated "yeah, there's not as much oxygen up here."That's true TREATING PRESSURE ULCERS IN THE ELDERLY... OR ANYONE You can see that there are 4 layers before the bone. Each layer that is "messed up" is the stage of the ulcer. In stage 1, it is non blanchable because the pressure has messed up the blood supply so that when you press down, you're ot re-occluding any vessels that will fill up once the pressure is released. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 1... THE The innate immune system is the answer to “how do you protect yourself IN GENERAL” from things: you have your skin that forms a protective barrier, cells that gobble up anything remotely suspicious MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . HODGKIN LYMPHOMA NON HODGKIN LYMPHOMA, ABVD AND CHOP Unless you're seeing it all the time because you're reading a bunch of articles about lymphomas, it can be tricky to differentiate CHOP and ABVD as well as knowing what they stand for.ALTITUDE AND OXYGEN
If you've ever been hiking or have been up really high, you might have noticed that you run out of breath faster. Maybe your dad or one of your friends put his hands on his hips and stated "yeah, there's not as much oxygen up here."That's true MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. GLAUCOMA | MEDICAL STUDENT REVIEW Glaucoma is the pressure increase in the eye. We usually divide it into open or closed angle glaucoma. Let's look at the anatomy of the eye, then discuss the pathology and then talk about drugs. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VASA RECTA COUNTERCURRENT EXCHANGE vasa recta countercurrent exchange. Posted 19th February 2018 byUnknown.
SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 1... THE The innate immune system is the answer to “how do you protect yourself IN GENERAL” from things: you have your skin that forms a protective barrier, cells that gobble up anything remotely suspicious MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . HODGKIN LYMPHOMA NON HODGKIN LYMPHOMA, ABVD AND CHOP Unless you're seeing it all the time because you're reading a bunch of articles about lymphomas, it can be tricky to differentiate CHOP and ABVD as well as knowing what they stand for.ALTITUDE AND OXYGEN
If you've ever been hiking or have been up really high, you might have noticed that you run out of breath faster. Maybe your dad or one of your friends put his hands on his hips and stated "yeah, there's not as much oxygen up here."That's true MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. GLAUCOMA | MEDICAL STUDENT REVIEW Glaucoma is the pressure increase in the eye. We usually divide it into open or closed angle glaucoma. Let's look at the anatomy of the eye, then discuss the pathology and then talk about drugs. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VASA RECTA COUNTERCURRENT EXCHANGE vasa recta countercurrent exchange. Posted 19th February 2018 byUnknown.
SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: CAUDA EQUINA CONUS MEDULLARIS What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
MEDICAL STUDENT REVIEW: POLYPS AND CRC Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarerALTITUDE AND OXYGEN
So, "per breath" you're still getting 20% of the respiration as oxygen. The difference is that look how much oxygen per breath you're getting at sea level vs. miles up. CONIDIOSPORE, CONIDIOPHORE, CONDIDIA, SPORANGIOSPORE as far as i'm concerned, your opportunistic fungal infection has two different types of structures. It's either contained in a dome Or it MEDICAL STUDENT REVIEW: EMULSIFICATION PH, PKA, BILE SALTS when the liver shoots out its bile acids into the gallbladder, which then releases the bile into the duodenum through the sphincter of Oddi/ Ampulla of Vater complex, these bile acids have a low pKa (because they're acids), however, the pH of the intestines can be higher than the pKa. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 1... THE The innate immune system is the answer to “how do you protect yourself IN GENERAL” from things: you have your skin that forms a protective barrier, cells that gobble up anything remotely suspicious MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . HODGKIN LYMPHOMA NON HODGKIN LYMPHOMA, ABVD AND CHOP Unless you're seeing it all the time because you're reading a bunch of articles about lymphomas, it can be tricky to differentiate CHOP and ABVD as well as knowing what they stand for.ALTITUDE AND OXYGEN
If you've ever been hiking or have been up really high, you might have noticed that you run out of breath faster. Maybe your dad or one of your friends put his hands on his hips and stated "yeah, there's not as much oxygen up here."That's true MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. GLAUCOMA | MEDICAL STUDENT REVIEW Glaucoma is the pressure increase in the eye. We usually divide it into open or closed angle glaucoma. Let's look at the anatomy of the eye, then discuss the pathology and then talk about drugs. MEDICAL STUDENT REVIEW: MAY 2019 So in both cases you're going to have RUQ pain and a pregnant woman. Sometimes it can be hard to differentiate the two, so if you keep in mind how the liver makes everything, then you'll be able to correlate a decrease in certain products (platelets, bilirubin) as a liver problem vs. a gallbladder problem. UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VASA RECTA COUNTERCURRENT EXCHANGE vasa recta countercurrent exchange. Posted 19th February 2018 byUnknown.
SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diabBIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diabBIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 2... THE Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: THE FRENCH, DUTCH, OR RAYNAUD? Primary = idiopathic Secondary = seen with other conditions CREST, MCTD Treatment is tough because first li MEDICAL STUDENT REVIEW: FETAL HEART RATE 1, 2, 3 What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MEDICAL STUDENT REVIEW: POLYPS AND CRC https://s-media-cache-ak0.pinimg.com/736x/85/9b/f6/859bf6d8ce2fb4f653763bc4f95ceb22.jpg Colonic Polyps aren't much fun . They're p UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VENTILATION AND CO2 AND OXYGENATION AND WTF IS GOING ON look at this! you're breathing in a bunch of air. oh no! that air has low oxygen concentration. you start hyperventilating. what's going on? Well, ventilating is due to your brain sensing an increase in CO2 and says "let's breathe all this out".BIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer PEUTZ-JEGHERS SYNDROME AND OSLER-WEBER-RENDU (AND JUVENILE versus So at first, they look pretty similar, right? dots on the skin, near and around the mouth. However, the subtleties make all thedifference.
SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diabBIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium . MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer IUGR | MEDICAL STUDENT REVIEW In Asymmetrical IUGR, the growth restriction doesn't affect every body part equally. Typically the Head is spared as you would see an increase in the ratio of the Head Circumference to the Abdominal Circumference. Asymmetrical IUGR is the most common type of IUGR andoccurs in
UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: PCV 13+23 OR JUST 23? OR 23 THEN 13+23 once you're 65 you get 13 and then a few months later 23. you get 23 before 65 if you have some sort of illness going on like COPD or diabBIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 2... THE Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: THE FRENCH, DUTCH, OR RAYNAUD? Primary = idiopathic Secondary = seen with other conditions CREST, MCTD Treatment is tough because first li MEDICAL STUDENT REVIEW: FETAL HEART RATE 1, 2, 3 What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
MEDICAL STUDENT REVIEW: POLYPS AND CRC https://s-media-cache-ak0.pinimg.com/736x/85/9b/f6/859bf6d8ce2fb4f653763bc4f95ceb22.jpg Colonic Polyps aren't much fun . They're p UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VENTILATION AND CO2 AND OXYGENATION AND WTF IS GOING ON look at this! you're breathing in a bunch of air. oh no! that air has low oxygen concentration. you start hyperventilating. what's going on? Well, ventilating is due to your brain sensing an increase in CO2 and says "let's breathe all this out".BIOPSY THAT CERVIX?
girl goes in for her pap smear. Results are #yikes. How do you know whether to biopsy or colposcopy, or LEEP? It depends on how yikes the results are, and your age. MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer PEUTZ-JEGHERS SYNDROME AND OSLER-WEBER-RENDU (AND JUVENILE versus So at first, they look pretty similar, right? dots on the skin, near and around the mouth. However, the subtleties make all thedifference.
SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium .POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. THE JVP AND BOYLE'S LAW AND IDEAL GAS LAW the "c" spike is due to the tricuspid valve bulging into the RA during isovolumetric ventricular contraction. The pressure in the LV pushes the tricuspid valve up a bit. HOW TO READ AN EKG... TIPS AND TRICKS. The direction is "up and to the left". Although there's a "to the left" portion, the "up" portion trumps it because our rule 2 says "The net movement of current is down and to the left". GARDNERELLA VAGINALIS We're going to go over some of the more interesting parts of gardnerella an important cause of vaginosis. Gardnerella is the key identifying organism for vaginosis. OVARIAN TORSION OR WHAT? Lady comes in, LMP 6 weeks ago. Crazy abdominal pain RLQ. DDX Appendicitis, ovarian torsion, ectopic pregnancy, necrotic small bowel You gotta look at the labs/ whole picture. MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer SO GOOD REVIEW GUIDES Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MUSCLE... SKELETAL, CARDIAC, SMOOTH... CONTRACTIONS In the image above, we see the "invaginations" of the sarcolemma, called the T-tubule, and on either side of the T tubule there are these yellow, bulging, raised, structuresTerminal cisternae, which are enlarged areas of the sarcoplasmic reticulum, a part of the "muscle apparatus" that stores and releases calcium .POLYPS AND CRC
Adenomatous polyps don't have that serrated appearance hyperplastic polyps do. they kind of just mushroom-out. These are neoplastic glandular proliferations, as opposed to the hyperplastic glandular proliferation of the hyperplastic polyps. these suckers can progressto
MEDICAL STUDENT REVIEW: 2018 At this point I always look for 15 or so things in no particular order) 1WPW 2AV block 3vtach (supraventricular or monomorphic) 4 a fib 5 vfib 6 RBBB (RsR' in v1 slurred S in V5-V6) THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. THE JVP AND BOYLE'S LAW AND IDEAL GAS LAW the "c" spike is due to the tricuspid valve bulging into the RA during isovolumetric ventricular contraction. The pressure in the LV pushes the tricuspid valve up a bit. HOW TO READ AN EKG... TIPS AND TRICKS. The direction is "up and to the left". Although there's a "to the left" portion, the "up" portion trumps it because our rule 2 says "The net movement of current is down and to the left". GARDNERELLA VAGINALIS We're going to go over some of the more interesting parts of gardnerella an important cause of vaginosis. Gardnerella is the key identifying organism for vaginosis. OVARIAN TORSION OR WHAT? Lady comes in, LMP 6 weeks ago. Crazy abdominal pain RLQ. DDX Appendicitis, ovarian torsion, ectopic pregnancy, necrotic small bowel You gotta look at the labs/ whole picture. MEDICAL STUDENT REVIEW: NOVEMBER 2016 Carcinomas are epithelial in origin, are much more common than sarcomas and usually affect people over 50 Sarcomas are from the mesoderm and are rarer THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 2... THE Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria just about anything. MEDICAL STUDENT REVIEW: ELASTIN V COLLAGEN (FOCUS ON ELASTIN) Collagen and elastin are both important proteins. Collagen is definitely more important, but elastin is nothing to sneeze at. Whereas collagen requires the hydroxylation of proline and lysine (using vitamin C, a defect of which will cause scurvy), there is no significant hydroxylation of proline and a total lack of hydroxylysinein elastin.
THOUGHTS ON NEJM JAN 16 2020 Title 1 Treating addiction as terminal disease 2 Trial of Anifrolumab in active SLE 3 Phase 3 trial of Difelikefalin in hemodialysis THE LIVER... SINUSOIDS, TRIADS, PORTAL VEIN AND ARTERY As we can see the bile flows in a different direction from the blood in the arteries and veins. This can make sense in the context of the bile ultimately going to the gallbladder from the liver, so it's not going to go in the same direction. MEDICAL STUDENT REVIEW: THE FRENCH, DUTCH, OR RAYNAUD? Primary = idiopathic Secondary = seen with other conditions CREST, MCTD Treatment is tough because first li MEDICAL STUDENT REVIEW: FETAL HEART RATE 1, 2, 3 What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted andgets all hard.
EMULSIFICATION PH, PKA, BILE SALTS/ACIDS AND THE emulsification pH, pKa, bile salts/acids and the enterohepatic circulation. when the pH is less than the pKa, the protonated form predominates. from the stomach to the small intestine, the pH increase significantly, reaching a physiological pH of 7.4 in the ileum. when the liver shoots out its bile acids into the gallbladder, which then UNDERSTANDING THE SAAG... SERUM ALBUMIN (TO) ASCITES Usually the oncotic and hydrostatic pressures are pretty similar. However, when hydrostatic pressure is increased (as in portal hypertension, CHF) hydrostatic pressure increases significantly, causing a relative increase in the serum albumin concentration, leading to an increased SAAG. VENTILATION AND CO2 AND OXYGENATION AND WTF IS GOING ON look at this! you're breathing in a bunch of air. oh no! that air has low oxygen concentration. you start hyperventilating. what's going on? Well, ventilating is due to your brain sensing an increase in CO2 and says "let's breathe all this out". PEUTZ-JEGHERS SYNDROME AND OSLER-WEBER-RENDU (AND JUVENILE versus So at first, they look pretty similar, right? dots on the skin, near and around the mouth. However, the subtleties make all thedifference.
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Mar
20
THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 2... THE ADAPTIVE IMMUNE SYSTEM... SPECIFICALLY ANTIBODIES Chapter two: Adaptive Immunity Adaptive Immunity is usually thought of as two parts… Humoral andCell Mediated
Humoral Immunity
This is the work of antibodies Cell Mediated Immunity This is the work of your B Cells and T Cells. There is overlap between Humoral Immunity and Cell Mediated Immunity because Antibodies are produced by B Cells and can be further specified by the interaction of B and T Cells.Antibodies
Antibodies are proteins that your immune system makes to help cells kill. Antigens are what antibodies attach to. Antigens can be pollen, worms, drugs, viruses, bacteria… just about anything. Antibodies work in many ways. Antibodies can bind to antigens and deactivate them. Antibodies can bind to antigens and then trigger a cascade of reactions called the “complement cascade” Antibodies can bind to antigens and then have Macrophages or other cells come and eat them Posted 1 week ago by rubecuber0
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Mar
20
THE IMMUNE SYSTEM FOR THE FOLKS AT HOME... PART 1... THE INNATEIMMUNE SYSTEM
The immune system’s purpose is to protect you from foreigninvaders.
These foreign invaders can be bacteria, viruses, drugs, pollen, really anything that your body doesn’t recognize as “self”. This is mainly the function of white blood cells. Chapter 1: Innate v. Adaptive Immunity The immune system can be thought of as being divided in two parts: innate and adaptive. The innate immune system is the answer to “how do you protect yourself IN GENERAL” from things: you have your skin that forms a protective barrier, cells that gobble up anything remotelysuspicious...
The adaptive immune system is the answer to “how do you protect yourself from THIS SPECIFIC THING”... like COVID19, or this particular strain of the cold, or a specific bacteria. If your immune system is the question “how do I protect myself from harm”?. Your innate Immune system’s response would be: you would not go out at night, you would make sure to avoid dangerous places, you would leave sticky situations before they became overwhelming, you would not associate with dangerous fellows… The adaptive immune system would say “hmm, I’m being chased by robbers, I should put on this clown costume and join the parade of clowns so I’ll escape unnoticed”. The idea is that it is specific to the situation, unlike the innate immune system, which are just generic roadblocks set in place. Innate Immune system Your innate immune system’s job is to say “this looks like trouble”. Just like how you know not to touch a bright hot stove, or a colorful snake, or a dog foaming at the mouth, there are things your innate immune system looks for that are signs of danger. Pathogen Associated Molecular Patterns (PAMP’s) On a snake you say “red and yellow can kill a fellow”. Similarly, there are patterns on dangerous molecules that your innate immune system recognizes. These are called PAMP’s. Specific cells in your body have the job of identifying PAMP’s and eating/destroying those targets.Macrophages
These are big cells that eat suspicious targets.Dendritic Cells
These are cells that present suspicious material to the rest of theimmune system.
Although both macrophages and dendritic cells eat foreign objects, a Macrophage’s main job is to eat and destroy, and a Dendritic cell’s goal is to eat and show everyone what you ate. Below are some other examples of white blood cells involved in the innate immune systemNeutrophils
Neutrophils are the most numerous white blood cells. They are the “first in line” when the immune system attacks a target. They mostly kill by Reactive Oxygen Species. This is when unpaired electrons (called Radicals) break apart molecules. It is very effective. Neutrophils have a distinct look- multiple lobes in thenucleus.
Eosinophils
Eosinophils are white blood cells that are mainly involved with allergic responses with large parasites (worms, protozoa…) and also in asthma and other allergic conditions. Eosinophils are different from Neutrophils in how they kill. Eosinophils tend to release inflammatory molecules, which sometimes hurts your own body. Eosinophils are typically stained pink in labs. How do white blood cells know to eat something? There are zillions of cells that make up your body. All these cells have distinct shapes with distinct features on each of them. Macrophages (and neutrophils, and dendritic cells…) are made with receptors meant to grab onto distinct suspicious features. What happens after the innate immune system cell eats an object? When dendritic cells break down an object, they present it on their surface. These dendritic cells will eventually go to the lymph nodes and kick the Adaptive Immune system into gear. Posted 1 week ago by rubecuber0
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Feb
22
PREVENTING FALLS IN OLDER ADULTS... FROM NEJM 02/20/2020 Falls in the elderly have consequences... fractures, rhabdomyolysis, fear of activity, bleeding if on anticoagulation.' The biggest risks are gait problems (slow gait, unsteady gait...), medication side effects, medical conditions like depression, orthostatic hypotension... So what do you do? Here are the big takeaways from my view. 1. Everyone 65 and up should be evaluated for fall risk and fallhistory.
Ask them to do a get-up-and-go test, time it! See how they walk, assess their balance! Ask about how many falls this year. Ask if they are afraid to do activity because of it. 2. Exercise is good. Exercise decreases falls and decreases the risk of fractures fromfalls.
The article talks about specific balance exercises, like getting up from a chair without the handles, and balancing on one leg. Walking by itself was surprisingly not shown to decrease fall risk. 3. Avoid and fix obvious problems Is it due to meds? switch'em or stop them. Is it due to orthostatic hypotension? Don't get dehydrated, get upslowly.
Is it because of vision problems? get it checked Do you have uneven floors? fix them! Is it due to syncope? See a cardiologist. All this and more, next time in the NEJM Posted 22nd February by rubecuber0
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Feb
9
LEFT VENTRICULAR NON COMPACTION What we have here, folks, is a new condition. When the Left ventricle first forms, it's originally all spongy, and then gets compacted and gets all hard. This way, the muscle contracts normally and is all nice and smooth. When the LV doesn't compact, it's all soft and can't contract normally and has all these trabeculae. Since the LV can't contract normally, you guessed it, you can get clots and emboli andall that jazz
It can be tough to diagnose, especially if the echo isn't super clear. You can also use MRI, CT if you feel the itch. https://en.wikipedia.org/wiki/Noncompaction_cardiomyopathy#/media/File:Cardiovasc_Ultrasound_LVNC_3.jpg Posted 9th February by rubecuber0
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Feb
9
THE FRENCH, DUTCH, OR RAYNAUD? PRIMARY = idiopathic SECONDARY = seen with other conditions... CREST, MCTD... TREATMENT is tough because first line is CCB like nifedipine, but unless you have concomitant hypertension you may feel lightheaded and not want to take it. You can also use topical nitroglycerin, but for the most part, treatment revolves around keeping those hands warm.Stop smoking!
Posted 9th February by rubecuber0
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Jan
27
THOUGHTS ON NEJM JAN 16 2020TITLE
1 Treating addiction as terminal disease 2 Trial of Anifrolumab in active SLE 3 Phase 3 trial of Difelikefalin in hemodialysis patients withPruritus
4 Randomized trial of EPO for neuroprotection in preterm infants 5 Lipoprotein reduction in persons with cadiovascular disease 6 JAK inhibitor therapy in child with USP18 deficiency 7 Congenital Heart Disease, cytokines, and beta blockersPROCESS
1 woman with opioid use under rehab goes to hospital for sepsis, endocarditis, cannot be operated on, and she needs to decide on hertreatment options
2 Anifrolumab is an antibody to type 1 interferons (like IFN alpha, beta, gamma, amongst others). Patients with moderately to severely active SLE were chosen to go through Anifrolumab every 4 weeks for 48 weeks or a placebo. The end results were improvement of symptoms, and no worsening in organ systems 3 Difelikefalin is a kappa opioid receptor agonist in the peripheral body systems. Three times a week for 12 weeks, people with CKD associated pruritis were split into tri weekly Difelikefalin or a placebo and then evaluated for itching. 4 Infants born from 24 to 27 weeks were given high dose epo within 24 hours of birth and then every 48 hours for 6 doses, and then three times a week until 32 weeks of post menstrual age, or were given a placebo. They were evaluated for death or severe neurodevelopmental impairment from 22 to 26 months of post menstrual age. 5 Patients with cardiovascular disease and lipoprotein A levels of at least 60mg/dL were given the AKCEA-APO(a)-LRx at different rates, and then evaluated the Lipoprotein A levelas at 6 months. 6 a child from saudi first cousins conceived via IVF was born with a deficiency of Ubiquitin specific peptidase 18, which stops interferon inflammation via JAK activity. This kid was given JAK inhibitor therapy via ruxolitinib. 7 Kids with Congenital Heart Disease, especially Tetralogy of fallot have an increase in binucleated cardiomyocytes. These cells have a decrease in ECT2 compared to normal cardiomyocytes. Beta blockers (in the case reported, propranolol, and alprenolol) increase ECT2, and should be further investigated in patients with tetralogy of fallot and pulmoary stenosisRESULTS
1 Woman chooses palliative care for her remaining time, but maybe she would have had more options if her addiction had been treated moreseriously
2 Mild improvements with Anifrolumab compared to placebo, especially with glucocorticoid use and musculoskeletal involvement 3 Difelikefalin reduces itching almost at onset, as well as at the endof the trial.
4 no difference in outcomes. not in bronchopulmonary dysplasia, intracranial hemorrhage, necrotizing enterocolitis... 5 Patients saw a decrease in Lipoprotein A levels in a dose - dependent manner. charting teh Lipoprotein A decrease based on the dosing interval we have placebo<20mgQ4weeks<40mgQ4weeks<20mgQ2weeks<60mgQ4weeks<20mgQweek 6 The child receives oral ruxolitinib and is the only child with this condition to survive past 7 months. He is 3 years old. 7 Beta blockers (in the case reported, propranolol, and alprenolol) increase ECT2, and should be further investigated in patients with tetralogy of fallot and pulmoary stenosisTHOUGHTS
1 I'm not very familiar with palliative care. The writer makes it clear he would have liked for the lady to have had earlier access to substance use treatment as well as more intervention on behalf of the healthcare system. The ending statement is particularly appropriate in this case, as it states that if addiction were treated as disease were, then actual care may be provided instead of judgement. 2 Doesn't seem to be a super game changer, people with a higher IFN gene signature seem to have a greater benefit. I don't know how widespread its use will be 3 Patients in both the control and the Difelikefalin group took topical anti itching creams during the trial, and both reported decreased itching. It just seems that the Difelikefalin group was more pleased than the placebo group. I don't see it being a big player because, although results are positive, so is the placebo, and it costs less. The article did not mention the proposed cost of the drug, which is a bummer because the pharmaceutical company definitely has an idea of what they're going to charge 4 man, what a shame. This is the kind of stuff that could have been a key next step forward development. I don't remember reading anything about the comparison with lose-dose epo, except in the opening paragraphs, but the article didn't delve too far into it. 5 pretty cool, however, clinical correlation would be really nice. Of course, the article talks about how LDL therapy in people with elevated lipoprotein levels is often ineffective and this could be abright light
6 Don't fuck your cousins. 7. Wonderful. Here there is a surgically-correctable problem, that can, theoretically, be completely avoided with medical intervention, or at least ameliorated. Hopefully there are some studies en route. Posted 27th January by rubecuber0
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Jan
12
TAKEAWAYS FROM NEJM... JANUARY 09 2020Title
1 Early surgery v conservative care for asymptomatic aortic stenosis 2 rivaroxaban after transcatheter aortic valve replacement 3 reduced leaflet motion after transcatheter aortic valve replacement 4 Luspatercept in patients witih low-risk myelodysplastic syndromes 5 Detection of Donor HIV in HIV postive kidney transplant recipientSummary
1 145 asymptomatic patients with aortic stenosis (valve Area <0.75, or aortic velocity ≥4.5 mps, or mean transortic gradient ≥50 mmHg were split into two groups. One had early surgery, the other had conservative care. They compared death rates. 2 1644 people were given either aspirin + rivaroxaban or aspirin+clopidogrel after TAVR and were evaluated for rates of death/thromboembolic events or bleeding 3 patients who underwent TAVR with no indication for anticoagulation/antiplatelet therapy were assigned to rivaroxaban+aspirin, aspirin+clopidogrel and were compared for leaflet motion abnormalities 4 people with low risk MDS who had been getting RBC's were given luspatercept and were compared by need for transfusion compared with aplacebo
5 61 year old HIV+ man with PKD under AntiRetroviralTherapy receives dead man's kidney who also has HIV. Donor's HIV was found in patient'sserum.
Results
1 early surgery was associated with lower death rates than those who underwent conservative care 2 People with an indication for anticoagulation after TAVR had higher risk of bleeding and thromboembolic events with rivaroxaban than with antiplatelet therapy. 3 people without indication for anticoagulation or antiplatelet therapy after TAVR had lower rates of leaflet abnormalities with rivaroxaban+aspirin than with aspirin+clopidogrel 4 patients with luspatercept had a lower severity of anemia compared to those receiving a placebo 5 Donor HIV found in patient's serum,but after continued antiretroviral therapy (with abacavir, lamivudine, and raltegravir) only the recipient's HIV was found.Thoughts
1 early surgery seems to be the best option in many cases. Might as well take care of a problem before it becomes serious. 2+3 Funny how they'd have one article where rivaroxaban has a negative effect and another where it doesn't. However in the first article, the patients had an indication for anticoagulation/antiplatelet therapy, and in the second the patients did not, but in the trial where there was an indication, it turned out for the worse. I wish the end points used had been the same so I could make a more appropriate comparison. 4 I don't care much for articles like these because it's very niche, but I am glad that this one drug is better than a placebo 5 HIV is tricky. I wonder what made that donor's HIV become untraceable after a little while, maybe the cell count wasn't large enough to propagate with ART Posted 12th January by rubecuber0
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Jan
12
TAKEAWAYS FROM NEJM... JANUARY 02 2020Title
1 Comparison of two different LDL targets after ischemic stroke 2 Alcohol Abstinence in people with AFib 3 Multi-year follow up after AAV5-hfVIII-SQ gene therapy forhemophilia A
***
Explanation
1 People who had had a stroke in the last 3 months or tia in the last 15 days with evidence of atherosclerosis had their LDL decreased to either below 70, or to 90 to 110 via statins or cholesterol-absorption inhibitors and waited for cardiovascular events defined bv in the article 2 People who drank ten drinks a week and also had AFib were split into two groups, with one asked to stop drinking, and the other asked tocontinue
3 Men with Hemophelia A were given factor 8 gene that was spliced up between a few adenoviruses used as vectors.***
Results
1 People with LDL below 70 after ischemic stroke had fewer cardiovascular events than those with LDL levels from 90-110 2 Decrease in AFib events in the group that abstained from alcohol 3 After three years, men who received adenovirus-associated gene therapy showed higher factor 8 levels, decreased bleeding events, and decreased use of factor 8 than before gene therapy***
Thoughts
1 I love articles like these. Universally applicable, easy benchmarks, clear results. They max'd atorvastatin at 80mg QD, 2 I guess drinking is bad vibes all around 3 Gene therapy in 20 years will be what antibody therapy is today. The article talks about how gene size limitation made using multiple different vectors necessary. The article is definitely worth a read as an intro to the other article in the journal about CRISPR and gene editing. The article is also worth reading because of how complicated it was to set up the trial...Happy New Year
Posted 12th January by rubecuber0
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Jan
1
TAKEAWAYS FROM NEJM... DECEMBER 26 2019 1 Preparing to end the HIV epidemic - the california way 2 Female genital schistosomiasis 3 Colchicine after MI 4 High dose Vitamin D in vitamin D-deficient ICU patients 5 Intermittent fasting's effect on health, disease, and aging 1Pharmacists in California can give a 30-to-60 day supply of PrEP to initiate pre-exposure prophylaxis 2 For women, HIV/AIDS, cervical cancer screening, as well as schistosomiasis have huge consequences, social, sexual, and more. 3 Colchicine after MI _decreases the likelihood of_ a) resuscitated cardiac arrest b) stroke c) urgent hospitalization for angina resulting in coronary revascularization_does not affect_
a) death from cardiovascular causes, b) MI's 4 540,000 units of Vitamin D in vitamin d-deficient ICU patients does not change mortality 5 Intermittent fasting improves outcomes in neurologic disorders like Parkinson's, Alzhemiers, improves weight loss, cardiovascular disease, diabetes, memory, cancer and a zillion other things.***
Thoughts
1 so the reason they let pharmicists initiate prep (with some pharmacist training) is so that there's less hesitancy to get treatment due to stigma or whatever. Thumbs up for that, however, the cost of Prep is still $22000 a year and needs to be taken every day of your life. That sounds like a bigger hindrance than anything else. It was also done in san francisco, where HIV/AIDS is a bigger deal, so maybe this will only work in cities. 2 This is a largely african problem, but it was interesting to see how Female Genital Schistosomiasis can cause problems like destroying the hymen and leading people to think one is sexually promiscuous. 3 It's a shame colchicine didn't work. The article talks a lot about the effect of inflammation on the heart, and the desire to find a pharmacological target that reduces its effects, but colchicine is notthat "magic pill"
4 bummer. I love articles like these because they are "plug and play"solutions.
5... Intermittent fasting either via 16:8 hours fasting:non-fasting or 5:2 days a week non-fasting:fasting seems pretty great, and I like how the article gives tips for getting people started (easing into the timing over two months). Posted 1st January by rubecuber0
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Dec
21
TAKEAWAYS FROM NEJM... DECEMBER 19 2019 AKA the Ovarian Cancer edition 1 Niraparib for patients with newly diagnosed ovarian cancer 2 Veliparib + chemo for maintenance & first line therapy in ovariancancer
3 Olaparib + bevacizumab as first-line maintenance in ovarian cancer 4 M72/AS01E trial for TB vaccine 5 Projected adult Obesity in the US at a state level 6 Care of Transgendered people***
1 PolyADPribose polymerase inhibitor, Niraparib, when used on newly-diagnosed patients that had a positive response to platinum-based chemotherapy showed benefits of progression-free survival regardless of BRCA status. 2 Veliparib in addition to (carboplatin + paclitaxel) as a first line therapy + Veliparib by itself as maintenance therapy increases progression-free survival compared to not using veliparib. 3 Olaparib + Bevacizumab for maintenance therapy is better than Bevacizumab by itself 4 50% of People in three african countries with IGRA-positive TB who had the M72/AS01E vaccine did not progress in symptoms after threeyears
5 By 2030, 50% of US adults will be obese, and the majority of states will have more than 50% of the adult population as obese 6 Covers topics such as... MaleToFemale, FemaleToMale, prepubescent issues, when to transition, requirements, and precautions***
Takeaways
1. PARPs work as maintenance monotherapy. Despite PARP's seeming to be effective, ovarian tumors seem to always come back in one way or another, unfortunately. Patients who were BRCA positive with the Niraparib took 21 months to progress, and those without the drug took 10 months to progress. In the overall population, it was a 13:8 ration in months. However, at 24 months, the paper states the Niraparib group had an increased survival advantage compared to the placebo group. (84% v 77% ) but the confidence interval for that data includes the null value, so I guess it's not super reliable. The patients all had serous or endometroid-types of ovarian cancer. 2. PARP's work when added to induction therapy + maintenance therapyfor ovarian cancer.
Looks like PARP's work all the time. Unfortunately, there is a greater incidence of neutropenia, anemia. 3. Bevacizumab has known safety concerns so people have been looking for alternatives like the PARP's. Still, combination therapy is better for maintenance therapy in ovarian cancer. 4. Since this took place in Kenya, South Africa, and Zambia I wonder what the application is outside of this area. The article talks about this need for expanding the population 5. Southern states have higher rates of obesity, though it's a problem everywhere in the US, and it's only going to get worse, especially for poorer families. Should childhood obesity be considered child abuse? 6. Interesting to see how the article states there is no room for hormone therapy in anyone less than tanner stage 2. The author also states the necessity to ensure the patient is of a sound mind and has no comorbidities. Apparently 0.6% of americans identify as transgender, and with these types of things becoming more accepted, I wouldn't be surprised if endocrinology is going to become a megabucks specialty with its fair share of lawsuits. Worth noting, the article does not promote or dissuade from surgery and hormone treatment Leave a comment if you have any ideas, please Posted 21st December 2019 by rubecuber0
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