I don't know how many med students there are on board, or how useful this review will be for you.. I am a firm believer in slow and consistent than an intellectual enema two days before the exam where once released never again to be regained.. So what I plan to do here, is share some things I feel are important..
In my pre-clinical years, I was president of the pharmacology club, and I enjoyed teaching it and exchanging ideas with others.. so if you have your own forte, quirks mnemonics that you'd like to share we can make a useful compendium..
I am only going to focus here on pharmacology and diagnostic testings.. so every day I'll give you five of each..
I am not going to start in any particular order but once in a section, I plan to complete it.. this will be just the high yield..
Oncology diagnostic testing
_____________
AFP (what disease is associated with it, and when do you answer this for a question?)
AFP is associated with the development of
1-hepatocellular ca.
2-ovarian cancer
3-non-seminomatous germ cell tumors
Answer AFP when you see a patient with alcoholic cirrhosis or chronic hepatitis B or V. AFP together with radiological imaging is used to screen for hepatocellular ca
____________________________________________
CEA
1-A protein elevated in a variety of cancers including colorectal cancer
2-serum CEA have a prognostic value in pts with newely diagnosed CRC. Those with higher levels have worse prognosis.
3-CEA level to monitor in colon cancer in pts after a surgical resection, it determines the presence of persistent, recurrent or metastatic disease
__________________________________________________ ___________
Colposcopy
Colposcopy is the direct visualization of the cervix, by use of a magnifying scope with a lamp
2-The transition zone must be visualized to ensure an adequate colposcopy. The border between squamous and columnar epithelium
3-a colposcopy is the answer for a pt with an abnromal pap
Atypical squams can't exclude high grade lesion ASC-II
low grade squamous intraepithelial lesions LSIL
high grade intraepithelial lesions HSIL
Atypical sqams of undetermined significance ASCUS if HPV DNA testing is positive
__________________________________________________ ___________
Estrogen and progesterone receptors
Should be done on all pts with breast cancer, in order to determine who should receive hormone therapy
2-Therapy with either tamoxifen or raloxifene should be added to any pt. with positive receptors. This is either for estrogen or progesterone positivity alone or in combination. The response to tamoxifen is better if both receptors are positive
__________________________________________________ ____
Mammogram
screening should begin at age 40 and should be performed every 1~2 years, screening at age 50 should be yearly
2-when mammogram shows abnormalities, a core biopsy including sentinel lymph node biopsy is the next best step. carcinomas of the breast are associated with clustered polymorphic microcalcifications.
3-screening lowers mortality most after age 50 and the dec is greater than that of a colonscopy or a pap smear
__________________________________________________ ________________
Now pharm
_____________
will start with infectious disease because it is the longest chunk
Acyclovir/valcyclovir/famiciclovir
all the above are the correct answer for
Herpes simplex including, genital, cutaneous, orolabial
for Herpes Encephalitis (acyclovir) IV form only in a hospital setting
Varicella zoster
shingles: Herpes zoster or reactivation
Bell's palsy
the above meds work by inhibition of thymidine kinase
-most common adverse effects are nephrotoxicity presumably from precipitation of the meds in the kidney tubule, sx of neurological toxicity in the kidney tubule, sx of neurological tox, such as confusion, tremors and hallucination occur rarely
__________________________________________________ __
Rifaximin
used to treat travelers' diarrhea such as that from E.coli, it isn't used for invasive diarrhea. an associated fever and bloody diarrhea indicate and invasive pathogen, such as campylobacter. When fever and bloody diarrhea are described, ciprofloxacin is the best answer.
rifa is a nonabsorbed version of the rifamycin antibiotic, it inhibits ribosomal RNA production of essential proteins
There are no major side effects since it isn't absorbed from the GI tract. it doesn't cause C.Diff, and may in fact treat it.
_________________________________________________
Daptomycin and Linezolid
they are both used for gram +ve organisms such as MRSA, streptococci and vanc resistant enterococci. Linezolid is the only oral antibiotic for MRSA. They can both be used for Vanc resistant organisms .
Liezolid is an oxazolidinone and inhibits protein synthesis at the ribosome. Daptomycin is a cyclic lipopeptide and disrupts cell membrane they are both unique classes of drugs
Linezolid commonly causes thrombocytopenia, and is a MAO inhibitor, avoid tyramine foods. Dapto caused CPK on liver functiion tests to be elevated!!
__________________________________________________ _____________
Tigecycline
an extremely broad spectrum anti-biotic that covrers MRSA, staph aureus, and well as gram negative bacilli. Tigecycline is the answer for complicated hospital of ICU acquired infections, tigecycline alone is equivalent to vanc and aztreonam in combination, it is also active against resistant enterococci and PCN resistant penumococcus
tigecycline is a glyclycyline antibiotic that binds to the ribosome and inhibits protein synthesis, it is unique that it covers staph, strep, gram negatives, anerobes and organisms resistant to vanc
tigecycline is hepatotoxic , caused nausea and diarrhea
__________________________________________________ ________
Polymyxin B (PMB) and colistin
useful for conjunctivitis, infections of the skin, and otitis externa, also correct for multi drug resistant gram negative bacilli, that cause ventilator associated pneumonia and sepsis from pseudomonas or acinetobacter.
works by disrupting phospholipids in the cell wall membrane
Polymyxin B (PMB) and colistin are very toxic to the kidney and nerves and is limited to topical applications of the skin and ear, they are also used for multi drug resistant gram negative bacilli when there are no other therapeutic options..
__________________________________________________ ______
That is it for today..
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
I haven't been on this forum for quite a while. I'm a 3rd year med student now & we're starting to focus on pathologies in our courses. So this thread will be really useful for me. Thanks!!
Dr Najeeb is brilliant not to mention hilarious in his description of the renin-angiotensin-aldoesterone system
I am sticking a link to all 79 videos.. most folks have problems with renal physiology the most but it would pay to listen to all his lectures actually ..
‘Say: If the ocean were ink wherewith to write out the words of my Lord, sooner would the ocean be exhausted, even if We added another ocean like it.’~Al Qu'raan (18:109)
Dr Najeeb is brilliant not to mention hilarious in his description of the renin-angiotensin-aldoesterone system
I am sticking a link to all 79 videos.. most folks have problems with renal physiology the most but it would pay to listen to all his lectures actually ..
^^ this guy is remarkable masha'Allah he did for me in one day what an entire semester of physiology didn't..
al7mdlillah.. I like the way he incorporates 'mango' in the topic of filtration, I must admit I have never encountered an Asian professor who didn't incorporate that fruit into any topic somehow..
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
Oh God yes.. I have been thinking of investing in one of those electrical stethoscope.. you know the art of the physical exam is really a dying one with all the technology we have .. although I wonder what that spells out to with the new healthcare reform
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
YouTube is possibly one of the best inventions ever. I've found so many amazing organic chemistry lectures . Al7amdulillah.
‘Say: If the ocean were ink wherewith to write out the words of my Lord, sooner would the ocean be exhausted, even if We added another ocean like it.’~Al Qu'raan (18:109)
^^ organic chemistry was the death of me.. I didn't even have internet when I was in under-grad.. I really think the number of hours I have vested studying would have been so much better utilized and elucidated if I had all that technology at my finger tips.. but al7mdlillah 3la kol 7al.. still there are plenty of folks with the latest technology who manage to do nothing at all with their lives as such I should be grateful even if I struggled alot!
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
^^ organic chemistry was the death of me.. I didn't even have internet when I was in under-grad.. I really think the number of hours I have vested studying would have been so much better utilized and elucidated if I had all that technology at my finger tips.. but al7mdlillah 3la kol 7al.. still there are plenty of folks with the latest technology who manage to do nothing at all with their lives as such I should be grateful even if I struggled alot!
Actually, I think struggle and hardships are what make a person ultimately successful. No hardships and ease all the time make a lazy student :X
Allahu 'Alam.
‘Say: If the ocean were ink wherewith to write out the words of my Lord, sooner would the ocean be exhausted, even if We added another ocean like it.’~Al Qu'raan (18:109)
hehe .. Orgo chem I and orgo chem II my life changers in college, allhamdulillah. Sort of a comebacks from miserable first year performance. Allhamdulillah. yet most folks dont like it and I can see why. You have to make those 2 courses your wives, at least for the whole semester and imagine that they are just nagging wives by nature.
Once you can relate pure orgo with the biochemical reactions and their mechanisms (the dreaded biochem courses) in your cells (purine/pryrimidine metabolism etc) you come to realize how each molecule is like a living being ... with its own life, its own ideals and its own destiny studying and "living" with these molecules for almost eternity make you start believing in them as each of them had a persona, a story to tell. There are universes within us. If you thought that this was crazy, we still dont know in detail how each atom and subatomic particles behave within these molecules ....as these chemicals dance to the tune of life.
*back to viro*
Last edited by CosmicPathos; 04-14-2010 at 08:43 PM.
Help me to escape from this existence
I yearn for an answer... can you help me?
I'm drowning in a sea of abused visions and shattered dreams
In somnolent illusion... I'm paralyzed
I don't think they are akin to nagging wives for surely one would construe something from the nags.. they were elusive, problematic and mocking.. the worst type of partnership ..
al7mdlillah it is behind us...
Text without context is pretext If your opponent is of choleric temperament, seek to irritate him
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