Medicine Hack

 DIAGNOSIS  Hypoglycemia can be diagnosed by whipple's triad which consists of: 1) symptoms consistent with hypoglycemia, 2) a low plasma glucose concentration measured by an accurate method, 3) relief of the symptoms when the plasma glucose level is raised.  SYMPTOMS  Symptoms of hypoglycemia are: 1) Neuroglycopenic symptoms like behavioral changes, fatigue, seizures, altered consciousness, 2) Adrenergic symptoms like palpitations, tremors, anxiety, 3) Cholinergic symptoms like sweating, hunger and altered sensations The cut off value for hypoglycemia is 70 mg/dL which is equal to 3.9 mmol/L.  TREATMENT  Relief of symptoms can be done by: 1) an initial 20 g of carbohydrate containing fluid or food can be given if the patient can tolerate orally, 2) I.V glucose 25 g bolus at 2 mg/kg/min followed by 10 g/hr. 250 mL of 10% dextrose is better than 50 mL of 50 % dextrose as there is less thrombophlebitis. 3) Glucagon 1 mg subcutaneously or intramuscularly works as rap

It is caused by an organism known as Bacillus anthracis. The latter is a gram positive, spore-forming rod that is found in soil. The spores can remain viable for years. Anthrax came to public notice in September 2001 when it was used as a bioweapon delivered through the U.S Postal System causing infection in 22 persons of whom 5 died. In the past i.e. during World War II , anthrax was studied mainly for its potential use as a biological weapon but following the Biological and Toxin Weapons Convention Treaty in 1972, such research was no longer allowed. Still, some nations and extremist groups do work on this agent secretly. There are 3 major clinical forms of anthrax: 11)       Gastrointestinal anthrax – from ingestion of contaminated meat 22)       Cutaneous   anthrax – from introduction of spores through opening in skin 33)       Inhalational anthrax- inhalation of spores that deposit in the alveolar spaces. The inhalational form is the one usually used for biot

1)  Measurement of height, weight, waist, BMI 2) Measurement of blood pressure  3) Examination of feet for pulses, loss of sensation to touch/vibration, signs of  infection  4) Measurement of visual acuity  5) Urine tested for albumin, ketones and glucose  6) Record made of current physical activity/recreational exercise levels, smoking  history and alcohol consumption, addition of salt to prepared food  If the resources and laboratory facilities are available then the following may be desirable.  •  ECG as baseline  •  Fasting blood lipids-cholesterol and triglycerides, HDL, LDL  •  Serum urea and creatinine for those with proteinuria  •  Retinal examination by fundoscopy  •  Urine for microalbuminuria if dipstick –ve  •  Glycosylated haemoglobin (HbA1c) 

The axilla is an irregularly shaped pyramidal area formed by muscles and bones of the shoulder and the lateral surface of the thoracic wall. The apex or inlet opens directly into the lower portion of the neck. The skin of the 'armpit' forms the floor. All major structures that pass between the neck and arm pass through the axilla. The cubital fossa is a triangularly shaped depression formed by muscles anterior to the elbow joint. The brachial artery and the median nerve pass from the arm to the forearm through this fossa. The carpal tunnel is the gateway to the palm of the hand. Its posterior, lateral, and medial walls form an arch, which is made up of small carpal bones in the proximal region of the hand. A thick band of connective tissue, the flexor retinaculum, spans the distance between each side of the arch and forms the anterior wall of the tunnel. The median nerve and all the long flexor tendons passing from the forearm to the digits of the hand pass through t

1) There is usually a tingling sensation in the throat in hemoptysis while in hematemesis the patient will usually complain from nausea and upset stomach. 2) The blood is usually frothy and bright red in hemoptysis while it is dark red in hematemesis, non-frothy and food particles may also be present at the same time. 3) Blood in hematemesis will give an acidic pH when tested with litmus paper whereas that in hemoptysis will be neutral to alkaline. 4) Stools will be almost always positive for occult blood in hematemesis while it is usually negative in case of hemoptysis. But it can also be positive at times if the patient has swallowed his sputum. Last reviewed on: 1 September 2015

Insulin binds to receptor on target sites. These sites have an intrinsic tyrosine kinase activity that lead to receptor autophosphorylation and recruitment of intracellular signalling molecules. The latter result in widespread metabolic and mitogenic effects of insulin as shown in the diagram above. Another effect is the activation of phosphatidylinositol 3 kinase that fastens the translocation of GLUT-4 containing vesicles to the cell surface. This is important to allow uptake of glucose by skeletal and fat cells. When insulin action ceases, the transporter-containing patches of membrane are endocytosed and the vesicles are ready for the next exposure to insulin. On the other hand, in the liver, this is not the mechanism of glucose uptake. Instead, it induces glucokinase, and this increases the phosphorylation of glucose, so that the intracellular free glucose concentration stays low, facilitating the entry of glucose into the cell by diffusion. Insulin-sensitive tissues l

The diagram shows a beta cell of the islet of pancreas and will explain how local factors regulate secretion of insulin from it. Glucose enters the cell via the GLUT-2 transporter. Inside the cell there is metabolism with the generation of ATP. This causes the ATP-sensitive K+ channel to close, as shown in A. Closure of this channel leads to cell membrane depolarization. This in turn allows calcium ions to enter the cell via another calcium channel, shown in B. Increased intracellular calcium activates calcium dependent phospholipid protein kinase. This leads to exocytosis of insulin granules.