Medicine Hack

Definition: It is a syndrome characterized by the production of abnormally large volumes of dilute urine due to the decreased secretion or decreased action of AVP (arginine vasopressin). AVP is also commonly known as ADH i.e. Anti Diuretic Hormone. Cause: 1) Central D.I - aka pituitary D.I or neurohypophyseal D.I. 2) Nephrogenic D.I Central D.I occurs because of an inadequate release of ADH from the posterior pituitary. The usual causes are idiopathic, traumatic, iatrogenic (surgery,radiation), neoplastic, infective, granulomatous (TB,sarcoidosis) and congenital being a rarer cause. Nephrogenic D.I is due to the resistance to ADH at the level of the collecting duct cell. The most common cause of resistance is the use of drugs like lithium (bipolar disorders) and amphotericin. But it can rarely be due to a congenital cause. Pathogenesis: The antidiuretic effect of ADH is achieved by increasing the hydroosmotic permeability of cells that line the distal tubule and medullary

Application: 1) Production of recombinant proteins like factor VIII, insulin and tissue plasminogen activator, 2) Transgenic organisms also called as genetically modified organisms like herbicide resistant crops, 3) Gene therapy to correct a genetic disorder or an acquired disease, though there has only been limited success in this field till now.

Group: macrolide Antimicrobial activity: Good against Gram positive and Gram negative organisms. Slightly less active than erythromycin against staphylococci and streptococci but more active against H.influenzae. It is also highly active against chlamydia, Mycobacterium avium complex and Toxoplasma gondii. Mechanism of action: It binds to the 50s ribosome subunit and hinders the translocation of the elongated peptide chain from the acceptor site to the peptidyl site. Thus the ribosome does not move along the mRNA to expose the next codon and peptide synthesis is prematurely terminated. Pharmacokinetic properties: Acid stability and more active in alkaline medium, rapid oral absorption but better given 1 hour before meals or 2 hours after meals, marked tissue distribution especially intracellular penetration (macrophages and fibroblasts), Half life : 2-4 days, therefore can be given as once a day dosing Clinical uses: 1) Legionnaire's pneumonia - 500 mg O.D for 2 wee

The use of I.V morphine in dyspnea from pulmonary edema due to left ventricular failure produces remarkable relief. The proposed mechanisms include:  1) reduced anxiety ( decreased perception of shortness of breath ),  2) reduced cardiac preload ( reduced venous tone ) and  3) decreased cardiac afterload (decreased peripheral resistance ).  However frusemide remains the treatment of choice.  Side effect is respiratory depression at a higher dosage which occurs because of inhibition of the brainstem respiratory mechanism.

 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)