Fixing the world, one HVLA at a time

Family member’s strategy for getting a cancer’s patient energy up.

FYI if it wasn’t clear please don’t do this.

resident to attending

10 minutes and a phone call later, we had the guy on lactulose

(via pleasedotheneedful)

clinic

an operating system continually demonstrating it is unfit for healthcare functions by virtue of its overriding updates

in two weeks I have to rev back up to top speed, as I’m doing a de facto audition back home next month. then I’m taking an easy elective to get ready for boards.

A group of 4th year students have banned together at Harvard Medical School to put a stop to the Step 2 CS exam. For those who (understandably) haven’t thought much yet about Step 2, the exam costs $1275 for the clinical skills portion alone and only takes place in 5 cities in the US. That means more money spent traveling and paying for accommodations = more debt.

Please check out this website to learn more and sign the petition:http://endstep2cs.com/. So far the petition has collected over 5000 signatures from more than 100 schools in 45 states. And please spread the news to your friends at other medical schools! More signatures strengthens our voice and increases the odds that by the time we reach fourth year, Step 2 CS may be a thing of the past.

Ok so here’s how to make your very own homemade neurotransmitter!

Start with a good, old fashioned amino acid, tyrosine. Pretty much in all proteins. Then you need the enzyme Tyrosine Hydroxylase (TH) add another hydroxyl group (OH) to turn it into DOPA! L-Dopa’s a treatment for parkinsons because it it a precursor for dopamine (I’ll further explain that when we get to function). Why not just give them straight up dopamine? Because it doesn’t pass the blood brain barrier (the series of cells surrounding the blood vessels passing through the brain preventing certain toxins from getting into the brain) but DOPA does. From DOPA, the enzyme AADC produces dopamine by removing the carboxyl group. This is the first of 3 catecholamines.

Next comes norepinephrine, which is made from dopamine using the enzyme DBH to add another hydroxyl group.

Project Monsoon  Clever colorful street art that only appears when it rains

Stem cell bandages

Bandages and band aids containing stem cells to help heal wounds are closer to reality after scientists found a way to keep stem cells alive at room temperature.

By encasing stem cells in a frogspawn-like gel made from a seaweed extract called alginate, scientists at Newcastle University can put them inside bandages, which could be used to help speed up healing from ulcers or burns for example.

The gel retains the cells so that they don’t leave the bandage – it’s the chemicals these cells make that actually do the healing.

The low-cost discovery also has lots of other potential applications, because until now stem cells have had to be kept in specialised conditions; at 37°C, in atmospheric oxygen and 5% carbon dioxide.

Alginate is a natural material extracted from seaweed that is used in cosmetics and food manufacturing and is already used in wound dressings, without stem cells, to keep burns moist.

Read more

NASA just saw something come out of a black hole for the first time ever!

You don’t have to know a whole lot about science to know that black holes typically suck things in, not spew things out. But NASA just spotted something mighty strange at the supermassive black hole Markarian 335.

Two of NASA’s space telescopes, including the Nuclear Spectroscopic Telescope Array (NuSTAR), miraculously observed a black hole’s corona “launched” away from the supermassive black hole. Then a massive pulse of X-ray energy spewed out. So, what exactly happened? That’s what scientists are trying to figure out now.

“This is the first time we have been able to link the launching of the corona to a flare,” Dan Wilkins, of Saint Mary’s University, said. “This will help us understand how supermassive black holes power some of the brightest objects in the universe.”

NuSTAR’s principal investigator, Fiona Harrison, noted that the nature of the energetic source is “mysterious,” but added that the ability to actually record the event should provide some clues about the black hole’s size and structure, along with (hopefully) some fresh intel on how black holes function. Luckily for us, this black hole is still 324 million light-years away.

So, no matter what strange things it’s doing, it shouldn’t have any effect on our corner of the universe.

Stem cell technique makes sperm in a dish

Scientists in China have finally succeeded in creating functioning sperm from mice in the laboratory. To accomplish this feat, the researchers coaxed mouse embryonic stem cells to turn into functional sperm-like cells, which were then injected into egg cells to produce fertile mouse offspring. The work, reported February 25 in Cell Stem Cell, provides a platform for generating sperm cells that could one day be used to treat male infertility in humans.

Quan Zhou, Mei Wang, Yan Yuan, Xuepeng Wang, Rui Fu, Haifeng Wan, Mingming Xie, Mingxi Liu, Xuejiang Guo, Ying Zheng, Guihai Feng, Qinghua Shi, Xiao-Yang Zhao, Jiahao Sha, Qi Zhou. Complete Meiosis from Embryonic Stem Cell-Derived Germ Cells In Vitro. Cell Stem Cell, 2016; DOI: 10.1016/j.stem.2016.01.017

Rheumatology lecturer  (via medschool-monarchess)

We learned about this today, too. I think a lot of people still call it Reiter syndrome, unfortunately. If I’m not mistaken, the Sketchy narrators call it Reiter syndrome in the Chlamydia video. 

(via seasidemedstudent)

This is just like Wegener’s Granulomatosis and the Clara cell. Props to scrubbing out Nazi names 👍🏼

List of medical eponyms with Nazi associations: https://en.m.wikipedia.org/wiki/List_of_medical_eponyms_with_Nazi_associations

(via lookingoutofwindowswhilestudying)

ANTIBIOTICS CHEAT SHEET :)

Also, REMEMBER!!!!

* Sulfonamides compete for albumin with:

Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies

Warfarin: increases toxicity: bleeding

* Beta-lactamase (penicinillase) Suceptible:

Natural Penicillins (G, V, F, K)

Aminopenicillins (Amoxicillin, Ampicillin)

Antipseudomonal Penicillins (Ticarcillin, Piperacillin)

* Beta-lactamase (penicinillase) Resistant:

Oxacillin, Nafcillin, Dicloxacillin

3°G, 4°G Cephalosporins

Carbapenems 

Monobactams

Beta-lactamase inhibitors

* Penicillins enhanced with:

Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)

Aminoglycosides (against enterococcus and psedomonas)

* Aminoglycosides enhanced with Aztreonam

* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)

* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)

* Both inhibited by Probenecid during tubular secretion.

* 2°G Cephalosporines: none cross BBB except Cefuroxime

* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.

* Cephalosporines are "LAME“ bc they  do not cover this organisms 

L  isteria monocytogenes

A  typicals (Mycoplasma, Chlamydia)

M RSA (except Ceftaroline, 5°G)

E  nterococci

* Disulfiram-like effect: Cefotetan & Cefoperazone (mnemonic)

* Cefoperanzone: all the exceptions!!!

All 3°G cephalosporins cross the BBB except Cefoperazone.

All cephalosporins are renal cleared, except Cefoperazone.

Disulfiram-like effect

* Against Pseudomonas:

3°G Cef taz idime (taz taz taz taz)

4°G Cefepime, Cefpirome (not available in the USA)

Antipseudomonal penicillins

Aminoglycosides (synergy with beta-lactams)

Aztreonam (pseudomonal sepsis)

* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

* Covers VRSA: Linezolid, Dalfopristin/Quinupristin

* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.

* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)

* Phototoxicity: Q ue S T  ion?

Q uinolones

Sulfonamides

T etracyclines

* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides

* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis

* Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.

* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.

* Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.

I’ve made some corrections and added ABs that didn’t include before!!! Here’s the link if you want to download the corrected chart:  [Antibiotics doc]

Also, I’m gonna add a couple of things that didn’t mention before:

* MRSA: Ceftaroline, Telavancin, Dalbavancin, Oritavancin, Vancomycin, Linezolid, Tidezolid, Daptomycin, Tigecyclin.

* Skin MRSA: TMP/SMX, Clindamycin, Doxycycline, Linezolid

* FQ: Gemi, Levo, Ciprofloxacin cover Pseudomona but do NOT cover anaerobes. Moxifloxacin covers anaerobes but do NOT cover Pseudomona.

* Ertapenem DOES NOT cover Pseudomona

* mAcrolides DO NOT cover stAph.

* ciPRofloxacin DOES NOT cover stReP

* Cefoxitin, Cefotetan: the only 2°G cephalosporins that cover anaerobes. Also deplete prothombin, so there’s increase risk of bleeding. 

* VRE: Tigecycline, Linezolid, Quinupristin/Dalfopristin, Daptomycin

* ESBL: (BLEE en español)  carbapenems, beta lactam+beta lactamase inhibitors