Medicine.Digest

06/07/2025

05/07/2025

Gynecomastia Causing Drugs ✅ Mnemonic

05/07/2025

The facial nerve can be injured in many ways. If the fibers above the facial nucleus are damaged, it's referred to as an upper motor neuron lesion or central facial palsy. Common causes include stroke, trauma, multiple sclerosis, and brain tumors.

A lower motor neuron lesion, or peripheral facial palsy refers to any injury that affects the facial nerve from the facial nucleus up until it gives off its terminal branches.

The main difference in presentation between the two is that in the central one, the contralateral muscles of the lower face will be affected.

However, in peripheral facial nerve palsy, all muscles of facial expression are involved, but on the same side as the lesion.

You can remember this with the phrase "Upper spares Upper" meaning an upper motor neuron lesion (central) will spare the muscles of the upper face.

03/07/2025

Tonicity of Fluids

03/07/2025

Cortisol is a steroid hormone with a wide variety of functions. It belongs to the glucocorticoid class of hormones produced by a pair of adrenal glands located above each kidney. Specifically, cortisol is released by the zona fasciculata of the adrenal glands under the control of adrenocorticotropic hormone (ACTH), which is released by the anterior portion of the pituitary gland.

Usually, cortisol secretion is pulsatile throughout the day, peaking in the morning around 6 am. However, cortisol is also secreted in response to various stressful stimuli, including hypoglycemia, infections, caffeine, sleep deprivation, and psychological stress.

Once secreted, cortisol travels via the blood and binds to glucocorticoid receptors, which are generally intracellular receptors within nearly every cell in the body. As a result, cortisol affects every organ system.

Let’s discuss a few of the ways that cortisol affects the body. In adipose tissue, cortisol triggers lipolysis, which is the breakdown of fats for energy. On the other hand, in the liver, cortisol promotes gluconeogenesis, which is the production of new glucose molecules.

Cortisol affects the musculoskeletal system and connective tissues. For example, it decreases bone formation by inhibiting new bone production by osteoblasts, suppressing calcium absorption in the bowel, and decreasing the production of type I collagen. Additionally, it inhibits fibroblasts, which leads to poor wound healing.

Cortisol can also affect the cardiovascular and nervous systems. For example, it helps maintain blood pressure levels since it up-regulates alpha-1 adrenergic receptors in blood vessels, which causes vasoconstriction. In the nervous system, cortisol increases brain performance and mental alertness while it inhibits retrieval of already stored long-term memory.

14/06/2025

Diuretics

12/06/2025

Pituitary hormones and functions ✅

12/06/2025

DENGUE & IV Fluid Management
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🩺 Types of IV Fluids in Dengue:
✅ 1. Crystalloid (First Choice):
Used in most Dengue patients unless complications arise.

🔹 0.9% NaCl (Normal Saline) – Preferred

🔹 0.45% NaCl – Children

12/06/2025

✅Battle's sign: Postauricular ecchymosis (bruising behind the ear) indicative of basilar skull fracture.

✅Pathophysiology

🔹Represents blood tracking along the path of least resistance from a fracture site in the posterior cranial fossa.
🔹Fracture may involve the temporal bone and mastoid process.

✅Clinical Relevance

🔹Sign of basilar skull fracture, specifically longitudinal temporal bone fractures.
🔹Associated with other signs of basilar skull fracture like Raccoon's eyes (periorbital ecchymosis), hemotympanum, CSF otorrhea/rhinorrhea.

✅Diagnosis

🔹Clinical observation: Bruising behind the ear that appears 1-2 days after injury.
🔹CT Scan: Imaging of choice for skull fractures.

✅Mnemonic for Basilar Skull Fracture Signs: "BATTLE'S CRASH"
B = Battle's sign

A = Auditory canal blood (hemotympanum)

T = Tinnitus or hearing loss

T = Torn meninges (CSF otorrhea/rhinorrhea)

L = Loss of consciousness

E = Ecchymosis (Raccoon's eyes)

S = Sugar (glucose) in CSF

C = Cranial nerve deficits

R = Ringing in ears

A = Anosmia (due to olfactory nerve damage)

S = Seizures

H = Halo sign (CSF on gauze pad)

✅Management

🔹Immediate: ABCs (airway, breathing, circulation), cervical spine stabilization.
🔹Neurosurgical consultation: For management of the underlying skull fracture.
🔹Antibiotics: Prophylactic treatment to prevent infections such as meningitis.
🔹Tetanus prophylaxis: If indicated.
🔹Monitoring and treatment: For potential complications like brain injury, CSF leak, and meningitis.

✅Complications

🔹Infection: Meningitis, brain abscess.
🔹Cranial nerve injury: Especially VII (facial nerve) with longitudinal fractures.
🔹CSF Leak: Otorrhea or rhinorrhea, risk of meningitis.
🔹Hearing loss: Due to damage to the middle ear or auditory nerve.

✅Prognosis

🔹Variable: Depends on extent of injury and presence of additional intracranial injuries or complications.

12/06/2025

The use of SGLT2 inhibitors was associated with a reduced risk for atrial fibrillation (AF) in patients with type 2 diabetes (T2D). http://ms.spr.ly/6182SUbs0

12/06/2025

✅ Colon Cancer Signs:

1. Change in bowel habits: Change in bowel habits including constipation or diarrhoea that lasts for more than a few days.

2. Narrowing of Stool: You may also have stools that appear narrower than usual or have a different size or shape than normal.

3. Blood in your stool: Bright Red blood or Blood in your stool that makes it look dark brown or black can also be associated with the colon cancer.

4. Abdominal pain and bloating: Pain in your re**um or abdominal area.The abdominal pain in colorectal cancer may be due to partial or complete obstruction of the bowl or evasion of the cancer into the peritoneum.

5. Unexplained anaemia: If you are anemic, you may find that you are tired, weak and may experience fatigue that improve upon resting.

6. Palpable Mass: Swollen abdominal mass can be palpable on the right lower quadrant of abdomen

7. Tenesmus: It is a feeling or sensation of urge to defecate and also a sensation of incomplete defecation.

Other possible signs of colon cancer are:

8. Unexplained weigth-loss which means you are losing weight without trying.
9. Vomiting
10. Fever

06/05/2024

Atherosclerosis
Risk Factors