I always mix up the stupid B vitamins and their actual names vs their number, and I told my internal med attending this and now I have to do a mini presentation tomorrow about B vitamins. So here is the handout I came up with, all basically from Step 1 First Aid.
B VITAMINS ARE COOL YEAH!
Vitamin B1 (th1am1ne)
- What does it do: cofactor for all the things in glucose breakdown
- Deficiency: impaired glucose breakdown = ATP depletion. Wernicke-Korsakoff. Beriberi (wet/dry). Seen in folks whose primary diet is husked white rice. Dx = increase RBC transketolase following thiamine administration
Vitamin B2 (riboflavin/r2b2)
- What does it do: component of FAD and FMN (source of e-), cofactors, kind of a big deal
- Deficiency: cheilosis, corneal vascularization, magenta-colored tongue
Vitamin B3 (niacin/sunglasses cat face—> B3 )
- What does it do: NAD+ and NADP+, redox rxns, Derived from tryptophan. Synth from B2 and B6. Used to tx dyslipidemia (lowers VLDL/raises HDL)
- Deficiency: glossitis. Pellagra (anything that decreases tryptophan absorption or inc metabolism) = diarrhea, dementia, dermatitis
- Excess: facial flushing, hyperglycemia, hyperuricemia
THERE IS NO B4!!!
Vitamin B5 (pantothenate/5 pants)
- What does it do: essential component of CoA and other things
- Deficiency: dermatitis, enteritis, alopecia, adrenal insufficiency
Vitamin B6 (pyridoxine/siX)
- What does it do: synthesis of lots of things (neurotransmitters, heme, molecules) and cofactor of transamination
- Deficiency: convulsions, hyperirritability, peripheral neuropathy, microcytic sideroblastic anemia, cheilosis/stomatitis. MCC etoh and isoniazid.
Vitamin B7 (biotin/ALMOST has 7 letters)
- What does it do: Cofactor for adding 1-carbon group
- Deficiency: dermatitis alopecia, enteritis, fasting hypoglycemia. Can be caused by eating too many raw egg whites (avidin binds biotin).
WHO NEEDS B8 NOT YOU
Vitamin B9 (folic acid/9 months of pregnancy)
- What does it do: converted to THF; synthesis of nitrogenous bases for DNA/RNA.
- Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, glossitis, NO NEUROLOGIC SX. Increased homocysteine, normal methylmalonic acid. MCC deficiency in US, dt etoh or pregnancy.
10 and 11 ARE SILLY NUMBERS!!!
Vitamin B12 (cobalamin but who calls it that let’s be real)
- What does it do: cofactor for important things
- Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, parathesias, subacute combined degeneration of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts. Increased homocysteine AND methylmalonic acid.
Dermatomyositis: Rare idiopathic inflammatory myopathy with characteristic cutaneous findings occurring in adults (commonly in age groups 50 - 70) and children.
Clinical Features of Dermatomyositis
- Gottron’s papules/nodules
- Heliotrope eyelids (purple eyelids)
- Reddish, bluish patches on sun exposed areas of skin
- Ragged cuticles and prominent blood vessels on nail folds
- Scaly scalp with thinned out hair
- Poikiloderma (atrophic skin, dilated blood vessels (red hue), post-inflammatory pigment (brownish discolouration)
- Found over bony prominences
- Particularly over metacarpophalangeal joints, proximal and distal interphalangeal joints
- Maybe found over elbows and knees
- Slightly elevated violaceous papules and plaques
- Maybe scaly like psoriatic plaques
- Changes in appearance: atrophy, telangiectasia, dyspigmentation
Symptoms of Dermatomyositis
- Muscular dysfunction: dysphagia, dysphonia, problems with voluntary muscle movements (climbing stairs, lifting objects, standing from crouching position, combing hair)
- Systemic manifestations: arthralgia/arthritis, dyspnoea, arrhythmia, malignancy (MUST ALWAYS LOOK FOR MALIGNANCY IN OLDER PATIENTS AS PART OF MANAGEMENT)
- Calcinosis: formation of calcium deposits in any soft tissue (common type dystrophic calcinosis: calcification occuring in response to soft tissue damage)
- Raynaud’s phenomenon
- Oral corticosteroids
- Immunosuppresive / cytotoxic: methotrexate, ciclosporin, cyclophosphamide
- Biologics: rituximab
- Diltiazem (ccb) for hypertension and calcinosis
- Colchicine to reduce calcinosis
- Hydroxychloroquine to help with photosensitive rash
- Avoid sun exposure
- Bed rest if severe inflammation
- Physical activity to keep joints and muscles moving
source: dermnetNZ, emedicine.medscape
It’s Medical Mnemonics Monday!
Renal Papillary Necrosis is a form of nephropathy characterized by coagulative necrosis of the renal medullary pyramids and papillae.
Causes of Papillary Necrosis can be remembered by the mnemonic “POSTCARDS”.
- P yelonephritis
- O bstruction of the urogenital tract
- S ickle cell disease
- T uberculosis
- Chronic liver disease,
- A nalgesia /A lcohol abuse,
- R enal transplant rejection
- D iabetes mellitus
- S ystemic vasculitis
Check out the list of the previous Medical Mnemonics here.
I feel like this is so important in medical school - it’s impossible to make it to the finish line alone!
To start off Birth Control Appreciation Day, I decided to make an informative masterpost on contraceptives! I hope this helps anyone who may want more information on their birth control or someone trying to decide what kind of birth control is best for themselves! Happy (birth control) hunting! - PaigeDIFFERENT TYPES OF BIRTH CONTROL:
- Birth Control Pills - [x] [x]
- Mini Pill (Progesterone-only Pill) - [x]
- The Patch (Ortho Evra) - [x] [x]
- The Shot (Depo-Provera) - [x] [x]
- Birth Control Sponge - [x] [x]
- Vaginal Ring (Nuva Ring) - [x] [x]
- Spermicide - [x] [x]
- Implant (Implanon and Nexplanon) - [x] [x]
- IUDs (Mirena, Skyla, and ParaGard) - [x] [x]
- Condoms (Male and Female) - [x]
- Withdrawal (Pullout Method) - [x] [x]
- Diaphragm - [x] [x]
- Breastfeeding - [x]
- Cervical Cap - [x] [x]
- Sterilization (Male and Female) - [x]
- Abstinence - [x] [x]
- Fertility Awareness-Based Methods (FAMs) - [x] [x]COMMON QUESTIONS ABOUT BIRTH CONTROL:
- Do certain medications make my birth control less effective?
- Can I delay or eliminate my period with my birth control?
- Will my pregnancy tests come out with an accurate result while I’m on birth control?
- Can I use several birth control pills at once in replace of an emergency contraceptive?
- Does birth control cause weight gain?
- What should I do if I miss a pill?
- What should I do if the condom breaks or slips off inside of me?
- If I’m on the ring or the patch and I forget to replace it on the right day, do I need to use backup?
- I’ve heard that the birth control ring can pop out. What should I do if this happens?
- Can birth control increase my risk of getting cancer?
- Can you change your mind after having a tubal ligation or vasectomy?
- Is it normal to spot or bleed in between periods while on birth control?
- Does certain hormonal birth controls affect my blood pressure?
- Can being overweight affect my birth control’s effectiveness?
- Can certain birth controls lower my libido?EMERGENCY CONTRACEPTIVES:
- Types of EC: Plan B / Ella / ParaGard IUD - [x] [x]
- What are emergency contraceptives?
- How do they work?
- How well does it work?
- What are the side effects?
- When should I take an emergency contraceptive?
- Are emergency contraceptives less effective the heavier you are?
- If I am under the age of 18 in the US, can I buy emergency contraceptives without my parent’s knowledge or consent?
- If I take an emergency contraceptive today, am I covered if I have unprotected sex tomorrow?
- Will taking emergency contraceptives too many times affect my fertility?
- To find more questions and answers about emergency contraceptives, you can go here.
- Información anticonceptivos de emergencia es disponible en Español, aquí.OPTIONS FOR PEOPLE WITH ALLERGIES AND/OR CERTAIN
- Condoms for people with latex allergies.
- Condoms for vegans. [x] [x] [x]
- Other vegan contraceptive options.
- Different types of birth control without estrogen.
- Contraceptives without any hormones.
- Birth control methods that are useful to people with religious concerns. [x] [x]OTHER BENEFITS OF TAKING BIRTH CONTROL:
- Taking oral contraceptives can help lower the risk of endometrial and ovarian cancer.
- Using birth control helps treat acne.
- Birth control can help treat the pain caused by Endomitriosis.
- Contraceptives offer relief to people with Polycystic Ovarian Syndrome (PCOS).
- Anemia can be avoided/treated by using birth control.
- Irregular periods can become more regulated by using birth control.
- The pill can lead to fewer ectopic pregnancies.MYTHS ABOUT BIRTH CONTROL (All the myths below are dispelled
through the links given):
- Emergency contraceptives and birth control pills cause abortions.
- Free contraceptives and/or condoms makes people participate in risky sexual behavior.
- The pill makes you gain a lot of weight.
- Douching after sex prevents pregnancy.
- You have to start your birth control on a Sunday.
- Taking the pill for a long time can make you infertile.
- Hormonal contraceptives protect you from contracting STIs.
- You don’t need to be on birth control while breastfeeding.
- I won’t get pregnant my first time having sex.
- The Pill is effective immediately after you take it.
- I won’t get pregnant if I shower or pee after sex.
- My body needs a rest from birth control at least once a year.
- Emergency contraceptives are affected by alcohol.
This is wonderful!