Posted 5 hours ago






Heart attacks symptoms are different for women. I recently learned this. 

Everyone should know these things.

thanks to mainstream media and being unable to show breasts on TV, way too few people know about female signs of cardiac distress, and impending heart attacks. they only know about the “pain in the left arm” male symptom.

i had all these symptoms once and they sent me right to hospital

it was scary bc i didnt know these were the symptoms for female heart issues

Please, please, PLEASE, reblog this. i don’t know if I did save or called false alarm, with my boss’ life tonight. I felt I was being a bit paranoid, overreacting, but I told Mirage my thoughts and he, after reading over the article I showed him, immediately sprung into action and then shooed her off to the hospital. I don’t know if I did or not, but I knew she’d been super stressed. She’d off-handedly commented on her arm tingling and I asked her if she felt queasy on a hunch. I went to look at the symptoms and we went from there.

Posted 3 days ago
Posted 5 days ago




Posted 5 days ago



7 reasons why cancer cells are immortal

1. Cancer cells don’t age.
Normal cells go through senescence through shortening of telomeres with every cell division. Cancer cells however have telomerase that will sustain the telomere length of the chromosomes rendering the cell virtually immortal.

2. Cancer cells have a way around apoptosis, their programmed cell death.
They overexpress antiapoptotic molecules and can multiply forever.

3. The Grim Reaper can’t recognize them.
The Natural killer cells, or the Grim Reaper; are supposed to cause death of the tumor cells. However, cancer cells remain undetected because they down regulate their MHC proteins or use decoy proteins to look innocent.

4. If recognized, the Grim Reaper can’t kill them.
Tumor cells block the death receptor pathway and directly interfere with the perforin/granzyme pathway. That is why, natural killer cells fail to kill them.

5. Cancer cells don’t need anything.
Cancer cells are self sufficient on growth factors. This means that they can continue to proliferate and divide independently, as opposed to normal cells that need external growth factors.

6. And if they do need something, they order it to come to them.
When cancer cells need of oxygen and nutrients, they stimulate angiogenesis; which is inducing growth of new blood vessels.

7. They have metabolic super powers.
The metabolism of malignant cells is usually more anaerobic than that of normal cells and is greatly accelerated. Malignant cells have the ability to withstand hypoxic conditions. They have increased glucose and amino acid uptake. In addition, they have high levels of hexokinase increasing their glucose utilization.

Poor Grim Reaper :’(

Posted 1 week ago



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.


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


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).


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.
Posted 1 week ago
Posted 2 weeks ago



Posted 3 weeks ago

Inflammatory Myopathies in a Nutshell / Dermatomyositis



Dermatomyositis: Rare idiopathic inflammatory myopathy with characteristic cutaneous findings occurring in adults (commonly in age groups 50 - 70) and children. 

Clinical Features of Dermatomyositis

  1. Gottron’s papules/nodules
  2. Heliotrope eyelids (purple eyelids)
  3. Reddish, bluish patches on sun exposed areas of skin
  4. Ragged cuticles and prominent blood vessels on nail folds
  5. Scaly scalp with thinned out hair
  6. Poikiloderma (atrophic skin, dilated blood vessels (red hue), post-inflammatory pigment (brownish discolouration)

Gottron’s papules

  • 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

  1. Muscular dysfunction: dysphagia, dysphonia, problems with voluntary muscle movements (climbing stairs, lifting objects, standing from crouching position, combing hair)
  2. Systemic manifestations: arthralgia/arthritis, dyspnoea, arrhythmia, malignancy (MUST ALWAYS LOOK FOR MALIGNANCY IN OLDER PATIENTS AS PART OF MANAGEMENT)


  1. Calcinosis: formation of calcium deposits in any soft tissue (common type dystrophic calcinosis: calcification occuring in response to soft tissue damage)
  2. Raynaud’s phenomenon


  1. Oral corticosteroids
  2. Immunosuppresive / cytotoxic: methotrexate, ciclosporin, cyclophosphamide
  3. Biologics: rituximab
  4. Diltiazem (ccb) for hypertension and calcinosis
  5. Colchicine to reduce calcinosis
  6. Hydroxychloroquine to help with photosensitive rash
  7. Avoid sun exposure
  8. Bed rest if severe inflammation
  9. Physical activity to keep joints and muscles moving

 source: dermnetNZ, emedicine.medscape

Posted 1 month ago


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”.

  • yelonephritis
  • bstruction of the urogenital tract
  • ickle cell disease
  • uberculosis
  • Chronic liver disease,
  • nalgesia /lcohol abuse,
  • enal transplant rejection
  • iabetes mellitus
  • ystemic vasculitis

Check out the list of the previous Medical Mnemonics here.

Posted 1 month ago

Common EKG Rhythms

Common EKG Rhythms

(Source: rightatrium)