The Passive Mentor | Trained to purge every trace of inferiority from myself | On a journey of words and wonder 🍁
Kampala, Uganda
Joined December 2019
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Loner001 🍁 retweeted
Sympathetic and parasympathetic systems share the same neurotransmitter at their first synapse: acetylcholine. So how do they produce such different physiological responses?
The answer lies at the neuroeffector junction, where different receptors, G-protein signalling pathways and second messengers translate neural signals into opposing cellular responses. The heart is a perfect example: same organ, different molecular switches, opposite physiological outcomes.
Loner001 🍁 retweeted
Patients with Hyperosmolar Hyperglycemic State (HHS) require thromboprophylaxis primarily because severe dehydration and extreme hyperosmolarity create a hypercoagulable, high-viscosity state that significantly elevates the risk of venous thromboembolism (VTE).
Severe Dehydration & Hemoconcentration: Osmotic diuresis causes massive fluid loss, reducing intravascular volume and concentrating blood components, which increases blood viscosity.
Endothelial Dysfunction:
Extreme hyperglycemia and serum hyperosmolarity cause vascular endothelial damage, promoting thrombus formation.
Pro-thrombotic State:
HHS triggers the release of pro-inflammatory cytokines, increases platelet activation/aggregation, and elevates clotting factors while suppressing fibrinolysis.
Immobility:
Patients are frequently altered mentally, lethargic, or comatose, leading to prolonged venous stasis.
Loner001 🍁 retweeted
Tourette's Syndrome.
It is a neurodevelopmental disorder characterized by involuntary, repetitive movements and vocalizations called tics that begin in childhood.
According to the CDC and the DSM-5-TR, a Tourette Syndrome diagnosis requires meeting all five of these compressed criteria:
• Tics Required: At least two motor tics and one vocal tic must be present, though not necessarily at the same time.
• Timeline: Symptoms must persist for over one year (even if they wax and wane).
• Age Limit: The first tic must appear before age 18.
• Exclusion: The movements and sounds cannot be caused by medications, substances, or other medical conditions
Lab investigations suggested :
1. ASO
2. Anti DNAse Antibodies
3. Next-generation sequencing (NGS) panels (such as testing for variants in genes like SLITRK1)
Refer : 1. Anti-DNase B share.google/w9PYyluK4JTS5MA…
2. Antistreptolysin O (ASO) Titer share.google/TPoQG7uI2VQwoYg…
Website : diagnopediaglobal.com
Loner001 🍁 retweeted
Heart Failure: Causes, Symptoms, Diagnosis & Treatment
#HeartFailure #HeartHealth #HealthAwareness #CardiacCare #VikaasShandily
Loner001 🍁 retweeted
RAAS Made Easy ✨
The renin–angiotensin–aldosterone system (RAAS) helps your body maintain blood pressure and blood volume.
Step 1: The kidney detects low blood pressure
↓ Renal perfusion → kidney releases renin
Step 2: Renin
Angiotensinogen → Angiotensin I
Step 3: ACE
Angiotensin I → Angiotensin II
Step 4: Angiotensin II
• Vasoconstriction → ↑ blood pressure
• Stimulates aldosterone release
Step 5: Aldosterone
Acts on the collecting duct:
• ↑ Na⁺ reabsorption → water follows
• ↑ K⁺ excretion
• ↑ H⁺ excretion
USMLE high-yield pattern:
RAAS activation: ↑ BP, ↑ volume, possible hypokalemia, metabolic alkalosis.
Where does each substance come from?
• Renin: Juxtaglomerular cells of the kidney
• Angiotensinogen: Liver
• Angiotensin I: Formed when renin cleaves angiotensinogen
• ACE: Mainly vascular endothelial cells, especially in the lungs
• Angiotensin II: Formed when ACE converts angiotensin I
• Aldosterone: Zona glomerulosa of the adrenal cortex
✨
Loner001 🍁 retweeted
STABLE ISCHEMIC HEART DISEASE: From Diagnosis to Revascularization
When should we choose optimal medical therapy, PCI, or CABG? The answer depends on more than coronary stenosis alone.
This 8-part visual masterclass explores the evidence behind diagnosing and managing chronic coronary disease.
What you'll learn:
1️⃣Clinical assessment and noninvasive testing
2️⃣ Optimal medical therapy and cardiovascular risk reduction
3️⃣ Antianginal drugs and symptom control
4️⃣ PCI vs. CABG: indications, benefits, and limitations
5️⃣ Landmark trials: COURAGE, ISCHEMIA, FAME 2, FREEDOM, SYNTAX and STICHES
6️⃣ Practical algorithms for revascularization decisions
Watch the full video, save it for revision, and share it with your colleagues.
#Cardiology #MedTwitter
Loner001 🍁 retweeted
ECG From Scratch #56: Right Ventricular Infarction
Up to one-third of patients with inferior MI may have right ventricular involvement.
Hypotension, elevated JVP, relatively clear lungs, or AV block should raise suspicion.
How can the #ECG help identify RV infarction before hemodynamic collapse?
Watch the full video.
Loner001 🍁 retweeted
This week the Heamatology and nephrology teams presented a 33 year old k own patient of Sickle cell disease who had been well controlled on hydroxyurea, Fansidar, folic acid and the required vaccinations. She had unilateral neprectomy 4yrs earlier due renal carcinoma. She was admitted with SCD nephropathy, vascular necrosis of the Rt femur and Acute chest syndrome. What would you prioritize in her management and why? @rkalyes1 @PeaceBagasha @AndiaBiraro @dmeya @kkananura @InternalmedMak @MakCHS_SOM @MulagoReferral @Makerere
Loner001 🍁 retweeted
CHEST PAIN MASTERCLASS: From Symptoms to Diagnosis
Chest pain is one of the most challenging presentations in clinical practice. The key is recognizing what cannot be missed, identifying the likely cause, and choosing the right investigations without delay.
This 10-part visual masterclass covers ACS, aortic dissection, pulmonary embolism, pericardial disease, pulmonary and gastrointestinal causes, musculoskeletal pain, and a practical diagnostic approach.
Based on major ACC/AHA and ESC guidelines.
Watch, learn, and save for revision.
Loner001 🍁 retweeted
A 70 year old woman presented with 1 month history of progressively deepening jaundice, pruritus and passage of pale bulking stool?
1. What is the diagnosis?
2. What is the commonest cause?
