Anatomical snuff box

The anatomical snuff box is among one of the most fun-named anatomic structures, it’s called the snuff box because people used to put snuff (tobacco) in it.

If you have dinky little hands like me, the snuff box is pretty prominent (as you can see in the doodle since that’s my left hand). The borders are the extensor pollicis longus posteriorly, extensor pollicis brevis and abductor pollicis longus anteriorly and the radial stylus process proximally. If you poke around the snuff box you can feel both the scaphoid and the trapezium as well as the radial artery. Like the rest of the forearm and hand, the snuff box is chock full of way too many structures. The radial nerve is deep in the box while the dorsal cutaneous branch of the radial nerve lies superficially to the extensor pollicis longus. The cephalic vein also originates in the snuff box.

Appendicitis

Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. The appendix doesn't seem to have a specific purpose.

Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe.

Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.

Symptoms 

Signs and symptoms of appendicitis may include:

* Sudden pain that begins on the right side of the lower abdomen

* Sudden pain that begins around your navel and often shifts to your lower right abdomen

* Pain that worsens if you cough, walk or make other jarring movements

* Nausea and vomiting

* Loss of appetite

* Low-grade fever that may worsen as the illness progresses

* Constipation or diarrhea

* Abdominal bloating

The site of your pain may vary, depending on your age and the position of your appendix. When you're pregnant, the pain may seem to come from your upper abdomen because your appendix is higher during pregnancy.

When to see a doctor

Make an appointment with a doctor if you or your child has worrisome signs or symptoms. Severe abdominal pain requires immediate medical attention.

Source: myoclinic

Diabetes mellitus

Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes.

All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. 

But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn't make enough insulin, it can't use the insulin it does produce, or a combination of both.

Since the cells can't take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That's why diabetes-- especially if left untreated -- can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.

Source: webmed 

Hernia

What is a hernia?

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.

Hernias are most common in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas. Most hernias are not immediately life threatening, but they don’t go away on their own and can require surgery to prevent potentially dangerous complications.

Common hernia types:

Inguinal hernia

Inguinal hernias are the most common type of hernia. They make up about 70 percent of all hernias, according to the British Hernia Centre (BHC). These hernias occur when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal.

The inguinal canal is found in your groin. In men, it is the area where the spermatic cord passes from the abdomen to the scrotum. This cord holds up the testicles. In women, the inguinal canal contains a ligament that helps hold the uterus in place.

This type of hernia is more common in men than in women. This is because a man’s testicles descend through the inguinal canal shortly after birth, and the canal is supposed to close almost completely behind them. Sometimes, the canal does not close properly and leaves a weakened area prone to hernias.

Hiatal hernia

A hiatal hernia occurs when part of your stomach protrudes up through the diaphragm into your chest. The diaphragm is a sheet of muscle that helps you breathe by contracting and drawing air into the lungs. It separates the organs in your abdomen from those in your chest.

This type of hernia is most common in patients over 50 years old. If a child has the condition, it’s typically caused by a congenital (birth) defect. Hiatal hernias almost always cause gastroesophageal reflux, which is when the stomach contents leak backward into the esophagus, causing a burning sensation.

Umbilical hernia

Umbilical hernias can occur in children and babies under 6 months old. This happens when their intestines bulge through their abdominal wall near their bellybutton. You may notice a bulge in or near your child’s bellybutton, especially when they’re crying.

An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is 1 year old. If the hernia has not gone away by this point, surgery may be used to correct it.

Incisional hernia

Incisional hernias can occur after you’ve had abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.

What causes a hernia?

Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.

Common causes of muscle weakness include:

• failure of the abdominal wall to close properly in the womb, which is a congenital defect
• age
• chronic coughing
• damage from injury or surgery

Factors that strain your body and may cause a hernia, especially if your muscles are weak, include:

• being pregnant, which puts pressure on your abdomen)
• being constipated, which causes you to strain when having a bowel movement
• heavy weight lifting
• fluid in the abdomen, or ascites
• suddenly gaining weight
• persistent coughing or sneezing

source: health line

Bulimia nervosa

Bulimia (boo-LEE-me-uh) nervosa, commonly called bulimia, is a serious, potentially life-threatening eating disorder. People with bulimia may secretly binge — eating large amounts of food — and then purge, trying to get rid of the extra calories in an unhealthy way. 

For example, someone with bulimia may force vomiting or engage in excessive exercise. 

Sometimes people purge after eating only a small snack or a normal-size meal.

Bulimia can be categorized in two ways:

* Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing.

* Nonpurging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting or excessive exercise.

* 

However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method.

If you have bulimia, you're probably preoccupied with your weight and body shape. You may judge yourself severely and harshly for self-perceived flaws. 

Because it's related to self-image — and not just about food — bulimia can be hard to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications.

Myoclinic 

Wilms' tumor

Wilms' tumor is a rare kidney cancer that primarily affects children. Also known as nephroblastoma, Wilms' tumor is the most common cancer of the kidneys in children. 

Wilms' tumor most often affects children ages 3 to 4 and becomes much less common after age 5.

Wilms' tumor most often occurs in just one kidney, though it can sometimes be found in both kidneys at the same time.

Improvements in the diagnosis and treatment of Wilms' tumor have improved the prognosis for children with this disease. The outlook for most children with Wilms' tumor is very good.

Breast cancer

Breast cancer is the top cancer in women both in the developed and the developing world. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles.

 Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where breast cancer is diagnosed in very late stages. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. 

Limited resource settings with weak health systems where breast cancer incidence is relatively low and the majority of women are diagnosed in late stages have the option to implement early diagnosis programmes based on awareness of early signs and symptoms and prompt referral to diagnosis and treatment.

Population-based cancer screening is a much more complex public health undertaking than early diagnosis and is usually cost-effective when done in the context of high-standard programmes that target all the population at risk in a given geographical area with high specific cancer burden, with everyone who takes part being offered the same level of screening, diagnosis and treatment services.

So far the only breast cancer screening method that has proved to be effective is mammography screening. Mammography screening is very costly and is cost-effective and feasible in countries with good health infrastructure that can afford a long-term organized population-based screening programmes. Low-cost screening approaches, such as clinical breast examination, could be implemented in limited resource settings when the necessary evidence from ongoing studies becomes available.

Many low- and middle-income countries that face the double burden of cervical and breast cancer need to implement combined cost-effective and affordable interventions to tackle these highly preventable diseases. 

WHO promotes breast cancer control within the context of national cancer control programmes and integrated to noncommunicable disease prevention and control.

Source: WHO

Vitamin D

Vitamin D is a vitamin. It can be found in small amounts in a few foods, including fatty fish such as herring, mackerel, sardines and tuna. To make vitamin D more available, it is added to dairy products, juices, and cereals that are then said to be “fortified with vitamin D.” But most vitamin D – 80% to 90% of what the body gets – is obtained through exposure to sunlight. Vitamin D can also be made in the laboratory as medicine.

Vitamin D is used for preventing and treating rickets, a disease that is caused by not having enough vitamin D (vitamin D deficiency). Vitamin D is also used for treating weak bones (osteoporosis), bone pain (osteomalacia), bone loss in people with a condition called hyperparathyroidism, and an inherited disease (osteogenesis imperfecta) in which the bones are especially brittle and easily broken. It is also used for preventing falls and fractures in people at risk for osteoporosis, and preventing low calciumand bone loss (renal osteodystrophy) in people with kidney failure.

Vitamin D is used for conditions of the heart and blood vessels, including high blood pressure and high cholesterol. It is also used for diabetes, obesity, muscle weakness, multiple sclerosis, rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), asthma, bronchitis, premenstrual syndrome (PMS), and toothand gum disease.

Some people use vitamin D for skinconditions including vitiligo, scleroderma, psoriasis, actinic keratosis, and lupusvulgaris.

It is also used for boosting the immune system, preventing autoimmune diseases, and preventing cancer.

Because vitamin D is involved in regulating the levels of minerals such as phosphorous and calcium, it is used for conditions caused by low levels of phosphorous (familial hypophosphatemia and Fanconi syndrome) and low levels of calcium (hypoparathyroidism and pseudohypoparathyroidism).

Vitamin D in forms known as calcitriol or calcipotriene is applied directly to the skin for a particular type of psoriasis.

If you travel to Canada, you may have noticed that Canada recognizes the importance of vitamin D in the prevention of osteoporosis. It allows this health claim for foods that contain calcium: "A healthy diet with adequate calcium and vitamin D, and regular physical activity, help to achieve strong bones and may reduce the risk of osteoporosis.” But the US version of this osteoporosis health claim does not yet include vitamin D.

WebMed

Vitamin A

Vitamin A is key for good vision, a healthy immune system, and cell growth. There are two types of vitamin A. This entry is primarily about the active form of vitamin A -- retinoids -- that comes from animal products. Beta-carotene is among the second type of vitamin A, which comes from plants.

The American Heart Association recommends obtaining antioxidants , including beta-carotene, by eating a well-balanced diet high in fruits, vegetables, and whole grains rather than from supplements until more is known about the risks and benefits of supplementation.

High doses of antioxidants (including vitamin A) may actually do more harm than good. Vitamin A supplementation alone, or in combination with other antioxidants, is associated with an increased risk of mortality from all causes, according to an analysis of multiple studies.

Why do people take vitamin A?

Topical and oral retinoids are common prescription treatments for acne and other skin conditions, including wrinkles . Oral vitamin A is also used as a treatment for measles and dry eye in people with low levels of vitamin A. Vitamin A is also used for a specific type of leukemia.

Vitamin A has been studied as a treatment for many other conditions, including cancers, cataracts , and HIV. However, the results are inconclusive.

Most people get enough vitamin A from their diets. However, a doctor might suggest vitamin A supplements to people who have vitamin A deficiencies. People most likely to have vitamin A deficiency are those with diseases (such as digestive disorders ) or very poor diets.

WebMed

Men cold - men vs.women-

When a man gets a cold, everything shuts down. He’s on the couch in misery -- unwilling to do anything (even go to the doctor). But a woman with a cold just bucks up and goes on about her day.

Or so the story of the so-called “man cold” goes.

“If a woman has a viral infection or cold, so to speak, she’ll go on with her day’s activities and maybe mention it to a friend,” says psychology expert William Pollack, PhD, explaining the stereotype. “Men will fuss about it and feel like it’s getting in their way, or be angry or irritable that they have to deal with it.”

Put simply, the “man cold” refers to the idea that men handle colds and  the flu worse than women.

But is there any truth to the myth?

Symptoms: His vs. Hers

Experts say men and women may, in fact, respond differently to colds.

“I’ve definitely seen it, but not to such epic proportions as some make it sound,” Pollack says.

The difference is less about gender and more about personality, explains Robert L. Wergin, MD, chair of the American Academy of Family Physicians board of directors.

“I certainly have a group of patients that are very in tune with their bodies and have lots of concerns about their health, he says. “So when they have a cold, they magnify it to some degree.”

These patients, Wergin says, tend to think that their symptoms mean something worse is going on. They might have a minor cold, but they’re worried it’s pneumonia.

“It’s a mix of men and women,” he says.

Biological Differences

The man cold might have some biological truth to it. Some studies say men may have more symptoms than women when they have a cold.

“Regarding colds, there may be some impact of sex,” says Kim Templeton, MD, a surgeon at the University of Kansas Hospital. Templeton has done extensive studies on gender differences in health.

The female sex hormone estrogen  slows down how fast a virus multiplies, Templeton says. This may lead to fewer symptoms. The flu virus may not spread as quickly in women because of estrogen and how the female body reacts to it. Studies have not shown if the same thing applies to the cold virus.

What’s more, the part of the brain that controls body temperature is larger in men because of testosterone. This may lead to higher  fever in men vs. women, Templeton says. But the research isn’t clear, she cautions.

Some say these things may not have much impact.

“The way men and women respond to infectious diseases, there’s not really much of a difference between a male response and a female response,” says Aaron E. Glatt, MD, chairman of the department of medicine at South Nassau .

“There are slight differences in studies and numbers,” Glatt says. “But practically, there are no significant differences in the immune system between men and women.”

Source: webmed

Varicose vein & aspider veins !

Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That's because standing and walking upright increases the pressure in the veins of your lower body.

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.

Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

Symptoms

Varicose veins may not cause any pain. Signs you may have with varicose veins include:

* Veins that are dark purple or blue in color

* Veins that appear twisted and bulging; often like cords on your legs

* An achy or heavy feeling in your legs

* Burning, throbbing, muscle cramping and swelling in your lower legs

* Worsened pain after sitting or standing for a long time

* Itching around one or more of your veins

* Bleeding from varicose veins

* A painful cord in the vein with red discoloration of the skin

* Color changes, hardening of the vein, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention

Spider veins are similar to varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and are often red or blue.

They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider's web.

How to study actively?

What are the fundamentals of active studying?

Four active processes will be used in the steps of any active study pattern and any study time that does not involve one or more of these steps is almost certainly passive and inefficient!

Identifying the important information – answering the eternal question of “what’s important here?”

Organizing the information – start with the “big picture” to create a framework that facilitates memorization and access appropriate for differential diagnosis.

Memorizing the information – this requires frequent review to keep it available for use!

Applying the information to more complex situations – practice questions, quiz questions, clinical applications, etc.

Everyone will develop their own “high volume” study methods eventually, but the majority of medical students benefit from a starting strategy – and one generally successful starting point uses five basic steps:

Finding the "big picture" by skimming the information before lecture – identifying and memorizing the four or five major topics will keep you on track during lecture.

Creating a complete rough draft of the material by annotating the lecturer's slides  – notes emphasizing the lecturer's context are supplemented as needed from other reading materials. Don't rewrite this!

Creating summary charts, lists or diagrams that organize the needed material to emphasize patterns that facilitate memorization.

Actively memorizing the charts, etc., as they are created, then incorporating quick and frequent review during later study to nail the information down – you'll still need the fundamentals after finals are over.

Practicing application using practice or quiz questions during the study process – and not to test yourself just before the exam.

  

Why find the "big picture" before lecture?

Many students find they lose sight of the forest as they focus on the leaves, much less the trees. If you notice you are getting lost during lecture, finding the "big picture" before lecture provides a road map through the forest that will increase active learning during lecture.

Pre-lecture work should take no more than 10 minutes/hour lecture and has 2 goals:

The road map. Scan the material to identify the number of major headings and the major subheadings each has, then take just a couple of minutes to memorize those (don't skip this part!). Read the introduction and summary, which emphasize those points.

The vocabulary. Scan the material again to note any definitions or equations. Exact definitions are crucial and equations help relate many different factors correctly.

If the lecturer provides a syllabus prior to the lecture – use it! If not, you can benefit from skimming theassigned reading.

How do I generate my "rough draft" of all this information?

Take lecture notes that emphasize context – the big picture and what the instructor thinks is important.

Much of the factual information is typically provided in a syllabus or a handout of a lecturer’s Power Point slides, so just annotate these – don’t forget you can use the backs of pages for your notes.

Focus on adding context from the lecturer – this requires decision-making and so is active.

On a power point graph, note the “point” a graph or chart is making, or clearly label the axes.

Emphasize any comments of the lecturer on what is important information vs. what is just “color”.

Always note circumstances that indicate when one reflex or response will outweigh another!

Number the pages of lecture notes for each subject so that you can easily identify them. You will need those specific page numbers for cross-indexing your notes and references from your summaries.

Use abbreviations and develop your own shorthand from them. Never write out the entire name of a macromolecule, gene, etc. after the first time. Use symbols for  words whenever possible and be creative. Keep a list of them for the first quarter or two and be consistent. As they become habit, your speed will improve a lot.

Create the rough draft by labeling, annotating and cross-referencing your lecture notes as you read through them the first time – this is the messy but complete document you’ll use as source material for more concise summaries.

Impose the “big picture” on your notes.

Add major headings and subheadings within the notes and in the left margin in a different color ink – this reinforces the organization of the lecture. The lecture outline will frequently provide headings if they aren't apparent from the lecture slides.

Label each topic in the left margin and circle specific definitions within the notes in a different color – these will be used both for reference and for keying memorization of the material.

These processes force you to analyze the material and begin to actually learn it (not just track it); this will speed up integrative summary design, also.

Supplement your notes with any additional information from other readings that will be needed to create effective summaries.

Use your notes about the lecturer’s emphasis to help decide “what’s important”, and to look for missing information – if the lecturer discussed three abnormal conditions and provided causes for only two, maybe you missed the third.

Use the index in the text to direct you to specific topics – don't get caught up passively reading large sections without actively pulling out the facts to incorporate into rough draft.

Cross-index your notes between lectures – you won't remember which lecture contained each experiment the weekend before the final.

Each time the lecturer mentions something you remember being discussed in an earlier lecture, stop, find the pages in your earlier notes and add the page numbers in both places.

This makes it much easier to create summaries that contain the from multiple lectures – which are the most useful summaries!

Your rough draft is the single reference document you will refer to incase you need to add detail later to summaries or check on somethingyou originally didn't think was important.

How do I create organized summaries from my rough draft?

Organizing “necessary detail” into integrative summaries facilitates both memorization and application – and these summaries combine to form the “final draft” of your information that you will use to study for the final.

What is "necessary" detail? See FAQ on "How do I know what will be on the exam?" or “How do I know how much detail to learn?”

Different material lends itself to different types of summaries – simple lists, charts, flow diagrams, or pictures – use whatever combination you prefer.

In each case, organize the material to emphasize connections and facilitate memorization.

Where possible, create "big picture" organizations that integrate material from multiple lectures.

If you're not sure whether to include a specific detail, leave it out and just put in an asterisk in the appropriate spot with the page number from your rough draft for quick reference.

Don't recreate the wheel. If you find a good chart in some text orother source, photocopy it and add it to your summaries. Be sure to add any additional information to make it complete or more comprehensive —try a different color ink to make it stand out.

Create and organize the headings before you spend any time filling in the actual information.

The headings or location within a diagram should reinforce the “big picture” or anatomy or chronological sequence or steps in a physiological process or someaspect of the process.

Finalize the organization of the headings for your list or chart, or the spatial organization for a flow chart or diagram before adding in any of the information (this uses up a lot of scrap paper).

This requires analysis and integration of the material, which isactive, and aids memorization, since there is a "reason" for the orderor spatial organization.

Use a hierarchical approach for headings or spatial organization – no more than five major headings on a list or chart or six major sections on a diagram — more is too hard to remember.

If you need more headings or sections, decide how they are related and create subheadings.

The same numerical limits apply to subheading – if necessary, go to the next level of subheadings.

Make sure your headings (charts/lists) or spatial organization (flow charts, diagrams) provide information due to their sequence or location.

Multiple summaries or diagrams are better than one big one.

Simple outlines in a syllabus provide a great source for topics that your summaries should cover.

Limit the material covered in a single summary to an amount reasonable to memorize, then use multiple summaries to cover the material from different points of view.

For complex material, the organization of the headings may not be enough to establish the "big picture"; in these cases, some summaries just focus on the big picture.

Don't hesitate to include the same information on different summaries,especially if they are organizing the material from different points ofview or at different levels of detail.

How can I memorize actively and be sure I know the material?

Don't put off memorizing material until just before the exam.

Of course you will forget much of it after the first time — that's why you need to build repetitions into your study pattern. But if you memorized it actively (see above), you forget the "address" of the information much more than the actual information. So review will move it into long term memory.  If you cram it the night before, you won't remember it a week later, much less the next quarter or the next year.

So save the picky (but necessary) details for the night before, but memorize all the concepts and the first couple of levels of detail as you go and review them as you study later material.

Memorize the headings first – their order should reinforce useful information like anatomy, time course, etc.

First, memorize how many items (e.g., headings) there are

Second, memorize the headings themselves – using biological logic, visualization, or mnemonics.

Third, memorize the information associated with each heading, starting with just a key word or short phrase, and finally adding the full item.

When you think you have memorized any piece of the chart, etc.:

Cover the original, and write out the material on a blank piece of paper (don’t be pretty, but don’t cheat!), then throw what you have just written away!!!

Look at the original – if you are confident you got it all – great! If there is any question, don’t compare with what you should have thrown away – just memorize it again.

This method emphasizes what you don’t know; comparing the new with the old only confirms what you already knew, which  misleads us into thinking we know more than we do.

Quizzing each other is good motivation, but beware of subliminal cues used to help answer the questions without mastering the material. Explaining it out loud to yourself is a good start, but you can verbally "hand-wave" around areas you aren't clear on. Always check yourself as above.

Frequent review is relatively painless with organized material – and extremely helpful.

When an earlier topic or concept is mentioned, stop and review to yourself the relevant summary list – start with how many, then the headings, then the key words, then the concepts or facts.

This review actually decreases the time needed to master later lectures, since later material builds on earlier; this also increases exam speed, since answering factual questions will be easier and faster.

How do I prepare for exam questions? 

What are the most common problems medical students have with exams?

Clarity of definitions or concepts vs. those derived from context.

Students often generate their own general concepts or definitions from context – after all, that’s how we learn to speak – but this doesn’t provide enough clarity to analyze and correctly answer the questions.

Medical terminology and equations are very precise – being “close enough” often isn’t sufficient.

Familiarity with material vs. mastery of the material.

“Familiarity” refers to recognizing the logic provided by someone else – as when leaving a good lecture, you can say, “yeah, that made sense.”

Mastery of the material requires integration and memorization of sufficient detail that the information can be successfully applied to new situation.

Good test questions discriminate between the two!

Not having enough time to answer the more difficult applications questions involving multiple steps in feedback loops or multiple related equations.

You need a method to approach complex question before you get to the exam.

Use examples given in lecture, quiz questions, or other practice questions while you are studying to work out approaches for such questions ahead of time.

Where do I find time for all this?

Successful high-volume studying relies on good investment strategies:

Finding the “big picture” before lecture is easily put off, but it usually saves more time during creation of the rough draft.

Creating summaries takes a lot of time, but it provides the "final draft" from which you study for the final – you won't have time to go back through the origninal notes!

There is more time available in a day than you think – use it all.

Divide your studying into a series of short tasks – don't wait until you have 2 or 3 hours to study. Use small bits of time while your clothes are drying or while the rice is cooking for dinner for a single task.

Use all the "extra" time you can in the early weeks to be caught up in lectures and ahead on papers so there is some slop when it gets really intense.

Be VERY careful about "robbing Peter to pay Paul" – it's inevitable, but try to keep it to a minimum. It’s tempting to completely quit keeping up with other classes to study for the upcoming exam, but this is a major trap – that class has a final, too. Usually, skipping class to do a paper or study for an exam ends up costing significantly more time in make-up time in the missed subject.

source: US SanDiego school of medicine

polycythemia

The word polycythemia indicates increased red blood cells, white blood cells, and platelets. Most of the time, it is used in place of erythrocythemia, or pure red blood cell increase, such as in secondary polycythemia.

The term polycythemia is reserved for the myeloproliferative disorder called polycythemia vera, in which all 3 peripheral blood cell lines can be increased. Erythrocytosis or erythrocythemia is a more specific term that is used to denote increased red blood cells.

pathophysiology:

Increased hemoglobin and hematocrit values reflect the ratio of red blood cell mass to plasma volume. Any change in either the hemoglobin or the hematocrit can alter test results.

Relative polycythemia, or erythrocythemia, results from decreased plasma volume (G a isb ö ck syndrome). A true polycythemia or erythrocythemia results from increased red blood cell mass. Therefore, hemoglobin and hematocrit levels cannot accurately help make this distinction. Direct measurement of red blood cell mass is necessary to differentiate these conditions.

In primary polycythemia, the disorder results from a mutation expressed within the hematopoietic stem cell or progenitor cells, which drives the eventual accumulation of red blood cells. The secondary polycythemic disorders may be acquired or congenital; however, they are driven by circulating factors that are independent of the function of hematopoietic stem cells.

source: medscape

stem cell transplant & cancer cells !

A bone marrow transplant, also called a stem cell transplant, is a procedure that infuses healthy cells, called stem cells, into your body to replace damaged or diseased bone marrow. A bone marrow transplant may also be used to treat certain types of cancer. A bone marrow transplant may be necessary if your bone marrow stops working and doesn't produce enough healthy stem cells.

Bone marrow transplants may use cells from your own body (autologous transplant) or from a donor (allogeneic transplant).

why it's done ?

A bone marrow transplant may help you by:
• Safely allowing treatment of your condition with high doses of chemotherapy or radiation
• Replacing diseased or damaged marrow with new stem cells
• Providing new stem cells, which can help kill cancer cells directly
Stem cell transplants can benefit people with a variety of both malignant (cancerous) and nonmalignant (noncancerous) diseases, including:
• Acute leukemia
• Adrenoleukodystrophy
• Aplastic anemia
• Bone marrow failure syndromes
• Chronic leukemia
• Hemoglobinopathies
• Hodgkin's lymphoma
• Immune deficiencies
• Inborn errors of metabolism
• Multiple myeloma
• Myelodysplastic syndromes
• Non-Hodgkin's lymphoma
• Plasma cell disorders
• POEMS syndrome
• Primary amyloidosis
• Risks:

A stem cell transplant poses many risks of complications, some potentially fatal. The risk can depend on many factors, including the type of disease or condition, the type of transplant, and the age and health of the person. Although some people experience few problems with a transplant, others may develop complications that may require treatment or hospitalization. Some complications could even be life-threatening.

Complications that can arise with a stem cell transplant include:

• Graft-versus-host disease (allogeneic transplant only)
• Stem cell (graft) failure
• Organ damage
• Infections
• Cataracts
• Infertility
• New cancers
• Death

source: myoclinic

Anemia

Anemia is a condition in which you don't have enough healthy red blood cells to carry adequate oxygen to the body's tissues. Having anemia may make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. See your doctor if you suspect you have anemia because it can be a warning sign of serious illness.

Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet.

symptoms:

Anemia signs and symptoms vary depending on the cause of your anemia. They may include:

• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headache

At first anemia can be so mild that it goes unnoticed. But symptoms worsen as anemia worsens.

Causes

Anemia occurs when your blood doesn't have enough red blood cells. This can happen if:

• Your body doesn't make enough red blood cells
• Bleeding causes you to lose red blood cells more quickly than they can be replaced
• Your body destroys red blood cells

What red blood cells do

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot and red blood cells to carry oxygen throughout your body.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs so that it can be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia

Different types of anemia and their causes include:

• Iron deficiency anemia. This is the most common type of anemia worldwide. Iron deficiency anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells.
  Without iron supplementation, this type of anemia occurs in many pregnant women. It is also caused by blood loss, such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-the-counter pain relievers, especially aspirin.
• Vitamin deficiency anemia. In addition to iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.
  Additionally, some people may consume enough B-12, but their bodies aren't able to process the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
• Anemia of chronic disease. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
• Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn't produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
• Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
• Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
• Sickle cell anemia. This inherited and sometimes serious condition is an inherited hemolytic anemia. It's caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.
• Other anemias. There are several other forms of anemia, such as thalassemia and malarial anemia.

source: myoclinic

Heterochromia

Heterochromia (héteros means different, chróma means color) is a difference in coloration, usually of the iris but also of hair or skin. Heterochromia is a result of the relative excess or lack of melanin (a pigment). It may be inherited, or caused by genetic mosaicism, chimerism, disease, or injury.