Cortisol/Glucocorticoids/Corticosteroids (actions and side effects)
Posted by: mixeva on: January 17, 2009
Recently it striked me the prevalence of use of Cortisone, secondary to prevalence of collagen and autoimmune diseases, and inflammatory or allergic conditions. Maybe the incidence is the same, but it’s just the advance of diagnosis and investigations, but the end result is the same, Cortisone is highly used nowadays in many, many conditions.
Well, to understand the side effects (especially of prolonged use of Cortisone), a quick reference to the actions of Glucocorticoids is a must:
1. Maintains metabolic homeostasis:
A. Regulates blood glucose level/permissive effects on gluconeogenesis/increases glycogen synthesis
B. Raises Insulin levels/permissive effects on lipolytic hormones
C. Increases catabolism/decreases anabolism (except fat)/inhibits growth hormone axis
D. Inhibits reproductive axis
E. Mineralocorticoid activity of cortisol
2. Affects connective tissues:
A. Causes loss of collagen & connective tissue
3. Affects calcium homeostasis:
A. Stimulates osteoclasts/inhibits osteoblasts
B. Reduces intestinal calcium absorption/stimulates PTH release/increases urinary calcium excretion/decreases reabsorption of phosphate
4. Maintains cardiovascular function:
A. Increases cardiac output
B. Increases vascular tone
C. Permissive effects on pressor hormones/increases sodium retention
5. Affects behavior and cognitive function
6. Affects immune system:
A. Increases intravascular leukocyte concentration
B. Decreases migration of inflammatory cells to sites of injury
C. Decreases antigen-antibody reaction
D. Suppresses immune system (thymolysis, suppression of cytokines, kinins, serotonin, histamine, collagenase, and plasminogen activator)
7. Antistress/Antishock
About side effects of prolonged use:
1. Edema
2. Hypertension
3. Heart failure
4. Cushing’s syndrome
5. Psychosis
6. Osteoporosis
7. Growth retardation in children
8. Delayed healing of wounds
9. Increases intraocular pressure (glaucoma)
10. May precipitate diabetes mellitus
11. Perforation of peptic ulcer
12. Infections: e.g. Activation of tuberculosis, fungal infection
13. Hirsutism, menstrual irregularities
14. Sudden withdrawal —> Acute adrenocortical insuffieciency/Addisonian crisis
Three new USMLE titles from Skyscape for Mobile Devices
Posted by: drhaisook on: January 14, 2009
Skyscape announces the release of First Aid Q&A For The USMLE Step 2 CK (The McGraw-Hill Companies, Inc.), First Aid Cases For The USMLE Step 2 CK (The McGraw-Hill Companies, Inc.) and First Aid For The USMLE Step 3 (The McGraw-Hill Companies, Inc.) for mobile devices.
First Aid Q&A For The USMLE Step 2 CK
(Tao Le, MD, MHS, Anil Shivaram, MD and Joshua Klein, MD, PhD)
This new study tool for the USMLE Step 2 CK features 1000 board-style questons and answers with explanations for correct and incorrect answers.
First Aid Cases For The USMLE Step 2 CK
(Tao T. Le, MD, MHS, Esteban Schabelman, MD, MBA, Anil Shivaram, MD and Joshua Klein, MD, PhD)
Designed to provides students with the most useful and up-to-date preparation guides for the USMLE Step 2 CK.
First Aid For The USMLE Step 3
(Tao Le, MD, MHS, Vikas Bhushan, MD, Robert W. Grow, MD, MS and Veronique Tache, MD)
First Aid for the USMLE Step 3 is the most useful and up-to-date preparation resource designed for residents and international medical graduates for the USMLE exams.
Those programs should work on: BlackBerry ®, iPhone/iPod Touch, Palm OS ® [3.5 or higher], Symbian S60 [3rd edition] (Nokia), Windows Mobile™ Pocket PC [all versions], Windows Mobile Smartphone, Windows 98/2000/ME/XP/Vista/Tablet PC.
Don’t forget to recheck your device compatibility before purchasing.
Medicopedia is not affiliated with Skyscape in any way.
HBV Antigenic Components / Markers and What They Mean
Posted by: drhaisook on: January 13, 2009
Reference:
s is related to the surface antigenic component
c is related to the core antigenic component
e is related to the envelope antigenic component
Look for these in the question! They could be the only key to the diagnosis!
• HBsAg » HBV infection
• No Anti-HBc » no HBV infection
• HBeAg » active viral replication
• Anti-HBs » immunity is present
• Anti-HBc » according to type of Ig:
IgM » acute/recent infection
IgG » chronic infection
Here’s also a table listing those in detail, in addition to markers of other hepatitis viruses. (Thanks to our author mixeva for the image. Original source: Cecil Essentials).
Hepatitis Markers
Introducing our new author, mixeva
Posted by: drhaisook on: January 11, 2009
A fellow author has recently joined Medicopedia!
Please let me introduce her to you:
mixeva has just finished her 6th year of Medical School in Egypt, and she will be starting her internship soon.
You can start reading her first post, titled “Interstitial Lung Diseases (ILD)/ including Pneumoconioses” by clicking here.
Hope you enjoy her posts!
Interstitial Lung Diseases (ILD)/ including Pneumoconioses
Posted by: mixeva on: January 11, 2009
- In: Cancer| Clinical| Respiratory| Step 2 CK| USMLE
- 2 Comments
Hello everyone 
So, while I was having my oral exams this year, I came across a question that many people were asked: “ILD”, so I looked it up to find that it includes a very wide range of diseases that I studied individually, but never had them collected, they’re quite interesting actually, especially the pneumoconiosis causes (that rhymes 
), let’s go:
ILD, or Interstitial Lung Diseases, is a term that refers to a group of diseases that affect the “interstitium” of lungs; alveoli, capillaries, the separating basement membrane and the perivascular/lymphatic tissues. Almost everything but the bronchial tree or the (Obstructive Lung Diseases).
They give a diffuse shadowing pattern, or a “miliary pattern” on chest x-ray.
The full classification is after the break.
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Dr Haisook's
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