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Which cell secretes what? Gastrointestinal mnemonics

medicowesome:

medicowesome:

"pH" for Parietal cells secrete H+ ions.

"PC" for Pepsin is secreted by Chief cells.
(Alternate mnemonic: I think of master chef making food rich in proteins, peptides being degraded by pepsin and that’s how I remember the association that Chief cells secrete Pepsin).

G for G cells & G for Gastrin. (Hah! That was easy!)

S for S cells & S for Secretin! (Medicine is easy!)

You’ve probably heard of the iPhone.. Heard of iCDs? Coz they’re gonna help you remember the rest of the cells secretions- I cells secrete CCK. Delta cells secrete somatostatin. Go ICDS!

That’s all! <3
Wait.. Which cell secretes intrinsic factor? Do you know the IP address of that cell? IP.. Yes, yes. Parietal cells! Intrinsic factor - Parietal cells!

Histology hint: Parietal cells are pink puffy cells. Like a puffy big pink balloon, they are in the upper region of gastric pits. (Compared to chief cells that are in the lower region, have rough endoplasmic reticulum making them blue, and are smaller!)

Adrenal gland histology photoset. Stare till you get it xD

For my medical reblogs turned 1 today!

For my medical reblogs turned 1 today!

(Source: assets)

Oval budding vs Round budding :|

ONE WORD CAN CHANGE YOUR ANSWER. Besides history, duh.

Anyway, they won’t be treated by antibiotics. Both of em grow on blood agar. Both are budding. And stuff. GAH. MYCOLOGY. I hate you.

Physicians deal with many ethical issues on a daily basis. Fundamental ethical principles assist us in understanding, negotiating and navigating these issues. Ethical dilemmas arise when two or more ethical principles apply in a particular case and would lead to different outcomes. In these situations physicians must balance these principles to arrive at the best course of action. There are other approaches to bioethics in which other principles may apply. However, in caring for patients, it is important for physicians to understand the following fundamental ethical principles that form the basis of Western bioethics: 

Autonomy: “Self rule”- Physicians must respect a patient’s right to make decisions regarding his medical care. Competent, informed patients have the right to choose among treatment options and refuse any unwanted medical interventions. By providing informed consent and following patients’ wishes, physicians demonstrate their respect for the patient’s autonomy.

Beneficence: Physicians must act in the best interests of their patients. Patients are vulnerable because of illness and lack medical expertise. Therefore, patients rely on physicians to offer sound advice and to place the their well-being first. If patients lack decision-making capacity, they need to be protected from making decisions that are contrary to their best interests. Physicians must put the interests of their patients ahead of their own interests or those of third parties such as insurers or managed care organizations.

Confidentiality: Physicians must maintain the confidentiality of medical information. Confidentiality respects patient autonomy and encourages patients to present for care and be candid. However, confidentiality can be overridden in order to protect third parties when there is the potential for serious, foreseeable harm to third parties. Legally mandated reporting includes certain infectious diseases like tuberculosis, loss of consciousness or child or elder abuse or domestic violence.

Do no harm: The principle of non-maleficence directs physicians to “do no harm” to patients. Physicians must refrain from providing ineffective treatments or acting with malice toward patients. This principle, however, offers little useful guidance to physicians since many beneficial therapies also have serious risks. The pertinent ethical issue is whether the benefits outweigh the burdens. 

Equality: The principle of distributive justice deals with issues of treating patients equally. Physicians should treat similarly situated patients similarly and allocate resources justly. In the face of limited health care resources, physicians should practice cost-effective medicine. Physicians should make recommendations and decisions based on ethically pertinent considerations.

Fairness: The principle of procedural justice requires that the process for making decisions for patients be fair and just. For example the process by which patients appeal rulings by the insurance company or by which organs are allocated must be fair and just.

Beneficence vs. Nonmaleficence
Beneficence: 
Definition: Beneficence is action that is done for the benefit of others. Beneficent actions can be taken to help prevent or remove harms or to simply improve the situation of others. 

Clinical Applications: Physicians are expected to refrain from causing harm, but they also have an obligation to help their patients. Ethicists often distinguish between obligatory and ideal beneficence. Ideal beneficence comprises extreme acts of generosity or attempts to benefit others on all possible occasions. Physicians are not necessarily expected to live up to this broad definition of beneficence. However, the goal of medicine is to promote the welfare of patients, and physicians possess skills and knowledge that enable them to assist others. Due to the nature of the relationship between physicians and patients, doctors do have an obligation to 1) prevent and remove harms, and 2) weigh and balance possible benefits against possible risks of an action. Beneficence can also include protecting and defending the rights of others, rescuing persons who are in danger, and helping individuals with disabilities.

Examples of beneficent actions: Resuscitating a drowning victim, providing vaccinations for the general population, encouraging a patient to quit smoking and start an exercise program, talking to the community about STD prevention.

Non-maleficence: 
Definition: Non-maleficence means to “do no harm.” Physicians must refrain from providing ineffective treatments or acting with malice toward patients. This principle, however, offers little useful guidance to physicians since many beneficial therapies also have serious risks. The pertinent ethical issue is whether the benefits outweigh the burdens.

Clinical Applications: Physicians should not provide ineffective treatments to patients as these offer risk with no possibility of benefit and thus have a chance of harming patients. In addition, physicians must not do anything that would purposely harm patients without the action being balanced by proportional benefit. Because many medications, procedures, and interventions cause harm in addition to benefit, the principle of non-maleficence provides little concrete guidance in the care of patients. Where this principle is most helpful is when it is balanced against beneficence. In this context non-maleficence posits that the risks of treatment (harm) must be understood in light of the potential benefits. Ultimately, the patient must decide whether the potential benefits outweigh the potential harms.

Examples of non-maleficent actions: Stopping a medication that is shown to be harmful, refusing to provide a treatment that has not been shown to be effective.

Balancing Beneficence and Non-maleficence:
One of the most common ethical dilemmas arises in the balancing of beneficence and non-maleficence. This balance is the one between the benefits and risks of treatment and plays a role in nearly every medical decision such as whether to order a particular test, medication, procedure, operation or treatment. By providing informed consent, physicians give patients the information necessary to understand the scope and nature of the potential risks and benefits in order to make a decision. Ultimately it is the patient who assigns weight to the risks and benefits. Nonetheless, the potential benefits of any intervention must outweigh the risks in order for the action to be ethical.

Autonomy vs. Beneficence
Autonomy: 
Definition: Autonomy is the “personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice.” Autonomous individuals act intentionally, with understanding, and without controlling influences.

Clinical Applications: Respect for autonomy is one of the fundamental guidelines of clinical ethics. Autonomy in medicine is not simply allowing patients to make their own decisions. Physicians have an obligation to create the conditions necessary for autonomous choice in others. For a physician, respect for autonomy includes respecting an individual’s right to self-determination as well as creating the conditions necessary for autonomous choice. 

Individuals come to doctors for guidance in making choices because they do not have the necessary background or information for making informed choices. Physicians educate patients so that they understand the situation adequately. They calm emotions and address fears that interfere with a patient’s ability to make decisions. They counsel patients when their choices seem to be disruptive to health and well-being. Respect for autonomy also includes confidentiality, seeking consent for medical treatment and procedures, disclosing information about their medical condition to patients, and maintaining privacy.

Examples of promoting autonomous behavior: Presenting all treatment options to a patient, explaining risks in terms that a patient understands, ensuring that a patient understands the risks and agrees to all procedures before going into surgery.

Balancing Autonomy and Beneficence:
Some of the most common and difficult ethical issues to navigate arise when the patient’s autonomous decision conflicts with the physician’s beneficent duty to look out for the patient’s best interests. For example, a patient who has had bypass surgery may want to continue to smoke or a patient with pneumonia may refuse antibiotics. In these situations the autonomous choice of the patient conflicts with the physician’s duty of beneficence and following each ethical principle would lead to different actions. As long as the patient meets the criteria for making an autonomous choice (the patient understands the decision at hand and is not basing the decision on delusional ideas), then the physician should respect the patient’s decisions even while trying to convince the patient otherwise.


Deontology 
The word deontology derives from the Greek words for duty (deon) and science (or study) of (logos). In contemporary moral philosophy, deontology is one of those kinds of normative theories regarding which choices are morally required, forbidden, or permitted. In other words, deontology falls within the domain of moral theories that guide and assess our choices of what we ought to do (deontic theories), in contrast to (aretaic [virtue] theories) that — fundamentally, at least — guide and assess what kind of person (in terms of character traits) we are and should be. And within that domain, deontologists — those who subscribe to deontological theories of morality — stand in opposition to consequentialists.

Parietal cell

Chief cell

Gastric mucosa histology

Why is there dicarboxilic acidemia in MCAD deficiency?

in MCAD—> accumulation of monocarboxylic fatty acids and dicarboxylic organic acids, which are structural analogues of the fatty acids that cannot pass through the MCAD step. 

—> These dicarboxylic acids are formed by an alternative metabolic pathway called w-oxidation that attempts, without success, to begin oxidation at the opposite end of the fatty acid. These w-oxidation products appear in urine —> dicarboxyllic aciduria

Apr 8
Apr 8
mynotes4usmle:

Anti HTN drugs - Vasodilators

mynotes4usmle:

Anti HTN drugs - Vasodilators

Heart Sounds

THANK YOU

(Source: usmlenotebook)