Dumb Medical Questions

Q: Can someone explain the types of sutures used in surgery? There are so many materials and uses but which ones should I really remember? A: I’ll divide the answer into two sections, one introducing the basic terms and terminology that we need to know to understand the suture lingo and the other section will involve using that terminology in a cool kidney transplant. Section 1: Introducing Sutures Sutures can be classified into absorbable and non-absorbable sutures: As the name suggests absorbable sutures are absorbed i.e broken down by the body by enzymatic degradation and hydrolysis and, the time taken to absorb depends on the suture material. For eg: vicryl takes around 2 weeks to breakdown in the body whereas the PDS takes around 8-9 weeks. Non-absorbable sutures do not get absorbed and therefore are either left in the body or are removed later if they are placed on the skin surface. Some things to keep in mind are: 1. Knowing the diameter/thickness/ ...

Q: How do cardiac, renal and hepatic edema differ with respect to diuretics given and why? Looks like Urine trouble. Guess what…We've got your back. Let's start by breaking down the  pathophysiology of edema in these conditions which would then help us understand the rationale of administering a diuretic. A) Cardiac Edema: The edema in heart failure is due to a :  A) Pump failure causing a mechanical backing up of fluid  B) Cardiovascular response to poor perfusion causing activation of the renin-angiotensin system (RAAS): Angiotensin II causes vasoconstriction of both afferent and efferent renal arterioles and stimulates release of aldosterone from the adrenal gland. With this background in mind, we’ll come back to your specific question. Mild congestive heart failure is initially managed with a thiazide diuretic. However, loop diuretics (e.g., furosemide, torsemide, or bumetanide) are the principal drugs used in acute exacerbations.  Loop diure...

We've come across a lot of questions that could be answered by a few lines, so we've decided to couple them into one big answer. Here we go! Q1: Why do my eyes tear up while I yawn? A: The most popular answer to this involves the stretching of lacrimal glands, tear ducts and the punctum associated with the eyes when the facial muscles stretch during an episode of yawning. Additional Trivia: New research shows that yawning could be a physiological response to increased brain temperatures!  (Source : Gallup AC, Eldakar OT. The thermoregulatory theory of yawning: what we know from over 5 years of research.  Front Neurosci . 2013;6:188. Published 2013 Jan 2. doi:10.3389/fnins.2012.00188) Q2: Why do hiccups happen and does water really stop them? A: Hiccups are transient episodic involuntary myoclonic jerks of the diaphragm , often in response to a stimulus arising from the esophagus. (through the vagus nerve) Esophageal stimulation, often due to excessi...

Q: ' If PCR amplifies DNA how do you know if the sequence you're seeing is original number or amplified? For example is AAGGT the sequence n u got AAGGTAAGGTAAGGT how do I know what's the original?' A:  The three essential steps in a PCR (Polymerase Chain Reaction) are: 1)  Denaturation: 'Melting' of DNA into single strands a higher temperatures 2)  Annealing: Addition of Complementary DNA Primers at lower temperatures 3)  Elongation: Replication of DNA by DNA polymerase The processes of denaturation, annealing and elongation constitute a single cycle. Multiple cycles are required to amplify the DNA target to millions of copies.  Now while we're calculating the amount of DNA present in a sample, we retrace to the original number of copies using certain formulae. The formula used to calculate the number of DNA copies formed after a given number of cycles is  2 n , where n is the number of cycles.   Thus, a reaction set for 50 ...

Q: How do I prepare for USMLE step 2 CK as an IMG? A: Step 1 often poses a tricky challenge for international graduates who are USMLE aspirants. Some attempt it several years after their medical graduation when their foundational knowledge has all but evaporated. It may feel like the boss-level in a video game, but it has its own cheat codes -- First Aid, Pathoma, Uworld. Yet when it comes to Step 2 CK students struggle for an entirely different reason. While Step 1 is akin to an incredibly difficult voyage, Step 2 is like sailing an uncharted sea. With no single exhaustive resource, it is tough to know where to begin. Here at Dumb CQs, we would like to review the available question banks, books and assessments to help you select the best one: QUESTION BANKS: 1) UWorld - If we had to recommend just one question bank, it would be Uworld. However, to get the most bang for your buck (as you must, the pricing starts at 349$), it's best to follow a systematic...

Q: What's the difference between physiological and pathological hypertrophy of the heart and how does pathological hypertrophy lead to heart failure while physiological hypertrophy does not? A: This question certainly isn't dumb, as scientists are still trying to work out the answer to this date! Physiological hypertrophy is often seen in athletes and pregnant women and is characterised by being reversible, comprising healthy myocardium and devoid of associated symptoms of Heart Failure. [2] Pathological Hypertrophy is often seen in conditions like Aortic Stenosis and Hypertension, where the hypertrophy is accompanied by irreversible scarring,fibrosis and symptoms of heart failure. [2]  Types of Cardiac Hypertrophy: ( Source: Intermittent pressure overload triggers hypertrophy-independent cardiac dysfunction and vascular rarefaction Cinzia Perrino, 1   Sathyamangla V. Naga Prasad, 1   Lan Mao, 1   Takahisa Noma, 1   Zhen Yan, 1   Hyung-Suk ...

SGLT2 Inhibitors and Renoprotection Q: “How do SGLT2 inhibitors help in chronic kidney disease?” A: The renoprotective effect of SGLT2 inhibitors is still being extensively studied, but the results have been very promising. Let’s start with discussing what SGLT2 inhibitors are. SGLT 2 inhibitors SGLT2 inhibitors (eg dapagliflozin, canagliflozin, empagliflozin etc) are a class of drugs that inhibit reabsorption of glucose in the kidney (by inhibiting the sodium-glucose transport protein 2 - ie, SGLT2) and therefore lower blood sugar. Because of their use in lowering blood glucose levels, they are regularly used in the management of type 2 diabetes mellitus (and increasingly in type 1 diabetes as well). In addition to glycemic control, they have been shown to provide significant cardiovascular benefit in patients with type 2 diabetes. Mechanism Sodium Glucose cotransporters (SGLTs) are proteins that are found in different tissues that play an important role in mai...