Alexeis' Blog

Documenting adventures and random thoughts
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Almost done! Abstaining from playing has led me to spend my free time on reading. 

After this, I’m considering reading A Thousand Splendid Suns, because I find Hosseini’s style captivating, direct yet fluroushing with poignant, trivial details that reveal the deep under the mundane. 
Although trivial, any mention of medical jargon in the book livens me up, because I can understand how he can describe medical terms and  ideas with vivid simplicity. My friend told me that he is a doctor. Upon further research, I learned that he abandoned his practice of medicine ten years ago to become a full - time author. 
And then, perhaps another different author or genre. Open to suggestions. 
A question mark, so the tumblr community can respond. .

”?”

Almost done! Abstaining from playing has led me to spend my free time on reading. 

After this, I’m considering reading A Thousand Splendid Suns, because I find Hosseini’s style captivating, direct yet fluroushing with poignant, trivial details that reveal the deep under the mundane. 

Although trivial, any mention of medical jargon in the book livens me up, because I can understand how he can describe medical terms and  ideas with vivid simplicity. My friend told me that he is a doctor. Upon further research, I learned that he abandoned his practice of medicine ten years ago to become a full - time author. 

And then, perhaps another different author or genre. Open to suggestions. 

A question mark, so the tumblr community can respond. .

”?”

sheenalovessunsets:

image

When Jesus was asked what the greatest commandment was, He replied that it was to love God and the second was to love others (see Matthew 22:36-40). It was all about relationships. How do your relationships fare in your life?

I’ve always said that it’s all about balance and priorities.

Today, I delete the program from the computer. 

I’ve done it twice already, but reinstalled the game immediately. By putting it in writing, I hope that I can internalize some finality to this decision. 

This is in light of the resumption of classes, which is three weeks away for me, but hopefully would be used to prepare for my first rotation , OB. 

Goodbye hearthstone, for now.

Greetings, clerkship.

mynotes4usmle:

ANTIBIOTICS CHEAT SHEET :)

Also, REMEMBER!!!!

* Sulfonamides compete for albumin with:

  • Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies
  • Warfarin: increases toxicity: bleeding

Beta-lactamase (penicinillase) Suceptible:

  • Natural Penicillins (G, V, F, K)
  • Aminopenicillins (Amoxicillin, Ampicillin)
  • Antipseudomonal Penicillins (Ticarcillin, Piperacillin)

Beta-lactamase (penicinillase) Resistant:

  • Oxacillin, Nafcillin, Dicloxacillin
  • 3°G, 4°G Cephalosporins
  • Carbapenems 
  • Monobactams
  • Beta-lactamase inhibitors

* Penicillins enhanced with:

  • Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)
  • Aminoglycosides (against enterococcus and psedomonas)

Aminoglycosides enhanced with Aztreonam

* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)

* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)

* Both inhibited by Probenecid during tubular secretion.

* 2°G Cephalosporines: none cross BBB except Cefuroxime

* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.

* Cephalosporines are ”LAME" bc they  do not cover this organisms 

  • L  isteria monocytogenes
  • A  typicals (Mycoplasma, Chlamydia)
  • RSA (except Ceftaroline, 5°G)
  •  nterococci

image

* Disulfiram-like effect: Cefotetan Cefoperazone (mnemonic)

* Cefoperanzone: all the exceptions!!!

  • All 3°G cephalosporins cross the BBB except Cefoperazone.
  • All cephalosporins are renal cleared, except Cefoperazone.
  • Disulfiram-like effect

* Against Pseudomonas:

  • 3°G Cef taz idime (taz taz taz taz)
  • 4°G Cefepime, Cefpirome (not available in the USA)
  • Antipseudomonal penicillins
  • Aminoglycosides (synergy with beta-lactams)

* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

Covers VRSA: Linezolid, Danupristin/Quinupristin

* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.

* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)

* Phototoxicity: Q ue S T  ion?

  • uinolones
  • Sulfonamides
  • T etracyclines

image

* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides

* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis

Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.

* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.

Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.

QT prolongation: macrolides, sometimes fluoroquinolones

For future reference!

(via inthewards)

Clerkship mantra

Clerkship mantra

Such an amazing live performance

Spent the weekend at Pinsal Falls in Sta. Maria, Ilocos Sur. 

It was another adrenaline - filled weekend. Again, I relished every moment that my bare feet found rock as I clambered atop boulders and descended the rocky terrains. 

I also developed a new skill: skipping stones. :) I figured out some principles in the 20 minutes we threw rocks.

  • Find rocks that are flat
  • Throw the stone as parallel to the water’s surface as possible
  • Throw hard! Use your entire arm, but time the throw to come from the wrist

Here are some photos of our second water - filled excursion this summer. 

The last shot was also taken atop the waterfalls. Behind and below me, unseen in the picture, is where we came from, a deep open void where water falls.

My brother has some really nice shots. Again, I’m either just smiling or pointing my thumbs up. Hahaha. 

Finally got around to watching this brief but insightful talk. What registered to me the most was the concept of identity capital and  picking your family consciously by planning for it before you even get around to it. 

To all the twentysomethings that stumble upon this, I urge you to spare 15 minutes of your time for something that may help gain perspective.