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Your Daily MedsDaily Education for Medical Students and Junior Doctors Author: Luke Reynolds
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Your Daily Meds - 10 December, 2021
Thursday, 9 December, 2021
Good morning and welcome to your Friday dose of Your Daily Meds.Bonus Review: What are the functions of the skin? Answer: The skin does a few things - * Protection (barrier)* Thermoregulation (both sensory and effector)* Environmental monitoring (sensory)* Role in Vitamin D metabolism* Psychosocial functions* Immune functions* Site for drug administration (patches), elimination (volatile anaesthetic agents) or metabolism.Sweets:Which of the following test results is not diagnostic of Diabetes?* Fasting venous blood glucose of 6.5 mmol/L* Random venous blood glucose of 11.5 mmol/L* Two-hours post oral glucose tolerance test venous blood glucose of 11.8 mmol/L* HbA1c of 7.2%* HbA1c of 55 mmol/molHave a think.Scroll for the chat.Drugz:Which of the following substances is least likely to exhibit a specific withdrawal syndrome?* LSD* Alcohol* Benzodiazepines* MDMA* CocaineHave a think.More scroll for more chat.Diabeetus:Diabetes can be diagnosed from fasting (> 7 mmol/L) or random (> 11.1 mmol/L) venous blood glucose concentrations; by formal measurement of venous blood glucose concentration two hours post oral glucose tolerance test (> 11.1 mmol/L); or from measurement of glycated haemoglobin.The upper limits of normal for glycated haemoglobin, 48 mmol/mol and 6.5%, are equivalent. Of our options, a fasting venous blood glucose of 6.5 mmol/L is not indicative of Diabetes.WithDrawaLS:Substance-related and addictive disorders are characterised by compulsive drug-seeking and drug-taking, despite adverse consequences, with loss of control over the use of the drug. Dependence may take the form of behavioural use patterns, avoiding the physiological effects of withdrawal, or continued use of the substance to avoid dysphoria or attain the desired drug state. Intoxication with depressants such as alcohol and benzodiazepines tend to manifest with euphoria, slurred speech, disinhibition, confusion and poor coordination. Their withdrawal is characterised by anxiety, anhedonia, tremor, seizures, insomnia, delirium, psychosis and death at worst. Intoxication with stimulants such as MDMA and cocaine is characterised by euphoria, mania, psychosis with paranoia, insomnia and seizures. Their withdrawal may be manifested by a ‘crash’, cravings, dysphoria and suicidality. Intoxication with hallucinogens such as LSD (Lysergic Acid Diethylamide), a 5-HT2A agonist, tends to manifest as distortions of sensory stimuli, enhancement of feelings, psychosis with visual hallucinations, delirium, anxiety and poor coordination. Other signs include tachycardia, hypertension, mydriasis and tremor. Tolerance develops rapidly to most hallucinogens, often within hours or days, making physical dependence unlikely. Hallucinogen withdrawal is usually absent of significant symptoms.So of our options, LSD is least likely to exhibit a specific withdrawal syndrome.Bonus: How is the skin involved in Vitamin D metabolism?Answer in Monday’s dose.Closing:Thank you for taking your Meds and we will see you Monday for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!Luke.Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks. Just credit us where credit is due. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit yourdailymeds.substack.com
