Doctor ⚕️ Evidence over opinion | Radiology Resident ☢️@ VMMC&SJH Off duty on ucl matchdays⚽ Views are personal | Not a clinical consultation
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Joined May 2025
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A medical student slept 10 hours every night.
Still exhausted.
Still sleepy.
Still falling asleep during lectures.
Blood tests were normal.
What neurological disorder was everyone missing?
Answer: (C)Seek urgent assessment for HIV postexposure prophylaxis (PEP)
Why is (C) correct?
A broken condom during sex with a potentially HIV-positive partner creates a possible exposure to HIV.
PEP (postexposure prophylaxis) is preventive antiretroviral medication given after a potential HIV exposure to reduce the likelihood of infection.
-Seek medical assessment immediately.
-Do not wait for symptoms.
-PEP should be initiated as soon as possible; the 72-hour window is critical.
-Harrison describes a 4-week course of three or more antiretroviral drugs in its occupational-exposure discussion.
-Baseline and follow-up HIV testing are important.
Answer: Vitamin A
Why Vitamin A?
Excessive vitamin A intake over a prolonged period can cause hepatotoxicity.
One important mechanism is alteration of hepatic architecture, which can lead to nodular regenerative hyperplasia—a condition in which liver tissue develops regenerative nodules without the usual cirrhotic scarring.
This may cause portal hypertension, meaning increased pressure in the portal venous circulation.
Dr. Suraj Baidya retweeted
The most likely explanation is acquired methemoglobinemia caused by a topical local anesthetic, particularly benzocaine-containing dental gel.
The important clue is that the patient's lips turned blue and his oxygen saturation barely improved despite receiving oxygen. This suggests that the problem may not simply be a lack of oxygen entering the lungs: the blood's ability to carry oxygen may have been impaired.
The most likely explanation is acquired methemoglobinemia caused by a topical local anesthetic, particularly benzocaine-containing dental gel.
The important clue is that the patient's lips turned blue and his oxygen saturation barely improved despite receiving oxygen. This suggests that the problem may not simply be a lack of oxygen entering the lungs: the blood's ability to carry oxygen may have been impaired.
3. How do we diagnose it?
The important investigation is arterial blood co-oximetry.
Arterial PaO2— May be normal
Co-oximetry— Increased methemoglobin fraction
This discrepancy between apparently normal arterial oxygen tension and abnormal oxygen saturation measurements is an important diagnostic clue.
4. Treatment principles—
-Stop exposure to the offending oxidizing agent.
-Give high-concentration oxygen.
-Intravenous methylene blue is the preferred antidotal treatment for symptomatic acquired methemoglobinemia.
- Treatment is started when methemoglobin exceeds 30%, or when symptomatic hypoxemia or ischemia is present.
- Methylene blue is contraindicated in G6PD deficiency; ascorbic acid is an alternative.
- Exchange transfusion and hyperbaric oxygen may be considered in severe or refractory cases.
Dr. Suraj Baidya retweeted
Dr. Suraj Baidya retweeted
Completed my admission process at VMMC. Finally, I can say it… I got Radio at VMMC! 😁❤️
Dr. Suraj Baidya retweeted
Vizag, Anakapalli, kakinada, konaseema, yanam east & west #Godavari people should stay Alert from 27th oct afternoon- 28th oct evening
Power banks, food ,medicines , water store cheskondi
Electricity & tele communications services will be effected badly due to high speed winds – at Ramannapet, India
Dr. Suraj Baidya retweeted
What factors I weighed before choosing my branch as a first gen doctor-
1. Future: Ai and robotics
2. Hospital setup
3. Patient base
4. Financial stability
5. Will I like doing the work for the rest of my life
6. Passion: I guess the most important
What all factors you considered before choosing your branch?
What factors I weighed before choosing my branch as a first gen doctor-
1. Future: Ai and robotics
2. Hospital setup
3. Patient base
4. Financial stability
5. Will I like doing the work for the rest of my life
6. Passion: I guess the most important
What all factors you considered before choosing your branch?
