REV MED

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✅ High Yield Slides

1: Schistocytes - Fragmented RBCs in microangiopathic hemolysis.
2: Smudge Cells - Fragile lymphocytes in CLL.
3: Rouleaux Formation - Stacked RBCs in multiple myeloma.
4: Basophilic Stippling - Coarse granules in lead poisoning.
5: Call-Exner Bodies - Rosettes in granulosa cell tumors.
6: Reed-Sternberg Cells - “Owl-eye” cells in Hodgkin’s lymphoma.
7: Perivascular Pseudorosettes - Tumor cells around vessels in medulloblastoma.
8: Auer Rods - Needle-like inclusions in AML.
9: Clue Cells - Vaginal epithelial cells with bacteria (Gardnerella).
10: Crypt Abscesses - Neutrophils in colonic crypts (ulcerative colitis).
11: Eosinophilic Keratin Inclusions - Damaged keratin deposits.
12: Hepatic Macrophages - Kupffer cells in hepatic sinusoids.

Let us know which topics we should cover next in the comments below! More notes for you here ⤵️

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Liver Function Tests (LFTs)
Interpreting Patterns of Liver Enzyme Elevations in Hepatic Disorders

✅ Mnemonic “CAO”

Visualize the fingers on each hand as enzymes:

C – Chronic Hepatitis (Left Hand)
All fingers slightly raised
🟢 Mild elevation in ALP, AST, ALT, GGT
→ Suggests chronic, low-grade liver inflammation
(e.g. Chronic HBV/HCV, autoimmune hepatitis, NAFLD)

A – Acute Hepatitis (Middle Hand)
Middle & ring fingers (AST & ALT) raised high 🟡
Index & pinky (ALP & GGT) slightly raised 🟢
→ Represents sudden hepatocellular injury
(e.g. Viral hepatitis, drug-induced liver injury)

O – Obstructive Jaundice (Right Hand)
Index (ALP) & pinky (GGT) markedly elevated 🟡
Middle & ring fingers (AST & ALT) mildly raised 🟢
→ Indicates bile duct obstruction (cholestatic pattern)
(e.g. Gallstones, pancreatic cancer, PSC)

C – Mild enzyme rise → chronic inflammation
A – High AST/ALT → acute liver injury
O – High ALP/GGT → obstruction/cholestasis

✅ Clinical Associations

🔸 AST:ALT > 2 → Suggests alcoholic hepatitis
(due to mitochondrial injury + B6 deficiency)

🔸 ALT > AST → Seen in viral hepatitis

🔸 If ALP is elevated, check GGT:
→ Confirms hepatic source (vs. bone disease)

🔸 GGT also rises with alcohol use
→ Helpful marker in alcoholic liver disease

🚨 BREAKING NEWS: Knicks center Mitchell Robinson reportedly suffered a broken pinky finger ahead of the NBA Finals. 🏀🤕 We need that MAMBA mentality Mitch!!

From a medical perspective, there are a few locations where a pinky fracture COULD occur 👀 We don’t have any confirmation of the specific area of injury yet.

✅ Possible fracture sites

*Distal phalanx → fingertip fracture
*Middle phalanx → middle segment injury
*Proximal phalanx → common with sports trauma
*5th metacarpal neck → “Boxer’s fracture”
*Base of the 5th metacarpal → can affect grip stability

Common findings:
*Pain/swelling over the pinky side
*Loss of knuckle contour
*Difficulty gripping

For an NBA center whose game depends on rebounding, catching passes, and rim protection… even a pinky fracture can become a serious issue.

Which nerve is associated with the pinky side of the hand?? Answer in the comments below.

Physiology 101 of High vs Low Blood Glucose. Read more below ⤵️

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Diabetes

✅ High vs Low Blood Glucose

After eating some food, glucose gets absorbed from the gut into the blood. To use the glucose, our body produces insulin, which is the hormone that helps cells absorb glucose from the blood.

Hypoglycemia (low blood sugar) is when blood glucose levels drop below 70 mg/dL in adults.

Signs & Symptoms:

-Pale, cold, clammy skin. Bounding, rapid pulse. Normal or high blood pressure. Normal or shallow breathing. Irritable, confused, uncoordinated, aggressive & anti-social behavior. Rapid loss of consciousness. Possible tremors & convulsions.

*Hunger
*Fatigue
*Shaking
*Anxiety
*Fast heartbeat
*Sweating
*Pale skin
*Headache & dizziness
*Can worsen to confusion, slurred speech, blurred vision, fainting, seizures and even coma.

Hyperglycemia (high blood sugar) is when blood glucose levels are more than 180 mg/dL in adults

-Flushed, hot, dry skin. Weak, rapid pulse. Low blood pressure. Labored breathing. Sweet, fruity (pear drops) odor on the breath. Abdominal pain, nausea & vomiting. Restless, drowsy, or lethargic behavior.

Signs & Symptoms:
*Super thirsty (Polydipsia)
*Stomach pain
*Irritablity
*Intense & unusual hunger (Polyphagia)
*Headaches
*Trouble concentrating
*Blurred vision
*Frequent urge to urinate (Polyuria)
*Fatigue (weak & tired)
*Weight loss

Everyone doubted Jalen Brunson and look where he is now. Don’t underestimate your self. Just study everyday and you’ll uncover the greatness within you. 🏀🫀

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