M A N G I

👨🏽‍⚕️| Kijana mpambanaji⛽
🏘Arusha & Moshi🌏...

[Dr CHIRAG 🩺 @Chiragrx07]

Montelukast is usually taken in the evening/night because:

Asthma symptoms often worsen at night due to increased nocturnal leukotriene activity and circadian changes in airway tone.

Montelukast blocks leukotriene receptors, so taking it in the evening helps control:

Night-time wheeze
Early morning symptoms
Nocturnal bronchoconstriction

[Dr RP Singh, MD @rpsingh1894]

💪 Muscle Pain – What’s the Cause?

Question: Muscle pain is due to?

🔴 Oxygen
🟢 Lactic acid ✅
🔵 Glucose
🟡 Protein

📌 Explanation

During intense exercise, oxygen supply to muscles becomes insufficient → muscles switch to anaerobic glycolysis.

⚡ This leads to accumulation of lactic acid, which contributes to muscle fatigue and burning pain.

🧠 Quick fact:
Delayed muscle soreness after exercise is also linked to micro-tears & inflammation, not only lactate.

#Physiology 💪
#MedTwitter 🩺
#MedicalEducation 📚

[Fortunatus Buyobe @fbuyobe]

Hapa namuongelea marehemu Reginald Mengi mwanzilishi wa makampuni ya IPP na Jackline Ntubayaliwe aliyekuwahi kutwaa taji la Miss Tanzania mwaka 200.

Naam!

Uzi👇

AFFECTION: A food best served cold in a business

[esanum @esanum]

@drabdulhameed07 ✅ Answer: B) Ramelteon
📍 Insomnia treatment acting as a melatonin receptor agonist
🔷 Selective MT1/MT2 agonist in the suprachiasmatic nucleus
⚡️ Minimal risk of dependence vs benzos/Z-drugs
💡 Good option in elderly or patients with history of substance misuse

[M A N G I @mangiMunuo]

@TweveDevota

[Dr.Bj @daoo100]

Imipramine ✅
✔️Anticholinergic effects: It helps relax the bladder muscles and contract the smooth muscles at the bladder neck, allowing the bladder to hold more urine.
✔️Sleep architecture: It may alter sleep patterns, potentially shortening deep sleep stages to help a child wake up more easily when they need to urinate.
✔️Hormonal impact: It may increase the production of vasopressin, a hormone that signals the body to reduce urine production at night.
#medtwitter #neetpg

[MedLearn Hub @MedLearnHub]

B) Acute adrenal crisis.
🔴Long‑term glucocorticoid therapy suppresses the hypothalamic‑pituitary‑adrenal (HPA) axis, abrupt stoppage leaves the atrophic adrenals unable to produce adequate cortisol leading to acute adrenal crisis with hypotension, vomiting, abdominal pain, weakness & posssible shock.
∆ Mechanism- Chronic exogenous steroids cause decreased CRH & ACTH via negative feedback leading to adrenal cortex (zona fasciculata) atrophy & therefore secondary adrenal insufficiency.
• Sudden withdrawal or stress (infection, surgery) without steroid cover precipitates the crisis.
📍 Emergency T/t- Immediate IV hydrocortisone & rapid isotonic saline (± dextrose), treat precipitating cause, then taper steroids gradually once stable to allow HPA axis recovery.

[The Vijay Medico Classroom @vijay_classroom]

👉 Silver sulfadiazine

It’s literally the classic burn-ward favourite because:
•It has broad-spectrum antimicrobial action
•Helps prevent Pseudomonas and other gram-negative/positive infections
•Easy to apply on large surface areas

The others?
•Clotrimazole → antifungal
•Hydrocortisone → steroid (reduces inflammation, not used for burns)
•Bacitracin → works mostly on gram-positive bacteria, but not preferred for burns

[MedLearn Hub @MedLearnHub]

B) Tamsulosin.
🟡Tamsulosin- It is an α1A‑selective blocker & is the most appropriate drug for rapid symptomatic relief in BPH because it relaxes smooth muscle in the prostate & bladder neck improving urine flow within days without altering prostate size.
• We usually Add finasteride when prostate is enlarged or risk of progression is high.
∆ Finasteride- 5‑α‑reductase inhibitor, shrinks prostate & prevents progression but onset is slow (months)& therefore it is used for disease modification Not acute symptom relief.

[esanum @esanum]

✅ Answer: B) Hemorrhagic stroke
📍 Aspirin = antiplatelet → can worsen intracranial bleeding/hematoma expansion
⚡️ In suspected acute stroke, avoid antithrombotics until CT/MRI rules out hemorrhage
🔷 Ischemic stroke/TIA: aspirin is used for secondary prevention (if eligible)
💡 Rule: “CT first—if it’s a bleed, no aspirin.”

[nervemed @nervemed]

Polycystic Ovary Syndrome Features

Mnemonic: OVARY CHAOS

O – Oligomenorrhea / Amenorrhea
V – Virilization signs (hirsutism, acne)
A – Anovulation → infertility
R – Raised LH:FSH ratio (>2:1)
Y – Young obese females

C – Cysts on ovaries
H – Hyperinsulinemia / insulin resistance
A – Acanthosis nigricans (dark skin folds)
O – Obesity & metabolic syndrome risk
S – Subfertility / cardiovascular risk

[M A N G I @mangiMunuo]

@EngMapundajr Msenge uyo

[Mastering the Differential 🩺 @MTD_MED]

🎯 Correct answer: B. Bupropion

🔥 Why?
Bupropion is a Norepinephrine–Dopamine Reuptake Inhibitor (NDRI) that reduces nicotine cravings and withdrawal symptoms.
It’s one of the main medications used for smoking cessation along with varenicline.
❌ Wrong options:
A. Sertraline → SSRI, no role in smoking cessation

C. Amitriptyline → TCA, not used here

D. Duloxetine → SNRI, not for smoking cessation

[MEDICINE MADNESS @Doctors_GUILD]

Which drug reduces risk of diabetic neuropathy progression?

A) Amlodipine
B) ACE inhibitor / ARB
C) Thiazide
D) Atenolol

[DrNadaSalma⚕ @drNadaSalma]

All vitamins are safe during pregnancy except ⁉️⁉️👏🏻👏🏻🤰🏻🚫

[M A N G I @mangiMunuo]

@TweveDevota @Kusekwa1307 Ndumila kuwili we ni Dalali tu kama mjomba wako zitto

[Dr Honey choudhary 🩺 @Doctors__squad]

What is the most likely diagnosis?

[Dr. Muhammad Moor @MoarSahitoPTI]

Which of the following drugs rapidly lowers severely high blood pressure in emergency hypertensive crisis.? 💉

A) Labetalol
B) Nifedipine
C) Hydralazine
D) Sodium Nitroprusside

[Dr. AK 🇮🇳 @docakx]

Which Vitamin deficiency may happen with prolonged use of loop diuretics ❓️

[MEDCRUX @medcrux]

🛑 Levothyroxine is taken BEFORE breakfast
🔷️ Food (especially fiber & coffee) reduces drug absorption
🔷️ Empty stomach gives maximum absorption (~80%)
🔷️ Ensures stable TSH levels
🔷️ Avoids interaction with calcium, iron, antacids
🔷️ Morning dose matches natural circadian rhythm of thyroid hormones
🔷️ Prevents variable absorption seen with mixed meals
🔷️ Gives consistent daily dosing, improving treatment accuracy.