Tirzepatide (GIP/GLP-1 agonist) for the treatment of DM-2 and weight loss

It's given as a subcutaneous injection once a week

It's a rare complication of bacterial pharyngitis/tonsillitis and involves an extension of the infection into the lateral pharyngeal spaces of the neck with subsequent septic thrombophlebitis of the internal jugular vein.

The bacteria involved is usually the anaerobic Fusobacterium necrophorum. And its most dangerous complication is thrombosis, which can cause stroke.

Paraneoplastic syndromes are very difficult to diagnose as they can pre-date definite cancer diagnosis by months or years (e.g. Lambert Eaton myasthenic syndrome, as the most legendary example of paraneoplastic syndrome).

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the concept of VOMIT (Victim of Medical/or Modern Imaging Technology) was put forth to prevent patients from needless diagnostic costs and mental anguish after being put through a battery of expensive and misdirected imaging tests.

That was fun to read

"The internet is the most potent anxiety provoking system ever devised"

A 15 year old girl complains of back pain. A neurological examination and various blood and radiological examinations are negative—except for the MRI scan (“I'm sure there'll be nothing, but let's be certain”). The scan shows a mild focal dilatation of the central canal of the spinal cord over two vertebral levels in the mid-dorsal region. She is referred for a neurosurgical opinion with a presumed diagnosis of syringomyelia. Her parents surf the net. Now they know all about small muscle wasting, intractable pains, dissociated sensory loss, and the strong likelihood of progressive neurological deterioration. They also learn that a major spinal (or, worse still, craniospinal) operation is the only way to alter this gloomy prognosis. They arrive for the consultation shattered but resigned.

Since I just recovered from the flu... Let's talk about viruses:

• Hemagglutinin
• Neuraminidase
• Fusion protein

These are called "surface proteins" that are present on some viruses.

The function of hemagglutinin is to bind to the cell surface to initiate infection of the cell. In the clinical laboratory, the hemagglutinin agglutinates red blood cells, which is the basis of a diagnostic test called the hemagglutination inhibition test.
The hemagglutinin is also the target of neutralizing antibody (i.e., antibody against the hemagglutinin inhibits infection of the cell).

The neuraminidase cleaves neuraminic acid (sialic acid) to release progeny virus from the infected cell. The hemagglutinin functions at the beginning of infection, whereas the neuraminidase functions at the end. Neuraminidase also degrades the protective layer of mucus in the respiratory tract. This enhances the ability of the virus to gain access to the respiratory epithelial cells.

Both of them are present on the surface of the influenza virus (and many others).

They all belong to the class of neuraminidase inhibitors (except for a relatively new drug). They inhibit the release of virus from infected cells. This limits the extent of the infection by reducing the spread of virus from one cell to another. They are effective against both influenza A & B. They are most effective when taken within 48 hours of onset of symptoms.

Oseltamivir (Tamiflu) & Zanamivir are the most common drugs in this class. There is a fear that the virus might develop resistance to these drugs, which is why we only use them in severe illness and/or in people with risk factors.