Ritalin VS Adderall

Bottom Line:

Ultimately Ritalin and Adderall belong to the same class of compounds, the phenethylamines. Ritalin is one of the trade names of the compound methylphenidate. It is also sold as Concerta and Biphentin which differ in dose and have small modifications to control release of the active compound. Adderall is a mixture of right and left handed enantiomers of amphetamine. Dexedrine is purely the right handed enantiomer of amphetamine, while Vyvanse is the right handed enantiomer with lysine attached, thus making it an inactive prodrug. All of these are stimulants and act on the release and reuptake of dopamine and norepinephrine. They are used primarily in the treatment of ADHD and narcolepsy.

Memory Aids:

Adderall is Amphetamine Continue reading “Ritalin VS Adderall”


Bottom Line:

NMS (neuroleptic malignant syndrome) is a potentially life threatening condition thought to be caused by blockade of the dopamine D2 receptor pathway. SS (serotonin syndrome) is also a potentially life threatening condition associated with increased serotonergic activity. Both conditions result in mental status changes, fever, dysautonomia (autonomic dysfunction), leukocytosis, and neuromuscular symptoms. Both conditions have a wide array of possible presentations, and both conditions are clinical diagnoses (lab tests do not confirm the diagnosis).

Generally speaking, SS has a more rapid onset (symptoms present within 24 hours of starting a drug or changing a dose) whereas NMS takes several days or weeks to appear. SS involves neuromuscular hyperactivity (e.g. clonus, hyperreflexia) whereas NMS involves bradykinesia (typically “lead-pipe” rigidity). In SS the clonus can involve the eyes and pupils can be dilated, neither of which occur in NMS. Both NMS and SS cause hyperthermia, but shivering is apparently unique to SS.

Treatment is similar for both conditions. Remove the offending agent and provide supportive care to normalize vital signs and prevent renal damage. Sedation with benzodiazepines may be considered. Resolution of the syndrome with treatment occurs over hours with SS, but can take days to weeks with NMS.

Memory Aids:


F – Fever

A – Autonomic instability

L – Leukocytosis

T – Tremor

E – Elevated enzymes (CPK, LDH, AST, ALT)

R – Rigidity


(this is taken from an article by Christensen in Current Psychiatry)

S – Shivering (is apparently one symptom that distinguishes SS from other hyperthermic conditions)

H – Hyperreflexia (especially in lower extremities)

I – Increased temperature

V – Vital sign instability

E – Encephalopathy

R – Restlessness

S – Sweating (anticholinergic toxicity, in contrast, has a similar presentation, but with hot, dry skin) Continue reading “NMS VS SS”

The Secret Origins of Atropos

The hotly anticipated third installment of our SECRET ORIGINS series …

Come meet the members of the Medical VS class in these exciting features. Learn their stories, their medical training, their combat skills AND find out how each one met their unfortunate demise.


Atropos was born in 154 AD in a small Germanic village on the banks of the Elbe in the Kingdom of the Marcomanni. Her father pledged her to a tribal leader as part of a debt repayment while her mother was still pregnant with her. As such, she was named Gisila at birth. Throughout her infancy she was traded amongst various tribal leaders until she ended up in the household of Ballomar, the Marcomannic King. She was a precocious child and he greatly favoured her, so much so that she was given the peculiar honour of a rudimentary education. At the age of 10 she learned to read and write Latin and became quite useful during the Germanic negotiations with the Roman military governor Marcus Iallius Bassus. Much to Ballomar’s dismay, she was given to the Romans in 167 AD as part of a truce agreement. As the Marcomannic wars exploded she was shipped to Aquileia and imprisoned briefly as her foster father Ballomar’s army besieged the city. Continue reading “The Secret Origins of Atropos”

Rh Factor VS RhD Factor

Bottom Line:

They are the same thing! D is the most common antigen in the Rh blood group system so people keep things simple by just saying “Rh” instead of RhD. Note that RhD can also be denoted as RhO (sometimes using a subscript letter O or number 0). So Rh, RhD, RhO, RhoD, RhO or Rh0 can all refer to the D antigen of the Rh blood group system.

Memory Aids:

When in doubt, it’s the Rh D antigen. Continue reading “Rh Factor VS RhD Factor”

Exudate VS Transudate

Bottom Line:

Fluid that collects in extracellular, extravascular spaces can be either exudative or transudative. Exudative fluid arises from inflammatory processes that make vessel walls more permeable to both fluid and proteins which allow them to exit the vessels and collect in the extravascular spaces. Transudative fluid exits the vessels due to a pressure differential between the intra and extravascular space (either hydrostatic or oncotic), but typically does not contain proteins since they are too large to squeeze out of the vessels. A fluid sample can be tested according to Light’s criteria to determine if it is exudative or transudative.

Memory Aids:

Exudates are from Enflammation (inflammation)

Light’s criteria – protein 5, LDH 6

(fluid protein:serum protein >0.5, fluid LDH:serum LDH>0.6) Continue reading “Exudate VS Transudate”


Bottom Line:

ADLs (activities of daily living) are the basic necessary daily self-care tasks people are required to perform such as bathing, dressing, toileting, grooming, and self-feeding. They are sometimes called Basic Activities of Daily Living (BADLs) to differentiate them from IADLs (instrumental activities of daily living) which are slightly more complex tasks that people are required to perform in order to live independently in society. These include shopping, banking, housework, and cooking among others.

Memory Aids:


D – dressing

E – eating (specifically feeding oneself, but not necessarily cooking or chewing or swallowing)

A – ambulation (walking and transferring)

T – toileting (including cleaning oneself afterwards)

H – hygiene (showering, grooming, combing/styling hair)


S – shopping

H – housekeeping

A – accounting (including banking, management of finances)

F – food preparation

T – telephone use (or another communication device) and transportation (driving or using the bus or calling a taxi) Continue reading “ADLs VS IADLs”