Discussion in 'AIIMS Nov 2013' started by samuel, Nov 10, 2014.

  1. samuel

    samuel New Member

    1) PTSD : CBT
    2) Parasuicide : cuts
    3) Alcohol dependence : Phenytoin has no role
    4) Single neurotransmitter disease : parkinsonism
    5) Haloperidol 10mg, uprolling of eyeballs : dystonia

    Kawasaki not seen in adults
    No meconium passed for 48 hrs, inv is lower gi contrast study
    Resp distress ques ..The child had no pneumonia (RR below 50), only cough and cold
    Ominous sign in neonate was conjugated hyperbilirubinemia.
    Intermittent watery discharge from umbilicus is patent urachus/urachal fistula

    Head trauma IOC:NCCT head
    Image-Bullous pemphigoid
    Burr hole-On the same side of the dilated pupil
    Le Veen shunt-Between peritoneum and Superior venacava
    Dexmedetomidine-Central alpha 2 agonist

    fibrous cortical defect sure
    cftr mutation sure
    pure gonadal dysgenesis sure
    patch clamp metod sure
    hartnup disorder
    aldolase b
    antoni a and b
    origin from ischiopubic rami
    non cotrast ct
    neurosecretory granule
    stab in abdomen
    mapelson a
    listeria monocytogen
    congenital lobar emphysema
    gouty arthritis
    volar tilt
    asses airway
    all sure

    when the bone lesion grows too fast and the periosteum does not have enough time to lay down a new layer, the Sharpey's fiber stretch out perpendicular to the bone, and later get calcified to give sun ray appearance..
    Sharpey's fibres are connective tissue matrix composed of collagen fibres, blood vessels and nerve fibres..
    Sharpey's fibres connect the periosteum to the bone..
    The calcification appears along blood vessels in Sharpey's fibers..

    So it is understood that
    1)Sun ray/burst appearance is due to calcification of blood vessels in Sharpey's fibres.
    2)It is NOT due to periosteal reaction.

    Periosteal reaction results in new bone formation as you see in Codmans triangle.

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