NIMHANS 2015 DM/Mch/MD

Discussion in 'PG Entrance Message Board' started by samuel, Nov 10, 2014.

  1. samuel

    samuel New Member

    Concentration of Sodium Channel in Nerve Per Square Foot :-

    6.6*10^-5 to 3.9*10^-2 per square foot

    Tyrosine Metab Disorders :-

    Tyrosinemia type-1
    Enzyme Defect - Fumaryl AcetoAcetate hydrolase
    Inheritence AR

    Tyrosinemia type-2
    Enzyme Defect - Tyrosine Transaminase
    Inheritence - AR

    Tyrosinemia type-3
    Enzyme Defect - 4 Hydroxyphenylpyruvate dioxygenase
    Inheritence - AR

    Hawkinsinuria - 4 HydroxyPhenylPyruvate
    dioxygenase
    Inheritence - AD

    Alkaptonuria
    Enzyme Defect- Homogentisic Acid oxidase
    Inheritence - AR

    Albinism
    Enzyme Defect - Tyrosinase
    Inheritence - AR

    Disorders of PhenylAlanine Metab :-

    PKU Type 1
    Enzyme Def :- PhenylAlanine Hydroxylase
    Inheritence AR

    PKU Type 2
    Enzyme Def :- Dihydropteridine reductase
    Inheritence :- AR

    Knowledge Share #1
    Hardest Stone to Break By Extra Corporeal Shock Wave Lithotripsy is Calcium Oxalate monohydrate.

    Lightbulb sign It refers to the abnormal AP radiograph appearance of the humeral head in posterior shoulder dislocation. When the humerus dislocates, it also internally rotates such that the head contour projects like a lightbulb.

    The arch of the aorta is a continuation of the ascending aorta . It lies behind the manubrium sterni and arches upward, backward, and to the left in front of the trachea (its main direction is backward). It then passes downward to the left of the trachea and, at the level of the sternal angle, becomes continuous with the descending aorta .

    Biochemistry
    Niacin deficiency causes Pellagra found in people eating corn based Diets (mainly rich in Leucine)
    [​IMG] [​IMG]

    caused by deficiency of Niacin n Tryptophan !

    Excessive Leucine Interferes with the utilization of nicotinic acid .
    Leucine Inhibits QPRT enzyme and so Niacin can not be converted to NAD+
    (Leucine Pellagra)

    Found In->
    Alcoholics
    Hartnup's dISEASE
    Carcinoid Syndrome


    Symptoms->
    Bright Red glossitis
    Casal's nECKLACE
    4 D's
    Dermatitis
    Diarrhea
    Dementia
    Depression
    Death
  2. samuel

    samuel New Member

    Loeffler's Syndrome is a disease in which eosinophils
    accumulate in the Lung in response to a Parasitic Infection.

    First Described by Loeffler in case of eosinophilic Pneumonia caused by Parasite Ascaris lumbricoides.

    Characterised By:-

    1)Blood Eosinophilia

    2)Mild Dyspnea

    3)h/O Asthma / Atopy

    4)Focal Consolidation on CxR USUALLY Transient/Fleeting

    5)Self Limiting

    6)Approx1/3 are Idiopathic
  3. samuel

    samuel New Member

    Langerhans Cell Histiocytosis

    a spectrum of proliferations of a special type of Immature dendritic Cell called "Langerhans Cell"
    these proliferations are monoclonal and are therefore likely to be Neoplastic in Origin.

    Presence of Birebeck granules in the Cytoplasm is characteristic.

    In Addition the Tumor cells Typically Express HLA-DR
    S-100 AND CD1A
  4. samuel

    samuel New Member

    The Capgras delusion is classified as a delusional misidentification syndrome, a class of delusional beliefs that involves the misidentification of people, places, or objects . It can occur in acute, transient, or chronic forms. Cases in which patients hold the belief that time has been "warped" or "substituted" have also been reported.

    The delusion most commonly occurs in patients diagnosed with paranoid schizophrenia, but has also been seen in patients suffering from brain injury and dementia. It presents often in individuals with a neurodegenerative disease, particularly at an older age. It has also been reported as occurring in association with diabetes, hypothyroidism and migraine attacks. In one isolated case, the Capgras delusion was temporarily induced in a healthy subject by the drug ketamine. It occurs more frequently in females, with a female:male ratio of 3:2.
  5. samuel

    samuel New Member

    Otto-Loewi Discovered first Neuro Transmitter AcetylCholine..

    Otto-Loewi alongwith Henry Davis got Nobel Prize For works on Neuro Transmission !!!

    <NIMHANS 2006>

    The Freezing Point of normal human plasma averages -0.54C
    It Corresponds to an osmolal concentration in plasma of 290 mOsmo/L
    Osmolarity = 2[Na]+[Glucose]/18 +[BUN]/2.8
  6. samuel

    samuel New Member

    Small molecule Transmitters
    a)mono-amine(Ach,Serotonin,Histamine)
    b)Catecholamines(Dopamine,NE,Epi)
    c)Amino-Acids(glutamate,GABA,Glycine)

    Large Molecule Transmitters
    a)Peptides including Substance P
    Enkephalins
    Vasopressin
  7. samuel

    samuel New Member

    Surgery Fact

    Perforation of the Oesophagus is usually Iatrogenic (Therapeutic EndoScopy) or due to BaroTrauma (Spontaneous Perforation) with Cervical region most Commonly Involved
  8. samuel

    samuel New Member

    Bing–Neel syndrome (BNS) is an extremely rare neurologic complication of Waldenström macroglobulinemia (WM).

    It involves central nervous system infiltration by neoplastic lymphoplasmacytoid and plasma cells with or without cerebrospinal fluid (CSF) hyperglobulinemia. This increases blood viscosity, which impairs its circulation through small brain and eye blood vessels.[3] Patients with BNS can be classified into Group A and Group B based on the presence of these cells within the brain parenchyma, leptomeninges, dura, and/or the CSF.[4]

    Symptoms include
    episodes of confusion
    slurred speech
    headache, fatigue, ataxia, memory problems, nausea, vomiting, and extremity numbness.

    Complete blood count, electrolytes, and liver enzymes are normal in patients with Bing-Neel syndrome.

    Diagnosis can include lumbar puncture and magnetic resonance imaging (MRI) of the brain and spinal cord.

    Treatment involves central nervous system penetrating chemotherapy. Some significant improvement has been shown in patients as a result of cranial radiation treatment preceding a brief course of intrathecal chemotherapy. In Arkansas, a patient was treated with "intrathecal chemotherapy with several cycles of systemic chemotherapy followed by autologous stem cell-supported high-dose therapy transplant". The patient discontinued all treatment in 2009 and was still asymptomatic by the time a follow-up report was published in 2013.
  9. samuel

    samuel New Member

    Abderhalden–Kaufmann–Lignac syndrome, also called nephropathic cystinosis, is an autosomal recessive renal disorder of childhood comprising cystinosis and renal rickets.

    Affected children are developmentally delayed with dwarfism, rickets and osteoporosis. Renal tubular disease is usually present causing aminoaciduria, glycosuria and hypokalemia.

    Cysteine deposition is most evident in the conjunctiva and cornea.



    Abderhalden-Kaufmann-Lignac syndrome has an autosomal recessive pattern of inheritance.
  10. samuel

    samuel New Member

    Neurogenic bladder dysfunction, sometimes simply referred to as neurogenic bladder, is a dysfunction of the urinary bladder due to disease of the central nervous system or peripheral nerves involved in the control of micturition (urination). Neurogenic bladder usually causes difficulty or full inability to pass urine without use of a catheter or other method.

    Causes:-
    Any condition that impairs bladder and bladder outlet afferent and efferent signaling can cause neurogenic bladder. It is often associated with spinal cord diseases (such as syringomyelia/hydromyelia), injuries like herniated disks, and neural tube defects including spina bifida. It may also be caused by brain tumors and other diseases of the brain, and by peripheral nerve diseases such as: Diabetes, Alcoholism and Vitamin B12 deficiency. It is a common complication of major surgery in the pelvis, such as for removal of sacrococcygeal teratoma and other tumors.

    Treatments:-
    Catheterization methods range from intermittent catheterization, which involves no surgery or permanently attached appliances, to the creation of a stoma, which bypasses the urethra to empty the bladder directly.

    Intermittent catheterization is the use, several times a day, of straight catheters (which are usually disposable or single-use products) to empty the bladder. This can be done independently by the patient, or with help, in the case that the patient lacks the dexterity to manage the catheter. For patients that are unable to tolerate disposable straight catheters, a Foley catheter allows continuous drainage of urine into a sterile drainage bag that is worn by the patient.

    Other treatments involve creation of a stoma that is continent and readily accepts a catheter. These are known as Mitrofanoff mechanisms. An example of this treatment is the creation of an Indiana pouch. Additionally, a muscarinic agonist like Bethanechol may also be used, particularly in the postpartum or postoperative period. Function of the stoma may be augmented by periodic injections of botulinum toxin to relax one of the two sphincters involved in normal urination. The effect is longer lasting with botulinum toxin type A than with type B.
  11. samuel

    samuel New Member

    Couvade syndrome, also called sympathetic pregnancy, is a proposed condition in which a partner experiences some of the same symptoms and behavior of an expectant mother. These most often include minor weight gain, altered hormone levels, morning nausea, and disturbed sleep patterns. In more extreme cases, symptoms can include labor pains, postpartum depression, and nosebleeds.The labor pain symptom is commonly known as SYMPATHY pain.
  12. samuel

    samuel New Member

    Commonest Cause of Intestinal Obstruction (Adult)
    BAND N ADHESION

    Commonest cause of Intestinal Obstruction (Neonate)
    Strangulated Indirect Inguinal Hernia

    Commonest cause of Colonic Obstruction
    Neoplasm

    Commonest Cause of Colonic Obstruction in Neonate
    Aganglionic colon
  13. samuel

    samuel New Member

    Guyon's Canal Contains Ulnar N. & Ulnar Art.

    Roof: Palmar Fascia & Palmar Brevis
    Floor: Flexor retinaculum + pisohammate ligament
    Medial Wall: Tendon of Flexor Carpi Ulnaris + Pisiform
    Lateral Wall: Hook of the Hamate
  14. samuel

    samuel New Member

    Rathke's Cleft Cyst :-

    Site of Origin -> Pars Intermedia of Pituitary
    Cell lining -> Cuboidal epithelium
    Cyst Contents -> Resembles Motor Oil
    Surgical Treatment -> Partial Excision and Drainage
  15. samuel

    samuel New Member

    Most Common Drugs Causing Nystagmus :-

    a) Alcohol
    b) Phenytoin
    c) Barbiturates
    d) Other CNS Depressents
  16. samuel

    samuel New Member

    Hamberger Classified Sphenoid Sinus into Three Main Anatomical Types :-

    A) Sellar Type(75%)
    B) Pre-Sellar Type(24%)
    C) Conchal Type(1%)
  17. samuel

    samuel New Member

    A 20 Yr Old Female Patient presented with episodic throbbing headache for last 1 Yr associated with Nausea and Vomiting ..

    Differential Diagnosis :
    Cluster Headache
    Migraine
    Tension Headache
    Angle Closure Glaucoma
  18. samuel

    samuel New Member

    DYSPHAGIA LUSORIA

    Common Causes :-

    (1) Rt Aortic Arch
    (2) Double Aortic Arch
    (3) Vascular Constrictive Ring
    (4) An Abnormal Rt Subclavian Art. arising from Aorta
    (5) Abnormal Inominate Art.
  19. samuel

    samuel New Member

    Simian Thumb -> Median Nerve

    Saturday Night Palsy -> Deep Peroneal Nerve

    Policeman's Tip Hand (Erb's Palsy)

    Cubital Tunnel Syndrome (Ulnar Nerve)

    Pointing Index (Median Nerve)
  20. samuel

    samuel New Member

    Tethered Cord Syndrome

    Radiographically ->
    Low Conus medulaaris below L2
    Thickened Filum Terminale
    Scoliosis
    Normal Diameter<1mm
  21. samuel

    samuel New Member

    Taste Modalities :-

    (a) Bitter : Back of the Tongue(Valate Papillae)

    (b) Sour : Edges of the Tongue

    (c) Sweet : Tip of the Tongue

    (d) Salt : Dorsum Anterior of the Tongue
  22. samuel

    samuel New Member

    M/C/C Of Seizure in

    Neonates :- Perinatal Hypoxia
    Infants and Children :- Febrile Seizures
    Adoloscents :- Trauma
    Older Adults :- CVD
  23. samuel

    samuel New Member

    RECOGNITION OF ACUTE TRANSFUSION REACTION:
    Signs and symptoms of Acute hemolytic transfusion reactions are:
    1) Fever with or without chills.
    2) Rigors with or without fever.
    3) Pain at infusion site or in chest, abdomen or flanks.
    4) Acute hypotension or hypertension.
    5) Tachypnea and hypoxemia.
    6) Nausea with or without vomiting.
    7) Hemoglobinuria.
    8) Urticaria, flushing, itching or oedema
  24. samuel

    samuel New Member

    THE ROLE OF TRANSFUSIONIST IN CASE OF AN ACUTE TRANSFUSION REACTION:

    He is the first to suspect and first to take action.

    1) STOP the transfusion immediately.
    2) NOTIFY the responsible physician.
    3) MAINTAIN I. V. line with normal saline drip.
    4) CHECK for all identifying information for clerical error.
    5) Notify Blood bank personnel and patient’s physician immediately:
    6) Conditions requiring aggressive management need to be ruled out immediately. A physician must evaluate the
    patient thoroughly diagnose an Acute haemolytic transfusion induced sepsis.
    7) Initiate appropriate therapeutic measures.
    8) Collect blood samples to be sent to blood bank for counter checking in 3cc EDTA and 5 cc in plain tube.
    9) Collect blood for coagulation profile in l0cc citrate tube, plain tube for biochemistry, electrolytes and
    appropriately for blood cultures.
    10) Return the discontinued blood bag along with IV administration set, attached IV solutions, all related forms and labels to the blood bank.
    11) In case the reaction is limited to urticaria or circulatory overload there is no need to evaluate post reaction blood or urine samples.
    12) Observe the post reaction urine sample for Hemoglobinuria indicative of Auto Immune Hemolytic Transfusion reaction by monitoring the hemodynamic status, urine output, ECG, ABG. Etc.
  25. samuel

    samuel New Member

    ALLE RGIC URTICARIAL REACTION:
    Incidence: 1 to 3%.
    Aetiology: Antibodies to donor plasma proteins.
    Clinical picture: Allergic urticarial reaction occurs towards the end of transfusion or immediately after it and is characterized by itching, urticaria, flushing rash, rarely laryngeal oedema, bronchospasm.
    Management:
    - No Need to stop transfusion.
    - IV chlorpheniramine 25mg.
    - IV hydrocortisone 100 mg.
    - Subcutaneous adrenaline 1: 1000, ONLY if laryngeal oedema.
  26. samuel

    samuel New Member

    DELAYED HEMOLYTIC TRANSFUSION REACTION:
    Two types: a) Anamnestic response to transfused RBCs
    b) Primary alloimmunization.
    Incidence 1: 11000 to 1: 5000 0, 05% to 0. 07% of transfusion recipient
    Clinical presentation: More common in multiple transfused & Muciparous women
    - Occurs 3-7 days post transfusion.
    - Extravascular hemolysis.
    - Absence of anticipated Hb or HCT rises following blood transfusion.
    - Jaundice
    - Fever
    - Rarely hemoglobinuria
    - Primary alloimmunization not delayed
    Investigations:
    a) Draw fresh blood to test for alloantibodies.
    b) Compare with previous sample.
    Treatment: Rarely necessary.
    Observe urine output.
    Blood transfusion that lack the corresponding antigen.
    Prevention: Blood that lacks the responsible antigen. Issue medical alert card to these patients.
    Maintain record of the offending antibodies.
  27. samuel

    samuel New Member

    PLATELET REFRACTORINESS:
    Incidence: 20 to 70 % cases requiring multiple platelet transfusion. Criteria:
    -Lack of accepted corrected count increment of two platelet transfusion, -Poor response to three platelets in 2 weeks.
    CCI = Post transfusion count - Pre Transfusion Count x BSA (M2)* No. of Platelet administered x 1011 Causes: Platelet alloimmunization Non immune causes
    Immune causes:
    ABO mismatch
    Anti HLA antibodies
    Platelet specific allo and autoantibodies Drug dependent antibodies.
    Most common cause: Anti HLA antibodies Produced by passenger lymphocytes. May disappear. Strategies for prevention:
    -ABO matched single donor apheresis platelets
    -Leucodepletion using leucocyte filters
    -HLA matched platelets difficult. Need a donor pool of 2000 to 3000 donor
    -Irradiation of HLA matched platelets is a must.
    * BSA = Body surface area (M2)
  28. samuel

    samuel New Member

    Most Common Cause of primary amenorrhoea- Gonadal dysgenesis > ROKYTANSKY KUSTER HOUSER
    SYNDROME

    Most Common Cystic Swelling of vulva- Bartholin’s cyst

    Gestational trophoblastic disease following hydatiform mole- Invasive mole

    Most Common Gestational trophoblastic disease- Hydatiform mole

    Most Common Facts :-

    Cause of death in Carcinoma cervix- Renal Failure

    Symptom/sign of PCOD- Hirsutism

    Cause of precocious puberty- Constitutional

    Site of metastasis of choriocarcinoma- Lungs

  29. samuel

    samuel New Member

    Post MBBS Common Paper For:-

    (a) MD Psychiatry

    (b) Dip.Psychiatry

    (c) Phd Clinical Neuro Sciences

    (d) DM Neuro

    (e) Mch Neuro Surgery
  30. samuel

    samuel New Member

    Most Common Facts:-

    Mutation in ovarian cancer- P53

    Malignant tumor of ovary- Serous cysadenocarcinoma

    Cause of Asherman’s syndrome- D&C for PPH

    Cause of DIC in pregnancy- Abruptio Placenta

    Primary Brain Neoplasm in pregnancy- Gliomas
  31. samuel

    samuel New Member

    Most Common Facts:-

    Mutation in ovarian cancer- P53

    Malignant tumor of ovary- Serous cysadenocarcinoma

    Cause of Asherman’s syndrome- D&C for PPH

    Cause of DIC in pregnancy- Abruptio Placenta

    Primary Brain Neoplasm in pregnancy- Gliomas
  32. samuel

    samuel New Member

    Most Common :-

    Cause of 1ST trimester abortion- Chromosomal abnormality

    Cause of mid trimester abortion – Cervical incompetence

    Cause of female pseudohermaphroditism- Congenital adrenal hyperplasia

    Cause of hirsutism- PCOD

    Genital prolapsed- Cystocoele
  33. samuel

    samuel New Member

    Hypothalamus

    Vassopressin-mainly produced in supraoptic nucleus
    Oxytocin-mainly produced in paraventricular nucleus
    neurosecretory cells in medial zone of hypothalamus-production of releasing & release-inhibitory hormones
    hypophyseal portal system-formed on each side from superior hypophyseal artery(branch of internal carotid artery)
    anterior hypothalamic area+preoptic area->parasympathetic response
    posterior & lateral nuclei of hypothalamus-sympathetic response
    anterior portion of hypothalamus-mechanism that dissipate heat loss-dilation of skin blood vessels
    posterior portion of hypothalamus-stimulation-vasoconstriction of skin blood vessels
    sets body temp- 98°F to 98.6°F(orally measured) and 1° higher(rectally measure)
    lateral region-hunger center
    medial region-satiety center
    other areas in lateral region-thirst center
    stimulation of lateral nuclei-symptoms & signs of rage and lesions leads to passivity
    stimulation of ventromedial nucleus-passivity and lesions leads to rage
    lesions of anterior part-seriously interfere with sleep-wake rhythm
  34. samuel

    samuel New Member

    Déjà vu,
    literally "already seen", is the phenomenon of having the strong sensation that an event or experience currently being experienced has been experienced in the past, whether it has actually happened or not.

    JAMAIS VU
    is the phenomenon of experiencing a situation that one recognizes in some fashion, but that nonetheless seems very unfamiliar.
    Jamais vu is most commonly experienced when a person momentarily does not recognise a word, person, or place that he or she already knows,[1] and it is more rarely experienced with people and places.

    Deja Entendu
    The experience of thinking that you have heard something before.
    It is an illusion of having already heard something which in actual fact it is being heard for the first time.
    French : deja, already + entendu, heard

    DEJA PENCE
    a completely new thought sounds familiar to the person and he feels as he has thought the same thing before at some time.
  35. samuel

    samuel New Member

    Peripheral signs of aortic regurgitation are mostly due to the high stroke volume and high pulse pressure. These are features of aortic run off and can occur in other situations of aortic run off like a ruptured sinus of Valsalva into right atrium.

    Arterial pulsations in the retina: Normally there are only venous pulsations visible on the ocular fundus. In aortic regurgitation, retinal arterial pulsations are visible. This is known as Becker’s sign.
    Muller’s sign: Systolic pulsations of the uvula in aortic regurgitation.
    Dancing carotids: Prominent carotid pulsations due to the wide pulse pressure in aortic regurgitation (Corrigan’s sign).
    de- Musset’s sign: Head nodding sign is aortic regurgitation.
    Bisferiens pulse is a more suggestive of free aortic regurgitation than a combination of aortic stenosis and regurgitation. Bisferiens pulse has two peaks in each systole.
    Locomotor brachii is a prominent pulsation of brachial artery seen in aortic regurgitation. It can also be seen in elderly individuals without aortic regurgitation.
    Collapsing pulse or water hammer pulse is noted in the radial artery, with upper limb lifted up passively and felt by the palm of the hand. Water hammer was a toy in the Victorian era in which fall of water in vacuum tube produces a characteristic feel.
    Presence of prominent nail bed capillary pulsations is called Quincke’s sign.
    Durozeiz murmur / sign: A stethoscope kept over the femoral artery picks up a systolic murmur with proximal compression and diastolic murmur with distal compression. The diastolic murmur is specific.
    Pistol shots sounds can be heard over the femoral arteries and sometimes over the brachial arteries (Traube’s sign).

    What are Gerhardt’s sign and Rosenbach’s sign in aortic regurgitation?

    Gerhardt’s sign is hepatic pulsations and Rosenbach’s sign is splenic pulsations in severe aortic regurgitation.
  36. samuel

    samuel New Member

    Spinal muscular atrophy (SMA) is an autosomal recessive disease caused by a genetic defect in the SMN1 gene, which encodes SMN, a protein widely expressed in all eukaryotic cells. SMN1 is apparently selectively necessary for survival of motor neurons, as diminished abundance of the protein results in death of neuronal cells in the anterior horn of the spinal cord and subsequent system-wide muscle wasting (atrophy).

    Spinal muscular atrophy manifests in various degrees of severity, which all have in common general muscle wasting and mobility impairment. Other body systems may be affected as well, particularly in early-onset forms. SMA is the most common genetic cause of infant death.

    The term spinal muscular atrophy is used as both a specific term for the genetic disorder caused by deficient SMN, and a general label for a larger number of rare disorders having in common a genetic cause and slow progression of weakness without sensory impairment caused by disease of motor neurons in the spinal cord and brainstem !
  37. samuel

    samuel New Member

    The symptoms vary greatly depending on the SMA type involved, the stage of the disease, and individual factors; they commonly include:

    Areflexia, particularly in extremities
    Overall muscle weakness, poor muscle tone, limpness or a tendency to flop
    Difficulty achieving developmental milestones, difficulty sitting/standing/walking
    In infants: adopting of a frog-leg position when sitting (hips abducted and knees flexed)
    Loss of strength of the respiratory muscles: weak cough, weak cry (infants), accumulation of secretions in the lungs or throat, respiratory distress
    Bell-shaped torso (caused by using only abdominal muscles for respiration)
    Clenched fists with sweaty hands
    Head often tilted to one side, even when lying down
    Fasciculations (twitching) of the tongue
    Difficulty cramming or swallowing, poor feeding
    Arthrogryposis (multiple congenital contractures)
    Weight lower than normal !!
  38. samuel

    samuel New Member

    1.Strongyloides is the only helminth that can replicate in the
    human host, allowing autoinfection.
    2.The ring forms of b.microti are distinguished from Plasmodium falciparum
    by the absence of central brownish deposit seen in malarial disease.
    3.Artemisinin-containing regimens are now recommended by
    the World Health Organization as first-line agents for Plasmodium falciparum malaria.
  39. samuel

    samuel New Member

    TapeWorm(Cestode) Infection Treatment :-

    Adult Stage (Intestinal Phase)

    -> Diphyllobothrium latum (Fish)
    -> Taenia saginata (Beef)
    -> Taenia solium (Pork)
    ->Dipylidium caninum (Dog)

    DOC - Praziquantel
    Alternative - Niclosamide

    In Cases of H.Nana Infection alternatively Nitazoxanide can also be given
  40. samuel

    samuel New Member

    Larval Stage (Tissue Stage)

    E.granulosus (Hydatid Cyst)

    DOC- Albendazole

    E.Multiocularis

    TOC- Surgical Excision

    T.Solium (Cysticercosis)

    TOC- Anti-Seizure Medications
  41. samuel

    samuel New Member

    Jarjaway Fracture -> Results from blows from front on Nasal Septum . Starts just above the Anterior Nasal Spine & run just above the junction of Septal Cartilage with Vomer.

    Chevallet Fracture -> Fracture of Septal Cartilage results from blows from Below.
  42. samuel

    samuel New Member

    Trotter's Syndrome ::

    Symptoms :: Deafness
    Nasal Twang of Voice
    Facial Pain

    Signs :: Soft Palate Paralysis
    Conductive Deafness
    Facial Neuralgia

    Aetiology :: Local Spread of Nasopharyngeal Tumor

    Diagnostic Aid :: PTA
    X-Ray Nasopharynx & Base of Skull

    Treatment :: Radiotherapy
  43. samuel

    samuel New Member

    - Babinski’s sign- By stroking the lateral aspect of the dorsum of the foot. There is contraction of tibialis anterior, hamstrings, and tensor fascia lata.

    - Baccelli’s sign-Good conduction of whisper in non purulent pleural effusion.

    - Ball’s sign- is seen in fetal death .There will be hyperflexion of the spine.

    - Ballance sign-The dullness can be elicited on both sides in rupture of spleen .On the right side there will be shift of the dullness ,but it is constant on the left side.

    - Ballentyne-Runge sign - Decrease in the abdominal circumference late in pregnancy due to placental insufficiency

    - Banana sign –the frontal lobes will be concave .This is due to neural tube defects

    - Barber’s chair sign in multiple sclerosis. An electric shock like sensation which radiates in to the arms., down the back to the legs, when the patient flexes the head..

    - .Barlow’s sign- Von Rosen’s sign In congenital instability of the hip joint the hips are held flexed and abducted , A click can be heard when the femoral head leaves the acetabulum

    - Bastedo’s sign seen in chronic appendicitis. On inflation of the colon with air ,pain and tenderness will be present in the right iliac fossa.

    - Battle’s sign-blood pigment stain behind the ear over the mastoid due to basal skull fracture (Sphenoid bone )

    - Beak sign - in patients with Hypertrophic pyloric stenosis. ,abrupt cut of the barium column in the pylorus.
    - Beak sign in renal arteriogram-Renal cyst.

    - Becker's sign - Pulsations seen in the retinal artery.

    - Beevor’s sign-in patients with paralysis of lower part of rectus abdominis the umbilicus will move upwards when the rising test is performed. The umbilicus will move downwards in paralysis of upper part of rectus abdominis

    - Beheaded scottish terrior sign- Spondylolisthesis.(In oblique view)

    - Belly dancer’s sign- It is seen in unilateral diaphragmatic paralysis .During inspiration the umbilicus shifts upward and toward the side of the paralysed diaphragm

    - Benda’s sign- This is of importance in tuberculous meningitis. Here the child has spasm of the trapezius muscle with the result that the shoulder on affected side is raised up and at times also brought forward. The sign is elicited by turning the head and chin to one side and if there is upward and forward lifting of the shoulder the sign is positive. It may be positive on one or both sides.

    - Bergara –Warten Berg sign-Loss of vibration on elevation of the closed upper eyelid. It is the earliest sign of facial nerve paralysis.

    -Bergman sign (Chalice sign)-is a finding in renal imaging studies where there is dilatation of ureter distal to a neoplasm. Such dilatation will be absent in calculus or thrombus.

    - Bing sign – Pricking the dorsum of foot by a pin produces extensor response.

    -Blue berry muffin sign- is seen in dermal metastases of Neuroblastoma .There will be raised purple skin lesions.

    - Blue dot sign-is seen in torsion of appendix testis .The appendix that has undergone torsion may be visible through the scrotal skin.

    - Blumberg’s sign – Rebound tenderness. It is seen in acute appendicitis.

    - Boas sign- is helpful in differentiating acute cholecystitis from other conditions. In acute cholecystitis there is a referred pain to the right scapula. There is an area of hyperaesthesia between the ninth and the eleventh ribs posteriorly on the right side..

    - Bow’s sign-Seen in septicemia in infants. The right side of the mediastinal shadow resembles a bow.

    - Bow string sign-is used in lumbar disc herniation. It is a variation of straight leg raising test. When the leg is raised pain will occur. At the point of pain, the knee will be flexed which will reduce the pain.

    - Branham’s sign- (see Nicoladoni’s sign) is seen in aretrio venous fistula .The swelling due to arteriovenous fistula disappears on applying pressure on the artery proximal to the fistula, thrill and bruit will decrease and the pulse rate fall .the pulse pressure will return to normal.

    - Brim sign- is seen in Paget’s disease.
    - Braxton –Hick’s sign-Intermittent uterine contractions can be detected by palpation after 16 weeks of gestation in pregnancy.

    - Brudzinski’s sign is seen in meningitis
    Flexion of one lower limb causes flexion of opposite limb immediately. It is the leg sign.
    Flexion of neck produces flexion of hips and knees. This is the neck sign.
    (Brudzinski’s neck Sign-Both the lower limbs should be in extended position, with full flexion of the neck, the child flexes both his lower limbs, at the hips as well as knees. This is a common sign of meningitis in infancy. There may be minimum flexion of the lower limbs when the child has paraplegia or quadriplegia; there is unilateral flexion of the unaffected limb. This not only helps in the diagnosis of meningitis but also in the diagnosis of hemi paresis.
    Brudzinski’s leg sign- Here one of the lower limbs is flexed to 45º at the hip and 90-120º at knee. While trying to extend the lower limbs there is flexion of the opposite limb at the hip and knee. This is a positive Brudzinski’s leg sign. In children who are constantly moving the lower limbs, particularly in the first 2-3 years of life, the test should be carried out 3 to 4 times before it is concluded as positive. If a child has weakness or paralysis of the opposite limb there may be minimum flexion at the hip and knee.)

    - Brun’s sign- Excruciating headache , vertiginous episodes , coma and death due to sudden movement of the head ,if the cysts are present in the fourth ventricle .

    - Bryant’s sign-in shoulder dislocation .Abnormal position of axillary folds.

    - Bulge sign- Small effusion in the knee joint. Apply gentle pressure first on the medial side of the joint when the patient is lying with the quadriceps relaxed. Watch for the bulge on the lateral side.

    -Button hole sign- is seen in Neurofibromatosis
  44. samuel

    samuel New Member

    - Aaron’s sign seen in appendicitis. On firm pressure over the McBurney’s point the patient with appendicitis will feel distress in the epigastrium or precordial region.

    - Abadie’sign -– This is the test of Muscle sense .Compress or squeeze big muscle bellies (calf,` triceps or biceps)and note whether the patient complains of pain (Abadie’sign ).This is the test of pressure sense too.

    - Adler’s sign- Is seen in Ectopic pregnancy .The abdominal tenderness is fixed ,even when the patient is turned from side to side.

    - Albright sign-Metacarpels are shortened in pseudohypoparathyroidism , nevoid basal cell carcinoma ,turner and Larsen .In the presence of short fourth metacarpal ,there will be a dimple at the metacarpophalangeal joint.

    - Alfred Demusset sign- Bobbing of the head with each heart beat. The rapid blood flow in the carotids will push the head with each beat, thus leading to movement of head up and down with each heart beat.

    - Allis sign- is seen in developmental dysplasia.

    - Arm drop sign- sign suggestive of complete tear of the rotator cuff.

    - Antenna sign- seen in Keratosis pilaris

    - Anterior drawer sign-(Bon bruise sign) for anterior cruciate ligament tear. It is used to diagnose rupture of the cruciate ligaments .The knee should be flexed at a right angle and the upper part of the tibia is pulled forward and pushed backward. Increased anterior and posterior movements will indicate the rupture of cruciate ligaments.

    - Asboe Hansen sign- (Bulla spread sign) – seen in Pemphigus

    - Auenbrugger’s sign-In pericardial effusion ,an epigastric prominence is seen.

    - Auspitz’s sign-When the scales of Psoriasis are removed ,pin point bleeding spots will be seen .
  45. samuel

    samuel New Member

    - Emptying sign in straw berry angioma

    - Erb’s sign-seen in latent tetany. Muscular contractions can be produced by application of subthreshold electrical stimulation.

    - Eye-of-the –tiger appearance- is a MRI finding in Hallevorden-Spatz disease

    - Ewart’s sign- (Pin’s sign) Is seen in compression collapse of the basal segments due to large pericardial effusion.. There will be dullness on percussion, increased vocal resonance, tubular breath sounds., increased vocal resonance. and bronchial breathing are seen in cardiac tamponade due to pericardial effusion.

    - Ewing sign- pericardial sign
  46. samuel

    samuel New Member

    Inversion of the Foot :-

    Tibialis Anterior
    Tibialis Posterior
    Helped by Flexor - Hallucis longus & Flexor digitorum longus

    Eversion of the Foot :-

    Peroneus Longus
    Peroneus Brevis
    Helped by Peroneus tertius
  47. samuel

    samuel New Member

    Polyamines are Aliphatic Amines

    Key Enzyme of Polyamine synthesis is Ornithine decarboxylase.

    Eg:- Spermine
    Spermidine
    Putrescine

    Reynold's-Brude Phenomenon is seen in Candida albicans Infection.

    Other Diagnostic Tests are :-

    Wet Films or gram Stain

    Culture on Sabouraud's Media
  48. samuel

    samuel New Member

    Q) The DCCT (Diabetes Complication & Control Trial)
    provided definitive Proof that Reduction in Chronic Hyperglycemia helps to Improve :-

    MicroVascular Complications of Type1 DM

    Heliotrope Rash / Gottron Rash ->DM

    pERIFASCICULAR ; pERIMYSIAL ; pERIVASCULAR iNFILTRATES -> DM
  49. samuel

    samuel New Member

    Drugs that cause True Myalgia :

    Cimetidine
    Cocaine
    Cyclosporine
    Danazol
    Emetine
    Gold
    Heroin
    Labetalol
    Methadone
    d-Penicillamine
    Statins & Cholesterol lowering Agents
    l-Tryptophan
    Zidovudine

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