Sunday, 25 February 2018
Saturday, 24 February 2018
Friday, 23 February 2018
TB Spine
• MC site of spinal TB in children =Upper thoracic spine
• MC site of spinal TB in adults = Lower thoracic and Upper lumbar vertebrae [Lower thoracic > Upper lumbar]
• Earliest sign of Spinal cord compression by TB Spine in thoracic region = Extensor plantar (Stage I) > Sensory loss (Stage II)
Paraneoplastic syndromes
● Occur in 10% of persons with cancer.
● They may be the earliest manifestation of an occult neoplasm.
● They may mimic metastatic disease and therefore confound treatment.
● Classification wise MC PNS =Endocrinopathies
● MC Endocrinopathy in cancers =Cushing syndrome.
● 50% of pts with Paraneoplastic Cushing syndrome have carcinoma of the lung, chiefly the small-cell type.
● It is caused by ↑↑ production of corticotropin or corticotropin-like peptides.
● Here Precursor of corticotropin is = Pro-opiomelanocortin.
● Lung cancer pts with Cushing syndrome have elevated serum levels of both pro-opiomelanocortin and corticotropin.
● ↑pro-opiomelanocortin is not found in serum of ptss with excess corticotropin produced by the pituitary = point of difference.
● MC PNS = Hypercalcemia
● Symptomatic hypercalcemia is
more commonly related to some form of cancer > hyperparathyroidism.
● Cancer Osteolysis in multiple myeloma = Not a PNS.
● Production of calcemic humoral substances by extraosseous neoplasms = Only mechanism considered PNS
● Hypercalcemia d/t 1° or 2° involvement of the skeleton by tumor =not a PNS.
● Most imp. factor for hypercalcemia of malignancy = PTHRP.
● Normal tissues which can produce PTHRP = keratinocytes, muscles, bone, and ovary.
● Function of PTHRP = regulates Calcium transport in the lactating breast and across the placenta,modulates pulmonary development and remodeling.
● MC Tumor asso. with paraneoplastic hypercalcemia = Ca Breast, f/b lung, kidney, and ovary.
● MC lung Cancer asso. with hypercalcemia = Squamous Cell Ca.
● In addition to PTHRP, other factors, such as IL-1, TGF-α, TNF, and dihydroxyvitamin D also implicated in the hypercalcemia of malignancy.
● Hypertrophic osteoarthropathy is seen in = 1% to 10% of Lung Ca.
● Migratory thrombophlebitis (Trousseau syndrome) MC seen in = deep-seated cancers Ca. Pancreas > Lung.
● DIC MC asso. with = Acute Promyelocytic Leukemia > prostatic adenocarcinoma.
Wilm's tumour: Oneliners(Very high yield)
Wilm's Tumor : Oneliners
1. MC malignant tumor of children less than 5 years = Wilm's Tumor.
2. MC malignant tumor of kidney in children = Wilm's Tumor (6-7% of all childhood malign.)
3. U/L >> B/L.
But B/L Wilm's more comminly seen in = Familial Wilm's.
4. Origin of Wilm's = Nephrogenic cell rests.
5. MC manifestation of Wilm's Tumor = Asymptomatic Abdominal Mass (80% cases at presentation) >> Abdominal pain(30%) or Hematuria (10-25%)
6. Acquired von Willebrand disease seen at the time of diagnosis of Wilm's tumor = in 5-10% cases.
7. Clotting factor deficiency seen =Factor VII
8. First/most important investigation = Renal USG.
9. Investigation to know tumor extension or pulmonary mets = CT scan.
10. B/L renal involvement at the time of diagnosis = Stage V wilm's.
11. Most sensitive imaging modality for IVC invasion= MRI
12. Best characterized WT gene = WT1
13. Syndrome asso. with Wilm's showing
WT2 mutation = Beckwith Wiedemann Syndrome.
[Mnemonic : Note it has Two W's => Hence WT2.] [Rest all are WT1 mutation associated]
14. Organomegaly + Macroglossia + Omphalocele + Hemihypertrophy in presence of Wilm's = Beckwith Wiedemann Syndrome.
[Mn : He is a Wide Man with everything large and umbilicus wide open.]
15. Most Important prognostic factors of Wilm's = Histology (presence of anaplasia is a bad marker) > Stage and histology > loss of heterozygosity at 1p and/or 16q.
16. Mental Retardation is a feature in which syndrome asso. with Wilm's = WAGR syndrome.
17. Rx is based on = staging & histology.
Cure rate with modern Rx = 85-90%.
18. Abdominal radiation is used in which stage Wilm's = stage lll.
Stage l & ll Rx = Surgery followed by chemotherapy with Vincristine, Actinomycin D, Adriamycin.
EEG's for NEET
EEG patterns
★ Anoxic Brain damage = Burst supression pattern (high voltage, slow sharp spiking bursts alternating with suppressed background)
★ SSPE = Rademecker complex (similar kind of discharge but occuring every 4-6 seconds)
★ Creutzfeldt dis = Most specific are periodic Sharp Waves
★ Absence seizure = 3 Hz spike & slow wave
★ Lennox Gestaut = 2 Hz spike wave
★ Focal loss of activity/flattening= Subdural hematoma or effusion
M.C site for skin diseases
1)Morphea = Forehead
2)Richls melanosis = Face & neck
3)Fordyce disease = Lips
4)Peutz jeghar syndrome (pigmentation) = Lips & oral mucosa
5)Acne, Impetigo & Herpes simplex = Face
6)Herpes Zoster = Thorax
7)Herpes gestationalis = Periumbilical region
8)Shagreen patch = Lumbosacral
9)Mongolian spots = Sacral > Gluteal & lumbar
10)Necrobiosis lipoidica diabeticorum = Front of legs
11)Atopic dermatitis = Antecubital & popliteal fossa
Types of cartilage and distribution
Hyaline cartilage:
- MC type of cartilage
- Foetal cartilage
- Growth plate
- Articular cartilage
- Resp. tract (with few exceptions)
- Costal cartilage
Elastic cartilage:
- Rare
- External ear
- Eustachian tube
- Epigottis
- Tip of nose
- Tip of arytenoid
- Corniculate
- Cuneiform
Fibrocartilage: (remember ortho stuff)
- Found near bone / joint
- IV Disc
- Articular disc
- Knee meniscus
- Glenoid/ acetabular labrum
- Tendon insertions
Among elastic and hyaline, memorise any one set to avoid confusion.
Radiation in pregnancy
*Maximum permissible dose of radiation in pregnancy is 0.5 rads (not 5 rads).
*The risk is greatest at = 8–15 weeks.
*Larger doses will be required at = 16–25 weeks to cause an equivalent proportion of cases of mental retardation.
*Current evidence suggests that there is no increased risk of malformations, growth restriction, or abortion from a radiation dose of = 0.5 rads or less.
*MRI uses nonionizing radiation and is very safe.
*MC fetal indication for MRI is suspected brain anomaly.
Wednesday, 21 February 2018
Bile salts
Simple topic where lots of questions are twisted and asked.
Never get confused between primary and secondary bile salts and bile acids.
MARS: Very high yield IBQ for AIIMS/JIPMER
Treatment in the intensive care unit of patients with end-stage liver disease has been limited. Liver transplantation has been a major improvement in this and has become standard in the management of these patients. However, many patients die awaiting liver transplantation, mainly due to the scarcity of organ donors. Conventional hemodialysis techniques have little or no effect on liver detoxification and do not improve the prognosis of these patients. In patients with acute hepatic failure, the majority of endogenous toxins leading to organ failure and accumulating in the blood are bound to albumin; therefore, the concept of albumin dialysis is of major interest.
To date, the most widely developed system has been the Molecular Adsorbent
Recirculating System (MARS), which is based on the selective removal of albumin-bound toxins from the blood.
MARS enables simultaneous liver and kidney detoxification, improving the patient's clinical condition. It is a major improvement in the management of patients with hepatic failure that could permit, when appropriately indicated, recovery from an acute episode and enhance the chances of survival while waiting for an available organ donor.
MARS is a liver support system that uses an albumin-enriched dialysate to facilitate the removal of albumin-bound toxins. The system has three different fluid compartments: a blood circuit, a circuit containing 600 ml of 20% human albumin with a charcoal column and an anion exchange resin column and a dialysate circuit.
MARS requires a standard dialysis machine or a continuous veno-venous hemodiafiltration device (CCVVHD) to control the blood and dialysate circuits.
Sunday, 18 February 2018
VENFLON COLORS AND SIZES = AIIMS QUESTION(MUST KNOW)
MNEMONICS: OG GP BY V
Obs GYn >Gen Practitioner BY Vidhya
This is the order
Orange graY green pink blue yellow violet
14>16>18>20>22>24>26
As we all know commonly used green is 18, so no confusion with other G ie Gray
Extra edge =White is 17(expected question)
