Monthly Archives: December 2010

Guillain Barre syndrome and variants

Guillain Barre Syndrome Ascending Areflexic paralysis Minimal or no sensory loss Preceded by infection with Campylobacter Jejuni(MC),CMV,Mycoplasma Autoantibodies against gangliosides usually anti GM1. IVIg is the treatment of choice,plasmapheresis also done. GBS variants AIDP Seen in adults Demyelinating disorder Anti …

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Mosquitoes and their eggs

Anopheles Eggs- In flowing water,with lateral floats ,laid singly. Culex eggs- Raft shaped,in groups Aedes- Cigar shaped,in groups Mansoni -Star shaped,beneath around water plants. Anopheles larvae- Free living lie parallel to surface. Adult anopheles sits at an angle to the …

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Trinucleotide repeats in diseases

GAA– Friederichs AtAxia CAG- Spino Cerebellar Ataxia CAG- Kennedy’s disease(tip:Cennedy’s disease) CAG- Huntingtons disease(Chorea) CAG- DRPLA CTG- Myotonic dystrophy CGG- Fragile X syndrome

Corticosteroids

Zona Glomerulosa-Mineralocorticoids Zona Fasciculata-Glucocorticoids Zona Reticularis-Sex corticoids GFR from outside to inside. Points to remember Maximum glucocorticoid activity- Dexamethasone Maximum mineralocorticoid activity- Aldosterone Glucocorticoid with maximum mineralocorticoid action-Hydrocortisone Least potent Glucocorticoid- Cortisone Most potent Glucocorticoid- Betamethasone Selective mineralocorticoid action(zero glucocorticoid …

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Hyponatremia

Osmolality All conditions causing hyponatremia are hypo osmolar except Pseudohyponatremia hyperlipidemia hypoproteinemia Hyperglycemia ECF volume Normal in SIADH,Adrenal insufficiency,Hypothyroidism Increased in Secondary hyperaldosteronism,CHF,Nephrotic syndrome,Cirrhosis Urine Sodium>20mmol/L Hypoaldosteronism,saltwasting nephropathy,recent diuretics SIADH Primary watergain followed by secondary Sodium gain Urine Osmolarity higher …

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Renal Tubular acidosis

Type I RTA DCT- H+ secretion Low Urine pH cannot be reduced<5.5 even by NH4Cl Type II RTA PCT –  HCO3 reabsorption Low Fanconis syndrome-Swan neck PCT Type III RTA Autosomal recessive Carbonic Anhydrase defect Type IV RTA DCT- H+/K+ …

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Causes of Reversible Dementia

Wernickes Encephalopathy Hypothyroidism Cushings syndrome Organ failure Neurosyphilis Whipples disease Chronic Subdural hematoma Normal pressure hydrocephalus Drugs,medications,Narcotics Depression(pseudo dementia) Schizophrenia Vasculitis Acute intermittent porphyria Recurrent non convulsive seizures