Category Archives: Medicine

Bronchial asthma triggers, treatment and precautions.

Posted by admin on May 3, 2012 No comments

Bronchial asthma which is often referred to as Asthma is caused by irritation of the airways. When irritation of the airways occur, the airways contract and hence the width of the respiratory passages decrease and they get filled with secretions …

Why does nocturia occur in heartfailure?

Posted by admin on March 13, 2012 No comments

While taking case history in a cardiac failure patient, one of the most important points to be enquired is whether there is a history of nocturia in the patient. What is nocturia? The tendency of the patient to urinate excessively …

What is syphilis?

Posted by admin on March 11, 2012 No comments

Syphilis is a sexually transmitted disease(STD) affecting the genital organs.Syphilis is transmitted by a spirochete bacterium named Treponema pallidum.It is most often transmitted by sexual contact, but it can also be transmitted from mother to fetus by placental route.When transmission …

Types of human herpes viruses and associated diseases.

Posted by admin on January 24, 2012 No comments

Human herpes viruses are 8 in number, they are associated with a number of diseases like fifth diseases, sixth disease,herpes zoster etc.

Different types of pelvis and associated conditions

Posted by admin on December 4, 2011 No comments

Types of pelvis and associated disease conditions.

Findings in congenital,primary, secondary and tertiary syphilis

Posted by admin on November 24, 2011 No comments

Congenital syphilis First sign – Rhinitis/Snuffles Primary bullous lesions Primary syphilis Painless punched out non bleeding indurated ulcer Painless rubbery lymphadenopathy Secondary syphilis Bilaterally symmetrical asymptomatic skin rash on palms and soles-MC finding Moth eaten alopecia Condyloma lata Arthritis and …

Prerequisite for drugs to be eliminated by dialysis

Posted by admin on October 17, 2011 No comments

Drugs eliminated by dialysis have the following features Low molecular mass<500da High water solubility Low plasma protein binding Small volume of distribution Long half life High dialysis clearance relative to total body clearance Drugs which can be cleared by dialysis …

Arterial pulse abnormalities

Posted by admin on July 20, 2011 No comments

Pulsus Paradoxus Pulse volume decreases during inspiration and becomes normal in expiration. First described in costrictive pericarditis, but it is usually rare in this condition. Typical of Pericardial tamponade. Severe airway obstruction. SVC obstruction. Pulsus Alternans Alternating small and large …

Framingham Criteria for diagnosis of heart failure

Posted by admin on July 20, 2011 No comments

Major Criteria Paroxysmal Nocturnal Dyspnoea Jugular Venous distension Rales Cardiomegaly Acute pulmonary edema S3 Gallop Positive hepatojugular reflex Rise in venous pressure>16cm H2O Minor criteria Lower limb edema Cough at night Dyspnoea on exertion Pleural effusion Decrease in Vital capacity …

Causes of Micovesicular and macrovesicular fatty liver

Posted by admin on June 24, 2011 No comments

Microvesicular hepatic steatosis Reyes syndrome Acute fatty liver of pregnancy Jamaican vomiting sickness Phosphorous,petrochemicals Drugs Sodium valproate Tetracycline Nucleoside analogues Macrovesicular hepatic steatosis Alcohol Insulin resistance Non alcoholic steato hepatitis(NASH) Total parenteral nutrition Intestinal bypass surgeries Inflammatory bowel disease Starvation …

Basal ganglia and their classification

Posted by admin on June 23, 2011 No comments

The basal ganglia is an important part of the brain which program impulses from cerebral cortex and initiates motor activities through cerebellum and corticospinal tracts. Parkinsonism is a disorder in which there is decrease in the dopaminergic neurons in the …

Lateral medullary syndrome

Posted by admin on June 21, 2011 No comments

Also known as Wallenberg syndrome. Vertebral artery is the most commonly involved artery (V4 segment) or Posterior Inferior cerebellar artery(PICA) Right sided lateral medullary lesion Loss of pain and temperature in right side of face and left side of body. …

Features of Petit mal seizures

Posted by admin on June 21, 2011 No comments

The word Petit mal conveys the meaning: Petit means Petty/small and Mal means an mproper order, unpleasant etc. So Petit mal should be a Small out of order situation(lasting less than 15 seconds typically) Petit mal seizures are also called …

Midbrain and pontine syndromes

Posted by admin on June 19, 2011 No comments

Midbrain Syndromes Weber’s syndrome Ipsilateral 3rd Nerve palsy with contralateral hemiplegia Nothnagels Syndrome Due to superior cerebellar peduncle injury. Ipsilateral 3rd nerve palsy with Contralateral cerebellar ataxia Benedicts Syndrome Due to involvement of red nucleus Ipsilateral 3rd nerve palsy with …

Juvenile Rheumatoid Arthritis

Posted by admin on June 13, 2011 No comments

Juvenile Rheumatoid Arthritis is a frequently repeated question in AIPGME. The features essential for diagnosis of JRA are: Athritis Non migratory Mono/Polyarticular Tendency to involve large joints or proximal interphalangeal joints Lasting more than 3 months Systemic features Fever Erythematous …

Heart murmurs and their physiologic responses to stress

Posted by admin on May 25, 2011 No comments

Heart murmurs vary in quality and duration with specific physiological influences.Knowing these changes can help us differentiate between specific murmurs. Respiration Inspiration Right sided heart murmurs become loud with inspiration Systolic sounds – TR/PS Diastolic sounds – TS/PR Right sided …

Drug induced lupus, drugs causing it.

Posted by admin on May 25, 2011 No comments

Features of drug induced lupus are: ANA positive,Anti Histone antibody positive. Caucasians are more affected. Less female predilection compared to SLE. Rarely involves kidney or brain. Rarely associated with anti ds DNA positivity. ANA will be positive even before the …

Bacterial diarrhea: Invasive vs Non Invasive diarrhea.

Posted by admin on May 19, 2011 No comments

Bacterial diarrhea’s can be classified into invasive and non invasive, this classification has an important role in determining treatment modalities. Non Invasive Diarrhea Caused by release of toxins from bacteria resulting in disruption of secretory process. Characterized by watery diarrhea. …

Hemophilia A vs Von Willebrand Factor deficiency.

Posted by admin on March 31, 2011 No comments

Hemophilia A Inherited as X linked recessiv(more common in boys). Factor VIIIc decreased. Clotting disorder. Ristocetin Cofactor level is normal. Hemarthoris ++. Bleeding time is normal. APTT is prolonged. PT is normal. Platelet aggregation in response to Ristocetin is normal. …

Gait disturbances with their causes.

Posted by admin on March 30, 2011 No comments

Festinant gait – Parkinsonism Reeling/ Ataxic gait – Cerebellar vermis involvement. Stamping/Tabetic gait – Sensory ataxia. Steppage/ Equine gait – Foot drop. Waddling gait/ Trendelenberg gait – Gluteal muscle weakness. Toppling gait – Vestibular neuronitis, Brainstem strokes. Apraxic gait, paratonia(Gegenhalten), …

Clinical features of Infective endocarditis

Posted by admin on March 30, 2011 No comments

Clinical features of Infective endocarditis is one of the favorite questions of examiners. Given below is the clinical features of IE and short explanations. Oslers nodes- tender nodules in pulp of fingers and sole. Janeway lesions – Non tender erythematous …

Named heart murmurs and their causes

Posted by admin on March 30, 2011 No comments

Carey Coombs murmur- Mid diastolic murmur, in rheumatic fever Austin Flint murmur- mid- late diastolic murmur,in Aortic Regurgitation. Graham- Steel murmur- high pitched, diastolic, in pulmonary regurgitation. Rytands murmur – mid diastolic atypical murmur, in Complete heart block. Docks murmur-diastolic …

Causes of Peripheral eosinophilia

Posted by admin on February 22, 2011 No comments

Connective tissue diseases (SLE, DM, Sjogren’s) Helminths (All worms, parasites, Giardia) Idiopathic hypereosinophilic syndrome Neoplasms Allergies, Asthma Mnemonic:CHINA

Guillain Barre syndrome and variants

Posted by admin on December 21, 2010 No comments

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 …

Trinucleotide repeats in diseases

Posted by admin on December 21, 2010 No comments

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

Hyponatremia

Posted by admin on December 20, 2010 No comments

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 …

Renal Tubular acidosis

Posted by admin on December 20, 2010 No comments

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+ …

Causes of Reversible Dementia

Posted by admin on December 20, 2010 2 comments

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

Channelopathies

Posted by admin on December 20, 2010 No comments

Sodium Channel Hyperkalemic Periodic paralysis Paramyotonia congenita Congenital Long QT syndrome Brugada syndrome Myoclonic epilepsy Pottassium Channel Jervell Lange Nielsen Syndrome Acquired neuromyotonia- Isaac’s syndrome Episodic Ataxia 1 Andersens syndrome Calcium Channel Hypokalemic Periodic Paralysis Malignant Hyperthermia ARDVC Familial Hemiplegic …

Involuntary movements and their Loci

Posted by admin on December 20, 2010 No comments

Chorea – Cuadate nucleus Tremor -Red nucleus,Substantia Nigra Dystonia- Putamen Athetosis- Putamen Hemiballsimus- Subthalamic nuclei Huntingtons disease- Poor prognosis,Striatal atrophy.

Transudative vs exudative pleural effusions

Posted by admin on December 20, 2010 No comments

Transudate Pleural effusions Usually due to non infectious etiology. CHF Cirrhosis Pulmonary embolism Nephrotic syndrome Peritoneal dialysis Urinothorax SVC obstruction Myxoedema Transudative effusions Mostly due to infectious etiology Neoplasms Infections Pulmonary embolism Collagen vascular diseases Occupational exposure Uremia Meigs syndrome …

Acid Base balance calculation

Posted by admin on December 20, 2010 No comments

pH:7.4+-.03 pCO2:40+-5mmHg HCO3-:24+-4 3 STEPS 1.Find the primary defect Metabolic Acidosis- Decreased HCO3- Metabolic Alkalosis- Increased HCO3- Respiratory Acidosis- Increased PCO2 Respiratory Alkalosis-Increased PCO2 2.Find the Compensation Metabolic acidosis(Dec HCO3-)- For every 1meq fall in HCO3-,PCO2 falls by 1mmHg Metabolic …

Respiratory failure types

Posted by admin on December 20, 2010 No comments

Type I Respiratory failure Arterial Hypoxia Due to oxygenation failure PO2- Low ,PCO2- Normal or Low PAO2-PaO2 gradient- Increased eg:ARDS,Pulmonary HTN,ILD,Pneumonia,Pulmonary Edema. Type II respiratory failure Arterial Hypercapnia Due to Ventilatory failure PO2-Low, PCO2-High PAO2-PaO2 gradient-Unchanged Eg:Myasthenia,GBS,MS,ALS,IC bleed,Polio,Narcotic overdose Type …

Brain abscess

Posted by admin on November 20, 2010 No comments

Most comon site of brain abscess: Otogenic abscess :Temporal lobe and cerebellum Cardiogenic/Peripheral septic emboli: Frontal and parietal>Temporal lobe,mostly supratentorial, MCA territory.

ECG Changes

Posted by admin on November 20, 2010 No comments

Hypokalemia ST depression Flattened/Inverted T wave Prominent U wave Prolonged PR interval SA block(rarely) Hyperkalemia Early:Increased T wave amplitude/peaked T wave Late(with severe hyperkalemia) Prolonged PR interval Prolonged QRS duration AV conduction delay Loss of P waves Sine wave pattern …

Electrolyte imbalances

Posted by admin on November 19, 2010 No comments

Massive transfusion Hyperkalemia Hypocalcemia Hypomagnesemia Acidosis initially Metabolic alkalosis

CHADS2 Score for Atrial Fibrillation Stroke Risk

Posted by admin on November 19, 2010 No comments

Congestive Heart Failure history? Yes +1 Hypertension history? Yes +1 Age ≥ 75? Yes +1 Diabetes Mellitus history? Yes +1 Stroke symptoms previously or TIA? Yes +2 If there is h/o stroke high risk group.

Glasgow coma scale

Posted by admin on November 19, 2010 No comments

Glasgow Coma Scale(GCS) is used all over the world to determine the prognosis following head trauma. GCS score has three components,Eye Opening, Motor response, Verbal response.A GCS score below 7 carries poor prognosis and GCS score above 9 has good …

Drugs removed by forced alkaline diuresis

Posted by admin on October 18, 2010 No comments

Forced alkaline diuresis is done with bicarbonate,urea,furesamide,mannitol Weak acids are removed by Forced alkaline diuresis and weak alkali removed by forced acid diuresis Alkaline diuresis Salicylates Long acting barbiturates Chlorpropamide Methotrexate Acid Diuresis Amphetamines Quinine

Cardiac conduction and anomalies

Posted by admin on October 12, 2010 No comments

Resting membrane potential is -80 to -100mv Phases of cardiac muscle contraction Phase 0- Na+ Influx Phase I- Initial rapid depolarization Transient K+efflux Phase II- Plateau phase Calcium efflux Phase III and IV- K+ efflux, delayed and inward rectifying K+ …

Medical PG entrance preparation,study tips,mnemonics

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