Friday, 29 November 2013

Exam points

24 hour urine protein
<0.03g. Normal
0.03 -0.3 g microalbuminuria
0.3-0.5 g dipstick positive
>2.5 g. Likely glomerular disease
> 4 g. Nephrotic range ( glomerular always)

Aconite also called mitha bish
Tree bark appearance in vessel wall seen in syphilis

Serosa is absent thru out esophagus except intra abdominal part

Blood vessels & lymphatic a travel thru sub mucosa

Toughest layer of oesophagus is. Mucosa

histadine decreases in pregnancy

paneth cells contain zinc

main estrogen after menopause...oestrone
main estrogen during reproductive year is oestradiol
main estrogen in prgnancy is oestriol

Gaenslens test – Sciatica
Mc Murrays test – Menisci

Bracket sign - lipoma of corpus callosum

Jail bar app - hemangioma spine

Rugger jersey spine - renal osteodystrophy

Triangular cord sign - biliary atresia

Antral sign - nasopharyngeal angiofibroma

Sandstorm app - alveolar microlithiasis

Biological oxygen demand >300 mg/L sewage is strong

BOD <300 mg/L sewage is weak

India - diabetic capital of world

Hyderabad. - diabetic capital of india

0-20. Idiot
20-50 imbecile
50- 75 moron

Addison's disease, sometimes called bronze skin disease - progressive destruction of the adrenal glands with the result being deficiency of secretion of adrenocortical hormones. Addison described this condition in his 1855 publication: On the Constitutional and Local Effects of Disease of the Suprarenal Capsules.
Addisonian crisis (or Addison's crisis) - an acute, life-threatening crisis caused by Addison's disease.
Addisonism - a set of symptoms resembling Addison's disease but not due to Addison's disease, that is, not due to any disease of the adrenal glands.
Addisonian anemia or Addison-Biermer disease - now synonymous with pernicious anemia which involves Vitamin B12 deficiency. Described first in 1849.
Addison-Schilder syndrome is a metabolic disorder combining the characteristics of Addison’s disease (bronze skin disease) and cerebral sclerosis Also known as Adrenoleukodystrophy.
Addison gave one of the first adequate accounts of appendicitis and wrote a valuable study of the actions of poisons. He also made seminal contributions to the recognition and understanding of many other diseases, including;
Alibert's disease I - a skin disease characterized by pinkish patches, bordered by a purplish halo
Allgrove's syndrome - a congenital defect in lacrimation
Rayer's disease - a disorder characterized by depigmented patches of skin, jaundice, and enlargement of the liver and spleen
AZZOPARDI EFFECT(=basophilic staining of vessel wall) is a/w----SMALL CELL CA LUNG
metabolism in tumor cell is by -------aerobic glycolysis ( WARBURG EFFECT)

Thursday, 28 November 2013

Pharma Drugs

Exenatide: For the adjunctive treatment of Type 2 diabetes mellitus
Mecasermin: For the treatment of growth failure due to Primary IGFD
Pramlintide: For the treatment of type I and type II diabetes
Tipranavir: For the adjunctive treatment of HIV-1 infections
Entecavir: For the treatment of chronic hepatitis B infections with evidence of active viral replication
Ibandronate: For the treatment and prevention of osteoporosis
Galsulfase: For the treatment of mucopolysaccharidosis VI (Maroteaux-Lamy syndrome)
Ramelteon: For the treatment of sleep-onset insomnia
Natalizumab: For the treatment of relapsing forms of multiple sclerosis
Nelarabine: For the treatment of T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma
Bevacizumab: For the treatment of metastatic carcinoma of the colon or rectum
Cetuximab: For the treatment of EGFR-expressing, metastatic colorectal cancer
Azacitidine: For the treatment of several myelodysplastic syndrome subtypes including refractory and chronic myelomonocytic leukemias
Telithromycin: For the treatment of infections caused by bronchitis, bacterial sinusitis and Community-acquired pneumonia
Rifaximin: For the treatment of Travelers' diarrhea caused by noninvasive strains of Escherichia coli
Fosrenol, lanthanum carbonate; For the treatment of hyperphosphatemia related to kidney dysfunction
Trospium chloride: For the treatment of overactive bladder with symptoms of urge urinary incontinence
Cinacalcet: For the treatment of secondary hyperparathyroidism and hypercalcemia in parathyroid carcinoma patients
Solifenacin succinate: For the treatment of overactive bladder with symptoms of urge urinary incontinence
Eszopiclone: For the treatment of insomnia and sleep maintenance
Natalizumab: For the treatment of relapsing forms of multiple sclerosis (currently suspended in US)
clofarabine: For the treatment of acute lymphoblastic leukemia in pediatric patients
Erlotinib, OSI 774: For the treatment of advanced refractory metastatic non-small cell lung cancer
Pegaptanib: For the treatment of wet age-related macular degeneration
Zemaira (alpha1-proteinase inhibitor: For the treatment of alpha1-proteinase inhibitor deficiency (Alpha-1) and emphysema
Enfuvirtide: For the treatment of HIV-1 infection in combination with other antiretroviral agents
Fosamprenavir calcium: For the treatment of HIV infection in adults in combination with other antiretroviral agents
Atazanavir sulfate: For the treatment of HIV-1 infection in combination with other antiretroviral agents
Laronidase: For the treatment of Mucopolysaccharidosis I (MPS I) in subjects aged 5 to 65
Ibandronate: For the treatment and prevention of osteoporosis
Pegvisomant: Injectable formulation for the treatment of acromegaly
Bortezomib: Injectable agent for the treatment of multiple myeloma patients who have received at least two prior therapies
Agalsidase beta: For the treatment of Fabry disease in adult patients
Tadalafil: Oral agent for the treatment for erectile dysfunction
Memantine: For the treatment of moderate to severe dementia of the Alzheimer’s type
Palonosetron: For the prevention of nausea and vomiting associated with emetogenic cancer chemotherapy
Aprepitant: For the treatment of nausea and vomiting associated with chemotherapy
Gefitinib: For the second-line treatment of non-small-cell lung cancer
Bortezomib: Injectable agent for the treatment of multiple myeloma patients who have received at least two prior therapies.
Gefitinib: For the second-line treatment of non-small-cell lung cancer

Wednesday, 27 November 2013


I.Medical Causes of abnormal urine odour A.Sweet or fruity odour
1.Diabetic Ketoacidosis
2.Maple syrup urine disease (infants, rare)

B.Ammonia odour
1.Bladder retention
2.Urine at room temperature for prolonged period

C.Fecal odour
1.Bladder-Intestinal fistula

D.Pungent odour 1.Urinary Tract Infection

E.Strong odour 1.Concentrated urine

F.Musty odour 1.Phenylketonuria

G.Sulfur odour 1.Cystine decomposition



Popcorn - hamartoma
Rice grain - Neuricysticercosis
Supra sellar - craniopharyngioma
Basal gangli - hyperparathyroid
Idiopathic Basal Ganglia cal-Fahr syndroe
Cardiac- carcinoid
Medial menical cartilage - pseudogout
Diffuse nodular -toxoplasmosis
Periventricular -CMV
Tram track-Struge-weber
Bracket shaped-agenesis of corpos callosum
Pericadial -pericarditis

One liners

1. Best research evidence is given by : Meta-analysis
2. Warfarin action potentiated (PT prolonged) by all except: Omeprazole/clofibrate/aspirin/barbiturates, Ans is Barbiturates
3. Half life of insulin is: <5 min
4. Toxin acting by G protein: Cholera
5. Which is a G protein coupled receptor: AMPA/Kainate/Metabotropic/NMDA: Ans Metabotropic
6. Inotropic action of catecholamines is mediated by : Beta 1 receptors
7. Intermediate paralysis by organophosphates treatment: symptomatic
8. Local anaesthetic act on: Na channels from inside the cells
9. Anakinra MOA: IL-1 receptor antagonist
10. Strongest vasoconstrictor is: Ang II/Bradykinin/Endothelin: Ans Ang II
11. Antihypertensive of choice in systemic sclerosis: ACE inhibitors
12. Non enzymatic spontaneous degradation is seen with: Atracurium
13. Anaesthetic causing max green house effect and global warming: Halothane/enflurane/desflurane/isoflurane: Ans Desflurane
14. Tocolytic beta agonist: Ritodrine
15. Not useful for acute attack of asthma: salbutamol/salmeterol/terbutaline/orciprenaline: Ans salmeterol
16. Which is not useful in hypercalcemia: Erythromycin/gallium/bisphosphonates: Erythromycin
17. Treatment of uveitis with raised IOT: Pilocarpine/timolol/steroids/atropine: Ans steroids
18. Treatment of choice for type 1 tyrosinemia: Nitisinone
19. True about methysergide are All except: ergot alkaloid/used in migraine/5HT2 antagonist/5HT3 antagonist: Ans 5HT3 antagonist
20. Drug used in acute attack of migraine: Sumatriptan
21. Which is osmotic diuretic: Glycerol
22. Beta blockers used in CHF are all except: Metoprolol/carvedilol/bisoprolol/atenolol: Ans: Atenolol
23. Antiepileptic not acting through GABA: CBZ/valproate/phenobarbitone/diazepam: Ans: CBZ
24. Antipsychotic useful in unipolar depression: Aripiprazole/quetiapine/risperidone/sertindole
25. Major disadvantage of ketamine is: apnoea/hypotension/hallucination and CNS problems/unconsciousness: Hallucination and CNS problems
26. NSAID cause peptic ulcer by: Decreasing PG and thus decreasing mucus and HCO3
27. Not a first line drug in ALL: Vinblastine/vincristine/methotrexate/6-mercaptopurine: Ans vinblastine
28. Non heme iron is absorbed less with food because: Food contains phytates and oxalates
29. Congential malformations caused if used in first trimester: cloxacillin/steroids/heparin: Ans steroids
30. Which is incretin mimetic: Exenatide
31. PPI not given i.v.: Omeprazole/esomeprazole/lanso/panto: Ans omeprazole
32. Pt taking clindamycin develops pseudomemb colitis likely organism: Cl. Difficile\
33. Primaquine induced hemolytic anemia occurs in patients with deficiency of : Glucose-6-phosphate dehydrogenase
34. DOC for hepatitis B: Entecavir
35. Mercury produce toxicity by: binding to sulfhydryl group
36. Potentiate the action of insulin: Chromium


All muscles pf palate by?
Pharyngeal plexus
Tensor vali palatini by
Trigeminal nerve
All muscles of larynx by?
Recurrent laryngeal nerve
Cricothyroid by
Ext laryngeal nerve
All muscles of pharynx by?
Pharyngeal plexus
Stylopharengeus by
Glossopharyngeal nerve
All muscles of tounge supplied by?
Palatoglossus by
Pharyngeal plexus
N supply of
Styloglossus ---12

One liners

What is associated with: Orphan Annie cells? Papillary carcinoma of the ovary
What is associated with: Russell bodies? Multiple myeloma
What isassociated with: Reinke's crystals? Leydig cell tumor
What is associated with: Blue sclera? Osteogenesis imperfecta
What isassociated with: Soap-bubble appearance on an x-ray? Giant cell tumorof the bone
What is associated with: Pseudorosettes? Ewing's sarcoma
What isassociated with: Lucid interval? Epidural hematoma
What isassociated with: Bloody tap on lumbar puncture? Subarachnoid hemorrhage
What is associated with: Pseudopalisades? Glioblastoma multiforme
What isassociated with: Charcot-Leyden crystals? Bronchial asthma (eosinophil membranes)
What is associated with: Cafe au fait spot on the skin? Neurofibromatosis
What is associated with: Streaky ovaries? Turner's syndrome
What isassociated with: Keratin pearls? Squamous cell carcinoma
What is associated with: Signet ring cells? Gastric carcinoma
What isassociated with: Mallory's bodies? Chronic alcoholism
What is associated with: Blue-domed cysts? Fibrocystic changeof the breast
What is associated with: Schiller-Duval bodies? Yolk sac tumor
What is associated with: Senile plaques? Alzheimer's disease
What is associated with: WBCs in the urine? Acute cystitis
What is associated with: RBCs in the urine? Bladder carcinoma
What is associated with: RBC castsin the urine? Acute glomerulonephritis
What is associated with: WBC casts in the urine? Acute pyelonephritis
What is associated with: Renal epithelial casts in the urine? Acute toxic or viral nephrosis
What is associated with: Waxy casts? Chronic end-stage renal disease
What is the most common: Cause of chronic metal poisoning? Lead
What is the most common: Cause of congenital cyanotic heart disease? Tetralogy of Fallot
What is the most common: Congenital cardiac anomaly? Ventricular septal defect (VSD)
What is the most common: Cardiac tumor? Left atrial myxoma
What isthe most common: Vasculitis? Temporal arteritis
What isthe most common: Primary tumorof the liver? Hemangioma (benign)
What is the most common: Primary malignant tumor of the lungs? Adenocarcinoma (30% to 35%)
What is the most common: Cause of nephrotic syndrome? Membranoproliferative
What isthe most common: cause of nephrotic syndrome in children? Lipoid nephrosis
What is the most common: Organism that causes pyelonephritis? Escherichia coli
What is the most common: Renal cell cancer type? Clear cell
What is the most common: Tumor of the liver? Metastatic cancer(GI, breast, lungs)
What is the most common: Malignant tumor of the esophagus? Squamous cell carcinoma
What is the most common: Tumor arising within the bone? Multiple myeloma
What is the most common: Primary malignant tumor of the female genital tract in the world?
Cervical neoplasia
What is the most common: Primary malignant tumor of the female genital tract in the US?
Adenocarcinoma of the cervix
What is the most common: Tumor of the female genitourinary tract? Leiomyoma
What is the most common: Benign tumor of the ovary? Serocystadenoma
What is the most common: Benign tumor of the breast? Fibroadenoma
What is the most common: Benign lesion that affects the breast? Fibrocystic change of the
What is the most common: Malignant tumor of the breast? Invasive ductal carcinoma
What is the most common: Tumor in men between the ages of 15 and35? Testicular tumors
What is the most common: Germ cell tumor in men? Seminoma
What is the most common: Testicular tumor in infants and children? Yolk sac tumor
What is the most common: Malignant germ cell tumor in women? Choriocarcinoma
What is the most common: Solidtumor in the body? Nephroblastoma
What is the most common: Acquired GI emergency of infancy? Necrotizing enterocolitis of
What is the most common: Primary malignant tumor of the ovary? Serocystadenocarcinoma
What is the most common: Cardiac tumor of infancy? Rhabdomyoma
What is the most common: Acute metal poisoning? Arsenic
What is the most common: Proliferative abnormality ofan internal organ? Benign prostatic
hyperplasia (BPH)
What is the most common: Malignant tumor in the bone of teenagers? Osteosarcoma
What is the most common: Site of a cerebral infarct? Middle cerebral artery
What is the most common: Cause of dementia between the ages of 60 and90 years? Alzheimer's
What is the most common: Primary CNS tumor in adults? Glioblastoma multiforme
What is the most common: Primary CNS tumor in children? Medullablastoma
What is the most common: Tumor on sun- exposed sites? Basal cell carcinoma
What is the most common: Chromosomal
disorder? Down syndrome(trisomy 21)

Years WHO theme

2014: Vector-borne diseases
2013: Healthy heart beat, Healthy blood pressure
2012: Good health adds life to years
2011: Anti-microbial resistance: no action today, no cure tomorrow
2010: Urbanisation and health: make cities healthier
2009: Save lives, Make hospitals safe in emergencies
2008: Protecting health from the adverse effects of climate change
2007: International health security
2006: Working together for health
2005: Make every mother and child count
2004: Road safety
2003: Shape the future of life: healthy environments for children
2002: Move for health
2001: Mental Health: stop exclusion, dare to care
2000: Safe Blood starts with me
1999: Active aging makes the difference
1998: Safe motherhood
1997: Emerging infectious diseases
1996: Healthy Cities for better life
1995: Global Polio Eradication

Tuesday, 26 November 2013

Investigation of Choice

CT scan HRCT (basic principle: “Bone algorithm”+ 1mm sections + small FOV & Narrowbeam collumation).
Lungs: - ILD
- Bronchiectasis
- Emphysema
Temporal bone: - Petrositis
- Mastoiditis
- Ossicular chain disruption
- Cong. anom [e.g.Mondani’s malforman]..MRI can be equally good
- EAC osteoma
- Cholesteatoma
- Fracture facial canal
NonContrast CT (NCCT)
- Initial test of choice for acute stroke (to R/o hemorrhagic stroke)
- Fractures: Skull
Facial bones
- Acute hemorrhage
Acute SAH
- Minimum air:
- Calcification anywhere in body
- Ureteric calculi
- Head injury (both for fracture skull& for acute h’ges)
- Metallic foreign body especially in eye
- CT PNS (coronal CT)
- Chronic recurrent sinusitis
- Sinonasal polyps
- Complicated sinusitis
- Pre-FESS ct
CTA (CT angiography)
- Screening of intracranial internal carotid (ICA) lesions
- Screening of circle of Willi’s lesions
- Chronic abdominal angina (SMV thrombosis)
- Pulmonary embolism
- Non-invasive coronary angiography
- Coronary anomalies
- Pulmonary sequestration (angio will demonstrate the supplying artery which arises directly for descending thoracic aorta; most common in LLL)
- Rapid screening tool for aortic lesions (as is TEE)
- Sensitive and specific screening tool for Renal artery stenosis
CT Head
- Oligodendroglioma (dense, blotchy, nodular or ribbon-like calcification)
- Screening for cortical venous thrombosis (‘Empty delta sign’ inn lateral sinus thrombosis)
- Evaluation of an acute change in mental status
- Evaluation of an Focal neurologic findings
- Conductive hearing loss
- Craniopharyngioma (suprasellar arc-like/ring-like calcification)
- Craniosynostosis
- Krabbe’s disease (Globoid cell dystrophy): bilateral hypodense thalami
CECT neck
- Staging of Ca larynx
- Staging of Ca thyroid
- Nodal characterization
- Chronic/ recurrent sinusitis (NCCT)
- Noninvasive fungal sinusitis (NCCT)
- Sinonasal polyps (NCCT)
- Neoplasms of maxilla (CECT)
- Juvenile angiofibroma (CECT; Holman Miller/Antral sign)
- Screening for Glomus jugulare (Phelp sign)
- CSF rhinorrhea (CT cisterography)
CT Orbit
- Metallic foreign body (NCCT)
- Optic drusen
- Retinoblastoma (calcification is pathognomonic; CECT)
CECT chest
- Screening, detection, and staging of lung cancer.
- Lung Hamartoma (well-defined mass with irregular or popcorn calcification)
- Pleural lesions
- Diaphragmatic hernia
- Anterior and middle mediastinal lesions.
- Congenital lobar emphysema (most common in LUL)
- Congenital adenomatoid lung malformation
- Morgagni’s hernia (seen at cardiophrenic angle)
- Medistinal lymphnode characterization (‘rim enhancement’=TB)
- Tubercular pericarditis
- Calcified cardiac tumors
CECT abdomen
- Blunt trauma abdomen (FAST i.e. Focused Assessment by Sonography for Trauma USG for screening & pref in hemodynamically unstable patients)
- Abdominal lump
- Abdominal wall hematoma
- Advanced rectal/ esophagus/ stomach/ bladder cancer
- Detection and Staging of Ca gall bladder and small bowel tumors
- Focal hepatic lesions
- Adrenal imaging (Nonfunctional lesions)
- Renal carcinoma detection and staging
- Oncocytoma (‘Central stellate’ scar)
- Renal and perirenal infections
- Complicated ADPKD
- Mesenteric cyst
- Enteric duplication cyst
- Abdominal lymphnode and peritoneal TB
- Diverticulitis and diverticular abscess (diverticulosis IOC=)
- Subdiaphragmatic abscess
- Bowel obstruction evaluation
- Complicated appendicitis
- Appendigitis epiploicae
CECT pelvis
- Adenexal mass
- Ovarian dermoid
- Ca urinary bladder
- Advanced prostatic cancer staging
- Sacrococcygeal teratoma
- Chronic Hemorrhage (GRE < FLAIR)
- Sensitive most for acute and hyperacute ischemic stroke (DWMRI)
- Demyelinating disorders (e.g. MS [Periventricular plaques; “Dawson’s fingers”], ALS, SSPE, SACD, SMON, CPM, ADEM, PML, PVL, PRES, etc)
- Infectious processes (encephalitis, meningitis)
- Abscesses
- Brain Neoplasms (supra as well as infra-tentorial & extra as well as intra-axial)
- Neurofibromatosis
- Diffuse Axonal Injury
- Vascular disorders (AVM’s, aneurysms, vasculitis, Moya-moya disease)
- Metastasis
- Internal auditory canal pathology
- Pituitary pathology
- Hydrocephalus especially in adults
- Cranial nerve pathology (e.g. vestibular schwannoma)
- Congenital anomalies (for anatomical review)
- Epilepsy (seizures in general)
- Parameningeal tumors
- Low CSF volume headache
Leptomeningeal metastases/carcinomatosis
- Cauda equina syndrome
- Tethered cord
- Arachnoiditis
- Marrow-replacing processes
- Degenerative disc disease
- Discitis
- Congenital anomalies
- Radiculopathy
- Spinal cord Tumours
- Trauma/contusion
- Syringomyelia
- Metastasis
- Vascular disorders
- Cord edema
- M.S. plaques
- Traumatic paraplegia
- Retroperitoneal tumor with spine extension
- Pott’s spine
- Myelomalacia
Musculoskeletal MRI
- Meniscal pathology
- Ligament/tendon injury
- Muscle/nerve impingement
- Rotator cuff tear
- Avascular necrosis
- Labral tears (shoulder, hip)
- Chondromalacia
- Inflammation (acute osteomyelitis)
- Primary bone tumors
- Spinal metastases
- Soft tissue tumors
- Perthe’s disease
- Cartilage injury (SPGRE sequence)
Cardiac MRI (Gating required):
- Infiltrative diseases like sarcoidosis, amyloidosis, etc
- Arrythmogenic Right Ventricular Dysplasia
- Ventricular function (accurate most)
- Myocardial perfusion especially in cases of Compact myocardium
- Post-op cases of Complex Congenital cyanotic heart disease
- Coarctation of aorta (better than 2D-echo because the size of stenosis, pre-stenotic lumen diameter and post-stenotic dilatated aortic size is best assessed; also echo has relatively poor acoustic window and is operator dependent).
- Cardiomyopathies (in general).
- Mediastinal masses Invading heart/pericardium
- Malignant cardiac tumors
- Congenital anomalies of bile duct and the entire biliary apparatus.
- Screening test of choice for primary sclerosing cholangitis, bile duct strictures, cholangiocarcinoma, bile leaks, etc
- Dysfunctional sphincter of oddi (scretin-MRCP).
- Liver donor transplant workup
- Segmental obstructions
MRA (Gd-enhanced MRA > TOF or PC MRA):
- Circle of Willis’s lesions
- Venous sinus thrombosis (MR venograms)
- Carotid and vertebral artery lesions
- Aortic lesions (in hemodynamically unstable patients we may prefer TEE or CT)
- Renal artery stenosis (3D-CE-Dynamic-MRA preferred)
- Vascular slings and anomalies (e.g. aberrant right subclavian, pulmonary sling, double aortic arch, right sided aortic arch, etc)
- Retropharyngeal abscess
- Nasopharyngeal carcinoma
- Carotid lesions like carotid body tumor (Lyre’s sign-splaying of ECA from ICA)
- Posterior mediastinal lesions (because usually these are neurogenic)
- Superior sulcus tumor (Pancoast tumor)
- Staging of Ca prostate, ca endometrium and anorectal cancers
- Anorectal sepsis and malformations
- Sensitive most for extraadrenal pheochromocytoma (however sensitivity is less than that of DOPA-PET)
- Brachial plexus injuries (pre-ganglionic as well as post-ganglionic).
Ultrasound - Hydrocephalus in infantsQ
- Thyroid nodule (hyperechoic lesions are less likely to be malignant)
- Initial evaluation of Rotator cuff injury/ subacromial bursitis/ bicipital tendinitisQ [MRI is more accurate and IOC]
- Synovial cysts (superficial ones)
- Pleural/ Pericardial effusionQ
- First investigation done for Acute abdomen and obstructive jaundice Q
- Congenital Hypertrophic Pyloric Stenosis (Target sign [transverse scan]; Cervix sign [longitudinal scan]).
- Intussusception (Doughnut sign [resolving one], Psuedokidney sign [basically consistent with bowel wall edema or thickening], Hamburger sign [longitudinal scan] and Target sign [transverse scan]).Q
- GallstonesQ
- Adenomyomatosis of Gall bladder (wall thickening of GB with “Comet tail” artefacts)
- Initial evaluation of focal liver lesions
- Initial evaluation of blunt trauma abdomen (FAST protocol) Q
- Minimal ascites Q
- Cystic hygroma
- Prostatic pathologies (TRUS)
- Seminal vesicle pathologies (TRUS)
- Staging of early rectal/pancreatic head malignancies (EUS)
- Neuroectodermal pancreatic tumors- insulinoma & gastrinoma (EUS)
- Scrotal pathologies
- Developmental dysplasia of HipQ
- Ectopic pregnancy (Empty uterus with pseudodecidual reaction with adnexal mass showing “Ring of fire” appearance on Doppler due to peritrophoblastic vascularity; TVS is IOC) Q

Monday, 25 November 2013


* Hyaline cartilage and Elastic cartilage constitute of Type II Collagen whereas Fibrocartilage of Type I Collagen.
* In larynsk : Thyroid,cricoid and aretenoid = Hyaline cartilage whereas Epiglottis and cuneiform = Elastic cartilage.
Q1] Which of the following is not a hyaline cartilage :-
[A] Articular cartilage
[B] Nasal septum
[C] Thyroid cartilage
[D] Articular disc
Ans = Articular disc
* Note that Articular cartilage = Elastic ,Whereas Articular disc = Fibrocartilage.
* Remember Ear = Elastic means any cartilage related to ear is elatic so
[1] Auricular cartilage
[2] Auditory tube/Eustachian tube
[3] External auditory canal (cart part)
All threee are elasic { E = Ear = Elastic}
Side by side remember that Nasal septum = Hyaline [ not elastic]
* Also remember that most of the cartilages related to joint eg
[1] articular disc
[2] intervertebral disc
[3] menisci
[4] labrum= glenoidal, acetabular
[5] symphysis = pubic
All r fibrocartilage except except except

Some important points about cartilage:
[1] cartilage of first pharyngeal arch = ??
[2] cartilage of 2nd pharyngeal arch = ??
[3] laryngeal cartilage arising from 4th arch =??
[4] laryngeal cartilge arising from 6th arch =??
[1] Meckels cartilage
[2] Reicherts cartilage
[3] Thyroid and epiglottic cart
[4] Crycoid,aretenoid, corniculate cart


Inferior vagina nerve suply-pudendal nerve
Alcohol cause cell membrane damage = P450 2E1 generated reactive oxygen species
Gradingo synderome-5th nerve
Palatine tonsil derived from which arch ?
Jones tendon transfer- is used to correct hyperextension at first metatarsasophalyngeal joint (ie seen in claw foot = so claw foot may be the ans )
Thickest part of optic disc-inferior
Paranasal sinus best examined by ctscan
Aminoglycocide affect which part of cochlea? As aminoglycoside causes high frequency hearing loss and apical turn of cochlea is responsible for perceivinghigh frequency sound so apical turn would be Ans.
Patho visera priserved-foramlin
Fluoride inhibit -enolase
Stain for basal/sque cel ca?
whic vit inhibit citric acid cycle- vitamin b5 ?
dna helicase-unwindning
wernicks encephalopathy not cause-confabulism ( it is seen in korsakoffs)
Time of anti d given-28 wk?
MC cromosomal anomaly leat abortion-trisomy 16
Pregnant woman cant hanged-crpc 416 ?
kappa axis-axis b/w pupilary and visual axis
Nasal haematoma not cause-perforation
No of somites= at the end of fifth week total no of somites formed in human is 42-44 pairs.
Hmg coa reductase-cholestero synthesis
Ivermectin dose 200 microgm/kg in strongyloides.
Also know Albendazole dose for ascariasis/trichuris/hookworm/pinworm = 400 mg orally single dose (in adults and chld>2 yrs) Note for pinworm repeat dose at 14 day needed
Verapamil side efct-constipation
Cochlear nerve-trapezoid body- Auditory pathway
The French size is a measure of the external diameter of a catheter ( foleys catheter). An increasing French size corresponds to a larger external diameter. Also know 1F = 0.33 mm.
Order of MAC of inhaeled anesthetics.
Check ? Marked q not sure about ans
Mc cause of transverse lie... multiparity?
Antemortem drowning best indicator?
Fertilisation of second ovum in a women who is already pregnant..superfoetation.
Motolov cocktail = incendiary bomb = gasoline is used in a bottle.
Mc ocular structure involved in toxoplasmosis= fovea
Orbital periostitis is seen in - syphills
Marcy repair = hernia= high ligation of sac + tightening of internal ring = repair of indirect hernia in children.
Various qs on glagow coma scale.
Thin split thickness skin graft thickness = 0.01- 0.015 inch ( also know thick split thickness skin graft = >0.015 inch)
Most chance of rejection in skin graft = full thickness> thick split thicknss> thin split
Murphy sign = acute cholecystitis
Components of metabolic syndrome.
Alcohol major metabolite ??
Howell jolly bodies = splenectomy
High reticulocyte count causes?
If the eyes remain open after death, the areas of the sclera exposed to the air dry out, which results in a first yellowish, then brownish-blackish band like discoloration zone called TACHE NOIRE. It is seen mostly after 7 to 8 hours after death.
Membrane protein that helps in receptor mediated endocytosis = clathrin
Myoglobin = 1 heme per molecule
Most radiosensitive bone tumor = ewing
Qs on color coding of cannula. See photo previously sent
Mc naughtens rule ?
Tertiary villi develop at = 21 st day
Functional unit of placenta = ?
Morbus caeruleus = The phenomenon of cyanosis of the skin and mucous membranes, usually spoken of as Cyanopathia or Morbus Caeruleus.
Standard total parenteral nutrition soln does not contain = fat ( ie why 20% fat emulsion given along with TPN to minimise deficiency of fatty acids.
GBS most common antecedent infection = campylo ?
Descending paralysis ?
Unilateral spontaneous serous or serosanguinous nipple discharge from single duct = duct papilloma.
Hypersegmented neutrophils photo
Laryngoscope photo
Kaposi = hhv 8
Rheobase = ?
Syringoma = tumor of eccrine gland.
Pediatric maintainance fluid is = isolyte P [ note maintainenece fluid for first 24 -48 h in <1000gm newborn = 5% dextrose and in > 1000 gm is 10% dextrose . Isolyte p = after 48 hrs as maintainenece fluid]
Also know ringer lactate composition.
Actinic keratosis ?
Groove sign = lymphogranuloma vanerum
Syphills = painless lymphadenopathy
Acidified serum lysis test = HAM test = PNH
Blood show spherocyte ,test indicated = direct antiglobin test DAT ( autoimmune hemolytic anemia)


The indications for tonsillectomy/adenotonsillectomy are:
1. Children with Obstructive Sleep Apnoea [OSA ]
2. Frequent Recurrent Acute Tonsillitis
3. Peritonsillar Abscess
4. Suspected Neoplasm
An increase in access to adenotonsillectomy for children with moderate/severe
obstructive sleep apnoea [OSA] is urgently required not mild.
7 in the previous year, 5 episodes in each of the previous 2 years, or 3 episodes in each of the previous 3 years was old criterio.
New criteria says more than 4 episodes with single episode of quinsy or cervical lymphadenopathy
Rose position best for surgery and left lateral after surgery.
New technique includes
Dissection and snare guillotine method
Intracapsular tonsillectomy with debrider
Ultrasound harmonic scalpel
Plasma mediated surgery
New technique always cause less bleed.
KTP laser is best laser
Indication or laser tonsillectomy—Bleeding disorders and contraindications to general anesethesia
Bleeding in cryosurgery is due to thrombosis of veins.
Cold method always cause less pain.
The harmonic scalpel is an ultrasonic dissector coagulator that utilizes ultrasonic vibration with a vibratory frequency of 55.5 kHz over a distance of 89 μm. The temperature of the harmonic scalpel is lower than electrocautery (50° – 100° C, 150° – 400° C, respectively), and there is less thermal damage to tissues.  The harmonic scalpel is an expensive product.
Postoperative pain scores tended to be lower in the harmonic scalpel group. 
The incidence of postoperative bleeding in the harmonic scalpel group is twice that of the electrocautery group.
Coblation, or cold ablation, is a technique that utilizes a field of plasma, or ionized sodium molecules, to ablate tissues.  Bipolar radiofrequency energy is transferred to sodium ions, creating a thin layer of plasma.  This effect is achieved at temperatures from 40° to 85° C, in comparison to electrocautery which can reach above 400° C.
Postoperative recovery following intracapsular adenotonsillectomy in children with obstructive sleep apnea is significantly earlier with use of either the coblator or microdebrider versus traditional extracapsular tonsillectomy with electrocautery.
Primary is during surgery ..most common is venous bleed due to paratonsillar vein which is also known as descending palatine and dennis brown vein.
Second most common is arterial which is due to tonsillar branch of facil artery.
Reactionary is due to slippage of ligature and management is Re ligate
Secondary is after 24 hrs and due to infections therefore management is I.V antibiotics.
Secondary haemorrhage is most commonly seen on 5-7 day
Average loss during tonsillectomy is 60-80 ml while during adenotonsillectomy is 80-120 ml
Epidemic of polio is clinically very important contraindication as glosspharyngeal nerve is involved.

Broadmans areas

Broadmann's areas
A. Somatosensory cortex I - ----3, 1, 2 (post central gyrus of parietal lobe)----sensations (touch, pressure, vibration, pain, temp)
B. Somatosensory cortex II - ---- superior wall of lateral sulcus---- – memory attached to sensations
C. Somatosensory association area---- 5 & 7 --- nature of the object sensed
D. primary motor cortex  ---- 4 (pre central gyrus) ---- control simple voluntary movements
E. Premotor cortex – ---6 - ----Programme sequence of movements, movement of motor joints and motor learning
G. Primary visual cortex------ 17----visual sensation
H. secondary visual cortex ---- 18----visual sensation
I. Visual association area- 19 --- nature of visual sensation
J. Primary auditory cortex----41------auditory sensation
K. Auditory association area-  22 & 42 --- nature of perceived sound
L. cingulate gyrus --- 24
M. angular gyrus-------39
N. Wenekies area------22 ( post end of superior temporal gyrus)--- word comprehension---#l/t sensory fluent aphasia
O. Taste area --------- 43 (Area I- post central gyrus….Area II- insular cortex)
P. Brocas area-44 (inferior frontal gyrus)----word expression (#l/t motor or nonfluent aphasia)
Q .arcuate fasciculus- connect brocas to wernikes- ---#l/t fluent faulty speech


golden hair-- arsenic poisoning
tests for arsenic poisoning are marsch,,reinsch and gutzeit test
polyneurits,paraathesias nd encephalopathy seen in arsenic poisoning
hyperkeratosis of palms and soles seen
in chronic poisoning,hair,nail,skin samples are preserved
Other features are rain drop pigmentation and red velvety mucosa of stomach( rapidly absorbed and max amount seen in liver)
measles like fading
it mimics cholera
antidote--freshly precipitated fe2o3
commonly and most popular homicidal poison
The study of incremental lines in the enamel of tooth to assess the age of a person is known as Boyde’s Method
 Stakes method:: Upto age of 12years, by measuring dimension of teeth and weight of teeth one can make out the age
Taurodontism is a peculiar tooth form in which the body of the tooth and the pulp chamber are enlarged at the expense of the root. Seen in Mongols
Declaration of geneva--> Declaration of a physician's dedication to the humanitarian goals of medicine
Declaration of Oslo--> Therapeutic abortion.
Declaration of Helsinki-->Human experimentation and clinical trials
 Declaration of Tokyo--> Torture in medicine*
 Kennedy phenomenon deals with Evaluation of exit and entry wound
 Carabelli's cusp. This is variably expressed but, when present, is a projection that occurs on the lingual (tongue side) surface of the maxillar first molars. Rare among Asiatics but very widespread among Native Americans.
Quinacrine dihydrochloride is used for staining Y-chromosome
Acriflavin Schiff reagent is used for staining X—chromosome
 Davidson body (drumstick appearance) in neutrophil ' Gonadal biopsy (from testes or ovaries) is a confirmatory method of determining sex. Present in females and absent in males
 A person accused of criminal offence may be medically examined without his consent on the request of the police:: Section 53, CrPC
CRPC 54: Examination of arrested person by medical practitioner at the request of the arrested person.
 Negligence by Doctor: 4 D's
Duty bound
Direct causation
 Algor mortis is the process by which the body cools after death as a result of loss of heat to the surroundings. A NOMOGRAPH is a diagram that allows a complicated mathematical relationship to be solved simply with a ruler.
Conditions causing postmortem caloricity:
   in heat regulation – sunstroke, pontine haemorrhage
Increased heat production in muscles – tetanus, strychnine poisoning
Bacterial / viral activity – septicemia / infections Intense asphyxia
Colour of post mortem lividity::
Normal – Bluish pink which later turns into bluish purple
Carbon monoxide – Bright cherry red
Cyanide – Pink
Phosphorous – Dark brown
Chlorates,nitrates,aniline – Chocolate brown
Hydrogen sulphide – Bluish green
Opiates – Black
Putrefaction is delayed in poisoning due to Carbolic acid, Barbiturates, lead, Datura, Arsenic, Strychnine, Cyanide

faget sign( relative bradycardia) seen in first week
rose spots occur on lower abdomen in second week
widal test is negative In First week nd strongly positive in second week
complications like septicemia,perforation occur in third week
hepatospleenomegaly seen in most cases
typhoid fever has other names like slow fever,,gastric fever,,pythogenic fever
cftr gene implicated in cystic fibrosis provides protection against typhoid infection
treatment of choice-- third generation cephalosporins
best method of diagnosis-- bone marrow culture
mercury poisoning
Mnemonic--Black MEAT
Blue black lining of gums
mercuria lentis(Brown mercury deposits on lens)-- early feature
erethism( neuropsychiatric. Changes in form of shyness,irritability,tremors,loss of memory
acrodynia(pink disease-- pink,puffy,paraesthesia,peeling of skin)(all india-93)
tremors danburry/ hatter's shakes/ glass blower's shakes
Other features of mercury
shaking palsy( aiims97)
minimata ds occured by eating poisoned mercurial fishes,,an example of point epidemic( aiims)
acute mercury poisoning involves--pct(all india--96)
arsenic poisoning resembles diphtheria in causing membranous colitis
hydragyrism-- chronic mercury poisoning
concussio mercuralis-- condition when patient becomes unable to dress,write or walk
maternal intake of hg in pregnancy leads to cerebral palsy in neonates
most poisonous salt is hgcl2( calomel) reduced to metallic mercury by sodium formaldehyde sulfoxylate
treatment-- dimercaprol,,ca EDTA not used(inc nephrotoxicity)


• Impetigo overall: Strep
• Impetigo contagiosa (non bullous): Strep (esp in warmer climate)>Strep+Staph (staph is usually a secondary colonizer)> staph
• Bullous impetigo: Staph aureus phage gp II>>>Rarely Strep
• Ecthyma (pyogenicum): Strep> Strep+Staph>Staph
• Ecthyma gangrenosum: Pseudomonas aeruginosa
• Erysipelas: Streptococci and rarely if at all Staph
• Cellulitis: Strep> Staph (occasional cause)
• Folliculitis : staph
• Furuncle : Staph aureus
• Carbuncle : staph aureus
• Sycosis : Staph aureus
• Periporitis : Staph
• Acute paronychia : staph aureus
• Erythrasma : Corynebacteriumminutissmum
• Erysipeloid : Erysipelothrix rusiopathiae
• Melioidosis : Burkholderia pseudomallei
• Glanders : Burkholderia mallei
• Rhinoscleroma : Klebsiella pneumoniae rhinoscleromatis (Klebsiella rhinoscleromatis)
• Cat scratch disease : Bartonella (Rochalimea) henselae
• Bacillary angiomatosis: B. henselae and B. quintana
• Oroya fever: Bartonella bacilliformis.
• Tropical (phagedenic) ulcer: at least two organisms, one of which is a Fusobacterium spp., usually F. ulcerans; the others include spirochetes or other anaerobic bacteria

Sunday, 24 November 2013

Tri nucleotide repeats

Huntington's Disease (Chromosome 4 (HTT gene) CAG)
Myotonic Dystrophy (Chromosome 19 (DMPK gene) CTG)
Fragile X syndrome (Chromosome X FMR1 gene) CGG)
Friedrich's Ataxia (Chromosome 9 (Frataxin gene) GAA)

Last minute revisions

Microbiological Tests---
* Ascoli Thermoprecipitation Test-- For
* VDRL/Kahn Test -- Syphilis
*Elek's Gel precipitation test-- Diptheria
* Eiken Precipitation Test-- E.coli toxin
* Widal test -- Typhoid
* Weil - Felix test-- Typhus
* Paul bunnel test- Inf.mononucleosis
* Coombs Test - Rh incompatibility
..* Sereny Test - Enteroinvasive E.coli
* Schick Test-- susceptibility to
* Dick Test - Scarlet fever diagnosis
* ASO test- Rheumatic fever
* Rose bengal card test - Identification of
Brucella contamination of milk..
* Fairley test-- Schistosomiasis
* Frei Test - Lymohogranuloma verenum
* Casoni Test-- Hydatid cyst
* Montegro/Leishman test- Leishmaniasis

SLE ---> Anti nuclear antibody .
Drug induced SLE---> Anti Histone
Systemic sclerosis---> Anti DNA Topoisomerase {Scl 70}

Scleroderma {CREST }---> Anti Centromere
Sjogren syndrome---> SSA (Ro) SSB (La)
Primary biliary cirrhosis---> Anti Mitochondrial
Mixed connective tissue disorders---> anti Rnp.
Churg Strauss---> Anti Myeloperoxidase ANCA
Multifocal motor neuropathy---> Anti GM1
Wegener’s granulomatosis--->C-ANCA
Ulcerative colitis ---> P-ANCA
Crohn’s disease---> Anti saccharomyces Cerevisiae ( ASCA)
Celiac sprue---> Antiendomysial & Antigliadin

Drug of Choice for Different Diseases :
For MRSA Infection-Vancomycin
For Malaria in Pregnancy-Chloroquine
❄For Whooping Cough or Perteusis- Erythromycin
For Kawasaki disease-IV Ig
For Warferin Overdose-Vit-K
For Heparin Overdose-Protamine
For hairy Cell Leukemia-Cladirabine
For Multiple Myeloma- Melphalan
For CML-Imatinib
For Wegner's granulomatosis-Cyclophosphamide
For HOCM- Propranolol
For Delirium Tremens-Diazepam
For Drug Induced Parkinsonism-Benzhexol
For Diacumarol Poisoning-Vit-K
For Type-1 Lepra Reaction-Steroids
For Type- 2 Lepra Reaction-Thalidomide
For Allergic Contect Dermatitis-Steroids
For PSVT-
For Z-E Syndrome- Proton Pump Inhibitor
For Chancroid-Cotrimoxazole
For Dermatitis Herpetiformis-Dapsone
For Spastic Type of Cerebral Palsy-Diazepam
For Herpis Simplex Keratitis-Trifluridine
For Herpes Simplex Orolabialis-Pancyclovir
For Neonatal Herpes Simplex-Acyclovir
For Pneumocystis carinii Pneumonia- Cotrimoxazole
For Nodulo Cystic Acne-Retinoic acid
For Trigeminal Neuralgia-Carbamezapine
For Actinomycosis-Penicillin
For Plague- Streptomycin
For Opioid Withdrawal- 1stMethadone
For Alcohol Withdrawal- 1stChlordiazepoxide
For Post Herpetic Neuralgia- Fluphenazine
For WEST Syndrome-ACTH
For Diabetic Diarrhoea- Clonidine
For Lithium Induced Neuropathy-Amiloride


Rice grain calcification- Neurocysticercosis
Spleenic calcification may occur in??histoplasmosis,brucellosis
Chicken wire calcification--->> chondroblastoma
Brackett calcification---->> agenesis of corpus callosum
Pancreatic calcification---->> chronic pancreatitis
Tram track calcification---->> sturge weber syndrome
Pop corn calcification---->>> pul. Hamartoma nd fibroadenoma
Bracket calcification - lipoma of corpus callosum
Serpentine calcification - sturge weber
Idiopathic basal ganglia calcification - Fahr's syndrome
Calcification of basal ganglia- hypoparathyroidsm.

Atypical tb

Photochromogens:- which develop pigments in or after being exposed to light
Examples include M. kansasii, M. simiae and M. marinum.

Scotochromogens:- which become pigmented in darkness
Examples include M. scrofulaceum and M. szulgai

Non-chromogens which includes a group of prevalent opportunistic pathogens called M. avium complex (MAC). E.g., M. ulcerans, M. xenopi, M. malmoense, M. terrae, M. haemophilum and M. genavense

Rapid growers include four well recognized pathogenic rapidly growing non-chromogenic species: M. chelonae, M. abscessus, M. fortuitum and M. peregrinum. Other examples cause disease rarely, such as M. smegmatisand M. flavescens.

Midbrain syndromes

Midbrain syndromes
Benedikt’s-Ipsilateral Oculomotor palsy and CL tremors,chorea,athetosis.Injury to red nucleus
Nothnagel’s-IL 3rd N palsy and CL cerebellar ataxia.Due to superior cerebellar peduncle injury
Webers-IL 3rd N palsy with CL hemiplegia.Due to cerebral peduncle injury.
Pontine syndromes
Foville-Lateral gaze palsy,ipsilateral facial palsy,CL hemiparesis.Dorsal pontine injury.
Millard Gubler- Similar to Foville,but only LR palsy.Ventral pontine injury.
Reymond Cestan Syndrome
Eaton Lambert’s myasthenic syndrome-Autoimmune disorder that affects voltage-gated calcium channels on the pre-synaptic membrane of the neuromuscular junction.Repeated stimulus improves response and invokes contraction.
Blindloop syndrome-
Short bowel syndrome-
LEOPARD syndrome-
ECG abnormalities-primary conduction defects
Ocular hypertelorism
Pulmonary stenosis and subaortic stenosis
Abnormal genitalia-cryptorchidism hypospadiasis
Retardation of growth
Wunderlich syndrome – spontaneous, nontraumatic renal hemorrhage confined to the subcapsular and perirenal space. It may be first manifestation of a renal angiomyolipoma (AML). Massive hemorrhage is seen.
kostman sundrome-absolute neutrophil count (ANC) chronically less than 500/mm3
leriche syndrome—impotence,pain in thigh and buttock both sides on walkng(claudication),absent or weak lower limb pulses,bruit over iliac region.cause is aorto iliac obstruction.
joubert’s syndrome-bat wing deformity of the ventricles seen,vermis absent,molar tooth appearence
Irvine-Gass Syndrome-Fluid accumulation within the sensory retina in the macular area,triad of vitreous touch,bullous keratopathy and cystoid macular oedema
Mirizzi syndrome– obstruction of biliary duct d/t stone impacted in hartmann’s pouch or cystic duct
Potters syndrome-B/l renal agenesis.Condition is incompatible wit extrauterine life and death is mc d/t pulmonary hypoplasia
Cat eye syndrome-Partial Trisomy(22pter-22q11)
Lady Windermere syndromeis mycobacterium avium complex pulmonary disease described in fastidious elderly women in the dependent portion of the lingula or the right middle lobe due to proposed habitual voluntary suppression of cough leading to the development of nonspecific inflammatory processes in these poorly draining lung regions – upon which MAC-PD engrafted.
Alagille syndromeis inherited cholestatic syndrome – associated with biliary hypoplasia (ductopenia) – vertebral anomalies – prominent forehead – deep-set eyes – peripheral pulmonic stenosis
Rubinstein-Taybi syndrome is congenital condition characterized by mental and growth retardation – short broad thumbs and/or halluces – and typical facial features
Poland syndrome is amastia associated with hypoplasia of ipsilateral musculature (microsyndactyly or lack of one hand) and chest wall (atrophy of the ipsilateral pectoralis major) and GU abnormalities; 10% have dextrocardia or dextroversion
Li-Fraumeni syndromeis mutant p53 allele inherited – predisposition toward breast carcinomas – sarcomas – leukemia – brain tumors – and adrenocortical carcinoma; half have tumors before age 30 – 70% before age 90
Gerstmann-Straussler-Scheinker syndromeis slow central nervous system disease – hereditary as well as transmissible prion disease with same mutation – point mutation in codon 102 of prion protein as CJD; characterized by cerebellar dysfunction with multiple plaques
Benedikt syndrome– clinical picture from paramedian midbrain infarction from occlusion of the paramedian penetrating branches of the basilar artery affecting the third nerve root fiber – red nucleus – cerebral peduncle resulting in ipsilateral medial rectus palsy with a fixed dilated pupil and contralateral tremor – chorea – and athetosis
Meckel-Gruber syndrome–sloping forehead – posterior encephalocele – polydactyly – and polycystic kidneys
Jorvell and Lange Neilson syndrome- potasium chanellopathy,Consists of deafness, prolongd QT n arrhythmia
senear-Usher syndrome is pemphigus erythematosus; a localized variety of pemphigus foliaceus confine


Dresslers syndrome-Pleural effusion in MI after 2 weeks
Munchausen Syndrome-Hospital addiction
Chediak Higashi Syndrome-Microtubule polymerization defect resulting in decreased phagocytosis.
Kartagener’s syndrome- Immotile cilia due to dynein arm defect.
Eaton Lambert Syndrome-Auto antibodies against calcium channels,clinically similar to myasthenia.
Cushings Syndrome- Elevated levels of cortisol due to any cause, whereas cushings disease is increase in ACTH due to primary pituitary adenoma.
Waterhouse Friedrichson Syndrome- Acute adrenal insufficiency due to adrenal hemorrhage a/w meningococcal septicemia.
Sheehan’s syndrome– Pituitary necrosis following postpartum hemorrhage.
Reyes syndrome - Fatal childhood hepatoencephalopathy due to viral infection that has been treated with aspirin.Hypoglycemia,coma,fatty liver(microvesicular)
Budd Chiari Syndrome- Occlusion of IVC or hepatic veins with centrilobular congestion and necrosis.
Gaisbock’s Syndrome-Relative Polycythemia
Von Hippel Lindau Syndrome-cerebellar hemangioblastoma.
Kippel fiel syndrome-Fusion of cervical vertebrae
Stewart treves syndrome- Lymphangiosarcoma developing in lymhedematous arm after radical mastectomy.
Gradenigo syndrome- Triad of Otitis media,Retrobulbar pain,Ipsilateral abducens palsy.
Plummer vinson syndrome/Paterson brown kelly syndrome-Combination of symptomatic hypo pharyngeal webs and iron deficiency anemia in mddle aged female.Radiological finding-web in post cricoid region,may develop post cricoid ca.Iron given orally.
Lynch syndrome- Endometrial ca,Colon Ca,Ovarian
Balint’s syndrome- State of severe spatial disorientation.Oculomotor apraxia,Optic ataxia,Simultanagnosia,bilateral parietal lobe involvement(OOPS!)

Heart shapes

Coeur en Sabot /Boot shaped heart - Tetralogy of Fallot
Pear/Money bag/purse - Pericardial Effusion
Box shaped heart - Ebstein’s anomaly
Egg on side - TGA
Snowman/figure of 8- TAPVC
Scimtar sign- TAPVC.
Wide Vascular Pedicle – Corrected TOGV
Sitting Duck shaped Heart- Persistant Truncus Arteriosus
Flask shaped Heart/Leather bottlewith Pulm. Oligemia- Pericardial Effusion
Snowman/Figure of 8/ Cottage leaf of Bread heart- TAPVC
Shaggy Heart– Pertusis
Figure of 3 (CXR)/Reversed E sign(Ba swallow) - Coarctation of Aorta
Hilar Dance sign(Fluoroscopy) - ASD
Egg in cup– Constrictive pericarditis.

Gastric polyps syndromes

1.JUVENILE POLYPOSIS STNDROME: > 6 polyps in rectum and colon, polyps al along GIT, family h/o polyposis syndrome.

2.FAMILIAL ADENOMATOS POLYPOSIS SYNDROME: 30 to 100 polyps, congenital hypertrophy of retinal pigment epithelium, smal intestinal adenomas, abdominal desmoid tumors, mandibular osteomas, other ca like PAP CA of thyroid, hepatoblastoma.gene is APC, 5q21 chromasome involved.

3.CRONKHITE CANADA SYNDROME: GI polyps, nail dystrophy, hyperpigmentation, alopecia.

4.GARDNER SYNDROME: GI polyps, multiple osteomas, epidermoid cyst, fibromatosis.

5.TURCOTT SYNDROME : Gi polyps,  brain meduloblastomas, brain glioblastomas.

6.LYNCH SYNDROME: GI POLYPS,  other associated ca most comonly endometrium, ovary, liver,etc.

7.MUIR TORRE SYNDROME : Gi polyps, multiple sabaecious tumors ( sebaceou ca) keratocanthomas (sq.cell ca), basal cel ca. 

8.COWEDANS DISEASE:gi polyps, facial trichillemmomas , acral keratosis,lhermitt duchlos disease. Gene involved is PTEN Gene of chromosome 10.

RAVALCADA MUIR SMITH SYNDROME : GI polyps, macrosomia, unusual facial deformities, mental retardation, pigmented macules on penis.

The pentalogy of Cantrell

The pentalogy of Cantrell is an extremely rare phenomenon with an incidence estimated at around 6 per million live births .
It encompasses the following 5 main features
ectopia cordis (abnormal location of heart)
diaphragmatic defect
pericardial defect or sternal cleft
cardiovascular malformations :-
ventricular septal defect (VSD)
atrial septal defect (ASD)
tetralogy of Fallot
left ventricular diverticulum


Important facts :
1. From the time of ovulation it takes 3-4 days(or 18-19 days from the last menstrual cycle) --- for Fertilized Ovum in the Ampulla (Tube) to reach the Uterus.
2. From the time of ovulation it takes 7-9 days (or 21 – 22 days from the last menstrual cycle) --- for Implantation (During this time the Uterine milk /secretions provide nutrition for early dividing Ovum) – The predominant morphological feature is edema of the endometrial stroma.
3. Oogenesis begins in ovary – 6-8 weeks of gestation
4. Maximum number of oocytes (6-7 million) are attained at 20 weeks (5th Month) of gestation.
5. At birth total content of Both ovaries is 2 million primary oocytes.
6. At puberty number is decreased further and is – 300000 – 500000 of which only 500 are destined to mature during an Individual’s life !
7. All the primary oocyte in the ovary of a newborn till puberty – arrested in Late prophase
8. First polar body is released just prior to ovulation
9. Second division starts just after it and is -- arrested in metaphase
10. Thus second polar body release occurs only at the time of fertilization.
11. LH surge precedes ovulation by 34 – 36 hrs.
12. LH peak precedes ovulation by 10 – 16 hrs
13. Prior to ovulation :
a) Follicle reaches a size of 18 – 20 mm (KCET 2009)
b) Endometrium is 9 – 10 mm thick
c) Endometrium shows triple line on USG
14. Maximum action of Corpus Luteum is at 22 days of Menstruation
15. In the absence of fertilization – corpus Luteum persists for – 12–14 days
16. Maximum Growth of Corpus Luteum is at 8th week of Gestation and degenerates at 6th month of gestation
Extra points :
1. LH surge tends to occur at around 3 AM.
2. Ovulation occurs in morning between (midnight and 11 AM) in Spring
3. Ovulation occurs in evening between (4 PM and 7 PM ) in Autumn and winter .
4. Ovulation occurs more frequently from Right Ovary
5. Ovulation occurs alternatively between the two ovaries in younger women
6. In women more than 30 yrs age .. ovulation occurs frequently from the same ovary.
Remember :
1. The primitive germ cells takes origin from Yolk sac at 3rd week of gestation and migrate to the Genital ridge by 4th week of gestation .
2. 1st meiotic division – arrested in Prophase – completed just prior to Ovulation releasing the 1st polar body.
3. 2nd meiotic division – arrested in Metaphase – completed at the time of fertilization releasing the 2nd Polar body.
4. Also, Primary Oocyte – 44XX; Secondary Oocyte – 22X;
5. Primary Oocyte(44X) – undergoes 1st meotic division – Arrested in prophase – completed just prior to ovulation – releases First polar body (22X) + Secondary Oocyte (22X)
6. Secondary Oocyte (22X) – 2nd meiotic division – Arrested in Metaphase – At the time of fertilization – releases Second Polar Body (22X) + Ovum (22X)
7. In Males : Primary spermatocyte (44XX) – undergoes 1st meiotic division – forms secondary spermatocytes (2 in number)
8. Secondary spermatocytes (22X) (2 in number) – undergoes 2nd meiotic division – forms Spematids (22X)(4 in number)
9. Spermatids undergoes transformation as spermeiogenesis – forms Sperma (4 in number)
10. Developmental process from Spermatogoonia to Sperma takes 74 days (Some books 61days)and entire process till the transit to the ductal system takes 90 days (3 months)
11. So, in case of infertility of males the repeat sperm analysis is done after 3 months.
Age in days and development events :
1. 2 days – Embryo at 2 cell stage
2. 3 days – Morula is formed
3. 4 days – Blastocyst is formed
4. 8 days – Bilaminar disc is formed
5. 14 days – Prochordal plate & primitive streak seen
6. 16 days - Intra-embryonic mesoderm is formed / Disc is three germ layers

Phosphodiesterase Enzyme Inhibitors-

PDE1 inhibitor: Vinpocetine
PDE2inhibitor: EHNA
PDE3 inhibitor: Enoximone,milrinone,Amrinone
PDE4 inhibitor: Ibudilast,pentoxiffyline,cilomilast,
PDE5 inhibitor: Sildenafil, tadalafil and vardenafil,
NONSELECTIVE: Theophyllins


DEF: the indian act permits the willfull termination of pregnancy prior to the age of fetal viability (20weeks of gest. )for well defined indications . it has to be performed by recognized medical practioners in a recognized place approved by the competent authority under the act
1. Medical ground :)
when the countinuation of pregnancy is likely to endanger the life of the pregnant women
~~causes gravious injury to her physical and /or mental health as in cases of severe hypertention.cardiac dis.
Diabetes m. Psychiatric illness .breast cancer
when there is substantional risk of child born with serious physical or mental abnormatities e.g. Hereditary disorders .
Congenital malformation in privious peg.with high risk of recurrence in subsequent child birth or Rhisoimmunisation .
Teratogenic drugs
when pregnance is caused by rare or incest
when 1. In actual or reasonably forceseeable future her inviroment(social or economic ) might lead to risk to injury to
her health 2.peg. Resulting from failure of contraceptive device or method
written content of the pt. On specialy prescribed form is necessary prior to undertaking the procedure

the act stipulates that no mtp can be performed at any other place than
1. Hospital established and maintained by the govt. recognized and approved by the govt . Under this act

these are broadly classified

~menstrual regulation
~dilatation and station evacuation
~cervical softning prior to d /e
~medical methods

~surgical evacuation
~extra outlar instillavion of drugs
~extrauterine methods
#1st trimester mtp
~#surgical methods
~~#menstual regulation:-)
it consist of aspiration of the contents of the uterine cavity by means of a plastic cannula (karmans cannula)
It has plastic 50ml syringe
capable of creating a vacuum of over 60cm hg.It is effective carried out within 42 days of begining of LMP
complications ~failure . Incomplete
evacuation .haemorrhage.cervical laceration.

~It is most efficient method for termination up to 12 weeks
~undertaken under local anasthetic papacervical block
coupled with some sedation
~cervix is dialated to introduce suction cannula of the
appropriate size
~a standerd negative suction of 650mm of hg is applied and
products are aspirated
1. Prostaglandins:-)
pro. Inj -prostin ,carboprost -prostaglandin F2 alpha -250
micro gm given i m every 3 hourly
~It is synthetic steroid a derivative of 19-nortesterone ,with
anti progesteronic effect.
~it has also anti gluacocorticoid and weak anti androgenic
It dose not prevent the fertilisation but by blocking the action
of proge. No the endometrium ,it causes sloghing and
shedding of decidua and prevents implantation
~if used singly effective in only 83% adding prostaglandin
increases success rate to 95%
600mg given as single dose
for mtp
.adrenal failure
.cardiac and asthmatic pt
.haemorrhagic disorder
.lacting women
.Adrenal failure
.headache maliase
. Failure to abort
.next menstulatio delayed by10 days
in some countries mtp up to 16 weeks accomplished by slow
and deliberate dialatation of cervix with laminaria tents ,p.g.
2. Aspirotomy
involves suction aspiration of liquor amni followed by
evacuation of fetal parts in pieces with help of specialy
desined instrument aspirotomy forecep
1 Extraovvlar instillation of drugs . e. g. Ethacridine lactate
2 . Intra cervical/extraovular instillation of cerviprime
3. Mifepristone and misoprost
4. Prostaglandins
5. Combined methods

Saturday, 23 November 2013

12th 5 year plan

the 12th Five Year Plan period, efforts will be
made to consolidate the gains and build on the
successes of the Mission to provide accessible,
affordable and quality universal health care, both
preventive and curative, which would include all
aspects of a clearly defined set of healthcare entitlements including preventive, primary and
secondary health services. At the national level, the targets would be as
Reduction of MMR to < 100 per 100000 live births
Reducing IMR to < 27 per 1000 live births
Reduction in NMR to < 18 per 1000 live births
Reducing TFR to 2.1 Elimination of Filaria – in all 250 districts; Kala-azar
in all 514 Blocks and Leprosy in all districts
Reduction in TB prevalence and mortality by 50%
Reduction in Annual Malaria incidence to <1/1000
Reduction in JE mortality by 50% Sustaining case fatality rate of less than 1% for

Salivary Gland

Controversy solved (Ref: devita oncology )

MC site of salivary gland tumor -parotid
Most major salivary gland tumor - Benign
Most minor gland tumor malignant
MC tumor of parotid -Pleomorphic adenoma
MC malignant tumor of parotid- Mucoepidermoid
MC malignant tumor of minor salivary gland -Adenoid cystic

Immuno Histo Chemical Markers

1. Tumor of epithelial origin ( carcinomas) - cytokeratin.
2. Tumor of mesenchymal origin ( sarcoma) - vimentin
3. Tumor of smooth muscle origin (leiomyoma) - smooth muscle actin, desmin
4. Tumor of skeletal muscle origin (rhabdomyomas) -desmin, myogenin
5. Tumor of vascular origin ( angiosarcoma) - factor 8, von willebrand factor, cd 31
6. Tumor of glial origin ( gliomas) - glial fibrillary acidic proteinGFAP
7. Tumor o f hepatic origin ( HCC) - heppar1, alphafetoprotein
8. Marker for stem cell - CD 34
9. B cells - CD 19, CD 20, CD 21, CD 22
10. T cells - CD 1,2,3,5,7
11. Pan B cell marker - CD 19
12. Pan T cell marker - CD 3
13. Classical Hodgkin's disease - CD 15, CD 30
14. Non classical Hodgkin's disease - CD 20, EMA
15. Hairy cell leukemia - annexin a1, cd 25, cd 103, cd11c
16. Mantle cell lymphoma - cycling D1
17. Apoptotic cells - annexin v
18. Seminoma - PLAP, HCG, oct 3/4, nanog
19. Yolk sac tumor - alpha veto protein
20. Choriocarcinoma - beta HCG

Friday, 22 November 2013


►►►►CLASS 1 A


Cinchonism is most often a sign of chronic quinidine toxicity, but it may appear in sensitive patients after a single moderate dose.


Hypotension and serious disturbances of cardiorhythm such as ventricular asystole or fibrillation are more common with intravenous administration of PA than with intramuscular administration. Because PA is a peripheral vasodilator in concentrations higher than the usual therapeutic range, transient high plasma levels which may occur especially during intravenous administration may produce temporary but at times severe lowering of blood pressure


The most serious adverse reactions are hypotension and congestive heart failure. The most common adverse reactions, which are dose dependent, are associated with the anticholinergic properties of the drug. These may be transitory, but may be persistent or can be severe. Urinary retention is the most serious anticholinergic effect.

dry mouth (32%),
urinary hesitancy (14%),
constipation (11%)

►►►►CLASS 1B

lidocaine for spinal anesthesia, the incidences of adverse reactions were reported to be about 3 percent each for positional headaches, hypotension and backache; 2 percent for shivering; and less than 1 percent each for peripheral nerve symptoms, nausea, respiratory inadequacy and double vision.
Toxicity is usually associated with serum lidocaine concentrations of 9 to 10 mcg per mL, but may occur with concentrations as low as 5 mcg/mL. Central nervous system toxicity has been observed in patients with hepatic cirrhosis who were receiving lidocaine at infusion rates as low as 2.2 to 2.5 mg per min.




CNS USE The most notable signs of toxicity associated with the intravenous use of this drug are cardiovascular collapse and/or central nervous system depression. Hypotension does occur when the drug is administered rapidly by the intravenous route. The rate of administration is very important; it should not exceed 50 mg per minute in adults, and 1-3 mg/kg/min (or 50 mg per minute, whichever is slower) in pediatric patients.
The most common side effects are neurotoxic and dose-related. They include:

impaired memory
slurred speech
decreased coordination
Long-term side effects
Some other side effects only appear after a person has been using Dilantin for a number of months or years. They are usually related to taking high doses. The most common ones affect appearance:

overgrowth of the gums
excessive hair on the face or body
coarseness of facial features
Overgrowth of the gums (gingival hyperplasia) is more common in children than in adults.

Urogenital:peyronies disease

skin :  Dermatological manifestations sometimes accompanied by fever have included scarlatiniform or morbilliform rashes. A morbilliform rash (measles-like) is the most common; other types of dermatitis are seen more rarely

The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are nystagmus, ataxia, and dysarthria. Other signs are tremor, hyperreflexia, lethargy, slurred speech, nausea, vomiting. The patient may become comatose and hypotensive. Death is due to respiratory and circulatory depression.

There are marked variations among individuals with respect to phenytoin plasma levels where toxicity may occur.

►Nystagmus, on lateral gaze, usually appears at 20 mcg/mL,
►ataxia at 30 mcg/mL;
►dysarthria and lethargy appear when the plasma concentration is over 40 mcg/mL, but as high a concentration as 50 mcg/mL has been reported without evidence of toxicity. As much as 25 times the therapeutic dose has been taken to result in a serum concentration over 100 mcg/mL with complete recovery.

paranoid psychosis-NOT  USED

►►►►CLASS 1C

PRO arrythimic effects


Dizziness  18%
Visual Disturbances 15%
Dyspnea 10%

(Dizziness includes reports of dizziness, lightheadedness, faintness, unsteadiness, near syncope, etc.
Visual disturbance includes reports of blurred vision, difficulty in focusing, spots before eyes, etc.)

Flecainide, like other antiarrhythmic agents, can cause new or worsened supraventricular or ventricular arrhythmias. Ventricular proarrhythmic effects range from an increase in frequency of PVCs to the development of more severe ventricular tachycardia, e.g., tachycardia that is more sustained or more resistant to conversion to sinus rhythm, with potentially fatal consequences.

In studies of ventricular arrhythmia patients treated with flecainide, three-fourths of proarrhythmic events were new or worsened ventricular tachyarrhythmias, the remainder being increased frequency of PVCs ornewsupraventricular arrhythmias.

♣In patients treated with flecainide for sustained ventricular tachycardia, 80% (51/64) of proarrhythmic events occurred within 14 days of the onset of therapy.

Flecainide slows cardiac conduction in most patients to produce dose-related increases in PR, QRS, and QT intervals. PR interval increases on average about 25% (0.04 seconds) and as much as 118% in some patients. Approximately one-third of patients may develop new first-degree AV heart block (PR interval ≥ 0.2 seconds).
The QRS complex increases on average about 25% (0.02 seconds) and as much as 150% in some patients. Many patients develop QRS complexes with a duration of 12 seconds or more.
In one study, 4% of patients developed new bundle branch block while on flecainide.
The degree of lengthening of PR and QRS intervals does not predict either efficacy or the development of cardiac adverse effects.
In clinical trials, it was unusual for PR intervals to increase to 0.3 seconds or more, or for QRS intervals to increase to 18 seconds or more.
Thus, caution should be used when such intervals occur, and dose reductions may be considered.
The QT interval widens about 8%, but most of this widening (about 60% to 90%) is due to widening of the QRS duration.


Unusual Taste
Nausea Vomiting
Elevated ANA Titers
Positive ANA titers have been reported in patients receiving propafenone

Agranulocytosis (fever, chills, weakness, and neutropenia) has been reported in patients receiving propafenone. Generally, the agranulocytosis occurred within the first two months of propafenone therapy and upon discontinuation of therapy, the white count usually normalized by 14 days. Unexplained fever and/or decrease in white cell count, particularly during the initial three months of therapy, warrant consideration of possible agranulocytosis/granulocytopenia. Patients should be instructed to promptly report the development of any signs of infection such as fever, sore throat, or chills.

Overall in clinical trials with propafenone, 4.7% of all patients had new or worsened ventricular arrhythmia possibly representing a proarrhythmic event (0.7% was an increase in PVCs; 4.0% a worsening, or new appearance, of VT or VF).


The most serious adverse reaction reported for  is proarrhythmia
Most common : Dizziness 11%  Nausea 7%


Many individuals experience facial flushing, a temporary rash on the chest, lightheadedness, diaphoresis, or nausea after administration of adenosine due to its vasodilatory effects.
►Metallic taste is a hallmark side-effect of adenosine administration. These symptoms are transitory, usually lasting less than one minute.

►It is classically associated with a sense of "impending doom", more prosaically described as apprehension. This lasts a few seconds after administration of a bolus dose, during transient asystole induced by intravenous administration. In some cases, adenosine can make patients' limbs feel numb for about 2–5 minutes after administration intravenously depending on the dosage (usually above 12 mg).

S/E after IV
Flushing 44%
Chest discomfort 40%
Dyspnea or urge to breathe deeplY 28%
Headache 18%
Throat, neck or jaw discomfort 15%
Gastrointestinal discomfort 13%
Lightheadedness/dizziness 12%


1) Asteroid bodies - Sporotrichosis
2) Councilman bodies - Yellow fever
3) Torres bodies - Yellow fever
4) Leishman’s Donovan’s bodies - Kala Azar
5) Halberstaedter -Prowazek’s bodies - Trachoma
6) Miyagava's bodies - Lymphogranuloma venereum
7) Levinthal-Cole-Lillie bodies – Psittacosis Negri bodies (intracytoplasmic, intra neuron, hippocampus) - Rabies
9) Guarnieri's bodies - Vaccinia (intracytoplasmic)
10) Bollinger's bodies - Fowl pox (intracytoplasmic)
11) Henderson-Peterson's bodies - Molluscum contagiosum
12) Cowdry type-A bodies - Yellow fever, Herpes virus infection
13) Cowdry type-B bodies - Adenovirus, Poliovirus(code-BAP)
14) Aschoff's bodies - Rheumatic fever
15) Russell’s bodies - Multiple myeloma ( Intranuclear )
16) Schaumann’s/Conchoids bodies (calcium & iron complexes) - Sarcoidosis & Berylliosis
17) Asteroid bodies (eosinophilic inclusions) -Sarcoidosis
18) Call-Exner bodies - Granulosa cell tumor of ovary
19) Verocay bodies - Neurilemmoma
20) Civatte’s (colloid) bodies - Lichen planus
21) Michaelis-Guttmann's bodies - Malakoplakia
22) Lewy bodies - Parkinson's disease
23) Lafora bodies - Familial myoclonus
24) Hirano bodies - Alzheimer’s disease
25) Weibel-Palade bodies - storage organelles of von Willebrand’s factor in platelets & endothelium
26) Pappenheimer bodies – non heme iron pigments in siderocyte
27) Howell-Jelly bodies - splenectomy , Megaloblastic Anaemia, Hemolytic anaemia
28) Hectoid bodies - Sickle cell anemia
29) Heinz bodies - thalassemia
30) Döhle bodies - cytoplasmic inclusion bodies in neutrophils seen in bacterial infection
31) Histiocytosis-X(HX)(Birbeck's granules) - Histiocytosis-X
32) Gamma-Gandy bodies - Congestive splenomegaly
33) Mallory's bodies - hyaline inclusions in hepatocytes seen in alcoholic, indian childhood cirrhosis etc...
34) Apoptotic bodies - membrane bound spherical structures in Apoptosis
35) Psammoma bodies - dystrophic calcification in meningioma, papillary serous cystadenoma of ovary & papillary carcinoma of thyroid, papillary type of RCC.
36) LE bodies (hematoxylin bodies) - SLE
37) Dumbbell shaped Asbestos bodies - asbestos fibres coated with glycoprotein & hemosiderin. stained with Prussian blue stain
38) Luys body - subthalamic nucleus
39) Davidson’s body - sex chromatin in neutrophils(dumbbell shaped)
40) Herring bodies - pars nervosa of pituitary gland
41) Donovan body - Granuloma inguinale
42) Nissl’s bodies - cytoplasmic inclusions in neurons
43) Moser’s bodies - Typhus fever
44) Lipschütz' bodies - intra nuclear inclusions in herpes simplex infection
45) Zebra bodies - cytoplasmic inclusions in schwann cell degeneration
46) Babes-Ernest metachromatic granules - Diphtheria
47) Reilly’s bodies - Hurler's syndrome
48) Gamma-Favre bodies - LGV
49) Winkler's & Ross's bodies - Syphilis
50) Sandström’s bodies - Parathyroid gland
51. Councilman Bodies = HEP B ( dying hepatocytes )
52. Feruginous Bodies = Asbestosis
53. Heinz BODIES = G6PD DEF
55. Creola BODIES = Asthma
56. Odland BODIES = Keratinosome
57. Rushton BODIES = Odontogenic CYSTS
58. Zebra BODIES = Metachromatic Leukodystrophy, Niemann Pick's Disease.
59. Brachy Wächter Bodies = Infective Endocarditis
60. Globoid bodies = Krabbes disease
61. Alder - Reilly Bodies = coarse azurophilic granules in the leukocytes in ALDER - REILLY
62. Bodies Of Arantius = aortic valve nodules
63. Verocay Bodies = schwannoma
64. Balbiani's Bodies = yolk nucleus
65. Bamboo Bodies = asbestos bodies
66. Brassy Body = dark shrunken blood corpuscle found in MALARIA
67. Coccoid X Bodies = psittacosis
68. Cytoid Bodies = in degenerated retinal.N fibres.seen in cotton wool spots
69. Harting Bodies = calcospherite in the cerebral capillaries
70. Body Of Highmore = mediastinum testis
71. Masson Bodies = rheumatic pneumonia
72. Mott Bodies = multiple myeloma
73. Donnes Bodies = colostrum corpuscles
74. Oken's Body = mesonephros
75. Paschen Bodies = variola or vaccinia
76. Schiller Duval's Bodies = ENDODERMAL SINUS TUMOUR
78. Body Of Highmore = medullary carcinoma of testis
79. Odland Bodies = Flegel’s Disease (i.e hyperkeratosis lenticularis perstans)
80. Red Neurons = Apoptosis

Exam points

1. Muller maneuver-for
determining the cause of sleep apnea.
► After a forced expiration, an attempt at inspiration is made with closed mouth and nose > (negative intrapleural pressure)
2. valsalva maneuver- to assess autonomic nervous control of the heart
►forceful attempted exhalation against a
closed airway, (usually done by closing mouth, nose)
3. Durant maneuver-use in air embolism
► the left lateral decubitus position
4. Sellick's maneuver- during endotracheal intubation, used to prevent regurgitation
► application of pressure to the cricoid cartilage
5. Heimlich maneuver-for treatment of Choking
►standing behind a patient and using their hands to exert pressure on the bottom of the diaphragm

Declaration of Geneva:: hippocratic oath
Declaration of Tokyo:: torture
Declaration of Oslo:: therpautic abortion
Declaration of Sydney:: organ transplantation
Declaration of Helsinki:: human experimentary ethic
Declarationn of Delhi:: health of climate changes

LOFGREN' S SYNDROME....seen in sarcoidosis
Erythema nodosum
Hilar lymphadenopathy

ENT Classifications
Sade classification: Retraction of pars Tensa
Toss classification : Retraction of pars Flaccida
Antoni classification:Acoustic neuroma
Derlacki classification: Congenital
Nelson classification: CSOM
Shea classification :Meniere's disease
Isshika classification:Thyroplasty
Wullstein classification :Tympanoplasty
Fisch classification::Glomus tumours
Glasscock-Jackon classification:: Glomus jugulare tumors
Broder's Classification : Oral Cancer, scc
Ohngren classification:: Maxillary sinus carcinoma
Lederman classification:Maxillary sinus carcinoma
Myer & cotton's grading :: subglottic stenosis

Iodine requirement :
infant - 50 mcg/day
Adults - 150 mcg/day
pregnancy - 250 mcg/day
lactation - 200 mcg per day
Level of iodisation in salt :
production level- 30 ppm
consumer level - 15 ppm
Double fortified salt contains 40 mcg iodine and 1 mg iron
urinary iodine level - ''principle impact indicator''..!!

Hampton's line:: benign gestric ulcer
Lines of zahn:: arterial thombi
Tuffier's line:: inter posterior iliac crests  line at  L4
Roser-Nélaton line:: ASIS to ischial tuberosity .
Frankfurt line:: Reid's base line
Reid's base line:: Infraorbital margin to upper margin of external acoustic meatus
Ohngren's line:: b/w medial canthus & angle of the mandible
Sebileau's line::1. Floor of orbit, 2. Floor of maxillary sinus
Rex-Cantlie line:: gallbladder bed to inferior vena cava and passes through the right axis of the caudate lobe.
Burtonian line:: lead poisoning
Mee's line:: Arsenic poisoning
Corrigan line:: copper poisoning
Clapton's line:: Greenish line seen on the margins of gum in copper sulphate poisoning
Wickham's striae:: lichen planus
Dennie's line :: atopic dermatitis
Muehrcke's line:: hypoalbuminemia
Vogt's striae:: keratoconus
Haab's striae:: congenital glaucoma
Sampolesii line:: pigmentory glaucoma
Paton's line:: papilloedema
Line of toldt:: peritoneal reflection
Brodel's line:: kidney(avascular line)

Last census

Latest census
Population 1,220,800,358 (2013 est.)
Growth rate 1.51% (2009 est.) (93rd)
Birth rate 20.22 births/1,000 population (2013 est.)
Death rate 7.4 deaths/1,000 population (2013 est.)
Life expectancy 68.89 years est.)
• male 67.46 years (2009 est.)
• female 72.61 years (2009 est.)
Fertility rate 2.5 children born/woman (SRS 2010)
Infant mortality rate 30.15 deaths/1,000 live births (2009 est.)
Age structure
0-14 years 31.1% (male 190,075,426/female 172,799,553) (2009 est.)
15-64 years 63.6% (male 381,446,079/female 359,802,209) (2009 est.)
65-over 5.3% (male 29,364,920/female 32,591,030) (2009 est.)
Sex ratio
At birth 1.12 male(s)l/female
Hdi 0.547

Thursday, 21 November 2013

Acts/Regulation and Year of launch

D.stop tb--2006
E.dots +---2006
A.RCH I--1997
B.RCH II--2004-05
D.nacp--1992-2011 phase wise planning--1951
A.kalazar Ctrl prg--1977
B.lynhtc filariasis ctrl--1955
C.yaws eradictn --1996-97
C.n goitre cp--1962
D.n iodine ddcp--1992
E.n mental hp--1982
F.n cancer cp--1975
G.integrated dis survillince project--2004-09
A.esi act--1948
B.factories act--1948
C.mines a--1952
D.minimum wages a--1948
E.workmen compensatn a--1923
A.bonded labor abolition a--1976
B.dock wprkr a--1986
C.census a-1948
D.consumer protection a--1986
E.transplantation f human organ a--1994
A.environment a--1986
B.BMW a-1998
C.hazardous waste s-1989
D.air and water a--1974
E.MTP a--1971
F.pcpndt a--1994
G.maternity benefit a--1961
H.dowry protctn a--1961
A.mental health a--1987
B.infant milk substitute a--1992
C.juvenile justice a--2000
D.child labor a--1986
E.child marriage restraint a--1929
A.nrega a--2005
B.rti a--2005
C.Hindu succession a--1956 ( prevntn f atrocite) a--1989
E.person with disability a--1995
F.drug and cosmetic a--1940
G.drug and magic remedy a--1955

Modes in USG

1. A-mode (Amplitude mode) - Ophthalmology, Orbital biometry
2. B-mode (Gray scale) - For all routine applications
3. M-mode - Echocardiography


1. Biophysical profile is a.k.a? Manning Score
2. Least common type of pelvis? Platypoid
3. Quadruple test is? Beta HCG, MS-AFP; UE3, DIA
4. Oesteblastic pelvis is of what shape? Triradiate
5. PAGE classification is used for? Abruptio Placentae
6.  Tubal ring sign a.k.a? Bagel sign
7.Risk of CCF maximum in? 2nd stage of labour
8. Apt test used for? Fetomaternal hemmorhage
9. Mag Sulphate therapeutic range is? 4-7 meq/dl
10. Crede's Method is? Applying fundal pressure with cord traction


Trichomonas vaginalis,
Schistosoma heamatbium,
Wuchereia bancrofti,
Dicoctophyma renela

Trypanosoma brucei gambinese,
Naegleria fowleri,
Acanthamoeba spp,
Balamuthia spp,
Angiostronylus spp

Paragonimus westermani,
Capillaria aerophila,
Entamoeba histiolytica


1.miners elbow? Olecranon bursitis
2.Tailors ankle?
Lateral malleolus
3.Bunion is seen on? Great toe
4.Weaver's bottom is? Ischial bursitis
5.Kochers maneuver is used for¿? Reduction in dislocation of shoulder
6.Carries sicca is? TB of shoulder joint
7.Wilson's osteotomy is done for? Congenital coxa vara
8;Syme's amputation? Thru ankle joint
9.Obers test is used to detect? Tight iliotibial band
10.Massonaise # ? # neck of fibula










Laying unsegmented eggs -
  Ascaris lumbricoides,
Laying eggs with segmented ova -
N americanus,
Trichostrongylus spp.,
Ternidens deminutus,
Oesophagstomum spp.
Laying eggs containing larva -
Enterobius vermicularis

Dracunculus medinensis,
Wuchereria bancrofti,
B malayi, B. timori
Trichinella spiralis

NBE Punch

1.USG frequency for transvaginal usg? 5-7.5Mhz view to visualize sphenoid sinus? Lateral view
3.Stryker's view for? Recurrent subluxation of shoulder
4.Position for renal scan? Prone
5.Contrast agent for hsg? Conray 280/240
6.IOC for insulinoma? Endoscopic usg
7.Bracket calcification is seen in? Corpus callosum lipoma
8.Goose neck sign is seen in? Endocardial cushion defects
9.Bull's eye lesion on barium meal? Leiomyosarcoma
10.Fish hook bladder is seen in? BPH

Ductus independent flow are just 3
Mneumonic anti tb treatment
1.Anomalous origin left coronary art from pulm art ALCAPA
2.Trunkus arteriosus
3.Total anomalous pul vein return Tapvr