Saturday, 8 February 2014

Medicine Facts

Medicine facts :-

MR develops in HOCM due to anterior papillary muscle displacement and systolic anterior motion of anterior mitral valve leaflet into narrowed LV outflow tract.

TEE is preferred over TTE to get information about thrombus formation in left atrium

SSPE usually presents between 5 and 15 years of age and presents after a latent period of 6-8 years following primary measles infection. It is characterized by progressive intellectual detorioration,seizure,myoclonus,ataxia,visual disturbance and has a mean survival period of 3-5 years after diagnosis. Classical EEG finding shows periodic pattern with bursts of high voltage,sharp,slow alpha waves every 3-8 seconds,followed by period of flat background.

Mumps,LCMV and advanced HSV encephalitis are the only viral encephalitis  that can have low CSF glucose levels.

Substansia nigra dopaminergic neurons have stimulatory effect on direct basal ganglionic pathways throught D1 receptor and inhibitory effect on indirect pathway through D2 receptor. This is responsible for the modulatory regulation of substansia nigra on the cortical signaling pathways from premotor and accessory motor cortex to putamen.

When a person is at rest,it is found that globus pallidus interum is continuously firing to send inhibitory signal to primary motor cortex to keep muscles at rest.

MELD score is used for liver transplantation to predict prognosis of patients with liver dz and portal HTN. It is based on following parameters: prothrombin time,serum bilirubin,serum creatinine.

So basically what we need to remember is that albumin is not part of MELD scoring,coz that is what is asked in mcq.

Mendelian susceptibility to mycobacterial disease is characterized by defect in IL12-IFNgamma axis,which leads to impaired IFNgamma dependent macrophage activation which leads to increased vulnerability to tuberculous and non-tuberculous mycobacteria. MSMD patients are also prone to develop salmonella infection. It should be suspected in patirnts with persistent mycobacterial infection inspite of appropriate treatment startegies.treatment of MSMD consist of administartion of IFNgamma that efficently bypass the IL12-IFN axis

CHARGE syndrome-colobama of eye,heart anomaly,choanal atresia,retardation,genital and ear anomaly occours due to CHD7 deficiency and is cause for impaired thymus development too leading to primary immune deficiency disease.

Thymic defect is most commonly observed in DiGeorge syndrome that occours due to deletions in chromosome 22q11.2.in additon to thymus there is also defective parathyroid gland development in Digeorge.

In DKA as ketoacidosis improves,beta-hydroxybutyrate is converted to acetoacetate.so on repeat test,ketone body levels may falsely appear to increase if measured using nitroprusside reaction which only detects acetoactate and acetone.

Metformin,alpha-glucosidase
inhibitors,thiazolidinediones and orlistat prevent or delay type2 DM in individuals with impaired fasting glucose or Impaired glucose tolerance. Metformin is considered to be most beneficial for this purpose

In Actually in DKA,beta-hydroxybutyrate is synthesized at a 3 times greater rate than acetoacetate,but it cannot be detected by nitroprusside test..

In sarcoidosis gallium-67 scan shows uptake in bilateral hilar and right paratracheal LN region called lambda sign of wings,while uptake in parotids or lacrimal and salivary glands leads to panda sign....this combination of lambda-panda scan is highly suggestive of sarcoidosis.

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