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fast n Final revision of Pediatrics

Posted by pawan2006e on June 27, 2012 at 9:10 AM Comments comments (1)

Final n fast revision of Pediatrics

                                                                                             drpawanwebs@gmail.com

• Crawling --8 months creeping –10 months

• @ 2months sustain head level with the body when placed in ventral suspension

• Head control – 3 months

• Seat with support 5 months

• 5 yrs chid remember upto 5 digits

• Preference of use one hand @ 3yrs

• Taste percepyion of baby develop @ birth

• Cornea attains size of adult at 2yrs

• 90% brain growth @ 2yrs n 100% @ 12yrs

• 1s epiphyseal centre appear in Os calis

• Growth spurt occur just before appearance of axillary hair

• Enzyme depressed in malnutrition -- oxidation

• to be continue....very soon

 

Fast n Final revision of ORTHO

Posted by pawan2006e on April 21, 2012 at 7:30 PM Comments comments (0)

FAST N FINAL REVISION OF ORTHO

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 Non dynamic splint – Cock up

 Commonest # of childhood is distal humerus

In amputation Distance(inches) from

1. Knee joint in below knee amputation--- 5.5

2.elbow in forearm amputation ---7

3.Acromian in arm amputation -- 8

 Most sensitive str in a joint is Fibrous capsule

 Chemical synoviectomy is done by Osmic acid

 Longitudinal growth responsible-- epiphyseal plate

 Arthroplasty – joint is excised & bone are so kept as to avoid fusion

 In diabetic foot 2 stage symes amputation is used

 MC cause of pathological # in child – Bone cyst

 Claw hand is seen in Syringomyelia ,cervical rib

 Streptokinase is not used in Fat embolism

 Syme’s amputation --- Ankle joint

 Replantation is not possible in Crush injury with avulsion

 BEST EXAMPLE FOR Type 4 epiphyseal injury --- Lateraral condyle # humerus

 Crush the epiphyseal plate very poor prognosis

 Green stick # -- part of cortex is intact & part is crumpled

 35% amputed person ----- Phantom limb

 During surgical procedure tendon repaired before nerve

 MONTEGIA # --- PROXIMAL 3RD OF ULNA WITH RADIAL HEAD DISLOCATION

 GALEAZZI # -- DISTAL 3RD OF RADIUS WITH DISLOCATION OF DISTAL RADIO-ULNAR JOINT

 POTT’S # -BIMALLEOLAR

 COTTON # --- TRIMALLEOLAR

 Medial meniscus is less mobile n more commonly injured

 In aging enzymatic degradation of proteoglycan not increase

 MC cause of pressure sore in india – leprosy

 Tendon transfer done @ 5yrs age

 Clumsiness of hand in case due to involvement of interosseus

 Rate of growth of nerve after peripheral nerve injury – 1mm/day

 Nerve repair in an infected wound --- delayed primary

 MC muscle involved in lower leg in polio – Ant. Tibialis

 MC muscle of upper limb involved in polio -- Deltoid

 Saturday nerve palsy – Radial n.

 Fasciectomy is indicated when intracompartmental pressure rises 45 mm Hg

 Commonest type of shoulder dislocation – subcoracoid

 Hill sach’s lesion -- bony defect in humeral head

 Luxatio erecta – inferior dislocation of shoulder

 Bankart’s lesion – Ant. Aspect of glenoid labrum

 Main ligament union b/w clavicle & remainder of upper limb --- Sternoclavicular lig.

 Shoulder joint is weakest below

 Crutch palsy in axilla --- Radial n.

 Absent lateral 1/3rd of clavicle is seen in Cleidocranial dysostosis

 Type 3 acromioclavicular dislocation best treated by coraclavicular screw

 Supracondylar # segment often displaced posteriorly

 Myositis ossificans is MC --- elbow joint

 Treatment of Acute Myositis ossificans is Immobilisation

 Open reduction in children --- Lateral condyl of humerus ,# of tibial epiphysis

 VIC mostly involve flexor digitorum profundus

 Oblique view is required to Dx # of Scaphoid

 Chauffer ‘s # -- intra articular ,oblique # of styloid process of radius

 Night stick # --- # shaft of ulna

 Reduction of bennet # is difficult to keep in position due to the pull of Abductor pollicis longus

 Dinner fork deformity --- radius #

 Mallet finger – Avulsion # of extensor tendon of distal phalanx

 Dupuytren contracture of hand commonly start in Ring finger

 MC complication of extracapsular # of NOF – Malunion

 Bryant’s triangle is useful in Dx of Infratrochanteric shortening

 In Subtrochantric # proximal fragment -- flexed abduction

 Watson jones operation is done for Hip replacement (AIIMS NOV 08)

 Obesity is not a risk factor for AVN

 Injury to poplitial art. In # lower end of femur due to distal fragment pressing art.

 Recurrent dislocation of patella in an adolescent could be treated by Lateral release

 Segmental compound # tibia 1cm skin wound is classify – Type 1

 # of talus may give rise to AVN of body

 Aviator # is # neck of talus

 Tractional injury to epiphysis of vertebra --- Scheurmann’s ds

 MC cause of scoliosis in children –post poliomyelitis

 Jefferson # --C1

 MC # of cervical vertebra – C5

 Cobbs angle --- Scoliosis

 MC type of spondylolisthesis – Congenital Dysplastic

 Joint commonly involved in Syphilitic srthritis

 Tom smith arthritis manifest as increase hip mobility & unstability

 Not seen in chronic osteomyelitis --- Myositis ossificans

 In blood born osteomyelitis earliest(periosteal rkn) X-ray sign is seen in 10 days

 Brucellar osteomyelitis is not a primary subacute osteomyelitis

 MC cause of osteomyelitis in <4 yrs ---- H. Influenzae

 Early feature of Pott’s paraplegia – flexor spasm

 Ususal site of TB -- Trochanteric

 Earliest movement to be impaired in TB hip – Flexion

 Spina ventosa is caused by T.B.

 Child 3 ¼ yrs treated for CTEV --- PMSTR

 U/L clubfoot which defect most likely to persist even after t/t – Hind foot equines

 CTEV -In(inversion) Ad(adduction ) Equ(equinus) ate

 ORAB – Ortolani test when reduces get abduct

 BAD – Barlows test get adduction when dislocate

 Commonest deformity in CDH --- Shallow acetabulum

 Von Rosen’s splint – CDH

 Ivory osteoma commonly arises – Skull

 Commonest benign tumour - Chondroblastoma

 Osteogenic sarcoma can develop into paget ds

 Osteogenic sarcoma – 10-20 yrs

 MC site for Aneurysmal bone cyst --- upper end of tibia

 Physalipharous cell(Large vaculated cell) ---- Chordoma

 Multiple exoxtosis usually preent at 5 yrs age

 Densely calcified metastatic shadow – osteosarcoma

 MC malignant tumour of bony chest wall – Chondrosarcoma

 Mafuccy syndrome --- multiple endochondromata ,soft tissue hemangioma,phlebolith

 Osteochondroma is not true tumour

 Shepherd crook deformity ---fibrous dysplasia

 Unicameral bone cyst --- single cavity with connective tissue lining

 Chicken wire pattern – chondroblastoma

 MC cause of focal expansile rib lesion is fibrous dysplasia

 GCT – 25% are malignant

 When size of osteoclastoma exceeded the size of metaphysic ---limited to metaphysic

 Gaensein’s operation for Sacroilliac subluxation

 Para articular erosion MC seen in Rheumatoid arthritis

 Rheumatoid arthritis MC causes Pericarditis

 Backache & asymmetrical lower limb weakness – seronegative spondyloarthropathy

 Synovial fluid with low viscosity –gout,septic arthritis,TB,RA

 Tarsal tunnel syndrome is caused by ----RA

 Triradiate pelvis is seen in Osteomalacia

 Bruton’s ds—scurvy n Rickets

 Fish head appearance --- osteoporosis

 Menisci calcification -- pseudogout

 Phosphoethanolamine in urine is suggestive of --- serum calcium level

 Diagnostic radiological finding of skeletal flurosis – interosseous membrane ossification

Epiphyseal

Dysgenesis hypothyroidism

Enlargement Scurvy

Separation JRA

Widening rickets

 Pseudo# --- osteomalacia

 Ant. Ligament calcification of spine and mottling of teeth --- flurosis

 Pencillike cortex --- Scurvy

 Butonniere deformity --- flexion of proximal interphalangeal joint n extension of DIP

 Pes cavus – weakness of intrinsic muscle

 Coxa vera --- perthes ds , rickets

 Recurrent club foot due to failure of development peroneal muscle

 Sprengel’s deformity – undescended /elevated scapula

 Cleidocranial dysostosis may show absence of clavicle

 Earliest changes in perthes ds is seen by nuclear scan

 Lisfranc dislocation --- tarsometatarsal dislocation

 Dysplasia epiphysis hemimelica – Trevor’s ds

 Osteocondritis dessicans occurs at Lateral surface medial condyl

 Engelman ds – Progressive diaphysial dysplasia

 Felon is terminal pulp space infection

 Bunion – adventitious bursitis lateral to 1st meta tarsal

 Ganglion is most commonly seen over dorsal aspect of wrist

 In trigger finger level of tendon sheath constriction is found at level of MCP joint

 Costoclavicular syndrome manifestation are mostly due to compression of Brachial plexus

 Shoveller ‘s # --- stress # of spinus process

 Trendelberg sign is not seen in tom smith arthritis

 Osteomyelitis of jaw is seen in caffey’s ds

 Gaenslen’s test +ve --- ankylosing spondlytis

 Macewen’s osteotomy is performed in case of genu vulgum

 Treatment based o Gate theory is Electricle nerve stimulation

 Schmorl’s node – radiological finding ;protrude nucleus pulposis into vertebral body

 Not a/s with osteogenic imperfect – cataract

 Trident hand – Achondroplasia

 Spina ventosa --- tuberculosis dactylitis

 Psoas spasm not seen in TB hip

 Fatigue # not occur in metacarpal

 Ring sign --- Scurvy

 Rocker bottom foot seen in Cong. Vertical talus

 Blind nasal intubation --- TM J ankylosis

 Thomas test is done --- fixed flexion deformity

 Modified allen’s test – radial art.

 Fibrosis of quadriceps is due to IM injection

 Ring type of sequestrum is present in lower part of bone after amputation

 Cotton wool appearance or ground glass appearance of expanded bone is characteristic of fibrous dysplasia

 Electric bulb sign – post. Dislocation of shoulder joint (JHPG2011)

 Duga’s test – ant dislocation of shoulder

 Fibular hemimella not a/s presence of polydactyly

 Bone infarct seen in sickle cell anemia

 Increased bone density – AVN,paget’s ds

 Lateral popiteal nerve repair has worst prognosis

 Dactylitis not seen in beta thalassemia

The end

 

 

Fast n Final revision of ANATOMY

Posted by pawan2006e on April 13, 2012 at 9:55 AM Comments comments (0)

Fast n Final revision of Anatomy

        www.drpawan.webs


 Extension of the metacarpophalangeal joint lost in injury to posterior interosseous nerve

 Ossification in foetus start in end of 2nd month

 Lymphnode 1st involved in Breast Ca – Pectoral

 Clavicular part of deltoid is a/s with Flexion ,Medial rotation

 Boxer’s muscle – seratus anterior

 Axillary nerve is arises from Posterior cord

 Palmaris longus tendon is frequently absent in the hand

 Serratus anterior not retract shoulder

 Short head of bicep and coracobrachialis originate from tip of coracoid process

 Median nerve – eye of the hand

 Coracoids process not form the boundary to the superior entrance into the axilla .

 Abductor pollicus longus s/b post interosseous nerve

 Abductor pollicus brevis s/b median nerve

 MCP flexed in Radial Nerve palsy

 Intercosto brachial is branch of 2nd intercostals nerve

 Latisimus dorsi s/b Subscapular artery

 Adduction of hand at wrist is done by Externalcarpi ulnaris

 Cubital foss – MBBR (medial to lateral)

 l l l head of coracho brachialis --- Struthers ligament

 Pronator quadratus has same innervation as flexor pollicus longus

 Power grip of hand – long flexor of finger

 Latissmus Dorsi not a/s with external rotaion of Shoulder

 Content of bicipital groove are ascending br. Of anterior circumflex artery

 SA node located Subepicardially

 Terminal br of internal mammary artery superior epigastric n musculophrenic a.

 Thoracic duct(pecquet duct,40 cm) crosses from right to left at level T5

 Subclavian a. forms a groove around apex of the left lung

 Azygous vein arching over hilum of right lung

 Base of heart is formed by Both artria

 At T4 --- arch of arota

 Sensory supply of trachea – recurrent laryngeal nerve

 Anterior cardiac vein is not drain into coronary sinus

 Oesophagus not s/b internal mammary artery

 Oblique sinus of pericardium lies behind the left atrium

 P. major is not cut during lateral thoracotomy

 Root of right lung does not lie behind Right vagus

 Superior intercostal a. is br. Of Costocervical trunk of subclavian

 Ventricle of heart constituted --- trabeculee carenae

 Last tributary of azygous vein –Right main stem bronchus

 Potential anastomosis -- coronary artery

 Spinal epidural space contain areolar tissue & internal vertebral venous plexus

 Patella completely ossify at 14 yrs

 Distal femoral epiphysis seen at 34 week

 Abduction and adduction of forefoot occur at Midtarsal joint

 Keystone of medial longitudinal arch of foot is talus

 Femoral nerve not supply tensor fascia latae(sup gluteal a.)

 Popliteal muscle Rotate the femur laterally on tibia

 Lateral rotator of hip 2+2 =4(quadratus femoris) P(pyriformis).G(g. maximus). Student(sartorius)

 Fascia cribrosa a/s femoral canal

 PHIC

 Medial meniscus attached at 3 points

 Extensor of knee by Quadriceps

 Abductor hallucis not arises from calcaneum

 Peroneus tertius not insert into plantar aspect of foot

 Sacral canal volume --- 25-33 cc

 Ossification centre in calcaneus and talus appear in 3 and 6th month

 Fabella – gastronemious lateral head

 Action of quadratus femoris – lateral rrotation

 Femoral nerve is not a content of Adductor canal

 I.V. infusion is avoided in Long sephanous vein

 Adductor hallucis supply by deep br of plantar nerve

 Lateral circumflex femoral is br of profunda femoris

 Abnormal obturator a. is br of inferior epigastric a.

 Lateral meniscus post surface is intended by popliteus muscle

 Largest br of lumbar plexus –Femoral nerve

 Extends the knee with hip flexion – rectus femoris

 Lymphatic drainage from heel n lateral part of foot to popliteal LN

 Planter flexion by plantaris ,FHL,Soleus,FDL,T.post

 Arterial br which supply head and neck of femur --- medial circumflex a. , obturator a.

 Lateral popliteus nerve injury can cause telepus equinovarus

Telepus equinovarus

In ---- Inversion

Ad Adduction

Equa Equinus

Te Toe Walking(plantar flexed)

 Anterior cruciate ligament --- Middle genicular a.

 Head of femur – Medial circumflex a.

 Middle genicular a. pierces the oblique popliteal ligament of knee joint

 Invertor of foot is Tibialis posterior

 ACL PCM

 Femoral nerve is not inside femoral sheath

 Lateral collateral ligament attached to head of fibula

 Not s/b posterior div of obturator nerve obturator internus

 illioFemoral ligament arises from Ant. Inf.iliac spine

 Deep peroneal nerve supply 1st web space of foot

 Form the tendinous sling in superficial arch of foot –peroneus longus and tibialis posterior

 Not induces visceral pain ---Cauterisation ,cutting

 1st event occur in MICTURATION REFLEX is realaxation of perennial muscle

 Appendicular artery is br of illeocolic a.

 Caudate lobe of liver situated IVC and Ligamentum teres

 Fascia of Denonvillers – fascia b/w rectal ampulla and the prostate and seminal vesicles

 MC type of hernia is Hiatus hernia

 Normal portal venous pressure 6-12 mm Hg

 Does not shrink in umbilical cord – Allantois

 Bowel does not get strangulated – Recto uterine pouch

 Renal collar formed by Left renal vein

 In hydrocele aspiration needle not passes to tunica albuginea

 

 All prostatic arteries are branches of inferior vesical

 CBD is separated from the IVC by epiploic foramen

 Superficial fatty fascia b/w umbllicus & pubis is Camper fascia

 Rectus sheath not contains genitofemoral nerve

 MC type of inversion of testes – Anterior

 Lymphatic of anal canal is --- Inguinal

 Structure in free border of lesser omentum to posterior are CBD,Hepatic artery,portal vein

 Lymphatic drainage of umbilicus – axillary and inguinal node

 Kidney has 5 segment

 Neurovascular bundle in ant. Abdominal wall is situated b/w Internal oblique and transverse abdominis

 Fascia extension of lacunar ligament along illiopectineal line – Cooper ligament

 Latissimus dorsi is not posterior to Rt. & Lt. kidney

 Pancreatic bed not included splenic artery

 Fascia of Gerota – Renal Fascia

 Left gastroepiploic art. Is branch of Splenic art.

 Attachment of mesentry of small gut – Lt. transverse process of L2 to Rt. Sacroiliac joint

 Embryonic ventral mesogastrium gives rise to Lesser omentum

 Superficial inguinal ring transmit illioinguinal nerve

 URETER --- anterior to internal iliac vessel /gonadal vessel

 Inferior mesenteric artery not supply ascending colon

 Splanchic nerve from thorax join the trunk below the diaphragm

 Tail of pancrease – max no. of islet of langerhans

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 Lymphatic drainage of testes is Pre & para aortic Lymph node

 Anal continence not contributed by valve of Houston

 Cremasteric reflex – L1

 Suprarenal gland is not supplied by superior mesenteric artey

 Lung has no end arterial supply

 Falciform ligament contain ligamentum teres

 Deep circumflex iliac artery is branch of external iliac artery

 Appendix epiploacae ---- present in alimentary canal along with mesentry

 COWPER GLAND open into penile urethra

 Inferior mesenteric vein drains into Splenic vein

 Anal canal is not completely lined by stratified squamous epithelium

 Cysterna chili are situated in the Abdomen

 Length of urethra male – 20 cm female – 4 cm(cervical canal – 2.5 cm)

 Omental bursa is located at left sub hepatic

 Relation of sympathetic trunk to IVC is left

 Cave of Ritzeus --- infront of bladder

 Lymphatic of vulva transverse the labia from medial to lateral side

 Inferior hypogastric plexus is located – on the side of rectum

 Ligamentum teres is remnant of left umbilical vein

 Free edge of falciform ligament encloses Ligamentum teres

 Ureter enter pelvis in front of bifurcation of common iliac artery

 Diaphragm not formed by Dorsal mesentry of oesophagus

 Ductus deferens not begin s in the head of epididymis

 Pyramidalis is s/b subcostal nerve

 Splenorenal ligament --- splenic artery + tail of pancrease

 Ureteric constriction is not found at mesentry

 Ant. N middle Thoraco lumbar fascia not attach to spinous process of lumber vertebra

 Sup. Epigastric ar. ---- br of superficial br of femoral artery

 inf. Epigastric ar --- br of External iliac ar.

 Sensory supply of fallopian tube & ovary – D10-D12

 Umbilicus drain into Axillary and inguinal lymph node

 Optic foramen is located b/w lesser wing & body of sphenoid

 Cilioretinal art. Is br of Choroidal art

 Narrowest part of middle ear -- Mesotympanum

 Skin at angle of jaw is s/b Greater auricular nerve

 Pterion not correspond to the Transverse sinus

 Cusp of carabelli is seen in 1st molar

 Internal thoracis vein are tributaries of Brachiocephalic vein

 Ansa cervicalis innervate sternohyoid

 No. of ossification centre in hyoid bone – 6

 Premature closure of foramen ovale results in Rt. Ventricular hypertrophy

 Internal carotid artery at bifurcation from the common carotid is lateral to the external carotid art.

 Cavernous sinus communicate directly all except Sigmoid sinus and straight sinus

 Arcuate eminence of petrous temporal bone is caused by Superior semicircular canal

 Cilliary ganglion located in the orbit apex of orbit b/w optic nerve & lateral rectus

 Incissor foramen in the mouth is foramen of scrapa

 Retina is outgrowth of Diencephalon

 Parasympathetic division innervate Detrusor muscle

 Circulus iridis major is situated in Root of iris

 Lamina cribrosa is a modification of Sclera

 Vein of Glen drains into Straight sinus

 Adult larynx extends C3 to C6

 4th ventricle is Rhomboid fossa form floor

 Cranio facial angle 1300

 Vocal ligament is not discontinuous with crico thyroid membrane

 Meckel’s cave – Trigeminal nerve passes

 Nerve of pterygoid canal is sympathetic + greater superficial petrosal nerve

 Superior malleolar ligament connect head of malleus to roof of epitympanum

 Superior cerebral vein drains into Superior sagittal sinus

 NLD --DLB

 Transverse ligament of atlas is part of Cruciate ligament

 Lingual nerve is in close relation with root of lower 3rd molar

 Pseudounipolar neuron are seen in Spinal dorsal ganglion

 Trochlear is decussate within brain

 Post fontanelles ossified – 3 month(ant –18month)

 100 lymph node in cervical group

 Muscle arising from oblique line of thyroid – Thyrohyoid

 Inferior oblique is not arises from apex of orbit

 Superficial incision on posterior triangle of neck leads to difficulty in shrugging of shoulder

 Sensory fibre from the taste bud in hard & soft palate travel along facial nerve

 Parasympathetic secretomotor nerve supply to nose is via vidian nerve

 Mental foramen is not norma basilaris

 Central artery of retina is br of ophthalmic artery

 Opening of larynx – PCA

 Ligament of berry in thyroid fixes Cricoid cartilage

 Larynx has 9 cartilage 3 paired n 3 single

 Supratentorial dura is innervated by br of trigeminal nerve where as infratentorial is s/b upper cervical spinal nerve & vagus nerve

 Occipital art. Is not a content of sub occipital triangle

 Pyramidal fibre are projection fibre

 In postnatal period greatest growth in grey matter of CNS is of Dendritic tree

 CSF is partly absorb by 1 2 7 8 CN

 Geniculate body is not a part of Epithalamus

 Medulla oblongata is not s/b AICA

 Facial nerve nucleus is not found in the floor of 4th ventricle

 Interpenduncular fossa contain all except ophthalmic nerve

 Lesion of medial temporal lobe is a/s Auditory amnesia

 Great vein of Galen is formed by Internal cerebral vein

 Branch of basilar art – S -- sup cerebral

 I --- AICA

 P--- post cerebral

 P--- pontine art

 L—labranthine art

 Mamilliothalamic tract terminates in anterior nuclei in the thalamus

 BBB is formed by Astrocytes

 Central sulcus is e.g. – Limiting sulcus

 Superior colliculus is concern with Vision

 Genu of internal capsul carries --- corticonuclear tract

 Not the br of maxillary br of internal carotid art --- ant. Tympanic

 Cerebrellar glomeruli are seen in granular layer

 Hofbauer cell are a/s Early pregnancy

 Mastoid process antrum begin to develop in the 6th month

Development of diaphragm by

 1. Septum transverum

 2.pleuro peritoneal membrane

 3.somites (3-5th)

 4.ventral pleural sac

 5.mesentry of oesophagus

 

 

 Tonsil develop embryologically from 2nd pharyngeal pouch

 Parathyroid is develop from 3rd & 4th brachial pouches

 Foot plate of stapes is develop from otic capsule

 Umbilical vesicle attain full development in 4th week of foetus

 Urachal fistula result from persistant allantois

 Uro – rectal septum separate the cloaca into rectum & urogenital sinus

 Shortgun perineum is congenital condition in female

 1st – MIAS 2nd __ 5s 3rd-- greater corn. 4th & 6th – cartilage of larynx

 Formation of primary ovary in female foetus takes place by 8th week

 Rt. Subclavian art is derived from Rt. 4th aortic arch

 Corona radiata of ovum from follicular cell

 Melanoblast cells appear in basal layer of epidermis during 3rd month of intrauterine life

 Notochord develop in 3rd week

 Paraxial mesoderm develop into Somites

 Germ cell are endoderm of yolk sac

 Torus aorticus an impression in the cavity of – Rt Atrium

 Mullerian duct remmant in male --- 1.Appendix of testes 2. Prostatic utricle…. All other remmant in male /female found in wolffian duct

 4th ventricle develop --- Rhombencephlon , 3rd ventricle—Diencephalon

 Meckel’s diverticulum is remmant of vitellointestinal duct

 Vitelline vein form – HIPS (hepatic vein ,IVC,portal vein ,sup MA)

 Outer layer of the blastocyst form trophoblast

 Forelimb bud appear on 26 days

 Cauda equina devlp frm Neural tube

 Spiral ganglion and organ of corti fully develop in fetus by 20 weeks

 Lymph capillary have discontinuous basement membrane

 Epithelium of cornea – stratified squamous non keratinized

 Ansa nephroni is lined by Cuboidal and squamous cell

 Gitter cells – microglia

 Synovial bursa b/w an aponeurosis and bone is called Subfascial

 No lymphatics --- bone marrow,cartilage

 Goblets cell present in trachea

 Von Brun nest is seen – normal urothelium

 Ruffled membrane is seen in Osteoclast

 Portal Acinus in liver is centered on hepatic arteriole

 Syndesmoisis --- inf. Tibiofibular joint

 Os trigonum --- Atavistic

 Manubriosternal joint – symphysis

 In interpharyngeal joint capsule is absent in Dorsal side

 1st carpometacarpal joint is Saddle joint

                                                                       The end

 

 


Final n fast revision of SKIN

Posted by pawan2006e on March 31, 2012 at 11:00 AM Comments comments (0)

Final n fast revision of SKIN

                      www.drpawan.webs.com

 


 Tzank cell – keratinocyte

 Wood lamp (filter is made up of nickel oxide & silica)uses – 360 nm wavelength

 Coral red fluorescence -- Erythrasma

 Ruby laser is selectively absorbed .

 Burrow ‘s solution – Almunium subacetate

 Atopic dermatitis best Dx by – Biopsy

 Munro micro abscess --- S. corneum

 Morbilliform eruption --- measles,rubella

 Nails are not involved in DLE

 Piebaldism refer to Association of vitiligo with white forelock.

 Dhobi itch – T. cruris

 Cradle cap is a special form of pityriasis capitis

 Erosion & discoloration of web space of toes Dx—Candidiasis

 DOC for mucocutaneous candiasis – KTZ

 Tinea crusis by– Mallassezia furfur

 Griseofulvin is not used in T. versicolor

 Erythema pernio due to Cold

 Nickel causes skin hypersensitivity

 Quincke’s Ds. Popularly known as Angioneurotic oedema

 Patch test for Allergic contact dermatitis

 Physical urticaria -- Dermographism

 Seborrhoeic dermatitis frequently seen in Parkinsons Ds.

 Veldt sore MC in Desert

 Erythrasma caused by Corynebacterium minutissimum

 Acute neuritis in leprosy respond best to Dapsone

 Acne agminata seen in T.B.

 Reversal lepra rkn show no response to thalidomide

 In 20 syphlis rashes are asymptomatic

 Leprosy not involve CNS

 Jarisch herxheimer rkn is common in Early syphilis(Chancre redux)

 Pitted keratocytes – bacterial infection

 Ollendorf sign --- 20 syphilis

 Earliest sensation lost in leprosy – thermal

 DOC of gonorrhoea – Streptomycin(also for GV)

 Esthiomine --- LGV

 Umblicated papule – Molluscum contagiosum

 Gonorrhoea not involve testes

 Myrmecia wart --- plantar wart

 Most contagious syphilis stage -- 20

 KI is useful in t/t of Sporotrichosis

 Copra itch caused by mites

 Macula cerulea seen in Pthiris pubis

 Vagabond ‘s ds—pediculosis corposis

 t/t of pustular psoriasis --- Retinoids

 Rhinophyma(sebaceous gland hypertrophy) complicate Acne Rosacea

 Crystalline miliaria due to obstruction of Sweat gland

 Pseudo pelade – cicatricial alopecia

 Pitting of nail – alopecia areata,psoriasis

 Moth eaten alopecia seen in 20 syphilis

 Toxic Epidermal necrolysis – lyell’s syndrome

 Erythema multiforme commonest etiology is viral(herpes simplexs)

 Sub-epidermal splitting is not found in P. foliaceus

 Pencillamine --- causes pemphigus

 TEN caused by – phenytoin,penicillin

 Slate like discoloration by Amiodarone,thiacetazone

 Riehl’s melanosis involve Face and neck

 Hypo –depigmented seen in Naevas depigmentosa

 Acanthosis nigricanshistologically show papillomatosis

 Basal cell carcinoma not spread by lymphatics

 TOC for solar keratosis – topical 5FU,cryoSx

 Freckles are not prone to malignancy

 Changes of squamous cell ca are seen in Bowen disease

 Genodermal ds that can cause skin malignancy – Xeroderma pigmentosa

 Chloroquene used in t/t of DLE

 Psoralen –A used in t/t of Vitiligo

 Pruritis is not seen in Pemphigus

 Darrier sign seen in Urticaria pigmentosa

 Cayenne pepper stippling due to hemosderin in plasma cell balanitis of zoon

Fish mouth vertebra

Osteogenesis imperfect

Ehler danlos syndrome

Homocystinuria

Marfan syndrome

 

 Ballooning is characteristic of herpes zoster

 Morphea occur usually in Limbs & back

 A positive Rumpel –leed test seen in RSMF

 TOC in cutaneous complication of porphyria is beta carotene

 Circulating lymphocyte are most sensitive to UV –C

 Honey colored crust characteristics of Impetigo

 Nail involvement is not a feature of DLE

 Co2 Laser not causes scarring and has minimum penetration

 Fordyce’s ds mainly involve Lips

 In Fox Fordyce’s ds common in areola & axilla

 Bulkeley membrane seen in Psoriasis

 Virchow’s cell --- Leprosy

 Necrobiosis lipoidica diabeticorum most marked in front of legs

 Liver spots are sign of Senility

 Compy sign --- measles

 Congenital erythropoietic porphyria enzyme deficient Is Uroporphyrinogen synthetase-!!!

 Iris pearl – Leprosy

 Granular layer is absent in Ichthyosis vulgaris

 Ichthyosis is caused by Refsum ds

 Koenon’s periungual fibroma are seen in >50% of cases --- tuberous sclerosis

 Linear lesion --- Sporotrichosis

 Tinea incognito seen with Steroid t/t

 Recurrent balanoposthitis seen in DM

 Shingles is other name of Herpes Zoster

 Eczema herpecticum – HSV

 Circle of hebra--- scabies

 Keratoderma is feature of Pityriasis rubra pilaris

 Grotton’s papules – violaceous papules over knuckles

 Bullous eruption not found in Lichen planus

 Pinkish red flurescence of urine with Wood’s Lamp --- porphyria cutanea tarda

 

 

THE END

 

Final n fast revision of PSYCHIATRY

Posted by pawan2006e on March 28, 2012 at 12:45 AM Comments comments (0)

 

 

Final n fast revision of PSYCHIATRY

            www.drpawan.webs.com

 



 Dementia due to def. of – Niacin

 Reversible dementia ---multi infarct , hydrocephalus,hypothyroidism

 Mini mental status – 30 point programme to evaluate cognitive function

 Apo E protein is involved in Alzheimer’s ds

 Pseudodementia – depression

 Delusion of love from high socioeconomic status --- De Clerambault syndrome

 Phencyclinidine often a/w Depersonalization

 In morphine addiction withdrawal is done with clonidine ,methadone

 Jhagnan phenomenon occur in cannabis

 Alcohol hallucination occur within 24 hrs

 Not a feature of heroin withdrawal – hypersomnia

 Not seen in alcohol withdrawal – excessive somnolence

 Amotivational syndrome is seen in Cannabis

 Not a feature of alcohol withdrawal syndrome -- Made phenomenon

 Wernicke’s encephalopathy --- Mammilary body

 Used in alcohol dependence – topiramate

 For averting smoking habit Bupropion not buspirone

 Lacrimation is seen in opium withdrawal

 Dopamine & serotonin is increased in Schizophrenia

 Schizophrenia is a/w ashthenic personalities & low socioeconomic

 Best prognosisi in Schizophrenia ---- Auditory hallucination

 Defect of conation typically seen in Catatonic Schizophrenia

 Incidence of Schizophrenia in india 1-5 /1000

 Grossly ,disorganize,severe personality deterioration & worst prognosis – Hebephrenic Schizophrenia

 S/E of Clozapine -- Sialorrhoea

 Not a feature of catatonic Schizophrenia – Catalepsy

 In catatonic Schizophrenia not found Gegenhalten

 Nihilistic ideas are seen in Cotard syndrome

 Visual hallucination is seen in simple Schizophrenia

 Neurotic depression not characterized by increased libido

 In depression deficiency of 5-HT(serotonin)

 Depression is S/E of Methyl dopa

 Mood disorder seen in Schizoid state

 TOC for rapid cyclers in bipolar illness – sod. Valproate

 Bipolar – 2 disorder – Repetitive depression hypomania

 Levomepromazine used prophylactically in Bipolar mood disorder

 Therapeutic dose of Li ---- 0.8 – 1.1 mmol/L

 Disassociation disorder not present in delirium

 Folie a deux (Shared paraphrenia )was 1st describe by Lasegue & Falret

 MC form of Disassociation hysteria is Amnesia

 Thenatophobia – typically at the stage of 8 yrs

 La belle indifference(Disassociative disoder) --- Disregard for symptom despite apparent severity

 Dhat syndrome is due to fear of losing Semen

 Folie a deux --- seen in paranoid

 Not a c/f of PTSD – hallucination (AI 08)

 Differentiation of hysterical fit from epileptic fit that it occurs when people watching

 Not a compulsive & habit forming disorder – Nymphomania

 Othello syndrome – pathological jealousy

 Very rigid inflexible & loves order & discipline ---- Anankastic

 Type D personality have been associated with adverse cardiac prognosis (aiims nov 11)

 In sleep regulation 5-HT is amine most imp. Role

 DOC for night terror – Diazepam

 TOC for obstructive sleep apnoea -- domiciliary CPAP

 Commonest cause of mental retardation -- birth asphyxia

 Attention deficiency disorder seen with Phenobarbitone

 ECT causes decrease in ICT

 Fluoxetine S/E – nausea

 Thiopentone/Piracetam – used to bring back a large no. of memories for event just before traumatic event.

 DOC for intractable hiccough --- Clorpromazine

 Pigmentry retinopathy is S/E of Thioridazine

 Bromide intoxication is best treated with Ammonium chloride

 Non addicting drug useful for suppressing symptom of opoid withdrawal – clonidine

 Depression is S/E of propranalol, Reserpine

 Amoxapine causes Tradive dyskinesia

 TOC of ballismus -- Haloperidol

 Zolpidem – rapid induction of sleep with least effect on sleep structure.

 Reserpine – Anti HTN was once used as anti psychotic

 Cognitive therapy is used for Depression

 Reinforcement – used in conditioning learning

 Oedepius complex(Boys 3-5yrs) describe by Freud

 Fixation of Hysteria – Phallic

 OCD is fixed at Anal stage

 Abreaction method of t/t for Hysteria

 a fundamental technique used in psychoanalysis is free association

 that part of mind which working on reality principle is Ego

 term ‘id’ is coined by freud

 visual hallucination seen in – Alcohol

 Auditory hallucination is not seen in Hysteria,Amphetamine toxicity

 Dopamine hypothesis postulated in Schizophrenia

 Sec 174 CPC – Inquest

 Paraaminpropiophenone used in t/t of Cyanide poisoning

 Delusion is not seen in dementia

 Delusion of infidelity of part of the sexual partner is known as Othello syndrome

 Corpralalia --- Tourette’s syndrome

 Pseudocyesis is a form of conversion hysteria

 Pinel is famous for Moral t/t of patient

 Pseudocommunity --- Paranoid state

 Indian lunacy act – 1912

 Peptic ulcer is uncommon in Schizophrenia

 Déjà Vu seen in normal person,Psychosis & temporal lobe epilepsy

 Jamias Vu – sensation of feeling of unfamiliarity

 Cocaine introduce in psychiatry is Freud

 Cognition Disoders--- DOPS--- DELUSION ,OCD , PHOBIA,SCHIZOPHRENIA

 SCHIZOPHRENIA Best prognosis -- catatonic

 SCHIZOPHRENIA worst ,,,,,,,, -- Hebephrenic

 Stockholm syndrome --- Captives

 Mainlining – drug addicts using main vein for injecting drugs

 Verbigeration – sensless repetition of same word over & over again

 Different multiple personality - Dissociative disorder

 Slow wave EEG – delirium

 Commonest hallucination - Auditory

 Delusion of secret lover – Capgras syndrome

 OCD – classified under anxiety disorder a/c to DSM İİİ

 

 

Neurotransmitters imbalance

 ↑ DA SCHIZOPHRENIA

 ↑NA MANIA , ANXIETY

 ↓5HT,NA OCD

 ↓GABA EPILEPSY

 ↓SEROTONIN DEPRESSION

THE END

 

 

 

 

 

Final n fast revision of RADIOLOGY

Posted by pawan2006e on March 25, 2012 at 10:30 PM Comments comments (0)

Final n fast revision of Radiology

        www.drpawan.webs.com

 

 

 

Pnemothorax is best demonstrated during expiration

 Dye used in bronchography Dianosil

 Solitary nodule lung lung cannot be NF

 B/L calcification of lungs not found in Friendlanders pneumonia

 Perihilar fluffy opacity on chest X-ray seen in pulmonary venous HTN

 Rt. Lung is seen to best advantage on Rt. Anterior oblique

 In Hamartoma no cavitating lesion in CXR

 Best CXR are performed at 60-90 Kvp

 Golden S sign seen in Rt. Upper lobe collapse

 Preferred modality for Dx of pulmonary embolism is Ventilation perfusion >angiography

 Well defined rounded opacity in the lung with coarse irregular calcification ---- Hamartoma

 MC cause of spontaneous pneumothorax – rupture of subpleural blebs

 Apex of lungs is best asses by AP view

 Bulging fissure in lungs is seen in --- Klebsiella pneumonia

 Tracheal bifurcation at T4-T5 level

 Floating water lily sign --- Hydatid Lung

 Hampton hump --- pulmonary embolism

 U/L hyperlucent lung on CXR --- Poland syndrome

 Mediastinal Lymph node calcification seen in Sarcoidosis

 Lt. atrial enlargement(ALSO MITRAL VALVE) is seen with Barium swallow Rt. Anterior oblique view

 Echocardiography can detect pericardial effusion min fluid – 15ml

 Hilar dance -- ASD,VSD,TGV

 Dx of acute MI hot spot seen with Tc 99

 Best Dx for dissecting aorta ---- MRI

 Flask shaped heart – Ebstein anomaly, TOF

 Square root sign --- Constrictive pericarditis

 Splenic calcification --- Brucellosis

 Pancreatic scanning isotope MC used -- Selenium -75

 In colitis cystic profunda whole colon can involved

 No hapatomegaly in Coeliac Ds

 Scalloping of the edge of sigmoid colon on barium enema seen in --- pnematosis intesinalis

 Barium meal in trendelenberg position used best in Hiatal disorder

 Invertogram to be done in newborn after 6 hrs

 Hepatic adenoma can be Dx with high accuracy by using Nuclear imaging

 Fox sign --- Acute pancreatitis

 Adenolymphoma - Tc-99 scan show hot spot

 Bird of prey sign ---- Sigmoid volvulus

 Gold standard IOC for GIST – PETCT

 Bead cystogram used in Dx of Stress incontinence

 Placenta localization by Tc99

 In nephrogram one see Collecting duct

 Renal scan should be done in Supine postion

 Rim sign – Massive hydronephrosis

 Neonate has mass in kidney which on USG is seen as hypoechoic shadow ---- Mesonephroblastic tumour

 Uereterocoele (IVP) --- Adder head appearance

 Central stellate scar on CT --- renal oncocytoma

 A tumour Trouser leg appearance on an ascending myelogram –intramedullary

 Stipple sign in transitional CC of the renal collecting system best seen in retrograde pyeloureterography

 ACUTE SAH < 48 Hrs - NON CONTRAST CT

 CHRONIC SAH >48Hrs - MRI

 DENSITY OF HEMORRHAGE DECREASES WITH TIME AND GRADUALLY APPROACHES THAT OF CSF

 Basal ganlia calcification seen in Wilson ds

 MC intracranial calcification is peneal calcification

 Tram-line calcification --- Sturge weber syndrome

 Commonest cause of intracerebral calcified shadow --- Oligodendroglioma

 Most serious complication of myelogram – Allergey

 Calcification in basal ganglia --- hypothyroidism, hypoparathyroidism

 In fluorescein angiography dye is injected in ante cubital vein

 Bracket calcification in skull X-ray – copus callosum lipoma

 Periventricular calcification --- CMV

 In meningioma no erosion occur

 Extramedullary intradural tumour – Neurofibroma

 Multiple sclerosis lesion in white matter

 Banana sign --- Spina bifida

 X-ray of Skull n phalanges is diagnostic in hyperparathyroidism

 Dead bone on X-ray look more radio opaque

 Intraosseous skeletal tumour is best Dx by CT scan

 Stryker’s view is used in shoulder joint to visualize --- Recurrent subluxation

 Normal metacarpal index is 5.4 – 7.9

 Stenver View(Towne view) --- internal auditory meatus ,mastoid air cell(MALIS see mnemonics page)

 Champagne Glass pelvis --- Achondroplasia

 Umbau Zones -- osteogenesis imperfect

 Caldwell view – Superior orbital fissure

 H – shaped vertebra --- Sickle cell anemia

 Schober ‘s sign --- Flexion of lumber spine

 Vertebra plana --- EG,Malignancy

 5 –FU not given in Mycosis fungoides

 Karnofsky scale --- measurement of size of tumour

 Sunburst calcification on X-ray -- insulinoma

 Calcific hepatic metastases --- Adenocarcinoma of colon

 S/E of USG in small organism --- cavitation

 Isotope selectively concentrated in abscess --- Gallium

 X-Ray film are least sensitive to which coloured light – red

 Photoelectric interaction Primarily in K shell

 Thesaurosis -- Resins in hairspray

 Grid – used for reducing scattered radiation

 Best Dx of nasopharyngeal angiofibroma – CECT

 Medusa head in X-Ray – ascariasis

 Spring water cyst – pleura pericardial cyst

 USG of umbilical artery done for to know heart beat

 USG frequency used in obs is 1-20 MHz

 Sestamibi Scan --- parathyroid adenoma

 UV A – 320-400 nm

 Active ingredient in Xray film – silver bromide

 “Time of Flight “ technique used in MRI

 Target angle in tele therapy --- 300

 T ½ of Co60 = 5.2 yrs

 Radioactive gold is used in malignant ascitis

 Radioactive phosphorus used in polycythemia

 Isotope which replacing radium – Cs

 Tc99 T ½ = 6hrs

 Latest source of neutrons for radiotherapy --- Californium -256

 A single whole body dose can cause death – 300 rad

 In teletherapy distance is 100 cm

 1st sign after Radiation is Erythema

 T ½ of Rn-222 =3-6 days

 1 gray(unit for absorbed)= 100 gray

 Benign condition treated by radiotherapy is pituitary adenoma

 Dose for total body irradiation in bone marrow transplantation – 1000 cgy – 1200 cgy

 Hyperfractionation Rx (Radiotherapy) used in Lung cancer

 Naturally occurring radioactive substance in the body – K40

 Radioactive isotope used in gamma knife for t/t of AV malformation—Co

 Not used in brachytherapy – I131

 RAIU – I 123 (AI 07)

 Max permissible dose of radiation for radiation worker 50 MSV per year

 1Curie = 3.7 Gbq

 Point B t/t of Ca of cervix by radiotherapy --- Obturator node

 Commonly used in intra operative Rx – Electron

THE END

 

Fast n Final revision of ENT

Posted by pawan2006e on March 21, 2012 at 5:00 AM Comments comments (0)

Final n fast revision of ENT

                        www.drpawan.webs.com

 

MEATUS --STRUCTURES OPENING

(1) SPHENO-ETHMOIDAL RECESS=Opening of SPHENOID sinus

 

(2) SUPERIOR MEATUS=POST.ETHMOIDAL air sinuses

 

(3) MIDDLE MEATUS=(a) BULLA ETHMOIDALIS

=(b) HIATUS SEMILUNARIS

=(c) INFUNDIBULUM

=(d) Opening of FRONTAL air sinuses

=(e) Opening of MAXILLARY air sinuses

=(f) Opening of ANTERIOR ETHMOIDAL air sinuses

=(g) Opening of MIDDLE ETHMOIDAL air sinuses

 

(4) INFERIOR MEATUS=Opening of NASOLACRIMAL DUCT

( gauded by Hasner's valve/lacrimal fold)

 

1) "TONSILS---/ TONSILITIS / TONSILLECTOMY --- infec.by group A & B streptococcal / strepto.pyogenes-(common org.)-Rxpenicillin for 10 days, pain in the post 1/3 tongue after tonsillectomy is due to injury to / throat pain radiating to the ear following tonsillectomy is due to IX cr. Nerve, tonsil develop embryologically from2nd.pharyngeal pouch, Hard elongated swelling in the tonsillar fossa after tonsillectomy --elongated styloid process, Tonsillectomy--indications-(1) F.B. tonsil, (2) unilat.enlargement of tonsil with suspected malignancy, (3) atrophic tonsillitis, (4) Recuurent acute tonsillitis , (5) recurrent quincy, postop. complication hemorrhage--Rx antibiotics + saline wash, sec.hemorrhage(5-8hrs)-is due to- infection,& it is the common postop.compli.,hemorrhage after 6hrs --reactionary H., main blood supply to tonsil is facial artery, tonsillectomy is CI in polioepidemic, Palatine tonsil have Efferents but no afferents, After Quincy interval tonsillectomy is done after 6 wks.,commonest L.N. to enlarge in acute tonsillitis is Jugulodiagastric L.N., tonsil reach their max. size by 5yrs.,"---------((20))

 

2) "OTOSCLEROSIS / OTOSPONGIOSIS ---A.D. more in Females, affects Oval window/stapes, ConductiveHearingLoss, colour of T.M.=FLAMINGO PINK, Paracusis willisii, Schwartz sign seen, Gelle's test -ve, Carhart's notch/ dip=2 khz, TOC=Stapedectomy with prostesis/Fluorides--cochlear otosclerosis,"-----------((19))

 

3) "VOCAL CORD(S)---is line by stratified sq. epithelium, REINKI'S layer seen, web form'n. post truamatically can be prevented by MC NAUGHT'S KEEL, unilat.V.C. palsy--commonest cause-Idiopathic, left unilat. V.C. palsy-cause-oesophageal ca., Precancerous lesion in V.C.-leukoplakia, localised nodule vocal cord of sq.cell ca. vocal cord-Rx-Excision, earliest symp.of ca.vocal cord--Hoarseness, MOUSE NIBBLED APP.of V.C.--seen in T.B. of V.C., granuloma of V.C.-is due to Intubation, unilat.complete paralysis of V.C. can be corrected by--Teflon inj.,cricoarytenoid arthrodesis,implant procedures, T1N0M0 CA.of V.C.-Rx--radical radiotherapy, Internal tensor lengthening mucosa of V.C. is Cricothyroid, pri.aetiological factor in contact ulcer of larynx--Vocal Abuse, V.C.paralysis--resp.obst., aphonia by adductor paralysis can be overcomed by Arytenoidectomy, 19yrs.old female with aphonia has bilat.abductor paralysis cause is functional,"----------((19))

 

4) "CANCER OF LARYNX---Squamous cell cancer of larynx is commonest presentation, it is the commonest cause of Hoarseness of voice in Elderly man of more than 2mths.duration / Laryngeal Stridor in a 60yrs.man, Early fes.of Ca.larynx= Hoarsness of voice, NO neck secondaries-->Rx only Radiation, STAGE-III-->SURGERY+RADIATION,Rx of Glottic cancer-- TOC.-for (T1N0M0)-->EXTRENAL BEAM RADIOTHERPY, Ca larynx with Fully Mobile Cords-TOC.-->RADIOTH.,Rx of Ca.larynx with Stridor-->PLANNED TRACHEOSTOMY,glottic cancer has least chance of Nodal Mets.,Glottic Vocal Cancer has Best Prognosis, Hoarsness Early in Glottic Cancer, INFRAGLOTTIC CA.-->Commonly Spreads to Mediastinal L N'S, Ant.Commissure growth-Rx-->Conservative Laryngectomy, post cricoid growth---"----------((17))

 

5) "OTITIS MEDIA---CSOM ( CHRONIC SUPPURATIVE OTITIS MEDIA)---attico antral(dangerous type of ear), Schwartze op. done, csom with cholesteatoma with acute onset of vertigo-Rx-immediate exploration, Rx-cholesteatoma-radical mastoidectomy"--------------((10))

 

6) "ACOUSTIC NEUROMA---Auditory defect, sensory aphasia, changes in audiometry, commonly affects-8 Cr.N. & that too Superior Vestibular Nerve, early symp.-UniLateral hearing loss, it is most common (CPA) Cerebello-Pontine Angle tumours, Numbness of Face, Deafness, Internal Hydrocephalus, Ac.Nr. of 1 cm-IOC/diag.of choice=C.T. SCAN, hypoesthesia of the post. aspect of the ext. auditory canal-this is an early sign, " ----------((9))

 

7) "MENEIRE DISEASE / ENDOLYMPHATIC HYDROPS--- Ass.withPresbycusis, fes.--Tinnitus, Recurrent Vertigo, Deafness, Low Frequency SNHL/SND.-on pure tone Audiogram, GLYCEROL TEST is done in this, CODYTACK OPERATION is done, Cochlear type M.D.--Cochlear Deafness, Rx--Vasodilators--> increase Endolymph reabsorption, vasodilators of internal ear-is-Nicotinic acid,"-----------((9))

 

8) "ANGIOFIBROMA (NASOPHARYGEAL)---Juvenile angiofibroma is locally enlarging tumour producing destruction of bony structures without producing distal secondaries, Young Males(10 yrs boys), Bilateral Nasal Obstruction, bleeding from nose/ Intermittent profuse Epistaxis, firm pinkish mass in nasopharynx, Inv.=X-ray base of skull, carotid angiography, C.T.SCAN(IOC), Benign but potentially malignant, "----------------((7))

 

9) "EPISTAXIS---most common site--AnteroInferior Part of the Nasl Septum ,this is also called as ' LITTLE'S AREA ' ,in Ederly pt.--commonest cause-HTN.,Rx give NTG to decrease B.P., Recurrent epistaxis in a 15 yrs.female--most common cause-Hematopoietic disorder, Epistaxis in a 5 yrs. old Boy is due to Bleeding Disorder,Recurrent Epistaxis=causes--DNS, Atrophic Rhinitis, Maxillary Ca.,"-----------((7))

IMP.ENT Topics

1) "FACIAL NERVE---secretomotor N.fibres of SphenoPalatine Ganglion supply the Lacrimal gland, Injury to Facial N.at Geniculate Ganglion-->Dryness of eyes, Site of lesion of F.N. causing Lacrimal gland involvement is Matoid Foramen, FACIAL NERVE PALSY---common cause--Bell's Palsy, F.N.P.-due Trauma, Immediate Rx--Decompression,"----------((6))

 

2) "MIDDLE MEATUS OF NOSE---Frontal air cells,Ant. Ethmoide, Maxillary sinus opens in it, BULLA-ETHMOIDALIS, HIATUS SEMILUNARIS are seen, "-------------((6))

 

3) "NAOPHARYNGEAL CANCER---EBV is a causative agent, Spreads to Lymph nodes, commonest Presentation--Cervical adenopathy, there is High Incidence of NODAL METASTASIS, "-----------((6))

 

4) "OTITIS MEDIA---ASOM (ACUTE SUPPURATIVE OTITIS MEDIA) commonest cause--Pneumococcus -->very serious O.M., Pulsatile Otorrhea seen, 3yrs. Child with Fever, Ear ache, Congested T.M. with slight Bulge, it is the commonest cause of hearing loss?, Rx--Penicillin ( Myringotomy+ penicillin)"------------((6))

 

5) "NASAL POLYP---ANTROCHOANAL P.---& POLYPECTOMY-intranasal & ext.approach--arises from maxillary sinus, single & unilateral,"---------((6))

 

6) "ATROPHIC RHINITIS---Sx young operation done., ozaena is seen, anosmia, alkaline douche sol'n=NaCl, Na-borate, NaHCo3"----------((6))

 

7) "STRIDOR---effect of BILAT. RLN damage, most common cause in adult--malignancy, Rx of congenital laryngeal stridor =reassurance to parents, most common cause pf stridor in newborn--laryngomalacia,"---------------((6))

 

8) "TRACHEOSTOMY---complication commonly occur in children-is-difficult decannulation, indication--stridor, coma of long duration , diptheria, laryngeal obst.,flail chest, tetanus(cyanotic spells) , It isnot used in F.B. / Obst.of post basal lobe /bronchus, commonest compli.of paediatric--Pneumothorax, "--------((6))

 

9) "TYMPANIC MEMBRANE---Blue Drum--seen in Secretory otitis media, nerve supply auriculotemporal nerve, T.M.-mobility--most mobile part-central, "----------((6))

 

10) "LITTLE'S AREA--- arterial supply= Ant.Ethmoidal art., Septal branch of facial art., Nasal branch of Sphenopalatine art., it is the commonest Bleeding site of nose / EPISTAXIS, or KIESSELBACH'S PLEXUS---Bleeding Area of nose is situated in the AnteroInferior surface of septum/medial wall of nasal cavity ,” ----------------((6))

 

11) "HEARING LOSS---SENSORENEURAL H.L.---(SNHL)--causes-old age, Cochlear Otosclerosis,Loud sound, Rx--COCHLEAR IMPLANT,Hydrops of Endolymphatic system-seen-in Alport's synd.,Usher's synd.,Pendred's synd.,"----------((5))

 

12) "MIDDLE EAR CAVITY---Nerve supply--Glossopharyngeal nerve,Floor--formed by INTERNAL JUGULAR BULB, In middle ear desease-there is - increased Threshold of AC & decreased BC (BC>AC), Resistance in middle ear-is-tested by IMPEDENCE Audiometry, Prominent Emenece over medial wall of midlle ear-is formed by-COCHLEA( BASAL TURNS),"----------((5))

 

13) "NASAL CAVITY---Function--Warming, Moistening, Filtration,NASAL SEPTUM---is formed by Vomer bone, Perpendicular bone of Ethmoid, Rostrum of Sphenoid, APPLE-JELLY NODULES on nasal septum--is due to Lupus Vulgaris, NASAL CARTILAGE-- 3 Paired & 1 Unpaired cartilages, NASAL MUCOSA---supplied by mainly Ext.Carotid artery,"-----------((5))

 

14) "RECURRENT LARYNGEAL NERVE---partial RLN palsy produces Vocal cord in PARAMEDIAN position, closely related to Inf.thyroid artery, BILAT.RLN PALSY=ADDUCTED position & stridor, supplies allexcept cricothyroid( SLN),"----------((5))

 

15) "RHINOSPORODIOSIS--- Rx- Dapson, fungal infec.,max.in Tamil nadu, Rx excision with cautery at base,"-----------((5))

 

16) "DNS / DEVIATED NASAL SEPTUM ---sharp DNS--Epitaxis, SPUR, recurrent sinusitis, Newborn with DNS= 20%, inf.tubinate hypertrophy,COTTEL'S TEST--patency of nares in DNS,"------------((5))

 

17) "FRONTAL SINUS--F.S. develops from ant. Ethmoidal cells,PNEUMATOCELE--fracture of F.S., not present at birth, FRONTAL MUCOCELE--"-----------((5))

 

18) "EPIGLOTTITIS---ACUTE--Commonest Organism causing it is -Hemophilus Influenze, DOC.in children--Ampicillin,commonest cause death-is-Respiratory obstruction,"------------((4))

 

19) "MYRINGOTOMY---done on POSTERO-INFERIOR Quadrant of T.M., commonest indication--Serous Otitis Media, a child with otitis media with Bulging T.M. with dull look, PUS in middle ear under tension,"-----------((4))

 

20) "PLUMMER VINSON'S SYND.---ass. With oesophageal ca., post cricoid growth, IDA, females, premalignant ( for hypopharyngeal ca., "---------((4))

 

21) "QUINSY---PERITONSILLAR ABSCESS---org.-streptococcus,quinsy+trimus--> Rx for 48 hrs. antibiotics only & then oral drainage,"----------((4))

 

22) "SEPTAL PERFORATION---of Cartilagenous nasal septum--septal abscess,leprosy ( ant. Septal perf.), Bony septal perforation--syphilis, Mucosa; inv. With nasal septum perforation in jaws-is-known as GANGOSA, "--------((4))

 

23) "MAXILLARY SINUSITIS---commonest / chronic sinusitis in children,"---------((4))

 

24) "PATCH IN THROAT--- / MEMBRANE IN THROAT --- (1) vincents angina, Black colour patch in mouth, (2) candida , (3) diptheria, (4) streptococcus, & IN THROAT OF ADULT----> Hemophilus, streptococcus, Neisseria, organism are seen but not E-Coli, "----------((4))

 

25) "GLUE EAR---8 yrs. Old child, Bilateral Conductive Deafness, seen in SECRETORY OTITIS MEDIA, or SEROUS OTITIS MEDIA---FLAT Tympanogram , "--------((4))

 

26) "MYRINGOPLASTY---Plastic Repair of T.M., note- initially audiometry done & then Sx done, or TYMPANOPLASTY---before T.plasty surgeon look for cochlear reserve, temporal fascia is used -it's metabolic rate is low, "-----------((4))

 

27) "BRAIN OTOGENIC ABSCESS---Mx-drainage of abscess followed by mastoidectomy, commonest site--temporal petrosal lobe, TEMPORAL LOBE ABSCESS---occurs in unsafe otitis media with high fever , convulsions "---------((3))

 

28) "ADENOIDECTOMY--- Indication--Recurrent Otitis Media, Sleep Apnoea synd., Middle ear infec. With deafness, C I --Submucous Cleft Palate, control of Hemorrhage--by Post.Nasal PACK, " ---------((3))

 

29) "ARNOLD'S NERVE---is a Branch of VAGUS Nerve, Irritation of this causes Ear Cough, Cough response caused while cleaning ear canal is mediated by stimulation of X Cr.N."----------(3)

 

30) "CARDIOSPASM / ACHALASIA CARDIA---difficulity for swallowing Liquids but not for solids, ass.with DEGENERATION of nerve plexus in the oesophagus, Barium Swallow-shows-Dilatation with smooth narrow ending, "--------((3))

 

31) "ENDOLYMPH---most imp. Constituent-K+ , is seen in Scala Media , Drains into Virchow Robin Space,"-------((3))

 

32) "EUSTACHIAN TUBE---most common cause of E.T. disease--ADENOIDS, LENGTH=36mm( 3.6 cm),"-------((3))

 

33) "GLOMUS TUMOUR---in middle ear, Location--Hypotympanum,Pulsatile Tinnitus ,Pulsatile tumour in EAM which Bleeds to Touch,"---------((3))

 

34) "GRADENIGO'S SYND.---abducent VI Nr. Palsy, Retroorbital Pain, pain over face, Aural discharge/ otorrhoea, Pralysis of Ext./lat Rectus, Nr. Inv.= 5,6, GRADENIGO'S TRIAD---Mastoiditis, Petrositis, L R palsy,"--------((3))

 

35) "MULTIPLE PAPILLOMA OF LARYNX---Rx Excision with Laser, common in Infants & Children, Laryngeal papilloma are usaually Multiple & VIRAL in origin, usual site of papilloma is larynx, Rx of single P.= Removal by Direct Laryngoscopy, "---------((3))

 

36) "TUBERCULOSIS OF LARYNX/TUBERCULOUS LARYNGITIS--- KISS ULCER of Larynx, common site of T.B. Larynx is POST.COMMISSURE OF L."-------((3))

 

37) "OTITIS EXTERNA---MALIGNANT--caused by P.Aeroginosa, common in D.M., & OLD age,"----------((3))

 

38) "RHINOSCLEROSIS / RHINOSCLEROMA--- bacilli infec., Mickulitz & Russel bodies seen,"-------------((3))

 

39) "RINNE'S TEST---+ve seen in presbycusis, -ve(BC>AC)-->middle ear disease,"--------((3))

 

40) "CSF RHINORRHOEA--- ant.cranial fossa fractures / Cribriform plate fracture , most imm. Rx-prophylactic antibiotics& x-ray, "-----------((3))

 

41) "ETHMOIDAL SINUS--First sinus to appear after Birth, ETH.S. Adenocarcinoma--seen in WOOD workers & Nickel workers,"--------((3))

 

42) "MAXILLARY SINUS---maxillary antrum commonest malignancy=sq.cell ca., secondary deposits from M.S.-->submandibular L.N.'S,this is present at birth,"----------((3))

 

43) "SINUSITIS---bloood stainded rhinorrhoea, nasal blockage, facial edema, complication=orbital cellulitis, Sx-proof puncture,"---------((3))

 

44) "STAPEDIAL MUSCLE---supplied by facial cr. Nerve, STAPEDIAL REFLEX---protective against loud sound , mediated by VII & VIII CR. N.,"---------((3))

 

45) "SUPRAMEATAL SPINE OF HENLE---landmark on lat.surface of temporal bone which acts as a guide to surgery to the antrum,"----------((3))

 

46) "VOCAL FOLDS---& VOCAL FOLD CA.---Vocal folds are abducted by post.cricoarytenoid, in CA. L.N.'Smets never seen,,has good prog.,"----------((3))

 

47) "FRACTURES OF ZYGOMA--- undisplaced fracture--no specific Rx,"--------((3))

Topics Asken more than Twice

 

1) BEZOLD ABSCESS---located in digastric fossa/ sternomastoid muscle,-------------((2))

 

2) "CALDWELL-LUC OP.---commonest complication=Infra orbital nerve Palsy, used for removal of AntroChoanal Polyp,"------------((2))

 

3) "CALORIC test---done with Warm & Cold water, has Slow & Fast Component, Tests function of Lat.Semicircular canal,"----------((2))

 

4) "CHOLESTEATOMA---filled with Keratinised Stratified sq. epithelium, deafness, Erodes bone,"------------((2))

 

5) "COCHLEAR NUCLEI---appreciation of sound, COCHLEAR IMPLANTS--- used in SNHL/ SND.,"--------((2))

 

6) "EXTERNAL AUDITORY MEATUS/ EAM---normal length=24 mm ( 2.4 cm),Cartilaginous portion is smaller than Bony portion,"--------------((2))

 

7) "FISTULA TEST---+VE after OPeration.of Labyrinth fenestration, FALSE +VE F.T.--seen in Hypermobile Ossicular chain, Labyrinthine Fistula, Post fenestration op.,"-------------((2))

 

8) "FOREIGN BODY OF NOSE---Unilateral Blood Stained & Fetid , Unilat. Nasal Obst., Nasal Discharge,"-----------((2))

 

9) "FRACTURE OF MAXILLA---fes. CSF Rhinorrhoea, Anasthesia of upper lip, Sugical emphysema cheeks,Not seen is malocclusion"------------((2))

 

10) "FURUNCLE OF EAR CANAL---Rx ear pack with 10% ICTHAMOL in GLYCERINE wick, most common site-EXT.cartilaginous auditory canal,"----------((2))

 

11) "LABYRINTH---destruction of Rt. Labyrinth causes nystagmus to Lt.side, Labyrinthine Artery is a branch of Ant. Inf. Cerebellar art.," ---------((2))

 

12) "LARYNGOSCOPY---KEY HOLE APP. of glottis is seen in PHONASTHENIA, the procedure that should precede microlaryngoscopy is laryngo-endoscopy, "-------------((2))

 

13) "LARYNGOMALACIA---most common Congenital Anamoly of larynx, most common cause of congenital stridor & inspiratory stridor is normal on crying,"-----------((2))

 

14) "LARYNX---Important function of Larynx is Protection of Lower Respiratory Tract, Narrowest part of Infantile Larynx=SUBGLOTTIS,"--------------((2))

 

15) PRECANCEROUS LESIONS OF LARYNX---KERATOSIS LARYNGITIS/ LARYNGIS SICCA?-PRECANCEROUS LESION,”------------((2))

 

16) "MAC EWEN'S TRIANGLE / SUPRAMEATAL TRIANGLE---felt thru. CYMBA Conche, Landmark for Mastoid Antrum"----------((2))

 

17) "MASTOIDECTOMY---commonest Extra-Cranial complication--Facial nerve Palsy, RADICAL MASTOIDECTOMY---inv.lowering of facial ridge, scrapping of middle ear ,removal of all ossicle except foot plate of stapes,"------------((2))

 

18) "MASTOIDITIS---ACUTE--clouding of air cells, deafness, obliteration of retroauricular sulcus, Complications-- Subperipsteal abscess-mastoid infec. Erodes outer cortex of bone,"----------((2))

 

19) "MAXILLARY SINUS -ANTRAL CARCINOMA---T3NOMO-Rx-->SURGERY+RADIOTH.,Malignant tumour arisis commonly from maxillary sinus,"-----------((2))

 

20) "NASOPHARYNGEAL FIBROMA---Rx Surgery, NASOPHARYNX---Oval shaped Space,"---------------((2))

 

21) "ORGAN OF CORTI---situated in SCALA MEDIA, along Inner edge of membrane"-------------((2))

 

22) "OTOTOXIC DRUGS---kanamycin, streptomycin, vincristine, gentamicin, "------------((2))

 

23) "PARACUSIS WILLISII---pt. Hear better in NOISE, cinical otosclerosis,"--------------((2))

 

24) "PAROTID---& TUMOURS OF PAROTID---NERVE commonly sacrificed is facial n. "-----------((2))

 

25) "PHONASTHENIA---KEY HOLE APP. OF GLOTTIS ON LARYNGOSCOPY,& PUBOPHONIA--- a boy failed to develop the crackling of voice which normally occurs in adolescence,"------------((2))

 

26) "PYRIFORM FOSSA/ SINUS---lymphatic drainage to upper cervical L.N.'S, malignant lesions of P.S. pain is reffered to Ipsilateral ear via vagus nerve,"------------((2))

 

27) REINKE'S OEDEMA---oedema of the free margin/edge of the Vocal cord ,”---------((2))

 

28) "ALLERGIC RHINITIS---test used intracutaneous test, scratch test, rash test, common cause of nasal discharge,"----------((2))

 

29) "VASOMOTOR RHINITIS---Sx Vidian Neurectomy, autonomic imbalance,"-------((2))

 

30) "CORYZA / VIRAL RHINITIS---PARCEL viruses, "----------((2))

 

31) "RHINOLALIA CLAUSA---seen in gross adenoid hypertrophy, voice abn.,"---------((2))

 

32) "RHINOSCOPY---ANTERIOR--Bulla Ethmoidalis, inf. Tubinates, little's area,are seen , not seen is sup.tubinate, POSTERIOR-- Eustachian tube, inf.meatus, middle meatus, not seen is sup. Concha,"--------((2))

 

33) "SPENOID SINUS---opens into sphenoethmoidal recess,"--------((2))

 

34) "ACUTE FRONTAL SINUSITIS---chronic periodic headache, disapears with sunset, "-----------((2))

 

35) "SUBMUCOUS FIBROSIS---premalignant,"--------------((2))

 

36) "SMR / SUBMUCOUS RESECTION---done > 16yrs. , DNS, "----------((2))

 

37) TRACHEA---begins at the level of lower border of cricoid cartilage,---------((2))

 

38) "TRAUMATIC RUPTURE OF T.M.---Rx conservative / No active Rx, pin-prick injury to eardrum-Rx-antibiotics,"----------((2))

 

39) "VINCENT'S ANGINA---ulcerative lesion of fusiform bacillus, / anaerobic, spirochaete, "----------((2))

 

40) "WEBER TEST--- in conductive deafness -W.T. lat. to deaf ear, note=both ear rinne's +ve & W.T. lat.to left I.e. left sided conductive deafness, "----------((2))

 

41) "IDDM WITH SEPTAL PERFORATION WITH BROWISH BLACK DISCHARGE / COLOUR OF INF.TURBINATE--- diagnosis is MUCOR MYCOSIS, "-----------

 

ENT:-- Occasionally Asked Topics

1) "ABC / ABSOLUTE BONE CONDUCTION TEST--- shortened in SNHL/ Perceptive deafness,"-----(1)

 

2) "ACOUSTIC REFLEX DECAY TEST--- +VE in Lesions of Auditory Cortex,"----------------((1))

 

3) "ADENOID FACIES--- Fes.-- Open mouth, Pinching of nose, Crowding of teeth, "--------((1))

 

4) "ANOSMIA----complete-Responda to inhalation of ammonia,"--------------------((1))

 

5) "ANTRAL WASH---for drainage of maxillary sinus is thru. Inferior meatus,"---------------((1))

 

6) "AUDIOGRAM---U-shaped A.--congenital deafness, FLATTENED A.- serous Otitis media,"--------((1))

 

7) "AUDIOMETRY---IMPEDANCE,"------------------((1))

 

8) ALLODYNIA---increased perception of Painful stimulus,----------------((1))

 

9) "BELL'S PALSY---Mx-Steroids & Surgical Decompression,"---------------(1))

 

10) "BRONCHOSCOPY---indicated in persisitent Wheeze,"------------------((1))

 

11) BLAST INJURY---most common organ affected -Ear Drum,---------------((1))

 

12) "CARHART'S NOTCH---seen at 2000 Hz., & in otosclerosis,"-------------((1))

 

13) "CHOANAL ATRESIA---BiLateral Complete-->life threatening complication,"-----------((1))

 

14) "CHORDITIS TUBEROSA---is due to Chronic Laryngitis,"--------------((1))

 

15) "CRICOID CARTILAGE---is Signet Ring shape, "-------------------((1))

 

16) "CRICOTHYROID MUSCLE---is supplied by SUPERIOR Laryngeal nerve( SLN ), & rest by RLN.,"---------((1))

 

17) "CONE OF LIGHT---is formed on ANTERIO-INFERIOR Quadrant,"----------------((1))

 

18) "CSF.---is similar to PERI-LYMPH,"------------(1))

 

19) "DIPHTERIA---Membranes firmly Attached & Bleeds on Touch, " ----------((1))

 

20) "DYSPHAGIA---SIDEROPENIC DYSP.--seen in Iron Def. Anemia,"---------------((1))

 

21) "DYSPHONIA PLICA VENTRICULARIS---is producing sounds withfalse cord,"------------((1))

 

22) "CAULIFLOWER EAR---is due to Hematoma of Auricle," -----------------((1))

 

23) "ENCEPHALOCELE---Herniation of Brain tissue with its Dural covering into the Nasal cavity, "-----((1))

 

24) "EPITYMPANUM---includes--head of Malleolus , Body of Incus,"----------((1))

 

25) "FITZGERALD-HALLPIKE TEST---uses Temp. at 30oC& 44oC, also called as caloric test?,"------((1))

 

26) "LE FORT'S FRACTURE---inv's ZYGOMA, MAXILLA, & NASAL BONES,"----------((1))

 

27) "Oblique & Horizontal Fracture of nasal septum--- is called asJARJAVAL FRACTURE,"------------((1))

 

28) "GLOBUS HYSTERICUS---lump in throat not interfering with swallowing,"----------------((1))

 

29) "GROMMET INSERTION---is done in anteroinferior quadrant,"------------((1))

 

30) GELLE'S TEST---done in Otosclerosis,-----------------((1))

 

31) "Great Auricular Nr. ---supplies Skin at Angle of JAW,"---------------((1))

 

32) "GLOSSOPHARYNGEAL NEURECTOMY--- Route of Approach -Tonsillectomy approach,"------((1))

 

33) Hearing impairment due to noise starts at 4000 Hz.,----------------((1))

 

34) "HEMANGIOMA---Bleeding Polyp of nose--arises from septum,"-----------((1))

 

35) HYPERACUSIS---normal sound are heard as loud & painful.,--------------((1))

 

36) "HYPERNASALITY---caused by Cleft palate, Submucous celft, Bifed Uvula,"--------------------((1))

 

37) HYPOPHARYNEAL CANCER---predisposing factors -Plummer Vinson's Synd.,----------------((1))

 

38) "INVERTED PAPILLOMA---of Rt.side of nasal cavity -TOC.=Total Maxillectomy,"-----------------((1))

 

39) "INNER AUDITORY MEATUS---facial nerve is lateral to superior vestibular nerve,"-------------((1))

 

40) "JUVENILE PAPILLOMA---Rx-Surgical excision,"-----------------((1))

 

41) "KERATOSIS OBURANS---is a Premalignant condition,"------------------((1))

 

42) KOBARK TEST---used for Minimal Caloric Stimulation,-------------------((1))

 

43) "KARTAGENER'S SYND.---Ass.with Sinusitis, Dextrocardia, Bronchiectasis, "----------------((1))

 

44) "LARYGEAL MIRROR---warmed before use by placing glass surface on Flame,"--------------------((1))

 

45) "LARYNGOFISSURE---Opening the larynx in midline,"-------------------((1))

 

46) "LARYNGECTOMY---after laryngectomy Voice is from Oesophagus,"--------------------------((1))

 

47) "LARYNGOCELE---Gas filled sac in neck region after VALSALVA MANOEURVE,"--------------((1))

 

48) "ANAESTHESIA OF LARYNX---occurs with Diptheria, Lead Poisoning, Multiple sclerosis,"---------(1))

 

49) "LYMPH NODE METASTASIS IN NECK --- is seen in SupraGlottic Ca., Ca.of Tonsil, Papillary Ca.of thyroid, NEVER seen in Ca.of Vocal Cords, "--------------------((1))

 

50) "MASKING---is applied for inability to hear,"-----------------((1))

 

51) "MASTOID TEMPORAL BONE AIR CELL GROUPS---include Petrosae, Retrofacial, Hypotympanic, Sublabyrinthine."-----------------((1))

 

52) "MASTOID TIP---appears by 2yrs. of age,"----------------((1))

 

53) "INFERIOR MEATUS OF NOSE---NasoLacrimal duct/ Frontonasal duct opens," ------------((1))

 

54) "MONOAURAL DISPLACUSIS---due to Lesions of Cochlea,"------------((1))

 

55) "MYIASIS OF NOSE---MAGGOTS OF NOSE, Rx-TOC.--CHLOROFORM Water,"---------((1))

 

56) "MYRINGITIS BULLOSA---caused by Virus,"--------------((1))

 

57) "NASAL DEPRESSED BRIDGE--- caused by Syphylis, Septal Abscess, Injury,"--------------------((1))

 

58) CROOKED NOSE---due to Deviated Tip & Septum ,---------------------((1))

 

59) "SADDLE SHAPED NOSE---due to Destruction of nasal septum," --------((1))

 

60) "OESOPHAGUS---cervical oesophagus receives its blood supply from Inf.Thyroid Artery, "-----------(1)

 

61) "BENIGN NEOPLASMS OF OESOPHAGUS---commonest --is Intramural Tumour of oesophagus--LEIOMYOMA,"-------------------((1))

 

62) "CARCINOMA OF OESOPHAGUS---RAT TAIL APP. on Barium swallowing,"------------------((1))

 

63) "OLFCTORY AREA---Looks YELLOW in colour,"-------------------((1))

 

64) "OSSICULAR RATIO = 1.3:1 , " -------------------((1))

 

65) "TUBERCULAR OTITIS MEDIA---Multiple perforations of T.M., "-------------((1))

 

66) "ACUTE NON SUPPURATIVE OTITIS MEDIA---Retracted drumhead with a hiar-line or air bubbles on otoscopy," ------------------((1))

 

67) "OTOMYCOSIS---most common fugas aspergillus fumigatus,"----------((1))

 

68) CSF OTORRHOEA--- fracture of petrous ridge/ petrous temporal bone,--------------((1))

 

69) "PENDRED SYND.--Thyroid swelling + nerve deafness,"------------------((1))

 

70) PARAPHARYNGEAL ABCESS---swelling in post. Part of middle1/3 of sternomastoid & tonsil is pused medially,----------------((1))

 

71) "PAROSMIA---PERVERSION OF SMELL,"------------((1))

 

72) "PHARYNGITIS- MEMBRANOUS---causes--streptococcal, ludwig's angina, diptheria, "-----------((1))

 

73) PHARYNGOMAXILLARY ABSCESS---medial bulge of pharynx ,----------((1))

 

74) "PLEOMORPHIC ADENOMA---most common tumour of parotid gland,"-------------((1))

 

75) PNEUMATOCELE--seen in fracture of frontal sinus,--------------((1))

 

76) PROCESSUS COCHLEARIFORMIS--attaches to handle of mallues,---------------((1))

 

77) "RESP.ALLERGY--house dust,"------------------((1))

 

78) "RANADIER'S OPERATION---done in Petrositis,"---------------((1))

 

79) CHRONIC RETROPHARYNGEAL ABSCESS--due to caries spine,-----------((1))

 

80) "SICCA RHINITIS--anterior nares inv.,",------------------((1))

 

81) "RHINOLITH--- deposition of calcium around the F.B. in nose,"-----------((1))

 

82) RHINOPHYMA---hypertrophy of sebaceous gland,------------------((1))

 

83) "SINGERS NODULE---Voice abuse,"-------------------(1))

 

84) "SCALA MEDIA ---shows endolymph,"----------------((1))

 

85) "SCHIRMER'S TEST---for lacrimal secr. To test facial nerve,"------------((1))

 

86) "SEMICIRCULAR CANALS--senses Angular movements,"--------------((1))

 

87) "SCHWARTZ SIGN ---seen in otosclerosis,"----------------((1))

 

88) "SCHWARTZE OPERATION---done in CSOM,"-----------((1))

 

89) "SPEECH DISCRIMINATION SCORE---lowest in retrocochlear SND,"------------------------((1))

 

90) "ALPORT'S SYND.---SNHL+Hereditary nephritis,"--------------((1))

 

91) "TEMPORAL BONE---petrous part-inner ear,"------------------((1))

 

92) "TONE DECAY TEST---done to fineout retrocochlear lesions,"------------((1))

 

93) "TOBEY AYER TEST---Lateral sinus thrombosis,"----------------((1))

 

94) "TRACHEOSTOMY TUBE---double tube, made of Titanium silver alloy, cuffed tube is used for IPPV, "--------((1))

 

95) "TROTTER'S TRIAD---seen in nasopharyngeal ca.,"-----------((1))

 

96) "UMBO---most reliable landmark on otoscopy,"-------------((1))

 

97) "VERTIGO---peripheral/ labyrinthine V. fes--unidirectional nystagmus, marked vertigo, ass.central abn.absent,"--------------((1))

 

98) "VESTIBULE---IS present in nose, larynx, pharynx,"--------------((1))

 

99) "VESTIBULAR SCHWANOMMA---IOC--GADOLINIUM ENHANCED MRI,"------------------((1))

 

100) VIDIAN NERVE---/ NERVE OF PTERYGOID CANAL---, ---------------((1))

 

101) "VOCAL NODULES---present at junction of anterior 1/3 & post. 2/3, "--------------------------((1))

 

102) "WOODRUFF'S AREA---post. End of inferior turbinate, "-----------------((1))

 

103) "WALDERYER'S RING ---inner w.group of L.N.=tonsils, lingual tonsils, adenoids,"-----------------((1))

 

104) "WARTHIN'S TUMOUR---Rx superior paratidectomy,"------------------((1))

 

105) ZENKER'S DIVERTICULUM --- it's asymp.-------------------((1))

 

106) "AT BIRTH---following structures are of adult size--tympanic cavity, malleus, tympanic ring , except -mastoid antrum,"-------------------((1))

 

107) "The ADDUCTION OF V.C. cannot occur while talking , but can occur with good cough --is a condition ass. With functional aphonia,"--------(1))

 

108) "SUPRAGLOTTIS--- include -aryepiglottic folds, false cords, laryngeal surface of the epiglottis,"---------------((1))

 

109) "TRANSBRONCIAL BIOPSY---is thru. Fiber-optic bronchoscopy,"----------------((1))

 

110) "NORMAL RANGE OF frequency of human haering = 20-20,000 hz,"--------------((1))

 

111) "AUDIBLE SOUND FOR NORMAL HUMANHEARING = 40-45 db,"---------------((1))

 

112) "PROLONGED EXPOSURE TO NOISE LEVELS > 85 db can impair hearing permanently,"---------------((1))

 

113) "RUPTURE OF T.M. /EAR DRUM occur at noise level > 160 db,"--------------((1))

 

114) "40 db COMPARED TO 20 DB is 100 TIMES,"-------------((1))

 

115) "RHINITIS SYNDROME---in mast cell mediator release category are categorised by sneezing , marked postnasal discharge, lacrimation,"----------------((1))

 

116) "WATER'S VIEW ( OCCIPITOMENTAL )--- provides good visualization of maxillary sinus, orbitofrontal sinus, frontal sinus,"--------------((1))

 

117) "CHILD WITH COMPRESSIBLE SWELLING ROOT OF NOSE---MENINGOMYELOCELE,"------------((1))

 

118) "STRUCTURES PASSING between the upper border of the superior constrictor muscle & base of the skull are levator palati muscle & the cartilagineous eustachain tube,"--------------------((1))

 

119) QUALITY OF VOICE--- not changed in total adductor palsy,-------((1))

 

120) "FAMILIAL PREDISPOSITION of malignancies--- are seen in -breast, leukaemia, thyroid,"----------------(1))

 

121) "GLOSSOPHARYNGEAL NERVE---supplies sensation to the middle ear mucous memb.,& tongue (post1/3)"-------------((1))

 

122) "MICROPHONIC POTENTIALS ORIGINATING IN COCHLEA are resistant to Ischaemia,"--------------((1))

 

123) "IVORY OSTEOMA--- sen in fronto-ethmoidal region,"-------------((1))

 

124) "PLICA SEMILUNARIS---is situated in Tonsillar area,"----------((1))

 

125) "SUBMANDIBULAR GLAND SURGERY---may result in damage of 7,11,12 Cr.N.,"-------((1))

 

126) "MICROLARYNGOSCOPY---size of lens used is 400mm.,"------------((1))

 

127) "VOCAL FREMITUS ---decreased in Emphysema , thick pleura, Pleural effusion,"-------------((1))

 

128) "common site of F.B. in lower respiratory tract is --Rt.Main Bronchus,"--------------------((1))

 

129) "IMPAIRMENT OF hearing due to noise starts at ---4000 hz.,/ 4khz.,"-----------------((1))

 

130) "EAM=24 mm, / 2.4 cm.,"-------------------((1))

 

131) "E.T / PT.TUBE=36 mm., / 3.6 cm.," -----------((1))

 

132) "U-SHAPED AUDIOGRAM---CONGENITAL DEAFNESS,"----------((1))

 

133) FLAT AUDIOGRAM---SEROUS OTITIS MEDIA,---------------((1))

 

134) "CARHART'S NOTCH ---2000 hz., / 2Khz.,"--------------((1))

 

135) "WAX IN EAR ---commonest cause of deafness,"-----------((1))



                                   The end

 

 

Fast n Final revision of PHARMACOLOGY

Posted by pawan2006e on March 19, 2012 at 4:25 PM Comments comments (0)

Final n fast revision of Pharmacology

www.drpawan.webs.com

 

 

 Detoxification or protective synthesis occur by Conjugation

 Highest 1st pass metabolism – propranolol,amitryptyline,labetalol,acebetalol,verapamil

 Atenolol is not protein bound substance while warfarin is protein bound

 BBB is deficient at the CTZ

 Atropine not crosses placental barrier

 Lovastatin is prodrug

 DDT is CYP-450 inducer

 Good clinical practice not seen in preclinical trials

 For 1st order rkn 97% of drug is eliminated after 5 half lives

 Combination of ampicillin n gentamycin ---- Synergy

 Cyclosporine has no drug interaction with pyridoxine

 Acidic drug bind with albumin while basic with a1 acid glycoprotein

 Combined phase 1 and phase 2 trial done for Anticancer drug

 Salicylates causes dyspnoea in children

 Sulfonylurea n chlorambucil ---- bone marrow depression

 Nicotinic acid causes Acanthosis nigricans

 Thioridazine ----pigmentry retinopathy

 Methylsergide--- retroperitoneal fibrosis

 Steroid can cause psychosis

 Chronic ulceration wound with clindamycin

 GnRH analogue can cause osteoporosis

 Phenindione --- urine colored

 Paralytic ileus --- Vincristine

 Gout is not ppt by sulfinpyrazone

 Tamoxifen --- retinal pigmentation

 Neutrophilia – Steroid

 HTN not seen by Levodopa (AIIMS MAY 07)

 Digoxin is deposited in muscles

 Cyclosporine not causes peptic ulcer

 Vagal stimulation does not affect secretion of Gall bladder

 Maxm nicotinic effect Is seen with Carbachol

 Nicotinic receptor are seen with skeletal muscle

 Baclofen is given in cerebral palsy

 Atropine--- central n peripheral cholinergic receptor

 Neostigmine useful for Cobra

 Sarin war ---organophosphorus poisoning

 Short acting mydriatic --- tropicamide

 Organophosphorus poisoning ---- clear airway  atropine diazepam pralidoxime

 PAM is not used in carbamate due to Anoinic site of Ach esterase is not free

 Atropine is C/I in Glaucoma

 Hyoscine not causes tachycardia

 Hexamethonium is nicotinic blocker

 Atropine has no effect on BP

 Amatoxin in mushroom poisoning acts by inhibiting mRNA

 Botulinum toxin presynaptic Ca channel blocker

 Molar ratio of catecholamine to ATP is 4:1

 Adrenaline not causes vasoconstriction of Gut n brain

 Isoprenaline is not an endogenous catecholamine

 Beta 2 - hyperglycemia(glycogenolysis and gluconeogenesis) also supported by alpha2

 Beta 3  breakdown TG n produces FFA

 Propranolol is C/I in CCF

 Alpha 1 mediated by Ca ion

 Atenolol least entry cross BBB

Beta blocker with sympathomimatic activity

COntain------------------------- Celiprolol,Oxprenolol

Partial pindolol,penbutolol

Agonistic Alprenolol

Activity Acebutolol

BB with membrane stablizing Activity

Posses propranolol

Membrane stabilizing or metoprolol

Local labetalol

Anaesthetic acebutolol

Property pindolol

Lipid insoluble BB excreted by kidney,long acting

Not nadolol(longest acting)

Soluble sotalol

A atenolol

acebutolol

B betaxolol

bisoprolol

C celiprolol

 

 Curare in therapeutic doses decreases amplitude of skeletal muscle

 Most effective MR – Ether

 Intubation dose of pancuronium 0.08 mg/kg

 Trimethaphan is ganglion blocker

 Antibiotic posses some property of neuro muscular blocking – streptomycin,polymyxin,gentamycin

 Depolarizing NM blocker a/s with fasciculations

 Erythropoiten enhances sport performance

 Lisotropic drug – carbachol

 Maxm dose of xylocain is 300mg

 Guedels stage of a. is seen in Ether

 

 

 

 Causes longest amnesia – Diazepam

 Mephenesin --- MR which causes jaundice as S/E

 Muscle of jaw and larynx -- most sensitive to tubocurarine

 H1 blocker least sedative – Terfenadine

 Maxm anti cholinergic seen with H1 blocker Diphenhydramine

 Mizolastin have no active metabolite

 Platelets aggregation by TXA2

PG actions

Bronchoconstriction

! ! ! !

D A L F

! !

Vasoconstriction

D—PGD

A—TXA2

L--- leukotrienes

F--- PGF2a

 DOC for theophyline poisoning – phenobarbitone

 DOC for exercise induced bronchial asthma – Cromolyn sodium(also used in Vernal conjuctivitis)

 Theophylline overdoses causes seizure

 Apomorphine not causes prolactine release

 PTU – proved teratogen in animal

 Lugols iodine acts by inhibiting RELEASE of iodine

 Newer insukine are monomer

 Sulfonylurea mainly used for MODY

 SHORT ACTING (regular onset in 30min active for 5-8 hrs) SEMILENTE LISPRO,ASPART,GLULISINE

 INTERMEDIATE (onset in 1-3hrs active for 16-24 hrs) LENTE NPH

 LONG ACTING (onset in 4-6hrs active for >32 hrs) ULTRA LENTE PZI

 30% SL +70%UL= LENTE

 Antidiabetic used safely in renal failure –Rosiglitazone

 T ½ of insulin 3-5min

 Shortest duration of action Repaglinide

 Benzoic derivative which stimulate insulin secretion – Repaglinide

 Guargum reduce post prandial hyperglycemia

 Insulin causes K+ entry into cell

 Metyrapone is useful in CAH it inhibit 11-beta hydroxylase

 Topical steroid – glaucoma

 Cortisone & ACTH – affective disturbance

 Corticosteroid without glucocorticoid --- DOCA

 Glucocorticoid act inflammation by increases Lipocortin

 Mestranol – not a progesterone

 Flutamide – fastest onset of action in BPH

 Esterogen --- reduces LDL ;increases TG

 Calcitonin not given given in Thyrotoxosis

 Somatostatin not inhibit Epinephrin

 Stress not increases insulin

 Octreotide is long acting somatostatin analogue

 Bone resorption enhanced by PGE2

 Paraldehyde on exposure to air changes into acetic acid

 Mandrax – hypnotic + antihistamine

 BARBITURATE – GABA MIMETIC + GABA FACILITATORY, INCREASES DURATION OF CL- CHANNEL

 BENZODIAZEPAM -- GABA FACILITATORY , INCREASES FREQUENCY

 TIAZINADINE – central alfa2 agonist

 B –CARBOLINE --- INVERSE AGONIST

 Valproate – potentiate action of GABA

 Phenytoin causes least sedation

 Carbamazepin in elderly causes hyponatremia

 DOC in antiepilepsy in porphyria – Clonazepam

 Vit B complex is C/I in levodopa

 Quinagolide --- D2 agonist used in hperprolactinmia

 Rabbit syndrome(treated by Trihexyphenidyl) – late onset ,drug indused extra pyramidal symptom

 TOC for Ballismus – Haloperidol

 Akathisia treated by propranolol

 I.V. fluphenazine decanoate used in Simple Schizophrenia

 Pimozide belongs to Diphenyl group

 Ethosuximide not compete with protein binding of imipramine

 TCA adversely interact with Tranylcypromine

 Pimozide is not antidepressant

 Sumatriptan – 5 HT receptor agonist

 Pt. with hypotension n cardiac ds best antidepressant – Mirtazapine

 Lithium toxicity not involve Liver

 Lithium level increased by administration of NSAID

 Characteristic of lithium toxicity—Nephrogenic DI

 Diazepam acts by ascending reticular activity system

 DOC for insomnia – Meprobamate

 Secobarbitone – short acting barbiturate

 Barbiturate is derivative of Urea

 BZD not causes tinnitus

 Asprin is C/I with warfarin

 Buprenorphine is used as sublingual

 Low dose asprin during pregnancy not used in DIC

 Paracetamol not causes platelate dysfunction

 Nabumetone –selectively COX-2 inhibitor

 Nefopan(nonopoid) – NSAID not inhibit PG synthesis

 Morphine withdrawal not causes miosis

 Orally effective opoid agonist without antagonistic action—dextropropoxyphene

 Propantheline – antispasmotic

 As compared to morphine methadone --- superior analgesic & hypnotic

 In Cocaine no tolerance seen

 Gold – dermatitis + stomatitis

 Ticaynafen – in pt. CCF with gout diuretic given

 Most efficient respiratory stimulant--- Doxapram

 Soporific --- Psychotomimetic

 Not cause pseudotumour cerebri – gentamycin

 Rivastigmine is not used with TCA

 Digitalis – decreases HR and decreases O2 consumption

 DOC for digitalis induced arrhythmia – phenytoin

 Therapeutic level of digoxin(T ½=40 hrs ) 0.8 – 1.5 ng/ml

 Bretylium interfere with release of nor adrenaline

 Quinidine is C/I in digitalis toxicity(lignocaine is used)

 Amiodarone – antiarrythymic with gr8 repolarisation

 Bretylium -- pharmacological defibrillator

 CCB with predominant peripheral action --- nifedepin

 Pentooxyphyline – used in peripheral vascular disease

 Masster’s test – antianginal drug

 Verapamil increases toxicity of Digoxin,phenobarbitone,BZD

 Dipyridamole(coronary steal ph.) – adenosine reuptake inhibitor

 Postural hypotension & ejaculation is S/E of Guanethidine

 Nifedipine & B-blocker is used to combat sympathetic overactivity due to nifedipine

 Indapamine is not used in hypertensive emergency

 Chlorthiazide not decreases plasma renin activity

 Propranolol is C/I in IDDM with HTN

 Nimodipine used in subarachnoid haemorrhage

 Atenolol is not a 1st line antiHTN drug

 Furosemide is sulphamoyl derivative

 Furosemide differ from Thiazide b onset & duration of action

 Mannitol when given I.V. – blood viscocity increases

 Metazone is active if the GFR is 30-40

 Mannitol – non electrolyte ,renal vasodilator

 Acetazolamide is not used in cirrhosis

 Vit K is required for overdose of Dindevan

 Phenobarbitone is not inhibit platelet aggregation

 Aprotinine – potent antifibrinolytic

 Dicumarol poisoning phytonadione is used

 TPA is least anaphylaxis

 Epsilon aminocaproic acid given prophylactically useful in C1 inhibitor deficiency

 Warfarin treated pt. skin necrosis found in protein C deficiency

 Cholestyramine increase activity of HMG Co reductase

 Nicotinic acid catabolises LDL,VLDL, Cholesterol

 Orlistat inhibit pancreatic lipase

 Fibrates acts by reducing VLDL

 Antacid not interfere with absorption of Erythromycin

 DOC in intractable hiccoughs – Chlorpromazine

 Veratrum alkaloid stimulate nodose ganglion of vagus

 MPS – Defoaming agent

 Bisacodyl(stimulant purgative) & castor oil causes hypokalemia

 Ezetimibe decreases absorption of cholesterol

 Safest antibiotic in renal failure is Cloxacillin

 Sulpha drug acts by competitive inhibition

 CNS S/E of ciprofloxacin ia increased by intake of salicylate

 Loop diuretics interact with cefotaxime

 T ½ of benzyl penicillin 30 min

 1gm penicillin = 1.667MIU

 Cilastatin is an inhibitor of Dihydropeptidase

 Aztreonam safest in pt allergic to penicillin

 Ampicilline , amoxicillin ,is better due to bioavailability is better whwn taken with food

 Framycetin not available for parentral use

 Streptomycin single dose is more effective than multiple small doses becoz concentration dependent lytic effect

 Methenamine mandelate releases HCHO

 Erythromycin acts on 50S by inhibiting translocation

 INH—active against both Dormant & nondormant bacilli

 MAC is not treated with pyrazinamide

 Griseofulvin( T ½ =24 hrs) is not used as topically

 Maxm endocrinal S/E seen with ketoconazole

 Ketoconazole – absorption is increased in Achlorhydria

 Amphotericin is not mixed with saline infusion

 Bromodeoxyuridine analogue of thymine

 Amantadine(inhibits rRNA,not given orally) is not C/I in severe renal disease

 Nelfinavir is not anti herpes drug

 Atazanavir not causes Dyslipidemia

 Foscarnet not causes hyperkalemia

 Primaquine has no role in P. Falceparum

 Chloroquine can be used in DLE

 Radical cure of P. vivax is by primaquine

 Chloroquine(cidal to blood schizonts) is not used in intestinal amoebiasis

 Chloroquine not causes HTN

 Chloroquine is not cysticidal for entamoeba

 Intraluminal amoebaicide of choice Diloxanide furoate

 Pyrantel pamoate is effective in both Entrobious & ascariasis

 DEC kill microfilaria and adult is more effective than ivermectin

 Ivermectin --- acts by GABA

 Praziquantal is not used in Trichinosis

 Cephalosporin taking pt are prone to infection with Pseudomonas

 Polymyxin –B ,Erythromycin can be used in renal failure

 Enterohepatic circulation is seen in Ampicillin

 Ampicillin is C/I in infectious mononucleosis(increases incidence of rashes)

 Erythromycin not increases neuromuscular blockade

 Azithromycin is not used in enteric fever

 Verapamil is CYP3A inhibitor

 Colistin is effective against Pseudomonas

 Anaerobic streptococci ---- clindamycin most effective

 DOC for Tropical Pulmonary Eosinophilia – Ivermectin

 DOC for prophylaxis for diphtheria -- Erythromycin

 MOA of actinomycin –D is transcription of DNA

 Commonest S/E of 5FU – Stomatitis

 Ntroso-ureas (used in brain tumour)crosses BBB

 Busulphan not causes toxic carditis

 Cytosine arabinoside undergoes Biotransformation to form an inhibitor of DNA polymerase

 Cyclophosphamide is not used in choriocarcinoma

 Cisplatin causes cross linking of DNA

 Chlorambucil act on lymphoid tissue

 Paclitaxel – stabilizes tubules

 Interferon gamma-1b --- most effective in causing activation of phagocytes and production of oxygen metabolites that are toxic for microorganism

 Complication of cyclosporine are HTN,hirsutism

 Tacrolims acts on T cell

 Psoralen MOA binding to DNA

 Calamine powder =zinc oxide + ferric oxide

 Ampicillin is not used in Acne

 T ½ of Vit B12 =6 months

 Hypervitaminosis A not causes peripheral neuritis

 Vit D has teratogenic effect in pregnancy

 BAL not used in Cd Fe

 EDTA Hg

 Pencillamine As

 Pyridoxine deficiency not causes growth retardation

 Fe is not exreted in milk

 Strychnine(postsynaptic) removing inhibitory effect of renshaw cell in spinal cord

 Mazindole reducing craving for Food

 Cimetidine not metabolise in liver

 Mepacrine most concentrated in collagen

 DOC for hepatolenticular degeneration --- pencillamine

 Reversible leucopenia --- nitrofurantion,chloramphenicol

 Penicillin is not secreted in bile

 Gugulip acting as free radical scavenger

 Desferoxamine is derived from microorganism

 Tizanidine –used in spasticity

 Methanol is not bind to activated charcoal

 Drug used in t/t of complication of multiple sclerosis is INH

 Metrifonate effective against Schistosomiasis

 Gastric irritation is least with Aminosalicyclic acid

 Anthraquinone causes Adenoma

THE END

 

 

Final n fast revision of Anaesthesia

Posted by pawan2006e on March 15, 2012 at 4:55 PM Comments comments (0)

Final n fast revision of Anaesthesia

            www.drpawan.webs.com



 Commenest cranial nerve affected in spinal anaesthesia 6th

 Maximum dose of xylocaine in spinal is 300mg

 Epidural anaes. Have no headache as complication

 In spinal last fibre sequence of affected is cold >heat>pain>touch>deep pressure

 MC complication of spinal a. is hypotension

 1st to paralyse after spinal a. is sympathetic syst.(autonomic>sensory>motor)

 Vital capacity is very low in lithotomy position

 Intra cardiac adrenaline given in 5th ICS left side

 Pneumothorax is compln of brachial plexus block

 For brachial plexus block needle is inserted lateral to subclavian artery

 Epidural narcotic not causes motor paralysis

 Barbotage  fluid (spinal) is alternatively withdrawn & reinjected under pressure

 Increase dose of epidural a. is indicated in a pt. who has increased height of the pt.

 Touhy needle ---- used in epidural a.

 Interscalene approach to brachial plexus block does not provide optimal Sx a. in Ulnar nerve

 MAC of desflurane 6

 Safest anaesthesia in practice is N2O

 In 2nd stage of a. pupil is partially dilated

 Unpleasant dream indused by ketamine is t/t by Diazepam

 Abductor paralysis to larynx is not a complication of endotracheal intubation

 Endotracheal tube sterilized by ETO gas

 Shivering MC seen with Halothane

 Hyperglycemia caused by ether

 Movt. Of eye ball is lost in Stage 3 plane 1

 1st reflex is appear in recovery of GA – Swallowing

 Color of halothane cylinder RED

 Dose of ketamine by IV route is 2mg/kg

 Blind nasal intubation is indicated in T.M> joint ankylosis

 Max analgesia – trielene

 Profound analgesia – ketamine

 Only analgesia – N2O

 No analgesia – halothane

 Gas with gr8 solubility in blood – methane

 Biphasic respiratory resp depression usually seen after neurolept a.

 The Heidbrink Meter in boyle Machine – indicate flow rate of gas

 Levodopa should not be used within 4 hrs of a.

Blood gas partition coefficient

DO DESFLRN .42

NOT NO .47

SEX SEVOFLRN .69

IN ISOFLRN 1.38

ENG ENFLRN 1.8

HIGH HALOTHANE 2.4

COURT CHLOROFORM 8

EVEN ETHER 12

ME METHOXYFLRN 15

MAC(%atm)

ME METHOXFLRN .16

THOXY TRIELENE .2

HIGH HALOTHANE .74

COURT CHLOROFORM .8

IS ISOFLRN 1.15

ENG ENFLRN 1.68

ETHER ETHER 1.92

SERVE SEVOFLRN 2

DESI DESFLRN 6

COUPLE CYCLOPROPANE 9

NIGHT NO 104

PIN INDEX SYSTEM

AIR 1,5

O2 2,5

N2O 3,5

CO2(>7.5%) 1,6

CO2(<7.5%) 2,6

CYCLOPROPANE 3,6

ENOTOX 7

 

 

 

Breathing circuit

 Open --------------------- ether ,chloroform ,ethyl chloride

 Semi closed(mapelson circuit )

1. Type A (Magil) circuit of choice for spontaneous ventilation (FGF=RMV)

2. Type B ---not used

3. Type C (water’s) -- not used

4. Type D (Bain’s) MC used circuit of choice for controlled ventilation (FGF=1.6*RMV)

5. Type E (ayer’s T piece ) pediatric circuit

6. Type F (Jackson Ree’s) MC used pediatric circuit

 Post shivering increase metabolic rate by 5 times

 Soda lime ---- 4% NaOH + 95% CaOH2

 Tare weight – gas cylinder

 O2 supply in pipe line --- 100 psi

 Paraldehyde excretion through lungs

 Pathophysiological effect of IPPV -- decrease cardiac output

 Definitive sign of phase 1 of a. is – fixation of eye ball

 Fresh air flow in Magil circuit is 5L/min

 Lacrimation during a. --- stage 3

 A. can be self administered by py. During labor – Trichloroethylene

 100 gm soda lime absorb 20% CO2

 Diffusion hypoxia seen during Reversal of a.

 Sreet fit – propofol

 Min starvation time for GA – 8 hrs

 Not used in controlling heart rate intraoperatively –propanolol/metoprolol

 MC nerve for monitoring during a. ulnar nerve

 Hypotension may be due to Isoflurane

 Critical temp for O2 -- -119 C N2O -- 36.5 C air --- -140.6 C

 Endotraheal cuff --- low volume ,high pressure

 Smooth induction – halothane

 Lorazepam – causes longest amnesia

 Horizontal laparotomy – highest postoperative pulmonary complications

 Pungent volatile a. agent are Iso/desflurane

 AOC in increased ICP - thiopentone

 A. agent with boiling point > 75 C is Methoxyflurane

 Most effective MR is Ether

 Intubation dose of pancuronium 0.06-0.08 mg/kg

 Dose of scoline beyond which dual block occur is 500mg

 Amino steroid derivative – ve/pan/pipecuronium

 In mendelson’s syndrome – onset of symptom generally occur within 30 min

 <15 sec breath holding time --- lack of cardiorespiratory reseve

 Elective Sx in pt. who had MI is best done after 6 month

 Most efficient respiratory stimulant is Doxapram

 Siggard –Anderson normogram determines – plasma bicarbonate

 Receptor of pain – Free nerve ending

 Tracheal tug seen in Light a. n aortic aneurysm

 AOC for manual removal of placenta -- GA

 Gag reflex --- 9th nerve

 HEART AND ITS PRESSURE IN DIFFERENT CHAMBERS

0-5 mmHg 5-15

15-25

25-125

 Most sensitive qualitative method for detection of air embolism is End expiratory CO2 content

 Inotropic agent of choice in child with pulmonary arterial HTN is Isoprenaline

 Carotid body not stimulated by Anaemic hypoxia

 Normal dead space is 30% of Tidal volm

 To prevent static electricity use cotton dresses

 Ventilation perfusion ratio is 0.8

 Dose of atropine per kg body weight is 0.01mg

 Total uterine paralysis is caused by Ether

 To decrease the resistance of airway in children – no valve is used

 Central hypoventilation --- no wide alveolar –arterial O2 gradient

 Atropine(during premedication )--- flushing of face

 Allen test – demonstrate the presence of collateral circulation of hand

 Flusol –DA is agent to increase O2 delivery to tissues

 Expiratory reserve volume – same for male n female

 Volume of reservoir bag for neonatal 240 ml

 Ketamine – minimally affect the laryngeal & pharyngeal reflex

 Drug used in central anticholinergic syndrome – Tacrine

 Armoured enforcement of ET tube is used in neuroSx

 Reflex bronchospasm due to anal stretching during lighter plane of a. is called – Bruer lochart’s reflex

 Drug causing anaphylactoid rkn – alcuronium

 End tidal volm is increased to maxm level malingnant hyperthermia

 Safest to be used in asthmatic pt. – chloral hydrate

 DIC is not a complication of cardiac resurcitation

 Hyperthermia is caused by MAO inhibitor

 Site of action of an intrathecal narcotics – dorsal horn of the spinal cord

 0.5mg Buprenorphine equivalent of 6mg morphine

 Last muscle to be rendered akinetic with retrobulbar anaesthetic block is Superior oblique

 Causes of increased mortality during a. is hyperpyrexia

 No Flat capnogram seen with Broncospasm

 Pentothal sodium should be injected preferably into vein over the outr aspect of forearm

 Drug for OPD analgesia is Alfentanyl

 During CPR external cardiac compression is given over upper third of sternum

 Opoid antagonist that can be given orally -- naltrexone

 

 

Methoxy flurane- 5 high

1. High BP

2. Nephrotoxic,

3. high fluride content

4. high output renal failure

5. high risk of Oxalate stone

Halothane 3D

 Dissolve rubber

 Drager narko test

 Dilation --- broncho/ vaso/uterus dilation,

N2O 5P

 Priestely discover

 In practice safest a.

 Poor muscle relaxant

 Pointing effect

 Pneumo condition C/I

 

 Sevoflurane ,trielene,methoxyflurane not used in closed circuit

Acts on

 Diazepam ---------------------limbic syst.

 

 Ketamine --------------------- thalamocortical junction

 

 Thiopentone --------------------- cerebral cortex (ultra short barbiturate)

 

For any feedback mail us drpawanwebs@gmail.com

 

The end

 

 

 

 

 pt.—patient a. – anaesthesia Sx --surgery AOC – a. of choice MR – musle relaxant

 

 

 

fast n Final revision of PSM

Posted by pawan2006e on March 13, 2012 at 12:05 AM Comments comments (1)

  Final n fast revision of PSM

                                                            By www.drpawan.webs.com

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 term Social medicine was 1st introduced by Jules Guerin.

 

 Germany---compulsory sickness benefit

 

 Winslow def. of public health not include immunization against ds

 

 PQLI in india 65

 

 Human suffering index 70

 

 CHERNOBYL TRAGEDY is e.g. of point source epidemic

 

 In an epidemic 1st to be done---confirm the Dx

 

 Restoration of body fn—medical rehabilitation

 

 Modern epidemiology refer to study of health services

 

 Toxoid is prepared – exotoxin

 

 De professionalization in medicine widely seen in india –primary health care practices

 

Carriers

 Incubatory – My PHD Is IMP measles,mumps,polio,hep B ,Diptheria ,Influenza ,Pertusis

 Convalescent – Water Chlorination c DDT Cholera diphtheria dysentery typhoid whoophing c

 Healthy – PSM Define Cholera & Health - polio salmonellosis Cholera diphtheria meningitis

 Chronic carrier -- malaria gonorrhea meningitis typhoid dysentery HBV

 

 Goiter is prevalent at higher altitude – indirect a/s

 

 No latent infection ---mumps

 

 Berkesonian bias – selection bias

 

 Leishmaniasis is not a dead end ds

 

 Prevalence of cataract at one point time can be determined by cross sectional study

 

 Communicability ---2 ndry attack rate

 

 Diagnostic accuracy ---predictive value

 

 Germ theory – Louis Pasteur

 

 Sentinel centre for vaccaine preventable ds not provide information on incidence rate

 

 Binary exposure to an antigen result in sudden increase in IgG

 

 After administrating live vaccine Ig given after – 2 weeks

 

 Rubella –introduce most recently

 

 Ring vaccination –around 100 yard of case detected

 

 1.Chicken pox----oka 2.measles --- Edmonston -Zagreb

 

 Choleric stool disinfected ---cresol

 

 Ideal e.g. of precurrent disinfection –pateurization of milk

 

 Savlon = cetrimide + chlorhexidine

 

 Screening in children has not been proved cost effective --T.B.

 

 Best method to compare new test bland & Altman analysis

 

 Cluster testing for STD

 

 Chandler’s idex no. of egg/gm of stool of ancyclostoma

 

 Not found in india – sleeping sickness

 

 English ds—Rickets

 

 IP of amoebiasis 3-4wks

 

 Not show iceberg phenomenon – chicken pox

 

 Beatuex index ----- aedes aegyptii

 

 Last case of small pox was reported in world in 1977(somalia)

 

 Not a complication of chicken pox -- pancreatitis

 

 Measles vaccine given to contacts of measles exert protective effect within 7 days

 

 Female receiving rubella vacc. Should not become pregnant for min 3 months

 

 Newer influenza vacc. Are split virus/neuraminidase vacc.

 

 Most infectious variety of diphtheria --- ant nasal diphtheria

 

 Infectivity of diphtheria pt. –for 15 days after infection

 

 Infective period of woophing cough last for 3 wks aftr onset of paroxysmal stage

 

 Ip for pertusis 7-14 days

 

 IP for meningococcal meningitis 5days

 

 Montoux test <5 cm means—susceptible to TB

 

 T-cell function are assesed by Migration inhibition test

 

Test read after

Patch test 2 days

Early Fernandez rkn 2 days

TB induration 3 days

Skin doubling time(psoriasis) 4 days

Kevim’s test 2 wks

Late mistuda rkn 3 wks

Normal skin doubling time 4 wks

 MC used combination of ATT in india INH+thiacetazone

 Direct BCG vaccination in india given upto 20 yrs

 DOC for mycobacterium bovis rifampicin

 Standard dose of tuberculin used in india 5 TU

 Prevalence of open case of TB in india 0.4%

 Min TB resistance is seen with Rifampicin

 Active against dormant bacilli --- rifampicin

 Sputum positivity in TB –more specific than sensitivity

 Polio virus in opv result in IgA

 Most predominant type of polio virus during epidemic is type 1

 Subclinical case ratio in polio 75:1000

 Pulse polio immunization introduce in 1995

 Certificate to cholera vaccination is valid after 10 days

 2.6 gm nacl in ORS of 1 ltr ors fluid

 ORS contain 20 K+

 Acetone killed typhoid vaccine immunity last for 3 yrs, alcohol killed –1-2yrs,phenol killed—3yrs

 Permanent carrier of typhoid one who excretes bacilli for more than 1yr

 Typhoid oral vaccine given 1,3,5 days

 Dengue virus survival in inter epidemic period is transovarian transmission of virus.

 h/o of malaria with acute red eye due to viral keratitis

 duffy negative RBC are resistant to P. Vivax

 expected reduction in API by 2000AD in india .1/1000

 ABER--- operational efficiency

 Current global strategy 4 malaria is =roll back malaria

 Most sensitive malariogenic index --- infant parasite rate

 Radical treatment of malaria primaquine is given 15mg /day for 5 days, chloroquine for 3 days

 IP for filariasis – 8-16 months

 Prepatent period in lymphatic filariasis is define as time interval b/w inoculation of infective larva & 1st appearance of detectable microfililaria

 % of people examined showing microfilaria in blood is called Filaria endemicity rate

 Chick fibroblast vaccine –most effective ARV

 Rabies free zone---lakshadeep

 Quarantine period of yellow fever 6 days

 <1% aedes aegypty index no risk of spread of yellow fever

Japanese Encephalitis.

 

 Immunity develop in 30 day

 Persist for 3 yrs

 Reactivation after 3yrs

 Vaccination done for < 3yrs child

 Case fatality rate 30%

 Spraying upto 3 km

 

 

 

 KFD transmited by haema physalis spinigera

 Declare an area free of plague 7 (longest ip)* 2 =14 day

 Total flea index = average no. of all flea of all species per rat

 Most contagious plague – pneumonic plague

 Specific flea index = average no. of flea of each species per rodent

 In kalazar aldehyde test become positive after 12 wks

 Lowest incidence of trachoma in Orissa (more water .less dust area)

 Exotoxin of tetanus not affect parasympathetic nervous system

 3 doses of TT confer immunity for 5 yrs

 Earliest sensation lost in leprosy temp

 In NLEP mass servey 10/1000

..

 

 Duration of t/t for pauci bacillary leprosy 6 month for multi bacillary 1yr

 Ip for leprosy 2-4 yrs

 A/c to NLEP elimination of leprosy is define as prevalence of leprosy more than or equal to 1/10000

 En demic syphilis is non veneral ds

 Highest no. of AIDS cases in india occur in 30-44 yrs age group

 Pt. on antacid therapy more susceptable to Salmonella

 Commonest cause of food poisoning is Salmonella

 Transovarian transmissionin of infection occur in Ticks,Mosquito, yellow fever

 IP (mumps) 18 days

 Mass t/t strategy for Filiariasis

 Earliest case of SARS is reporte in China

 Scabies is not a zoonotic ds

 Vaccine develop in 20th century –anti diptheria

 Morbid obesity cause of death due to CVS complication

 Beer consumption  rectal ca

 Prevalence of RHD in india  6/1000

 Visual acuty needed as cut off in school 6/9

 WHO  blindness is Visual acuity <3/60 in better eye with best correction

 Under National programme for control of blindness , the goal is to reduce the prevalence of blindness to a level of 0.3% (target for blindness control for 2000 year)

 BMI is known as  Quetelet’s index

 Other than cataract Glaucoma has highest prevalent cause of blindness in the world

 SET centre are established if prevalence % leprosy is 1-5

 As per WHO LEPROSY is public health problem if prevalence is 0.01%

 AIDS WAS 1st detected in india in 1986

 Cancer control programme was launched in 1976

 In india TB to be labeled as under control the incidence should be less than 10 per 1000

 Iodised salt was 1st started in which country india

 Anti malarial month is  june

 3 by 5 initiative in AIDS  Providing 3 million people t/t by end of 2005

 NLEP STARTED - 1983

 THE MILLENNIUM DEVELOPMENT GOALS is to achieve by year 2010

 IN Chronological order of national programme Malaria – filarial – TB – Anemia (MUFT)

 Basal body temp. increases at the time of ovulation 0.5 F

 Failuire of OCP is mostly due to improper use

 Undergoing vasectomy pt. not give advise for Bed rest

 National health policy was formulated in 1982

 


 


very soon it can be download from download page.

to be continued.......

 

 

 

* ds—disease,Dx --diagnosis

 

 

 

 

 

 

 



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