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“Screening test” most important series Dr.deep All important and most frequently asked points in the fmge…it really helps dr.deep 1/1/2011
Cereals---------------------threonine and lysine
Pulses----------------------methionine and cystine
Maize----------------------tryptophan and lysine
Thumb print sign on x ray---epiglottitis and ischemic colitis
Thumb sized stools—polio
Thumb print shape---b.pertussis
Onion peel----------------ewing sarcoma
Onion skin ----------------systemic lupus erythematous
Onion peel appearance in ercp------primary sclerosing cholangitis
Satellite ulcers---------------mycotic ulcers in the eye
Satellite lesions in the eye----chronic arsenic poisoning
Satellite lesions-----------borderline leprosy
FOLLOWING ARE PHOTOSENSITIVE DRUGS-------DDLP
Demeclocycline
Doxycycline
Levofloxacin
pefloxacin
SOME IMP MICROS
Microangiopathy------------hemolytic uremic syndrome
Microaneurysm--------------diabetes mellitus
Munroe micro abscess----psoriasis
Micropenis--------------mumps
Nanopththalmia------uveal effusion
SOME QUESTIONS…
1,Hydatid cyst is commonly found in
1, liver
2, lungs
3, kidney
(ans:liver )
2, Most common site of abscess formation due to Amoeba
1, liver
2, Lungs
3, kidney
(ans:liver )
3, Umblical cord has (repeated question in all previous papers)
1,2artery n 1 vein
2,2 vein n 1 art.
(Ans:2 artery n 1 vein)
4, Apoptosis
Programmed internal suicidal cell death
5, wheal and flare reaction is
1, Type 1 hyper sensitivity
2, Type 2 hyper sensitivity
3, Type 3 hyper sensitivity
4, Type 4 hyper sensitivity
(ans:Type 1 hyper sensitivity. All the anaphylactic reactions comes under type 1
hyper sensitivity)
BORED ………………………..!!!!!!!!!!!! A PICTURE PNEUMONIC FOR YOU
The above picture gives mnemonic for Ewing's tumor.
First let us analyse the picture.
Note the chick and swelling of Diaphysis of Tibia with the onion.
Chick says VAC VAC VAC VACA, VAC VAC VAC AV / CV.
The chick has fat and hence PAS stain positive.
Note the moon and star at the top, Radio streaming music and chick fluttering it's wings up and down
to the music as represented by 2 arrow marks at the left side.
See the melted snow below the bone and a blood vessel from the side ( left corner ) Now, this is what
the picture says: Ewings - the chick with wings; Arises from Diaphysis, most common bone is Tibia.
Seen in children as represented by the chick. Onion represents the onion peel appearance in X-rays.
The wings going up and down ( arrows ) represent that the size of tumor increases and decreases (
H/O Exacerbations and remissions ).
The moon & star represents the clinical feature that pain is worse at night.
Radio represents that the tumor is extremely radiosensitive - therefore melts like snow.
Spread is by blood vessels and lymphatics.
And what the chick says is the chemotherapy regimen - VAC ( Vincristine, Adriamycin,
Cyclophosphamide ), VACA ( VAC + Actinomycin ), AV alternating with CV.
BIOCHEMISTRY.MIGRAINE.COM
I know but have to remember the following read it thousand times remember it once…..in the exam atleast…till
fatty acids is very important for fmge…
Rate Limiting Enzymes
Proccess
Phosphofructokinase-1 -Glycolysis
Pyruvate dehydrogenase
complex
-Pyruvate Metabolism
Isocitrate dehydrogenase -TCA cycle
Citrate synthase -Citric acid cycle
Glycogen synthase -Glycogenesis
Glycogen phosphorylase -Glycogenolysis
Phosphoenolpyruvate
carboxykinase
-Gluconeogenesis
Glucose 6 phosphat
dehydrogenase
-Hexose Monophosphate
Shunt
Glucose-6-phosphate
dehydrogenase
-Pentose phosphate
HMG-CoA reductase -Cholesterol synthesis
HMG-CoA synthease -Ketone body formation
Acetyl CoA carboxylase -Fatty acid synthesis
Carnitine acyl transferase
[CPT-1]
oxidation of fatty acids-
Acetyl-CoA-carboxylase -Lipogenesis
Cytidyltransferase- Phospholipid synthesis
3 ketosphiganine synthase -Sphingolipid synthesis
Phospholipase A2 -Eicosanoid synthesis
Phospholipase A2 -Prostaglandin synthesis
CSCC (27 desmolase) -Steroidogenesis
Aminolevulinate synthase -Heme synthesis
Active transport into bile
ducts
-Bilirubin metabolism
Ribonucleotide reductase DNA synthesis
Glutamine Prp transferase Purine synthesis
Carbamoyl phosphate
synthetase II
Pyrimidine synthesis
Carbamoyl phosphate
synthetase I
Urea cycle
Q AND A
An 82-year-old man presents with 8 weeks of periorbital edema,
6 weeks of rash, and 2 weeks of bilateral shoulder and arm aches
and weakness. What is the diagnosis?
a. Polymyalgia rheumatica
b. Inclusion body myositis
c. Hypothyroidism
d. Polymyositis
e. Dermatomyositis
ANS. DERMATOMYOSITIS
Answer: e
• Three causes of idiopathic inflammatory myopathy:
Dermatomyositis (DM)
Polymyositis
Inclusion body myositis
• Dermatomyositis has a bimodal age distribution • Skin findings associated with DM:
HELIOTROPE HUE OF THE EYELIDS
RASH OF THE METACARPOPHALANGEAL AND PROXIMAL INTERPHALANGEAL
JOINTS (GOTTRON’S PAPULES)
Photosensitivity dermatitis of the face
• Proximal myositis with associated pain and weakness is
characteristic of DM
• The serum creatine kinase and aldolase values are usually
increased in DM
• The anti-Jo1 antibody is present in 25% of patients with DM
• The electromyogram is characteristic, but not diagnostic, of
the inflammatory myopathies
• Amuscle biopsy is suggested for all patients with inflammatory
Myopathy
• Patients with DM have an increased risk for cancer
• DM is treated with immunosuppressive drugs.
This is a dermatology question.this might not come in this way as a picture but the
most tested points are heliotrope
rash and gottrons papules.you have to at least remember these and try asking
your friends as many times as you can
….this is important…
Q . The carpal tunnel contains all of the following important structures except:
A. Median nerve.
B. Flexor pollicis longus.
C. Flexor carpi radialis.
D. Flexor digitorum superficialis.
Ans. C
This type of question can come directly as it is….remember carpal tunnel
syndrome is a anatomy question which is very important….
Q . The type of hemoglobin that has least affinity for 2,3-
diphosphoglycerate (2,3-DPG) or (2,3-BPG) is:
A. Hg A.
B. Hg F.
C. Hg B.
D. Hg A2.
Ans. B
Physiology ----2,3 dpg concept is very important.read it learn it
memorize and understand it.
TIT BITS
1.The spleen is the most commonly injured solid organ in the blunt abdominal
trauma.
2.serum ferritin:measure of iron stores..remember tin always stores..
So serum ferritin is decreased in iron deficiency anemia.
3. SKIN-LEARN LEPROSY, LEPRA TEST,PSORIASIS,LICHEN PLANUS.
4. PSYCHITRY
REMEMBER DIFENCE BETWEEN DELUSION,HALLUCAINATION,ILLUSION,
ONE Q FOR SCHIZOPHENIA IS CONFIRM.
5. Curling’s Ulcer - Acute gastric ulcer associated with severe burn.
6. Cushing’s Ulcer - Acute gastric ulcer associated with CNS trauma.
7. Autosplenectomy -- Sickle cell anemia: switch a glu to val in β chain 6th position.
Autosplenectomy was asked in sep2010 m.c.i paper …..
IN THE NEWS
A new study has found evidence of increased lung cancer risk among
people with tuberculosis. Researchers at China Medical University and Hospital in Taiwan randomly
selected 1 million patients covered under the country's National Health Insurance (NHI) programme.
All patients aged 20 years and older with a new diagnosis of tuberculosis between 1998 and 2000 were identified as the exposed cohort and all
people without tuberculosis history were the non-exposed cohort.
Results showed that patients with tuberculosis were 10.9 times more likely than non-tuberculosis patients to develop lung cancer.
"It is well known that lung cancer is causally associated with smoking. Less attention has been focused on whether people with tuberculosis are
also at higher risk of developing lung cancer," said Dr. Chih-Yi Chen, one of the researchers.
"The risk of lung cancer may increase further to almost 16 times greater if patients with tuberculosis also suffer from chronic obstructive pulmonary
disease," he said.
"This study suggests that it is also important to watch out for lung cancer prevention in the campaign against tuberculosis."
The study was published in the January issue of the Journal of Thoracic Oncology.
MOST COMMON CANCER IN SMOKERS--------SQUAMOUS CELL CANCER
MOST COMMON CANCER IN NON-SMOKERS---ADENOCARCINOMA
ABOVE POINTS ARE IMPORTANT AND HAVE BEEN TESTED IN PREVIOUS EXAMINATIONS.
NEWMONICS
1.Vitamin B3 (niacin, nicotinic acid) deficiency: pellagra
The 3 D's of pellagra: Dermatitis Diarrhea Dementia
· Note vitamin B3 is the 3 D's.
2. Na+/K+ pump: movement of ions and quantity
K+ and in each consist of 2 characters, so so 2 K+ are pumped in. Na+ and
out each consist of 3 characters, so 3 Na+ are pumped out
3. ABCD:
Anderson's=Branching enzyme.
Cori's=Debranching enzyme.
4. Preeclampsia: classic triad PREeclampsia: Proteinuria Rising blood pressure Edema
5. Uk-CAT
U............USG...............6-40WKS.
C...........CVS................9-12
A..........AMNIOCENTESIS..15-18
T............TRIPLE TEST.......16-18
6. CVS and amniocentesis: when performed "Chorionic" has 9 letters and Chorionic
villus sampling performed at 9 weeks gestation. "AlphaFetoProtein" has 16 letters and it's
measured at 16 weeks gestation.
TOPIC OF THE BOOK
Myasthenia gravis
1) 35 yr female with double vision at the end of the day, dysphagia, nasal voice,
upp ext weakness, her sx improve after a night’s sleep. Dx?
2) What is MG?
3) Best initial test for MG?
4) What is the specific test for MG?
5) What is the sensitive test for MG?
6) Most accurate test for MG?
7) Tx for MG? If primary tx fails, what to use (initial choice) for MG?
9) If initial tx after primary tx fails, what tx for MG? 10) Tx for acute MG crisis?
Answers
1) Myasthenia Gravis
2) Dis. Of NMJ, presents with weakness and fatigue. Ab to Ach receptors -> dec #
of active/functional Ach receptors at postsynaptic membrane
3) Ach receptor Ab
4) Fatigued muscle weakness plus +Ach receptor Ab test
5) Edrophonium (Tensilon) test
6) EMG (decremental dec in muscle fiber content on repetitive nerve stimulation
7) Anticholinesterase (pyridostigmine) Immunosuppressive tx with
glucocorticoids
9) Azathioprine and steroid combo 1
0) Plasmapheresis and IVIG
11) Thymectomy.
Bolly wood super star amitabh bacchan also suffered from myasthenia gravis.