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* IMPORTANT 231 *
Please remember :
*ARTERY/ARTERIES/VEIN/VEINS/BLOOD VESSELS*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient:
Problem in your *BLOOD CONDUITS/BLOOD CHANNELS*
paceUrMRCP.
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* IMPORTANT 230 *
Please remember :
*TRANSIENT ISCHEMIC ATTACK ( TIA )*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient:
You had a *MINI STROKE*
paceUrMRCP.
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IMPORTANT 229 *
Please remember :
*BRONCHUS/BRONCHI*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient:
Problem in your *AIRWAY/AIRWAYS* .
paceUrMRCP.
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* IMPORTANT 228 *
Please remember :
*TRACHEA*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient:
Problem in your *WINDPIPE* .
paceUrMRCP.
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Dear all I regret to inform you that we will not be having any sessions on Sundays for a month, we will start again in Dec 23 if all goes well. I regret any convenience.Regards
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* IMPORTANT 228 *
Please remember :
*TRACHEA*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient:
Problem in your *WINDPIPE* .
paceUrMRCP.
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*IMPORTANT 227*
*Result of water deprivation test in nephrogenic DI*
No increase in urine osmolality after desmopressin
paceUrMRCP.
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*IMPORTANT 226*
*Result of water deprivation test in cranial DI*
Urine osmolality increases to >600mOsmol/kg after desmopressin
paceUrMRCP.
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*IMPORTANT 225*
*Common causes of Nephrogenic Diabetes Inspidus*
â˘Inherited.
â˘Metabolic: low potassium, high calcium
â˘Drugs: lithium, demeclocycline
â˘Chronic renal disease.
â˘Post-obstructive uropathy
paceUrMRCP.
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*IMPORTANT 224*
*Common causes of cranial Diabetes Inspidus*
â˘Idiopathic
â˘Congenital: defects in ADH gene, DIDMOAD.
â˘Tumour (may present with DI + hypopituitarism): craniopharyngioma, metastases, pituitary tumour.
â˘Trauma: DI is usually temporary after trauma
â˘Hypophysectomy.
â˘Autoimmune hypophysitis
â˘Infiltration: histiocytosis, sarcoidosis
â˘Vascular: haemorrhage.
â˘Infection: meningoencephalitis
paceUrMRCP.
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*IMPORTANT 223*
*Extraintestinal manifestation of Hepatitis C* by courtesy of Dr Urvashi. Thanks a lot Dr
Essential mixed cryoglobulinemia
Peripheral neuropathy
Porphyria cutanea tarda
Lymphoma
Autoimmune phenomenon
Peripheral nephropathy
Diabetes mellitus
paceUrMRCP.
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IMPORTANT 222
Extraintestinal manifestation of Hepatitis B
Polyarteritis nodosa
Glomerulonephritis
Nephrotic syndrome
Arthritis dermatitis syndrome
Palpable purpura
paceUrMRCP.
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*IMPORTANT 221*
Some signs of Acromegaly
Increased growth of hands ( may be spade-like), jaw and feet (sole may encroach on the dorsum).
Coarsening face; wide nose. Big supraorbital ridges.
Macroglossia (big tongue).
Widely spaced teeth.
Puffy lips, eyelids, and skin (oily and large-pored); also skin tags. Scalp folds (cutis verticis gyrata; due to expanding but tethered skin).
Skin darkening.
Acanthosis nigricans.
Laryngeal dyspnoea (fixed cords).
Obstructive sleep apnoea.
Goitre ( increased thyroid vascularity).
Proximal weakness + arthropathy.
Carpal tunnel signs in 50%.
Signs from any pituitary mass: hypopituitarism Âą local mass effect ( reduced vision; hemianopia); fits.
paceUrMRCP.
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*IMPORTANT 220*
Always try to rule out MEN 1 in a case of Acromegaly.
paceUrMRCP.
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IMPORTANT 219
*Some info about Irritable Bowel Syndrome ( IBS )
Please remember that the following must be frequently excluded in diagnosing IBS:
Obstruction
IBD
Lactose or sorbitol intolerance
Malignancy (in older patients or those with family history)
paceUrMRCP.
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IMPORTANT 218
*Some info about Irritable Bowel Syndrome ( IBS )
Treatment options
Diet and lifestyle changes (e.g., avoiding dairy products,excess caffeine).
For diarrhea try diphenoxylate,loperamide.
For constipation try colace, psyllium, cisapride.
For abdominal pain try antispasmodics (e.g., pinaverium, trimebutine, peppermint oil,
cimetropium/dicyclomine), , rifaximin.
antidepressants may help.
paceUrMRCP.
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IMPORTANT 217
*Some info about Irritable Bowel Syndrome ( IBS )
The Rome IV criteria for the diagnosis of irritable bowel syndrome (IBS) ( earlier it was Rome 111 )
Patients have had recurrent abdominal pain on average at least 1 day per week during the previous 3 months that is associated with two or more of the following
⢠Related to defecation (may be increased or unchanged by defecation)
. Associated with a change in stool frequency
⢠Associated with a change in stool form or appearance
paceUrMRCP.
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*IMPORTANT 216*
*Some info about Irritable Bowel Syndrome ( IBS )
This is a clinical diagnosis, and a diagnosis of exclusion.
All laboratory test results are normal, and no mucosal lesions are found on sigmoidoscopy.
paceUrMRCP.
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*IMPORTANT 215*
*Some info about Irritable Bowel Syndrome ( IBS )
*Common Clinical Features of IBS*
1. Change in frequency/consistency of stool diarrhea, constipation (or alternating diarrhea and constipation)
2. Cramping abdominal pain (relieved by defecation)-location varies widely,
3. Bloating or feeling of abdominal distention
paceUrMRCP.
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*IMPORTANT 214*
*Some info about Irritable Bowel Syndrome ( IBS )
Symptoms are exacerbated by stress and irritants in the intestinal lumen ( some foods )
Symptoms should be present for at least 3 months to diagnose IBS.
paceUrMRCP.
