Facebook: PFT-1

Q1) Which of the following is/are not a contraindications of performing PFT(Pulmonary function test)? 

A) MI within one year

B) Unstable angina

C) Recent thoraco-abdominal surgery

D) Recent ophthalmic surgery

E) Past history of pneumothorax

So correct options are - A and E

Following are contraindications to perform pulmonary function test. 

Mnemonic: UR IRcTC

U- Unstable angina

R- Recent thoracoabdominal surgery

I- Myocardial infarction within the last month

R- Recent ophthalmic surgery

T- Thoracic or abdominal surgery 

C- Current pneumothorax

That's it! 

-Demotional bloke. 

Parasitic infections and Asthma

In parasitic infection, polyclonal IgE produced by body occupies the receptor produced by mast cells. This leads to decrease action of specific IgE required for asthma. 

This mechanism is probably the cause of decrease prevalence of asthma in tropical population. 

That's it 

-Demotional bloke

Choristomas Vs Hamartomas

I get super confused with both the following terms, so I made a lame technique to remember both of them. 

Choristomas:

It sounds more like a Christmas. So Christmas tree is usually not grown in India but we do keep it as a sign of Christmas. 

So Christmas tree is normal, but the site (India or any other habitat) is not the usual site of tree, so let's say abnormal. 

So Choristomas is normal tissue at abnormal anatomical sites.

Example - Normal pancreatic cells under the small bowel mucosa.

They are not considered as neoplasm.

Hamartomas:w

'Hamara' in Hindi means 'mine'. 

Remember: this place is mine. So here, place is normal and tissue is abnormal!

That is, abnormal tissue at normal anatomical sites.

Example - Lung hamartomas exhibit cartilage, bronchi, and blood vessels. 

They are considered as neoplasm.

That's it! 

-Demotional bloke

Areas devoid of pain fibres

Areas devoid of pain fibers 

Mnemonic: BED PACK

B- Brain parenchyma

E- Ependyma

D- Duramater (Neither covering blood vessel or forming dural venous sinus) 

P- Pia mater

A- Arachnoid mater

C-Choroid plexus

That's it 

-Demotional bloke

Areas devoid of BBB

Area devoid of BBB 

Mnemonic: MAP SNOW
M- Median eminence
A- Area postrema
P- Pineal gland
S- Subfornical organ
N- Neurohypophysis
O- OVLT- Organum vasculosum laminer terminalis 

That's it 

- Demotional bloke

Egg shell calcification

Following are the cases in which we get eggshell calcification of lympho nodes on radiography. 

Mnemonic:

SSRI Love Hitting BAT

(Lame? I know!) 

S-Silicosis

S-Sarcoidosis

R- After Radiotherapy

I L- Post irradiation lymphoma

H- Histoplasmosis

A- Amyloidosis

T- Tuberculosis

That's it ! 

- Demotional bloke

Ocular Alzheimer's disease

A paper published in 2003 has dubbed glaucoma as 'ocular Alzheimer's disease' because some of the pathophysiological elements are similar.

Cataract in Rubella- interesting fact

The progressive nuclear cataract in Rubella may harbor live virus particles.

Psychiatry MCQ-1

So here are two multiple choice questions, whose answer changes with options. 

Q1)Most common psychiatric disorder is :-

A) Anxiety

B) Depression

C) Phobia

D) Schizophrenia

Here answer is A) Anxiety

Most common psychiatric disorder is 

A) General Anxiety disorder

B) Panic anxiety disorder 

C) Phobia anxiety disorder 

D) Depression

Here answer is D) Depression. 

Reason for such variation is that Anxiety is not just a single disease like depression.

Infact it is group of disorders. 

So Depression is the single most common psychiatric disease whereas Anxiety is the most common psychiatric disease. 

GANGLION (Last minute revision)

Hello Awesomites !

These are point on parasympathetic ganglion.

-Upasana Y.

Spherocytosis

Hello Awesomites !

The future blogs will be on confusers.

Q. On peripheral blood smears there is presence of spherocytes. What are the differentials and the test to identify the same?

Most of you have prompted it as hereditary spherocytosis.
 Let see.

Ans. DIFFERENTIALS :- 

• HEREDITARY SPHEROCYTOSIS
• AUTO-IMMUNE HEMOLYTIC ANEMIA

 Best next step is to do DIRECT COOMBS TEST to rule out autoimmune hemolytic anemia.
For hereditary spherocytosis go for osmotic fragility test.  


 So spherocytosis doesn't means Hereditary, it could be acquired, usually preceded by an infection.

HAPPY STUDYING :) 
-Upasana Y.

Integrating Trendelenburg

This blog will compel all the signs /symptoms Or test related to 'Trendelenburg'. Let us know if you know more of the 'Trendelenburg' in the comment section so we can integrate it here. 

Trendelenburg's gait: 

A child with unilateral dislocation of hip lurches on the affected side while bearing weight on it. Seen in DDH, poliomyelitis, Superior Gluteal nerve palsy.
Trendelenburg's gait is also known as Abductor gait or lurching gait.

Trendelenburg's test:

Trendelenburg's surgery/procedure:
It is done in GSV and SFJ incompetence. Here flush ligation of SFJ is done. Flush ligation means vein is ligated as close as possible.
Six tributaries also need to be ligated to reduce recurrence rate.
Laterally: Superior circumflex iliac.
                  Superior epigastric vein.
Medially: Superior external pudendal
                   Deep external pudendal
Distally: Accessory anterior saphenous vein
                Posterior medical thigh vein

Stripping is an additional surgery. Should be done till knee, not below knee to avoid Saphaneous nerve.

Brodie Trendelenburg's test: 

It is done to determine the incompetency of the sapheno-femoral valve and incompetency of the communicating vein.
In both the tests, patient is first placed in the recumbent position and his legs are raised to empty the veins. The sapheno-femoral junction is now compressed with the thumb or a torniquet can be used.
1) To check sapheno-femoral valve incompetency, patient is asked to stand up quickly and pressure is released. If varices fill quickly by a column of a blood from above, it indicates incompetency of the sapheno-femoral valve. This is called Trendelenburg test.
2) To test communicating system, pressure is not released but maintain for 1 min. Gradual filling of the veins indicates incompetency of communicating veins.

That's it

-Demotional bloke. 

AVPU Scale

Hello Awesomites !

LONG TIME .

AVPU scale is like glasgow coma scale to determine the level of responsiveness.

A=ALERT AND AWARE

• Eyes open 
• Knows name,date,time,place

V=RESPONDS TO VERBAL STIMULUS 

• Not oriented to time and place
• Responds in a meaningful way
  

P=RESPONDS TO PAINFUL STIMULUS 

• Eyes do not open

• Responds when trapezium muscle is pinched

U=UNRESPONSIVE

• Eyes do not open
• Does not respond to pinching of muscles 

Best (A) to Worst (U)

Happy Studying :)
 -Upasana Y.