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Important Medical Study MaterialPLAB Study Material

Most Important Points for PLAB





Hemochromatosis is deposition of iron in hepatocytes, with resulting
damage to the liver cells.
Hemosiderosis is the deposition of iron in Kupffer cells, with no
damage to the liver cells

Oral lichen planus is an ongoing (chronic) inflammatory condition that
affects mucous membran nes inside your mouth. Oral lichen planus
may appear as white, lacy patches; red, swollen tissues; or open sores

Post-coital bleeding in middle aged females is CERVICAL cancer
until proven otherwise.

Post-coital bleeding in post-menopausal females is ENDOMETRIAL
cancer until proven otherwise.

Since they’re asking for the most appropriate (not the initial most)
investigation, I’ll go for endometrial sampling.

Remember transvaginal ultrasound > endometrial sampling > biopsy.
bilateral parotid and lacrimal gland enlargement was characterized by
the term Mikulicz’s disease if the enlargement appeared apart from
other diseases. If it was secondary to another disease, such as
tuberculosis, sarcoidosis, lymphoma, and Sjögren’s syndrome, the
term used was Mikulicz’s syndrome.

Sudden severe — PID

Gradual ( chronic ) with other features eg scoliosis etc — AS

Morning — they can because while getting up if posture is nt straight ..

AS — involvement of sacroiliac joints is classic
And also morning stiffness

Myasthenia is autoantibodies to post ganglionic acetylcholine

receptors, LES is autoantibodies against presynaptic receptors.
Clinically, LEMS has weakness predominantly in lower limbs and less
of ocular weakness etc.
Also LEMS the weakness improves (means patient gets better) with
repeated use unlike myasthenia where patient gets fatigue due to
repeated use
antibodies differ….MG…anti ACH abs while in LEMS…abs against Ca
channels plus usually associated with SCLC!

Painless syphlis
Painful single ulcer — hem ducreyi
Hsv — multiple

Beneficence – promote the well being of your patient
Non-maleficence – principle of NOT harming your patient in any way
is more important than doing them good.

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CT scanning is recommended for most patients in the acute phase of
stroke. CT is widely available, practical, quick and easy to use in ill
patients.
CT is very sensitive in diagnosing haemorrhage in patients in the acute
stage.
In patients with ischaemic stroke, especially those with mild
neurological deficits, CT imaging is often normal in the first few
hours but the accuracy for ischaemic stroke delineation improves after
six hours.
However, CT remains less accurate than MRI for determining the site
and extent of ischaemic damage, particularly for small lesions and
posterior fossa lesions.
The accuracy of CT is reduced after one week following the stroke
event, especially distinguishing between haemorrhagic and ischaemic
stroke origin.

MRI may be contra-indicated in up to a fifth of patients because they
are too ill, confused, dysphasic, have an intraocular or intracerebral
metallic foreign body or have a pacemaker.

MRI should be the imaging investigation of choice in individuals with
epilepsy. It is particularly important in patients
who develop epilepsy before the age of 2 years or in adulthood
who have any suggestion of a focal onset on history, examination or
EEG (unless clear evidence of benign focal epilepsy)

in whom seizures continue in spite of first-line medication.
CT is used when MRI is not available or contraindicated to identify
underlying gross pathology or for children and young people in whom
a general anaesthetic or sedation would be required for MRI but not
CT – gpnotebook.

CT of the sinuses as well as the orbit ± brain:
CT is usually indicated only for children (unless the child is very well
and the episode is mild) or if orbital cellulitis is suspected in an adult.
if an intracranial abscess is suspected, CT is the gold standard imaging
modality, carried out to identify any subperiosteal abscesses, paranasal
sinusitis or cavernous sinus thrombosis (all needing multi-speciality
input).
It is also valuable in assessing trauma where there may be concerns
about a retained orbital or intraocular foreign body.

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Pancoast tumour is a type of lung cancer defined primarily by its
location situated at the top end of either the right or left lung
Pancoast tumour can include a complete Horner’s syndrome in severe
cases: miosis (constriction of the pupils), anhidrosis (lack of
sweating), ptosis (drooping of the eyelid) and enophthalmos (sunken
eyeball). In progressive cases, the brachial plexus is also affected,
causing pain and weakness in the muscles of the arm and hand
(thoracic outlet syndrome). The tumour can also compress the
recurrent laryngeal nerve and from this a hoarse voice and bovine
cough may occur.

Current screening protocols in the United Kingdom
Newborns

Well baby protocol:

For babies who had no requirement for special care (or <48 hours in
special care).

Uses the AOAE test. Babies not passing this test are given the AABR
test.
Neonatal intensive care/special care baby unit protocol:
Uses both AOAE and AABR tests. The latter can detect auditory
neuropathy, which is more common in special care babies.

Automated otoacoustic emissions (AOAE) test
Automated auditory brainstem responses (AABR) test

It was brain stem evoked response till 6 months.
6months till 2 years it’s distraction tests
>2 years audiometry.
5years..pure tone audiogram

grey membrane on tonsils – diphtheria
yellow membrane on tonsils – infective mononucleosis!!

Muscle pain due to inflammation in the body’s soft tissues. Myofascial
pain is a chronic condition that affects the fascia (connective tissue
that covers the muscles). Myofascial pain syndrome may involve
either a single muscle or a muscle group. In some cases, the area
where a person experiences the pain may not be where the myofascial
pain generator is located. Experts believe that the actual site of the
injury or the strain prompts the development of a trigger point that, in
turn, causes pain in other areas. This situation is known as referred
pain.
Myofascial pain symptoms usually involve muscle pain with specific
“trigger” or “tender” points. The pain can be made worse with activity
or stress. In addition to the local or regional pain associated with
myofascial pain syndrome, people with the disorder also can suffer
from depression, fatigue and behavioral disturbances.
Diagnosis
Trigger points can be identified by pain that results when pressure is
applied to an area of a person’s body. In the diagnosis of myofascial
pain syndrome, four types of trigger points can be distinguished:

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Adjustment disorder usually lasts < 6 months
Anticipation of next episodes and persistent concern of additional
attack is there in Panic disorder and not in adjustment

Parvovirus B19 is a common infection, usually presenting as erythema
infectiosum in children. There is a wide range of potential
consequences of parvovirus B19 infection. These extend from minor
febrile illness to erythema infectiosum (fifth disease, slapped cheek syndrome), a generalised rash illness clinically indistinguishable from
rubella, aplastic crises in patients with increased red cell turnover,
arthropathy, and persistent infection in the immunocompromised.

median nerve compression actually a complication of tight
cast…decompression surgery is done

The National Institute for Health and Clinical Excellence (NICE)
advises that women should be offered screening for anaemia at
booking and at 28 weeks of gestation.[2] Anaemia is defined as an Hb
level <11.0 g/dL at booking; haemodilution will result in further drops
during pregnancy and subsequent reduction in oxygen-carrying
capacity. In the second and third trimesters the diagnostic level for
anaemia is an Hb level of <10.5 g/dL. Postpartum the diagnostic level
is 10.0 g/dL.

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