It costs time

 

 

Hello! Q. Today, in our OPD ,a 45 year old diabetic Male, farmer by profession  presented with an ulcer on left lateral malleolus . He had a  history of oedema in lower limb a/w itching 2years back. 6 months back he got an ulcer on left lateral malleolus which is not healing since then. On examination:- Pigmentation of skin ,eczema lipodermatosclerosis ,atrophied Blanche are present  and dilated veins on the medial aspect of left lower limb. My  question is how to differentiate whether the ulcer has arised due to neuropathy ,Venous stasis  or obliteration of artery . Why this doubt has arised? Because Venous ulcer are commonly found at the lower third of the leg usually on the medial side and even on the foot. Ans. (I) To rule out neuropathy , 1.Ask whether he feel the ground and peeble while walking barefoot 2.Test for the pain sensation ,whether it is intact or not. (II) Venous ulcer have characterstic finding. History is utmost important. The...

Hello! >500/mm3 - Candidal vaginitis Persistent Generalized lymphadenopathy 200-500/mm3 - Pneumococcal pneumonia Pulmonary TB Herpes Zoster Oropharyngeal Candidiasis (Thrush) <200/mm3- Pneumocystis jiroveci pneumonia Miliary/Extrapulmonary TB <100/mm3- Candida Esophagitis Penicillinosis Toxoplasmosis Cryptococcosis <50/mm3- Mycobacterium avium coplex(MAC) Disseminated cytomegalovirus (CMV) Hope this will help. -Upasana Y.

Hell o! I)Serologic markers of hepatic fibrosis can broadly be categorized as indirect or direct:   ●Indirect markers reflect alterations in hepatic function, but do not directly reflect extracellular matrix metabolism. Examples include the platelet count, coagulation studies, and liver aminotransferases. ●Direct markers of fibrosis reflect extracellular matrix turnover. Examples include procollagen types I and III, hylauronic acid , and tissue inhibitor of metalloproteinase . II)Permissive role of hormone- It means that the hormone enhances the action of another hormone. LEPTIN- It has an important permissive role in the progression into puberty and the maintenance of normal hypothalamic-pituitary-gonadal function. KISSPEPTIN- It is a principle activator of GnRH neurons and is a pre-requisite for the onset of puberty and maintenance of normal reproductive function. It is a neuropeptide. Loss of function mumtation of kisspeptin receptor gene (KISS1R) ...

Hello ! 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.

Definition:- Modification of response  to one drug by another drug or non drug (like food ,beverageslike alcohol,smoking) when they are administered simultaneously or in quick succession  . Factors for drug interactions:- 1.Multiple drugs for same disease. 2.Multiple prescribers. 3.Multiple diseases. 4.Poor patient compliance . 5. Drug factors like it is not palatable or too many in frequency . 6.Multiple unknown action of drugs. 7. Most imp is patients age . Effects of drug interaction:- 1.Quantitative i.e Increase  or decrease the response intensity. 2. Qualitative:- abnormal /different type of response. Mechanism of drug interaction :- A.Pharmacokinetic interactions include,  1.Absorption (either complex formation ,pH change ,or alteration in motility of GIT.) 2. Distribution:- (displacement from plasma protein binding site + inhibition of metabolism /or excretion) 3. Metabolism:- ( induction of enzymes or inhibition of enzymes or hepatic b...

Wow! I didn't know this about wound healing. Ionising radiations - delays wound healing. Non -ionising radiations(UV rays)- improves wound healing. :) -Upasana Y.

Hello :) 1. Echinococcus granulosus You can remember by "g". Do"g" - Echinococcus "g"ranulosus. 2.Toxoplasma gondii You can remember it by "T" Ca"T"- "T"toxoplasma gondii Take care.:) -Upasana Y.

Hello! :) I have never studied vitamin in this way .These were the questions asked during my pharmacology vivas. And I found it fascinating after studying. Q. Which vitamin deficiency is related with lowering of seizure threshold? Ans. Pyridoxine Vit B6 . As it is associated with synthesis of neurotransmitter GABA . Therefore it is indicated during Isoniazid induced convulsions. :) Q. Why laropiprant (20mg) + Niacin (1g) is used in combination? Ans. We know that here the main reason is nicotinic acid (a derivative)  which results in flushing of face. Why? Vasodilation of  cutaneous vessels. So we combine it with specific anti-flushing drug called laropiprant. Q .In hyperemesis gravidarum,what you give for associated Wernicke's encephalopathy following hyperemesis ? Ans. Even I thought of anti-emetics but it came out to be "vitamin B1" . (Everytime Wernicke's encephalopathy doesn't result from alcohol:P) That's for today. Take care. :) -Upy...