Stroke Volume

Stroke volume is determined by four factors:

1. The volume of venous blood returned to the heart
2. Ventricular distensibility, or the capacity to en-large the ventricle
3. Ventricular contractility
4. Aortic or pulmonary artery pressure (the pressure against which the ventricles must contract)

source: http://btc.montana.edu/olympics/physiology/cf04.html

Tarsal Bones

I used to confuse , which is medial and which is lateral among Navicular and Cuboid.?

 So i remembered it as N is Close to M in alphabetic order , hence Navicular is Medially placed.

Image Source : http://drugster.info/img/term/tarsus-bony-14742_3.jpg

J-shaped sella

A J-shaped sella is a variant configuration of the sella turcica, where the tuberculum sellae is flattened, thus forming the straight edge of the "J". The dorsum sellae remains rounded and forms the loop of the "J"


Differential diagnosis for a J-shaped sella includes: 
mucopolysaccharidoses : e.g. Hurler syndrome 
optic chiasm glioma
hydrocephalus : mild
achondroplasia
neurofibromatosis
normal variant (~5% of children)


"Mnemonic : MOHAN"

Mesoblastic Nephroma and some related points.

Mesoblastic nephroma (fetal renal hamartoma) is the commonest renal tumour in the neonate, most cases presenting by the age of 3 months, rarely above 12 months. It is solid but may contain cystic, haemorrhagic and necrotic areas. It is locally infiltrative and may recur if incompletely resected, and on rare occasions metastasize to lungs, brain and bone.

Treatment of mesoblastic nephroma is "Surgery" (with capsule)! Adjuvant Radio and chemo incearses morbity without improved survival (May be tried in mets or recurrent cases)!!

1- Most common abdominal mass in neonates- Multicystic dyaplastic kidney (then comes hydronephrosis of kidney with PUJ obstruction).
2- Most common renal tumour in neonates- Mesoblastic nephroma.
3- Most common abdominal lump before 2 Yrs- Neuroblastoma.
4- Most common abdominal lump between 2 and 5 yrs - Wilms tm.

Mnemonics Created By DrAyushGoel

1. Coomb's Test (ABCD)
   This is one of my fav. creation :-)
   A - after transfusion etc
   B - Bound
   C - Coomb's
   D - Direct Coomb's

1. Low C3 (PoSCaL) (like Rascal)
   Po - Post Streptococcal (Transient)
   S   - SABE
   C   - Cyroglubulinemia
   L    - Lupus

1. Infection ( I-A , A-M ) (here Ais not with A )
   
   IUCD - Actinomyces israeli
   Abortion - Mycoplasma
   

1. Measels (BDS) (remember as Me BDS )
   
   Complications :
   Most Life Threat - Bronchopneumonia
   Most Common - Diarrhoea
   Rare - SSPE
   

1. Lepra Reaction (clock wise 1234)
   
   Reaction 1    Reaction 2
   Type 4 HS    Type 3 HS
   
   HS means Hypersensitivity.
   
2. 
   
3. 
   
4. Leprosy Blindness Cause ( LITE)
   
   Lepromatous - Iridocyclitis
   Tuberculoid - Erosive Keratitis

Some PSM/CM Mnemonics

1. Notifiable to WHO ( RIMPE)
   
   R - Relapsing Fever
   I  - Influenzae
   M - Malaria
   P  - Polio
   E  - Epidemic Typhus (Louse Borne)
   

1. Essential AA ( The Likely PM IS Trying Very Hard )
   Threonine
   Lysine
   Phenylalanine
   Methionine
   Isoleucine and Leucine
   Tryptophan
   Valine
   Histidine and Arginine

AMYLOID

TRUE REGARDING AMYLOID IS

1) LENGHT IS 7.5nm
2) EM--BETA PLAEATED SHEET LIKE STRUCUTRE
3) THIOFLAVIN T MAY B USED FR STAINING
4) DEPOSIT FRST IN ZONA FASCULATA FIRST 

ANSWER:

Ans : 3
LENGTH OF AMYLOID IS --INDEFINITE DIAMETER----7.5 TO 10 NM
DEPOSIT FIRST SEEN IN (IN CASE OF ADRENAL)IN ---ZONA GLOMERULOSA

LAD-2

Which of following is not ass. with LEUCOCYTE ADHESION DEFECIENCY-2
1)neutrophilia
2)delayed separation of umblical cord
3)mental retardation
4)bombay blood group 

ANSWER:

Ans : 2
delayed separation of umblical cord is feature of LAD-1

SJOGREN SYNDROME

MOST COMMON EXTRAGLANDULAR MANIFESTION OF SJOGREN SYNDROME :
1)ARTHRITIS
2)RAYNAUDS PHENOMENON
3)LYMPHOMA
4)SPLENOMEGALY

ANSWER:

1. Arthritis

Ringertz tumour

An inverted papilloma is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.


Other names - Ringertz tumor , Transitional cell neoplasm , Shnedarien papilloma , Sinus papilamatosis, cylindrical cell neoplasm.

Hyponatremia and RMP

Hyponatremia has no effect on RMP coz?
a. cell membrane impermeable to Na+
b. ECF Na+ concentration is high
c. intracellular K+ conc. is high
d. eqilibrium potential for Na+ is +60 mV 

ANSWER:

A

Diagnosis of iron defeciency anemia (IDA)

Best test for diagnosis of iron defeciency anemia (IDA) in patients with chronic inflammation?
1)serum iron
2)serum ferritin
3)free erythrocyte protoporphyrin
4)soluble transferrin receptor

ANSWER:

Ans : its 4 soluble transferrin receptor (not 2)

Reason : Serum ferritin is an ACUTE PHASE REACTANT so it will be increased in chronic inflammation and it will mask IDA DIAGNOSIS
So in such case soluble transferrin receptor is best.

FREE ERYTHROCYTE PROTOPORPHYRIN is increased in IDA as well as in ANEMIA OF CHRONIC DISEASE and this test is used to differentiate between IDA AND THALESSEMIA (its NORMAL in thallessemia)

Biological weapon

Which of the following carries highest potential for use as a biological weapon for microbial bioterrorism :
a. Plague
b. Small Pox
c. Botulism
d. Brucellosis

ANSWER:

C. Botulism

Acute Ischaemic infarct - Brain

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Q. Which of the following best describes the appearance of an acute ischaemic infarct of the brain?

a. Hypointense on diffusion-weighted (DW) MRI and low apparent diffusion coefficient (ADC) values.

b. Hyperintense on DW MRI and low ADC values

c. Hypointense on DW MRI and high ADC values

d. Hyperintense on DW MRI and high ADC values

ANSWER:

B . Hyperintense on DWI and Low ADC values...

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NE and E (in Pheochromocytomas)

About 50% of adrenal pheochromocytomas produce near exclusively norepinephrine, this representing the same pattern as in extra-adrenal pheochromocytomas.

Production of epinephrine (best detected by an increase in metanephrine) indicates an adrenal location,

exclusive production of norepinephrine (best indicated by increases of normetanephrine with normal metanephrine) may reflect either an adrenal or extra-adrenal location.

Practically all epinephrine-producing pheochromocytomas are found in the adrenal gland or are recurrences of previously resected adrenal tumors.

All of the catecholamines are broken down into inactive substances that appear in the urine:

• Dopamine becomes Homovanillic acid (HVA)
• Norepinephrine becomes normetanephrine and vanillylmandelic acid (VMA)
• Epinephrine becomes metanephrine and VMA

Effect	Epinephrine	Norepinephrine
Heart rate	increases	decreases
Cardiac output	increases	variable
Blood pressure	increases	increases
Respiration	increases	increases
Metabolism	increases	small increase
Behavior	passive, tense	aggressive
Eosinophil count	increases	----
Skin blood vessels	dilate	constrict
Muscle blood vessels	dilate	small dilation

Day of appearance of rash in a febrile patient

Very Sick Person Must Take Double Tablets

Very – Varicella (day 1)
Sick – Scarlet fever (day 2)
Person – Pox – small pox (day 3)
Must – Measles (day 4)
Take – Typhus (day 5)
Double – Dengue (day 6)
Tablets – Typhoid (day 7)

Anaesthetic agents used in day care anesthesia

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Mnemonic for anaesthetic agents used in day care anesthesia is :

Indian MAP

Indian – Isoflurane
M – Mivacurium
A – Alfentanil
P – Propofol

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Anaesthetic agents causing increased CSF pressure

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Anaesthetic agents causing increased CSF pressure

Mnemonic : SNAKE

S – Sevoflurane
N – Nitrous Oxide
A – Althesin
K – Ketamine
E – Enflurane.

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