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purpuric rash,not blanching .fever and painful joints
40 year old female with tonsillitis,
Henoch Schonlein Purpura I
What are the clinical diagnosis of HSP?
Arthritis/ arthralgia
Abdominal Pain
Nephritis
Common org involved in HSP?
Group A Streptococcus
What is the initial management for HSP?
Urinalysis
Blood pressure
What is the most common complication of hSP?
Intussusception
What are the medical management of HSP?
Mild:
Bed Rest
Paracetamol - Ibuprofen / Naproxen
Moderate to Severe pain:
Steroids (glucocorticoids) in children
Oral Prednisolone or IV Methylprednisolone
Nontender soft swelling in the neck
Thyroglossal cysts
Anemia, weight loss
Angular stomatitis
Plummer Vinson Syndrome
What is the confirmatory Test for PVS?
Endoscopy
- to identify the presence of esophageal webs
CI in pregnancy, antidepressant
Paroxtine
Safe in pregnancy, for depression
Escitalopram
positive ANA test in a patient with joint pain
Uveitis
The most common presentation is delayed passage of meconium. Other symptoms can include poor feeding, poor weight gain, progressive abdominal distention, and vomiting
Hirschsprung disease
Hirschsprung disease typically presents with severe constipation or signs of intestinal obstruction. In some cases, the disease may present with ongoing symptoms from early childhood or with the development of functional obstruction, fecal impaction, and megacolon in later life
Definitive Diagnostic Test for Hirschsprung disease
Rectal Biopsy
commonly presented as a useful biomarker for the diagnosis or prognosis of AMI.
Serum lactate (SL)
It can present with a wide range of symptoms, including cough, shortness of breath, chest pain, fatigue, fever, weight loss, and skin rash
. A systolic murmur at the apex may be indicative of cardiac involvement in sarcoidosi
Sarcoidosis
s a liver condition that occurs during pregnancy and is characterized by intense itching (pruritus) and abnormal liver function tests
The itching is often worse at night and can be generalized or localized to the hands and feet
Elevated levels of bile acids in the blood are a hallmark
The yellow tinge of the sclera and abnormal liver function tests, including elevated bilirubin and alkaline phosphatase (ALP), are consistent with the diagnosis
Intrahepatic cholestasis of pregnancy
Systolic murmur at 3rd Left intercostal, fixed split, no cyanosis.
ASD
blood film tear drop cells.
Myelofibrosis, which is a serious bone marrow disorder.
A bone marrow biopsy definitive diagnosis
characterized by the absence of discrete P waves, presence of fibrillatory (f) waves, and an irregularly irregular ventricular rhythm
This irregularity in the R-R interval is a key feature
AF
Presence of anti-neutrophil cytoplasmic antibodies (ANCA), which appear in the blood of most people who have active granulomatosis with polyangiitis
ANCA testing can help support the diagnosis, but it is not specific to granulomatosis with polyangiitis and can also be positive in other forms of vasculitis
Wegener’s granulomatosis
anti-glomerular basement membrane (anti-GBM) antibodies, which lead to the development of glomerulonephritis and pulmonary hemorrhage
Goodpasture syndrome
is a kidney disease characterized by the deposition of immunoglobulin A (IgA) in the glomeruli, leading to glomerulonephritis.
IGA nephropathy
Gram stain showing diplococci is a characteristic finding for Neisseria meningitidis, which is a common cause of bacterial meningitis in adults
a) Neisseria meningitidis.
fever, rashes, neck stiffness, and a tonic-clonic fit are consistent with
meningitis
CABG done, c/o dyspnea. Ecg given
Atr flutter with av block
Duputyrens pic given, whats the cause?
Alcohol
Female with Try infertility hx of chlamydia+ (lap view of tubes
shown) best way to conceive? Ivf? Icsi? lui?
Panic attack pt ABG whats pco2 po2 and ph
Colles fracture pic given, way to keep the hand when fixing
Copd pt. Whats the indication for home oxygen? Fev1? Oximetry
<85%?
9days baby with nonbilious vomitting, K+ high Na+ low
diagnosis? Pyloric stenosis? Congen adrenal hyperplasia?
Pyloric Stenosis
SBO xray given pt pcame with feculant vomitting pain etc tachy
at admission 112bpm initial mgt done and KUO then tachy rises to
130 now what to do? Surgery?
2yr old bp pulse unrecodable ecg VT whats mgt? Shock?
Amidarone?
Amidarone?
Pt found in road . V fib. Two shocks given on the way. Still v fib.
Whats next adrenaline? Amiadarone?
Rubella vacc taken two weeks back, now found she is pregnant.
What to do? Serology? Terminate?
10/52 poa mother, asymptic. Her baby got chickenpox what to
do?
Senior collegue studying for specialist exam. Co insomnia and
req for a tamazepam pres from you. What to do? Suggest sleep
techs? Send to his gp?
48 yrs old female, not visited doc for 10 yrs past . Healthy.
Mom has osteoporosis at 65 and breat ca at 76, paternal grandad
colon ca in 70s brother has dm in 50s, what to check on her now?
Mammo? Cervical screening? Colonscopy? Fbs? Dexa scan?
Calculate GCS of a pt eye open to pain, limbs to pain and
incomprehensibe words
Young guy who dropped school. Threat to stab mom. Whats
the resona for behavior?
Chronic cannabis use 07/08/2023
question
Fx of moderate depression what to give?
Venlaxfixine
Most indicative fx of a pt with ectopic fx for urgent
intervention?
Shoulder tip pain
Xray of a child who swallowed coin. What to do?
. A sensorineural loss ques
Answer: audiometry
Image of blacked lower leg, medial malleolus. What is the diagnosis ?
A. Chronic Venous hypertension
B. Arterial insufficiency
C. DM
A. Chronic Venous hypertension
Calculation of Negative Predictive Value
Sudden onset of severe abdominal pain, back pain or renal colic in a patient over 60 years.
Abdominal Aortic Aneurysm Rupture