Thread: all india 2009 paper- facts summed up

- diseases that get disability benefit under national trust act
cerebral palsy, mental retardation, mental disabilities

-uses of lithium
bipolar disorder
hyperthyroidism
neutropenia
feltys syndrome
cluster headache

-uses of Modafinil
wake promoting agent-
-narcolepsy
-shift work sleep disorder
-OSAS
but its NOT used in lethargy d/t depression

-Ultrasound appearance of
benign lesion(eg colloid nodule)- hyper-echoic
malignant lesion/mets- hypo-echoic or nonechoic. microcalcifications

-amifostine
added to alkylating agents/platinum based(eg cisplatin) therapy
bcoz it protects the normal body cells frm their action
But, it doesn't cross the BBB! Hence CNS toxicity will still remain

-Down's syndrome
skull- brachycephaly , delayed fontanelle closure, hypoplasia of sinuses
atlanto axial subluxation(C1-C2)
CHD is seen in 40%- endocardial cushion defects VSD,TOF
ribs- 11 pairs
GIT-umb hernia, hirschsprungs, duodenal atresia

-Thallium scan
for Reversible myocardial ischaemia(angina like chest pain, with non specific ecg)
Thallium 201 goes to the perfused areas-> how much viable myocardium is left?

Whereas Tc-99 goes to infarct areas
Tc 99 agents- sestamibi (for Parathyroid), tetrafosmin, teboroxime

cardiac functioning- best is MRI
nuclear scan for cardiac functioning- MUGA scan(multiple gated blood pool imaging) in which label Tc 99 to albumin or RBCs. Used when Echo technically difficult

-ossification of post longitudinal ligament
=japanese disease
resulting in compression of spinal cord
MC in cervical spine(mid/lower)
there is multilevel involvement!
MRI is the best Inv. for spinal stenosis(best for all spinal conditions in fact.) affected ligaments will appear dark on both T1 and T2
Blooming effect- on graded echo, osteophyte size may be exaggerated resulting on overestimation of canal stenosis

pulmonary artery hyperT
CXR- peripheral pruning
rt descending pulm artery more than 16mm
main pulmonary artery is wide
Right sided cardiac enlargement

most sensitive for DCIS
MRI
but mammography is used for screening bcoz MRI is nonspecific

fat containing breast lesions
lipoma
galactocoele
traumatic fat necrosis
hamartoma

changes in mammography sensitivity with age
as age inc, glandular tissue involutes and is replaced by fat
so as age inc, mammography sensitivity increases
less sensitive in young women with more glandular tissue ie more dense breasts

adrenal adenoma on CT
rapid uptake and rapid washout of contrast
well defined, homogenous bcoz benign
though calcification is rare
low attenuation is d/t lipid content

ultrasound findings in following conditions of GB
-adenomyomatosis- thickened GB wall, comet tail/ring down/rokintasky ashcoff sinuses/reverberation artefacts(hyperechoic)
-emphysematous GB-similar but also h/o large round GB, Diabetes,WBCs often normal
-cholesterolosis- normal thickness of GB wall. comet tail defects present
-Cancer of GB- thick wall, no comet tail defect

signs of successful stellate block
Horner's syndrome('pamela'- ptosis, anhidrosis, miosis, enopthalmos, absence of ciliospinal reflex)
flushing of face, conjunctival suffusion
lacrimation(sup. cervical ganglion)
mueller's syndrome- injection of tympanic membrane
guttmans sign- ipsilateral nasal stuffiness
inc temp & vasodilation- ipsilateral face n upper limb

paravertebral block spread doesnt occur to
subarachnoid space(there is no communication)

additives to local anaesthetic solutions
sodium bicarbonate- inc pH -inc unionised form of LA- diffuses quickly. ***inc speed, intensity, duration (thus overall quality) of block
1ml of 8.4% per 10 ml of LA
adrenaline- inc speed, intensity, duration (thus overall quality) of block
-dec toxic level of drug
dextrose- added to subarachnoid solutions, to adjust baracity(density) of solution wrt CSF
narcotics/opioids- analgesics

will add more Qs soon