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Measles virus is a paramyxovirus which is an enveloped ssRNA virus.Selenite F broth is used as an enrichment media for dysentery causing bacteria like Shigella/Salmonella.Motility of Treponema can be demonstrated by dark ground microscopy.Sheathed microfilaria with pointed tail free of nuclei suggests Wuchereria bancrofti.A positive hair perforation test is causes by T.mentagrophytes.
Dear Medicos/Subscribers of DR QBank, As promised earlier, the validity of your subscription has been extended till May 21st 2022. (Total validity increased from 90 to 130 days) - You will receive an email about the same soon. Those who have not yet subscribed - go ahead - you will enjoy solving the clinical questions and it will build up your confidence. Regards Dr Ramgopal
Anticholinergics like benzhexol/trohexiphenidyl are used in treating metoclopromide induced involuntary movements.The formula for drug dosing rate is clearance X plasma concentration.Clarithromycin when used along with digoxin can cause digoxin toxicity due to inhibition of P glyocprotein.The anticancer activity of methotexate is by inhibition of dihydrofolate reductase.Metronidazole produces disulfiram like reaction in patients consuming alcohol.
Rifampicin is a potent Cytochrome P 450 enzyme inducer. When given along with OCPs it would induce the metabolism of OCPs and leads to contraceptive failure.ACE inhibitors should be avoided in pregnancy as they are teratogenic.Indomethacin can cause premature closure of ductus arteriosus if given to pregnant women.Timolol is contraindicated in bronchial asthma patient with glaucoma.Aspirin inhibits COX-1 and this inhibits formation of thromboxane A2 which is a platelet aggregator. This is responsible for the bleeding complication of aspirin.
3Ds of Pellagra (Vitamin B3, Niacin) deficiency are: Diarrhea, Dermatitis and Dementia. Casal's necklace is seen.The GAG (Glycosaminoglycan) responsible for corneal transparency is keratan sulphate.In classic homocystinuria, the amino acid needed to be supplemented in the diet is Cysteine.The source of blood glucose in a person fasting overnight is hepatic gylcogenolysis.DNA mismatch repair will be deficient in HNPCC Lynch syndrome.
Injury to the saphenous nerve can occur while accessing the great saphenous vein to use for CABG - Can present with parasthesia and sensory loss over the medial leg and medial foot.Most likely nerve to be damaged during submandibular gland resection is the lingual nerve.Difficulty in flexion of elbow and supination of forearm with loss of sensation over lateral aspect of forearm suggests musculocutaneous nerve injury.Beta2 receptor action leading to hypoglycemia/hyperglycemia is mediated through adenylyl cyclase.Oligodendrocytes involved in myelin formation are affected in multiple sclerosis.
A young male presenting with low back ache, heel pain, early morning stiffness and HLA B27 positive suggests ankylosing spondylitis.Pen test is used to assess the median neve.Flexion, adduction and medial/internal rotation (FADIR) of hip suggests posterior dislocation of hip.Optic chiasma is likely to be compressed by an aneurysm of the anterior communicating artery leading to bitemporal hemianopia.The vertical and downward descent of the spleen is prevented by phrenicocolic ligament.
Multiple episodes of non bilious vomiting in IHPS (Infantile Hypertrophic Pyloric Stenosis) leads to hypokalemic hypochloremic metabolic alkalosis.Clinical scenarios of a child with generalised edema, hyperlipidemia, massive protenuria and fat bodies in the urine suggests nephrotic syndrome.In a child with suspected shunt associated meningitis, next best procedure is to take a blood culture and CSF sample from shunt tap.Umbilical artery carries deoxygenated blood from heart to placenta during fetal period.In SSPE (Subacute Sclerosing PanEncephalitis), CSF IgG anti measles antibody will be elevated.
In the first trimester, Crown Rump Length (CRL) measured by ultrasound is the best method to assess gestational ageThe obstetric score of a pregnant wpman who has previously delivered twins would be G2P1.The order of ligation of vessels to arrest bleeding in atonic PPH is uterine artery - ovarial artery - internal iliac artery.In a pregnant woman with active genital herpes, acyclovir + elective Cesarean section is the appropriate treatment.A patient with transverse vaginal septum can have retrograde menstruation which increases the risk of endometriosis (according to Sampson's theory).
Please compare with Post No.28 (SPIKES protocol to break bad news to patients)Background: The physician should make sure they know the patient’s situation—not only their diagnosis and outlook, but also their socio-economic and educational status as well as their support system.Rapport: Build a rapport with the patientExplore: Start with what the patient knows and explore from thereAnnounce: the bad newsKindle: Kindling step to ensure patient has understood what you have told themSummarize: the main points of the discussion and the way forward
