Primarily a zoonosis—natural host is the primate Macaque monkey. Endemic in South east Asia (Malaysia, Borneo, Philippines, Myanmar); but is ABSENT in Africa. Transmitted by bite of Anopheles mosquito. Affects adults mainly. Asexual cycle of parasite in humans is 24 hours—hence called “quotidian” malaria. Malaria is non-relapsing. Treatment: Chloroquine and Primaquine.
Richter SyndromeTransformation of CLL into an aggressive large B-cell lymphoma (seen in 3-10% of cases)Inactivation of TP53 and of CDKN2A is a main mechanism in the transformation to Richter syndromeManifests with weight loss, fevers, night sweats, muscle wasting, (i.e., B symptoms) and increasing hepatosplenomegaly and lymphadenopathy. Treatment remains challenging and prognosis poor
Medical negligence requires the plaintiff (i.e. the patient or relative if the patient has died) should establish the following 4Ds: Existence of the doctor’s Duty to the plaintiff based on existence of the doctor-patient relationship. Applicable standard of care and its violation (Dereliction of Duty). Direct causation (failure to exercise a duty of care must lead to damage) Damage (a compensable injury).
Carney’s triad: GIST, Pulmonary chondroma, and/or functioning extra-adrenal Paraganglioma. Carney’s syndrome: GIST, paraganglioma and germline mutation of succinate dehydrogenase.
Less common Signs of Appendicitis are:Rovsing sign (RLQ pain with palpation of the LLQ): Suggests peritoneal irritation Obturator sign (RLQ pain with internal and external rotation of the flexed right hip): Suggests the inflamed appendix is located deep in the right hemipelvis Psoas sign (RLQ pain with extension of the right hip or with flexion of the right hip against resistance): Suggests that an inflamed appendix is located along the course of the right psoas muscle Dunphy sign (sharp pain in the RLQ elicited by a voluntary cough): Suggests localized peritonitis Markle sign (pain elicited in a certain area of the abdomen when the standing patient drops from standing on toes to the heels with a jarring landing):
Mnemonic for Corneal Stromal DystrophiesThe dystrophy- material deposited and staining method can be remembered by this mnemonic - "Marilyn Monroe Always Gets Her Men in L.A.City" !!Macular dystrophy - Mucopolysaccharide - Alcian blueGranular dystrophy - Hyaline materials - Masson trichromeLattice dystrophy - Amyloid - Congo red
Highlights of Fungal Keratitis Trauma by vegetative/plant matter; indiscriminate use of topical steroids Apergillus (MC in India); Fusarium; Candida Symptoms: Acute pain, redness, watering, decreased vision, photophobia - Less severe than bacterial keratitis - "More Signs less symptoms!!"Signs: Blepharospasm, lid edema, ciliary congestion O/E : Dry looking yellowish white lesion with feathery edges; satellite lesions seen, dense immobile hypopyon present which may NOT be sterile (since fungi can penetrate intact Descemet’s membrane); Perforation and vascularisation are rare Treatment: Antifungal drops and ointments )Itraconazole, anatmycin); Cycloplegics (Homatropine/Cyclopentalate/Atropine)
Dyes commonly used in tattooing are: Black color: India Ink (MC used); China Ink, Soot Blue: Prussian blue (ferric ferrocyanide); Cobalt, Indigo, Ultramarine Green: Chromic oxide Red: Cinnabar, vermillion Brown: Ochre Methods to make tattoo readily visible are: Infrared photography Ultraviolet light Rubbing the part and examining under magnifying glass Treating with hydrogen peroxide and 0.5% caustic potash Histological examination of regional lymph nodes may show tattoo pigment deposition.
Anatomical Snuff Box Boundaries Medial: tendons of the extensor pollicis longus Lateral: tendons of the Extensor pollicis brevisand more laterally abductor pollicis longus Floor scaphoid, trapezium bones tendons of the ECRL and ECRB base of 1st metacarpal can be palpated distally and the radial styloid process can be palpated proximally Contents Radial artery Superficial branch of the radial nerve Cephalic vein (variable)
Source: https://www.prostateconditions.org/images/about/New_Gleason_Chart_.jpg