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NEUROLOGY(G)

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 a)There is loss of power of adduction and extension of the ulnar two or three fingers and an inability to grip and release rapidly with these fingers. These changes have been termed "myelopathy hand" and appear to be due to pyramidal tract involvement.  b) Finger escape Wartenberg's sign is a neurological sign consisting of involuntary abduction of the fifth (little) finger, caused by unopposed action of the extensor digiti minimi. . This finding of weak finger adduction in cervical myelopathy is also called the "finger escape sign". c) Hoffman's sign or reflex is a test used to examine the reflexes of the upper extremities. This test is a quick, equipment-free way to test for the possible existence of spinal cord compression from a lesion on the spinal cord or another underlying nerve condition

GASTROENTEROLOGY(C)

  1) What is the most probable diagnosis in this patient? à Differential Diagnosis: ·          Ruptured Liver Abscess. ·          Organized collection secondary to Hollow viscous Perforation. ·          Organized Intraperitoneal Hematoma. ·          Free fluid with internal echoes in Bilateral in the Subdiaphragmatic space. ·          Grade 3 RPD of right Kidney à The most probably diagnosis is there is abdominal hemorrhage. This will give reasoning to the abdominal distention, and the blood which is aspirated.     2) What was the cause of her death? à After leaving the hospital, the patient went to Hyderabad and underwent an emergency laparotomy surgery. The patient passed away the next day. Cause of her death can be due to complications of laparotomy s...

CARDIOLOGY(B)

 1.What are the possible causes for heart failure in this patient? ANS: obesity  alcohol diabetes hypertension 2.what is the reason for anemia in this case? ANS:   Alcoholics frequently have defective red blood cells that are destroyed prematurely, possibly resulting in anemia. Alcohol also interferes with the production and function of white blood cells, especially those that defend the body against invading bacteria. Consequently, alcoholics frequently suffer from bacterial infections. 3.What is the reason for blebs and non healing ulcer in the legs of this patient? ANS: The pt. had recurrent blebs and ulcer on lower limbs (foot). This is due to Type to diabetes mellitus. Diabetic foot ulcers generally arise as a result of poor circulation in the foot region. While high blood sugar levels and nerve damage or even wounds in the feet may result in foot ulcers in many cases.  In cases of poor circulation of blood, the foot ulcers take quite a bit of time to heal ...

CARDIOLOGY(A)

 1.What is the difference btw heart failure with preserved ejection fraction and with reduced ejection fraction? ANS: -The amount of blood pumped out of the heart with each beat is called the ejection fraction (EF). A normal EF is usually around 55 to 70 percent, but it can be lessened in some forms of heart failure. -People with heart failure with reduced ejection fraction (HFrEF) have an EF that is 40 to 50 percent or lower. This is also called systolic heart failure. People with heart failure with preserved ejection fraction (HFpEF) do not have much of a change in their ejection fraction. This is often called diastolic heart failure.  -HFrEF were often diagnosed earlier in life and right after a heart attack.   HFpEF were diagnosed later in life and first experienced symptoms of heart failure between the ages of 65 and 69. Many of those with HFpEF also shared that they have other health problems that led to their diagnosis. Many of them also live with additional h...

NEUROLOGY(A)

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  A1. Evolution of the symptomatology:    apparently asymptomatic 9 days ago                                                              ⬇                                                   suddenly started talking, as well as laughing to himself                He was conscious, but oriented to time, person and place only from time to time               He was unable to lift himself off the bed and move around, a...

NEUROLOGY(D)

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  A1. Occurrence of seizure due to brain stroke: ·          Cells in the brain send electrical signals to one another ·          The electrical signals pass along your nerves to all parts of the body ·          A sudden abnormal burst of electrical activity in the brain can lead to the signals to the nerves being disrupted, causing a seizure ·          This electrical disturbance can happen because of stroke damage in the brain. ·          A seizure can affect vision, smell and taste, loss of consciousness and jerking movements. Mechanism of seizure activity: ·          You’re more likely to have a seizure if you had a haemorrhagic stroke (bleed on the brain). ·          Seizures can also be mor...

Neurology(C)

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A1. EVOLUTION OF SYMPTOMS: Patient was apparently asymptomatic 8months ago   ·          Developed pedal edema (B/L) pitting type which was gradually progressive                Aggravated on sitting and standing               Relieved on taking medication ·          Palpitations: Duration: since 5days; sudden in onset, seen more during night time Aggravated on lifting weights and speaking continuously Relieved on taking medication, drinking more water Dyspnoe during palpitations(NYHA III) since 5days   ·          Pain: since 5 days ; radiating along the left upper limb ·          Chest pain associated with chest heaviness   ANATOMICAL LOCALIZATION: PEDAL EDEMA   PALPITATIONS ...