death in acute myocardial infarction with thrombolytic therapy is due to 1 intracranial hemorrage ans aiims may 04,q118 Post

Options Sun May 08, 2011 6:41 pm (4 days ago) #53 qs49) cognitive theory...beck ref for all bhatia students swt last yyear and notes for others across rewiew qs cardiac polyp fibrinous clot _________________ simplysameer4u wrote: yatinptalwar wrote: qs32)body wt not transmitted by costcervical costclavicular acromioclavicular interclavicular ans

ever heard about a interclavicular liga/joint option a was coracoacromian and may b thats the ans also

u may be right sir but actually i dont recall it properly and going by the diagram in bdc on page49 0n new bdc vol 1 old volume had a diagram all i want to say is the 2 clavicles newer joined any ref welcome Sun May 08, 2011 6:53 pm (4 days ago) #56 qs 50)6 wks old female found unconscious in crib .she was previously healthy.normal bp,hyperpigmentation of genitalia bsl 30 mg/dl dsis is cah 21 alpha hydroxylase deficiency familial glucocorticoid def cushing syn insulinoma ans familial glucocorticoid def

ref nelso 18/e pg 2356 and its a rare ARcondition yatinptalwar wrote: qs45)now again a boomberang QS WAS !!!!!THE GOLD STANDARD !!! investigation for gerd options 24 hr ph mano but one option of interest was endoscopic inv now if its ioc(investigation of choice )then it might be 24 hr ph/acid or what not but GOLD STANDARD which is like a paatthar ki lakheer so ans endoscopic inv

Investigation is advisable if patients present in middle or late age, if symptoms are atypical or if a complication is suspected. Endoscopy is the investigation of choice. This is performed to exclude other upper gastrointestinal diseases which can mimic gastro-oesophageal reflux, and to identify complications. A normal endoscopy in a patient with compatible symptoms should not preclude treatment for gastro-oesophageal reflux disease.

Twenty-four-hour pH monitoring is indicated if, despite endoscopy, the diagnosis is unclear or surgical intervention is under consideration. This involves tethering a slim catheter with a terminal radiotelemetry pH-sensitive probe above the gastro-oesophageal junction. The intraluminal pH is recorded whilst the patient undergoes normal activities, and episodes of pain are noted and related to pH. A pH of less than 4 for more than 6-7% of the study time is diagnostic of reflux disease.

referance davidson Last edited by amanshoots on Sun May 08, 2011 6:58 pm, edited 1 time in total

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 6:55 pm (4 days ago) #58 QS 51) A GIRL WITH severe hyperkalemia and peaked t waves on ecg .fastest way of shifting

it in icf/manageemnt cal gluconate iv oral resins insulin + glucose nahco3 ans insulin+glucose ref harrison 17/e pg 284 bhatia sir notes book 4 harrison

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 6:57 pm (4 days ago) #59 amanshoots wrote: yatinptalwar wrote: qs45)now again a boomberang QS WAS !!!!!THE GOLD STANDARD !!! investigation for gerd options 24 hr ph mano but one option of interest was endoscopic inv now if its ioc(investigation of choice )then it might be 24 hr ph/acid or what not but GOLD STANDARD which is like a paatthar ki lakheer so ans endoscopic inv

middle or late age, if symptoms are atypical or if a complication is suspected. Endoscopy is the investigation of choice. This is performed to exclude other upper gastrointestinal diseases which can mimic gastro-oesophageal reflux, and to identify complications. A normal endoscopy in a patient with compatible symptoms should not preclude treatment for gastro-oesophageal reflux disease.

Twenty-four-hour pH monitoring is indicated if, despite endoscopy, the diagnosis is unclear or surgical intervention is under consideration. This involves tethering a slim

catheter with a terminal radiotelemetry pH-sensitive probe above the gastrooesophageal junction. The intraluminal pH is recorded whilst the patient undergoes normal activities, and episodes of pain are noted and related to pH. A pH of less than 4 for more than 6-7% of the study time is diagnostic of reflux disease.

referance davidson

did u read GOLD STANDARD Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 6:59 pm (4 days ago) #60 QS 54)ALL ARE TRUE EXCEPT FOR TROCHLEAR NERVE? longest intracranial course. arise from dorsum of brainstem. supply ipsilateral superior oblique. Ans.supply ipsilateral

Posts: 177 Credits: 1222 Aim: AIPGE 2011 Sun May 08, 2011 7:02 pm (4 days ago) #61 yatinptalwar wrote:

amanshoots wrote: yatinptalwar wrote: qs45)now again a boomberang QS WAS !!!!!THE GOLD STANDARD !!! investigation for gerd options 24 hr ph mano but one option of interest was endoscopic inv now if its ioc(investigation of choice )then it might be 24 hr ph/acid or what not but GOLD STANDARD which is like a paatthar ki lakheer so ans endoscopic inv

middle or late age, if symptoms are atypical or if a complication is suspected. Endoscopy is the investigation of choice. This is performed to exclude other upper gastrointestinal diseases which can mimic gastrooesophageal reflux, and to identify complications. A normal endoscopy in a patient with compatible symptoms should not preclude treatment for gastro-oesophageal reflux disease.

Twenty-four-hour pH monitoring is indicated if, despite endoscopy, the diagnosis is unclear or surgical intervention is under consideration. This involves tethering a slim catheter with a terminal radiotelemetry pHsensitive probe above the gastro-oesophageal junction. The intraluminal pH is recorded whilst the patient undergoes normal activities, and episodes of pain are noted and related to pH. A pH of less than 4 for more than 6-7% of the study time is diagnostic of reflux disease.

referance davidson

Twenty-four-hour pH monitoring is indicated if, despite endoscopy, the diagnosis is unclear so even after endosopy diagnosis is not clear so where is laker wali bat ultimately ph karwana pada then which is gold standard..

did u read GOLD STANDARD

Posts: 177 Credits: 1222 Aim: AIPGE 2011 Sun May 08, 2011 7:07 pm (4 days ago) #62 Esophageal Acid Testing: This testing is called gold standard for diagnosing GERD. The quantity of acid in an individual suffering from GERD is compared to a normal person's level of acid. The Esophagus contains acid most of the time in patients of GERD; this can be determined by a test called the 24-hour esophageal ph test. A small tube called a catheter, with an acid sensor at its tip, is inserted through the nose and positioned in the esophagus. The other end travels down to the waist after exiting from the nose and then attaching to a recorder. The recorder records every reflux episode in the esophagus and a 24 hour frame of data is analyzed referance omni medical search dot com Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:07 pm (4 days ago) #63 there is some confusion in above qs one gentleman called just now confusion is about inside/outside course practically if any one can help would be obliged

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:10 pm (4 days ago) #64

qs55)Abscess in axillary region is safely drain by which wall medial posterior lateral floor Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:11 pm (4 days ago) #65 amanshoots wrote: death in acute myocardial infarction with thrombolytic therapy is due to 1 intracranial hemorrage ans aiims may 04,q118

ya dr aman is right

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:13 pm (4 days ago) #66 qs 56) In a animal exposed to cold. Wht is true. vagal inhbtn of heart inhibited sympathetic tone to heart not affected. perfusn of adipose decreases

vagal stimulation inhibited? yatinptalwar Elite Titan

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:14 pm (4 days ago) #67 qs 57)trauma severity speed score not true shock score ischemic score neurological score energy of wound ---confirmed it with 2 guys it was the fourth option and the answer qs58)girl chid wid focal segmental albumin 2gm,lipid casts.diagnosis low c3 level nephritic syn iga nephropathy no deposits in bm iga /c3

on the face of it looks as nephritic syn Post Options: Add to favourite . Tell a friend . Email me when a reply is posted Back to top

yatinptalwar Elite Titan

Posts: 250 Credits: 8221 Aim: AIIMS May 2011

Sun May 08, 2011 7:19 pm (4 days ago) #69 qs 59)for atherosclerosis which one is true intake of pufa associated with decreased risk thoracic more severe than abdominal extend of lesion in veins same as arteries hypercholestr does not increase the risk of atherocler ans intake of pufa ref robbin 8/e pg 496.497.498 Post Options: Add to favourite . Tell a friend . Email me when a reply is posted Back to top

anupam_4202000 Serious Veteran

Posts: 43 Credits: 594 Aim: AIPGE 2012 Sun May 08, 2011 7:20 pm (4 days ago) #70 there ws no hematuria buddy so nephritic doesnt fit in ans

Sun May 08, 2011 7:20 pm (4 days ago) #71 60)tamoxifen in breast cancer s/e allexcept ans ca spread to other breast

method to detect protein miggration ans frap ref wikipedia

Sun May 08, 2011 7:20 pm (4 days ago) #72

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:22 pm (4 days ago) #73 anupam_4202000 wrote: there ws no hematuria buddy so nephritic doesnt fit in ans

sir yes now it came to mind that fourth stem of qs was no hematuria so the ans should be option 4th no complement /iga yeah its a min change gm thanks bro Post Options: Add to favourite . Tell a friend . Email me when a reply is posted +4 RxPG credits 1 Back to top

yatinptalwar Elite Titan

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:25 pm (4 days ago) #74 qs61)octreotide is not useful in? insulinoma Glucaganoma

Carcinoid tumor Glioma

Pharmacokinetic data Bioavailability 100%; I.M.: 60% to 63% of subcutaneous dose Protein binding 65% Metabolism Hepatic Half-life 1.71.9 hours Therapeutic considerations Pregnancy cat. B(US) Legal status Prescription only Routes Subcutaneous, intramuscular, intravenous Y(what is this?) (verify) Octreotide (brand name Sandostatin, Novartis Pharmaceuticals) is an octapeptide that mimics natural somatostatin pharmacologically, though it is a more potent inhibitor of growth hormone, glucagon, and insulin than the natural hormone. It was first synthesized in 1979 by the chemist Wilfried Bauer. Contents [hide] 1 Uses 1.1 Approved uses 1.2 Radiolabelling 1.3 Off-label and experimental uses 2 Contraindications 3 Adverse effects 4 Pharmacokinetics 5 Pharmacological effects 6 Interactions 7 References [edit] Uses[edit] Approved usesThe Food and Drug Administration (FDA) has approved the usage of a salt form of this peptide, octreotide acetate, as an injectable depot formulation for the treatment of acromegaly, the treatment of diarrhea and flushing episodes associated with carcinoid syndrome, and treatment of diarrhoea in patients with vasoactive intestinal peptidesecreting tumors (VIPomas). [edit] RadiolabellingFurther information: Octreotide scan Octreotide is used in nuclear medicine imaging by labelling with indium-111 (Octreoscan) to non-invasively image neuroendocrine and other tumours expressing somatostatin-receptors.[1] More recently, it has been radiolabelled with gallium-68 enabling imaging with positron emission tomography (PET) which provides higher resolution and sensitivity. Octreotide can also be labelled with a variety of radionuclides, such as yttrium-90 or lutetium-

177, to enable peptide receptor radionuclide therapy (PRRT) for the treatment of unresectable neuroendocrine tumours. [edit] Off-label and experimental usesOctreotide has also been used off-label for the treatment of severe, refractory diarrhea from other causes. It is used in toxicology for the treatment of prolonged recurrent hypoglycemia after sulfonylurea and possibly meglitinides overdose. Octreotide has also been used with varying degrees of success in infants with nesidioblastosis to help decrease insulin hypersecretion. In patients with suspected esophageal varices, octreotide can be given to help decrease bleeding.[2] Octreotide has been investigated for patients with pain from chronic pancreatitis.[3] It may be useful in the treatment of thymic neoplasms.[citation needed] The drug has been used off-label, injected sub-cutaneously, in the management of hypertrophic pulmonary osteoarthropathy (HPOA) secondary to non-small cell lung carcinoma. Although its mechanism is not known it appears to reduce the pain associated with HPOA.[citation needed] It has been used in the treatment of malignant bowel obstruction.[4] Octreotide may be used in conjunction with midodrine to partially reverse peripheral vasodilation in the hepato-renal syndrome. By increasing systemic vascular resistance, these drugs reduce shunting and improve renal perfusion, prolonging survival until definitive treatment with liver transplant.[5] The drug has also been shown to be effective in the treatment of chylothorax.[6][7] A small study has shown that octreotide may be effective in the treatment of idiopathic intracranial hypertension (IIH).[8][9] [edit] ContraindicationsOctreotide has not been adequately studied for the treatment of children, pregnant and lactating women. The drug is given to these groups of patients only if a riskbenefit analysis is positive.[10][11] [edit] Adverse effectsMost frequent adverse effects (more than 10% of patients) are headache, cardiac conduction changes, gastrointestinal reactions (including cramps, nausea/vomiting and diarrhea or constipation), gallstones, high or low blood sugar, and (usually transient) injection site reactions. Slow heart rate, skin reactions like pruritus, hyperbilirubinemia, hypothyreosis, dizziness and dyspnea are also fairly common (more than 1%). Rare side effects include acute anaphylactic reactions, pancreatitis and hepatitis. Data on the frequency of alopecia vary.[10][11] A prolonged QT interval has been observed in patients, but it is uncertain whether this is a

reaction to the drug or part of the patients' illness.[10] [edit] PharmacokineticsOctreotide is absorbed quickly and completely after subcutaneous application. Maximal plasma concentration is reached after 30 minutes. The elimination halflife is 100 minutes (1.7 hours) on average when applied subcutaneously; after intravenous injection, the substance is eliminated in two phases with half-lives of 10 and 90 minutes, respectively.[10][11] [edit] Pharmacological effectsSince octreotide resembles somatostatin in physiological activities, it can: inhibit secretion of many hormones, such as gastrin, cholecystokinin, glucagon, growth hormone, insulin, secretin, pancreatic polypeptide, TSH, and vasoactive intestinal peptide reduce secretion of fluids by the intestine and pancreas reduce gastrointestinal motility and inhibit contraction of the gallbladder inhibit the action of certain hormones from the anterior pituitary cause vasoconstriction in the blood vessels reduce portal vessel pressures in bleeding varices. It has also been shown to produce analgesic effects, most probably acting as a partial agonist at the mu opioid receptor.[12][13] [edit] InteractionsOctreotide can reduce the intestinal resorption of ciclosporin, possibly making it necessary to increase the dose.[14] Patients with diabetes mellitus might need less insulin or oral antidiabetics when treated with octreotide. The bioavailability of bromocriptine, is increased.[11] Bromocriptine, besides being an antiparkinsonian, is also used for the treatment of acromegaly. [edit] References^ Medscape: Octreoscan review ^ Abid S, Jafri W, Hamid S, et al. (March 2009). "Terlipressin vs. octreotide in bleeding esophageal varices as an adjuvant therapy with endoscopic band ligation: a randomized doubleblind placebo-controlled trial". Am. J. Gastroenterol. 104 (3): 61723. doi:10.1038/ajg.2008.147. PMID 19223890. ^ Uhl W, Anghelacopoulos SE, Friess H, Bchler MW (1999). "The role of octreotide and somatostatin in acute and chronic pancreatitis". Digestion 60 Suppl 2: 2331. doi:10.1159/000051477. PMID 10207228. Post Options: Add to favourite . Tell a friend . Email me when a reply is posted Back to top

yatinptalwar Elite Titan

Posts: 250 Credits: 8221 Aim: AIIMS May 2011 Sun May 08, 2011 7:26 pm (4 days ago) #75 VIPomaFrom Wikipedia, the free encyclopedia Jump to: navigation, search VIPoma Classification and external resources ICD-10 C25.4 or E16.8 ICD-O: M8155/3 DiseasesDB 13877 MedlinePlus 000228 eMedicine med/2379 med/2399 ped/2428 MeSH D003969 A VIPoma (also known as Verner Morrison syndrome, after the physicians who first described it [1]) is a rare (1 per 10,000,000 per year) endocrine tumor,[2] usually (about 90%) originating in the pancreas, that produces vasoactive intestinal peptide (VIP). A syndrome caused by non- islet cell tumors. It may be associated with multiple endocrine neoplasia type 1. The massive amounts of VIP in turn cause profound and chronic watery diarrhea and resultant dehydration, hypokalemia, achlorhydria (hence WDHA-syndrome, or pancreatic cholera syndrome), acidosis, vasodilation (flushing and hypotension), hypercalcemia and hyperglycemia.[3] Contents [hide] 1 Symptoms and Signs 2 Diagnosis 3 Treatment 4 References [edit] Symptoms and SignsThe major clinical features are prolonged watery diarrhea (fasting stool volume > 750 to 1000 mL/day) and symptoms of hypokalemia and dehydration. Half of the patients have relatively constant diarrhea while the rest have alternating periods of severe and moderate diarrhea. One third have diarrhea < 1yr before diagnosis, but in 25%, diarrhea is present for 5 yr or more before diagnosis. Lethargy, muscle weakness, nausea, vomiting and crampy abdominal pain are frequent symptoms. Hypokalemia and impaired glucose tolerance

occur in < 50% of patients. Achlorhydria is also a feature. During attacks of diarrhea, flushing similar to the carcinoid syndrome occur rarely. [edit] DiagnosisBesides the clinical picture, fasting VIP plasma dosage may confirm the diagnosis, and CT scan and somatostatin receptor scintigraphy are used to localise the tumor, which is usually metastatic at presentation. [edit] TreatmentBesides treating the water and electrolyte abnormalities, octreotide (a somatostatin analogue) can be used to temper symptoms. Surgery is the only curative option. [edit] References