npas
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Topics: 8
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Zainab..I'am so sorry I coudn't answer ur Qs..I was not getting internet for 1 day..its late night out here..will catch up tomarrow..sorryyyy
I did board crush Qs today..not very good source I would say..there was nothing very intelectual in it..
GL..see u tomarrow
npas
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| npas
Forum Senior
Topics: 8
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#9 As always I have doubt about the best "initial Dx test"...is it air fluid level in Chest Xray or "BIRD BEAK" appearance in Barium esophagography..!!The latter sounds more appropriate,right?
#10 Most accurate....ESOPHAGEAL MANOMETRY
#11 and 12.. Pneumatic dilatation...and in those not willing "Botulinum toxin"
#13 Laproscopic Surgical myotomy
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| npas
Forum Senior
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How do I post in bold?
GL
npas
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| zianab
Forum Elite
Topics: 17
Posts: 282
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9- barium swallow
10- Manometry
11- pneumatic dilatation
12- may be botulinum injections
13- surgical myotomy
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| zianab
Forum Elite
Topics: 17
Posts: 282
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SCLEODERMA:
Q NO 14:-what is the best INITIAL diagnosic test?
QN0 15:what is the gold standard test to diagnose SCLERODERMA?
Q N0 16:What is the best initial TREATMENT FOR SCLERODERMA?
Q#17:What is the next best step in treatment?
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| npas
Forum Senior
Topics: 8
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Hi Zainab..I have done 12 chapters in paeds..thats all..its been a slow weekend..went thru board buster..today I will revise whatever I have done in paeds 'coz I don't want to forget everything as soon as I pick up the next sub..i didn't hear the lectures coz there is some problem with the DVD.
I think u will be able to finish psychiatry soon..7 more,right..u will finish it pretty soon..
The "B" option is not here in my page..don't know why!!so i guess I have to post it this way
so lemme not waste time and try out ur Qs
Scleroderma is just not only an esophageal motility disorder but it is a systemic sclerosis involving skin(discoloration,thickening,ulcers),lung(fibrosis and vascular changes),heart(conduction blocks,cor pulmonale,pericardial fibrosis and more) and even kidney(thats a real bad prognosis)..and 90% of the cases are associated with Raynaud's phenomenon..
Since we r discussing GIT I think I should answer the esophageal dismotility
#14 Barium swallow is the initial test..but endoscopy should be done to find out Barettes or simple esophagitis.
#15 Ambulatory Ph monitoring(Is it Anti nuclear antibody for the systemic one?)
#16 and 17 Mx is similar to GERD..(ofcourse we have to give the CCBs,ACE inhibitors etc for the Mx of systemic scleroderma.)
My answers r not 100% sure'coz I just try to analyze my best and give the answers ..must consult before mugging up..
Good luck
npas
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| npas
Forum Senior
Topics: 8
Posts: 198
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Dr Pumpkin...we r waiting  ..Hope u will join us soon
npas
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| dr.pumpkin
Forum Newbie
Topics: 4
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heyyyyyy npas,, zianab
how hav u been ? i m back after a huge break frm studies , this forum n u guys ...
The wedding went great,,then i got busy wid a few festivals..Now i really have to gear up to catch up the lost studies..
Zianab,,u started a really great topic..i m sure by this way we ll cover up medicine in a good n a appropriate way...i ll too be posting answers in the journal
npas so hws ur peds coming along ?? i can see zianab u r done wid most of psych...thts really good..
I am still left wid the ethics n the public health chapters ( n the lectures too )...
guys,, good luck to us..
tk cr
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| npas
Forum Senior
Topics: 8
Posts: 198
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I can see Dr Pumpkin is really in gr8 spirits..a after every message ...thats good..we missed u too Dr Pumpkin..
Zainab,good that u too took a break with trhe family..now that we all r back lets kick start our studies..october is ending..time to get fast.
yesterday I did my revision except immuno and half of fluids-electrolytes chapter..that will be finished in 1 hour today..its respi and cardio for today.I'am not doing questions side by side..will do it at the end of the subject..
whats ur approach to psych?I think the lectures r really nice..Is it?How many hours now a days?
Good luck and may we all fasten up
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| npas
Forum Senior
Topics: 8
Posts: 198
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Questions for today/b
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| npas
Forum Senior
Topics: 8
Posts: 198
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/B ESOPHAGEAL CANCER
Q#18 BEST INITIAL DIAGNOSTIC TEST FOR ESOPHAGEAL CANCER IS________
Q#19 MOST ACCURATE TEST IS ______
Q#20 WHATS THE TREATMENT?
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| zianab
Forum Elite
Topics: 17
Posts: 282
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SCLEODERMA:
Q NO 14:-what is the best INITIAL diagnosic test?
ans 14:barium swallow when dysphagia present(for GI CASE)
(other tests which can be done when systemic symptoms are given are ana postive 95 % CASES ,anti scl 70,anti centromerenormochromic normocytic anemia,elevated esr, decreased vital capacity on PFT)
QN0 15:what is the gold standard test to diagnose SCLERODERMA?
ANS 15:MANOMETRY IS THE CONFIRMATORY TEST
Q N0 16:What is the best initial TREATMENT FOR SCLERODERMA WITH GI SYMPTOMS?
ANS NO 16:ANTI REFLUX THERPY,WHICH INCLUDE PPI,H2 BLOCKERS ETC.
PATIENT SHOULD NEVER BE GIVEN CALCIUM CHANNEL BLOCKERS AND NITRATES IN GI SYMPOMS AS IT CAN RELAX LES MORE AND WORSEN THE SYPTOMS.
Q#17:What is the next best step in treatment?
ANS 17:ANTI-REFLUX IS THE ONLY TREATMENT OTHERWISE NO EFFECTIVE THERAPY AVAILABLE FOR GI SYPTOMS
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| zianab
Forum Elite
Topics: 17
Posts: 282
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since scleroderma is a systemic disease in this topic we are just covering the GI Manifestation.I think when we do connective tissue diseases then it will more complete explanation of this diseases.Here Re my answers.
NPAS ,I am answering a few qs which are different from your answers.Please check it and let me know if I am telling right.As far as I think they are correct answers
DR PUMKIN WECOME BACK AND IT WILL JUST BE GREAT IF YOU START POSTING TOO.
BUT PLEASE ANYBODY WHO POSTS ANSWERS SHOULD CHECK WITH THE BOOK BEFORE POSTING AS THERE IT IS NOT BENEFICIAL .
I thought the next topic in kaplan notes was nut cracker esophagus ???
Npas are my notes different then yours??If it is I AM SORRY for posting this topic because I was making qs sequence wise according to kaplan notes.as i donot want to miss any topics.Please let me know if you have different notes ?
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| zianab
Forum Elite
Topics: 17
Posts: 282
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ESOPHAGEAL CA:
NO 18:-what is the best INITIAL diagnosic test?
ANS18:BARIUM SWALLOW .
(LAB :HYPERCALCEMIA IS FOUND WITH SQUAMOUS CELL CA)
QN0 19:what is the gold standard test to diagnose esophageal CA?
ANS NO 19:EGD WITH BIOPSY
(MRI AND CT SCAN TO EVALUATE FOR METASTATIC DISEASE.
Q N0 20:What is the best TREATMENT FOR ESOPHAGEAL CA?
ANS NO 20:CHEMPTHERAPY WITH CISPLATIN ,5 FLUOROURACIL AND RADIATION IS USED IS USED IN SOME METASTATIC CASES.
IN OTHER CASES SURGICAL RESECTION MY BE BENEFICIAL.
PATIENTS IN END STAGE WHO CANNOT TAKE SURGERY/CHEMORADIATION AN ENDOSCOPICALLY PLACED ESOPHAGEAL STENT ME BE PLACED TO IMPROVE QUALITY OF LIFE.
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| zianab
Forum Elite
Topics: 17
Posts: 282
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DIFFUSE ESOPHAGEAL SPASM:
Q N0 21-what is the best INITIAL diagnosic test?
QN0 22:what is the gold standard test to diagnose?
Q N0 23:What is the best TREATMENT for esophageal spasm?
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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wanted to add in NO. 18 #The Best initial test for esophageal ca..
Barium swallow presents with a filling defect or an apple core lesion
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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Diffuse esophageal spasm
No# 21 : Since it presents as chest pain therefore rule out cardiac cause by doing an EKG
Best initial test ; Barium esophageography , shows a cork screw pattern ( present only at the time of spasm)
NO#22
Gold standard test ; esophageal manometry
No#23
Best treatment : Calcium channel blockers , nifedipine. and Nitrates
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| dr.pumpkin
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Topics: 4
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guys,, i had a doubt...its abt achalasia ; is it progressive in nature ? but i think its a motility dysphagia so wuld present wid difficulty in swallowing fr both liq n solids at its onset..
hey npas, r u done wid peds ?? i think i ll also review medicine unit wise, the way u r doing...wat abt other subjects ?
Hi zianab,, u must too have been relaxed wid tht trip of urs...have u completed psych ? What all sources r u doing for the epi/ biostats part ?
guys,,how to do the public health ? Do we have to mug up the tables of `causes of death in diff grps` n wat all question sources to refer ? plzz let me knw,,i m confused abt it..studied abt 5 hrs today...
gudluck guys,,going off to sleep nw..wuld be revising medicine tomm..
tk cr
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| zianab
Forum Elite
Topics: 17
Posts: 282
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NUT CRACKER ESOPHAGUS
N0 24-what is the best INITIAL diagnosic test?
QN0 25:what is the gold standard test to diagnose?
Q N0 26:What is the best TREATMENT for NUT CRACKER ESOPHAGUS?
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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hi npas , zianab
didn`t study a word today,,act had gone to buy the books..Guys,,First Aid and Crush step 2 aren`t available here ...is there somthing like the recent edition fr First Aid ?? Do u guys have Step up to Medicine? Would it be good fr making references when i d be doing questions frm UW ?
Please do tell me a reference book fr surgery ...
npas,,where r u buddy..do tell abt ur progress,,it helps a lot..
Good going zianab,,not much left in psych fr u nw...wat do u plan to pick up next ??
Gud luck frns...
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| npas
Forum Senior
Topics: 8
Posts: 198
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Yesterday I completed cardio and respi(paeds)..there is 2 more pages of cardio to be completed though..Just 6 hours of concentrated study..hopefully I will do more today!!
So sorry Zainab for the answers on scleroderma..actually I just read the "quick access medicine" and in that it was given 'Mx and Dx of esophageal schleroderma is like that of GERD"..and I took it casually.In future I will make sure to be more accurate.I think we both have different edition of kaps..but thats fine..U can post all the Ques according to ur book..
Dr Pumpkin I don't have any of the books u mentioned.And I don't think I will ever get time to look into all those...but I will get First Aid for the last moment revision soon..If u don't get it at ur place order it online and see if u can get it by post.
For Surgery I will read Kaplan's and just 'refer' to the books I have..that is CSDT and SCHWARTZ SURGERY..I just have online access to these books..so I will search only the topic of my interest and look into it.
good luck and take care
npas
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| npas
Forum Senior
Topics: 8
Posts: 198
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I HAVE THIS BAD CONFUSION ABOUT NUT CRACKER ESOPHAGUS AND DIFFUSE ESOPHAGEAL SPASM!! GUYS..WHEN THERE R TWO DIFFERNT THINGS GIVEN IN NOTES AND TEXT BOOKS WHICH ONE DO U TRUST??
NOTES___"DIFFUSE ESOPH SPASM AND NC ESO ARE THE SAME THING EXCEPT FOR THE MANOMETRIC PATTERN"
SCHWARTZ,CSDT___DIFF ESO SPASM IS A SUBGROUP OF NUT CRACKER..AND BOTH R DIFFERENT IN THE SENSE THAT DES PRESENTS WITH DYSPHAGIA AND CHEST PAIN AND ESOPHAGEAL MYOTOMY IS A GOOD Tx OPTION..WHERE AS ONLY CHEST PAIN OCCURS IN NUT CRACKER(MOSTLY) AND MYOTOMY IS NOT OF MUCH USE.
ANS#24..CARDIAC WORK UP IS THE INITIAL STEP(CHEST PAIN)...THEN RULE OUT THE MOST COMMON CAUSE OF NONCARDIAC CHEST PAIN(GERD) BY AMBULATORY Ph MONITORING AND THEN ESOPHAGEAL MANOMETRY.
ANS#25..GOLD STD IS ESOPHAGEAL MANOMETRY(NORMAL PERISTALSIS WITH AMPLITUDE >180mm Hg and DURATION >6 Secs )
ANS#26..CCBs and MYOTOMY HAS BEEN TRIED WITH NOT MUCH IMPROVEMENT.
Hope this helps..U can bash me up for the confusion created but then we will recollect more if we study this way..
bye bye
npas
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| zianab
Forum Elite
Topics: 17
Posts: 282
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N0 24-what is the best INITIAL diagnosic test?
Ans :I think it is barium swallow also.
what do u think???
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| zianab
Forum Elite
Topics: 17
Posts: 282
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SCHATZKI RING AND PLUMMER VINSON SYNDROME:
Q #27:WHAT IS THE BEST INTIAL DIAGNOSTIC TEST FOR SCHATZKI RING AND PLUMMER-VINSON SYNDROME?
Q NO 28:WHAT IS THE TREAMENT FOR SCHATZKI RING?
QNO 29:WHA IS THE TREATMENT FOR PLUMMERVINSON SYNDROME?
BARRET ESOPHAGUS:
QNO 3O:WHAT IS THE BEST INITIAL DIAGNOSTIC TEST?
Q NO 31:WHAT IS THE NEXT BEST STEP IN DIAGNOSING BARRET?
QNO 32:WHAT IS THE TREATMENT FOR IT?
QNO33:HOW OFTEN SHOULD AN EGD BE PERFORMED FOR PATIENT WITH BARRET?
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| zianab
Forum Elite
Topics: 17
Posts: 282
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ZENKER DIVERTICULUM
QNO 34:WHAT IS INITIAL DIAGNOSTIC STEP?
QNO35:WHY EGD IS CONTRAINDICATED?
QNO 36:WHAT IS THE TREATMENT?
MALLORY WEISS TEAR
Q NO 37:WHAT IS THE INITIAL DIADNOSTIC STEP?
QNO 38:WHAT IS THE TREATMENT?
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