dr.pumpkin
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hey guys,,i had looked up in the harrison`s the difference between Diffuse esophageal spasm n Nutcracker Esophagus..It doesn`t mention abt the symptoms , but tells the following thing abt manometric pattern :
DES ; Non peristaltic contractions of large amplitude and long duration
Nut cracker Esophagus ; Hypertensive but persistaltic contactions.
hope this helps...
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| dr.pumpkin
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Posts: 168
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SCHATZKI RING and PLUMMER VINSON SYNDROME
No#27 Barium oesophageography
No#28 Dilatation with bougies
No#29 Dilatation wth bougies and iron therapy.
BARRETT`S ESOPHAGUS
No#30 Endoscopy with biopsy ( shows a orange gastric type epithelium extending frm the stomach in a tongue like pattern)
No#31 ?? isn`t it same as above (plzz clarify)
No#32 Treatment is long term PPI`S
No#33 surveillance endoscopy should be done in patient with barett`s n also patients with alarming symptoms such as weight loss,anemia,odynophagia,dysphagia and GERD > 5 YRS.
pt with BARETT`S ; Repeat endoscopy every 2-3 yrs
pt with LOW GRADE DYSPLASIA ; Endoscopy every 3-6 mths ( meanwhile treat the patiet extensively with PPI`S)
pt with HIGH GRADE DYSPLASIA ; distal esophageal resection
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| dr.pumpkin
Forum Newbie
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Posts: 168
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ZENKER`S DIVERTICULUM
no#34 Barium esophageogram
no#35 EGD is contraindicated cos of risk of perforating the posterior pharynx.
no# 36 Surgical diverticulectomy.
MALLORY WEISS TEAR
no#37 Upper endoscopy
no#38 First stabilise the patient with fluid replacement , blood transfusions (if needed) . usually there`s spontaneous resolution.
If it doesn`t then do endoscopic cauterisation, or inject epinephrine at the injection site.
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| dr.pumpkin
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hey budds,,
i ll be fair nw, leaving the rest of questions fr u ...thx guys,,even i m planning to do FIRST AID ( trying to get it online),,cos i am too not left wid much time..
started with pedia today, have done the newborn chapter..will post before sleeping the topics covered
zianab, i have completed my psych.. haven`t done the questions fr public health, epi/biostats. wuld do while doing UW ,watever comes thru it..
npas,,hw much more of peds is left fr u ?? hmm..i got tht, those topics were of peds u`d mentioned..act it was getting tough to do rev of med unit wise. so,i ll be doing it via the ques way thru this journal..
So,,frns will post more by nite  gud luck to us...
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| npas
Forum Senior
Topics: 8
Posts: 198
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ANS#24..PLEASE CHECK IT FROM SOME RELIABLE BOOK 'COZ IT IS GIVEN IN MORE THAN ONE PLACES THAT "BARIUM SWALLOW IS USUALLY NORMAL IN NUT CRACKER EXCEPT WHEN THERE IS AN EPIPHRENIC DIVERTICULUM"..so why do we have to perform it at all?Please do let me know.
Morover is it necessary that there has to be an INITIAL BEST diagnostic test for every disease?I always thought that test should have to be most SENSITIVE..what about u guys..
Zainab ur renal question was a tough one and good too.
yesterday I did 50 questions..my condition was a little depressing..have to work hard.what the progress at ur end?
good luck
npas
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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hey npas,,plz check ur inbox...
gud luck
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| zianab
Forum Elite
Topics: 17
Posts: 282
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dear dr pumkin.
I read in kaplan book that
QNO 29:WHA IS THE TREATMENT FOR PLUMMERVINSON SYNDROME?
ans:surgery is the treatment for plummervinson syndrome.
I don't know which one is correct.
We need your help npas???
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| zianab
Forum Elite
Topics: 17
Posts: 282
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ESOPHAGITIS:
QNO 39:WHAT ARE DIFFERENT CAUSES OF ESOPHAGITIS?
ans 39:
viral(herpes,varicella zoster,cmv)
bacterial(streptococcus,cryptosporidium,mycobacterium tuberculosis,pneumocystis carnii)
candida,radiation exposure or therapy,corrosive exposure.
hiv,pill induced esophagitis( NSAIDS,IRON SULFATE,ALENDRONATE,DOXYCYCLINE,QUINIDINE)
QNO 40:HOW DO U DIAGNOSE ESOPHAGITIS?
ans no 40: diagnosis largely based on history and confirmed by responsiveness to therapy.
EGD reserved for cases who donot respond to treatment.
CANDIDA:NODULAR FILLING DEFECTS ON BARIUM ESOPHAGOGRAM
HSV,VZV:VESICLES AND DISCRETE EROSION ON EGD
CMV:intranuclear inclusions on biopsy via endoscopy.
QNO 41:WHAT IS THE TREATMENT OF ESOPHAGITIS?
ANS #40:
CANDIDA:fluconazole peroral
HSV:acyclovir iv
CMV:ganciclovir iv.
PILL INDUCED ESOPHAGITIS:best treated with hydration and ingestion of medication in upright posture
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| zianab
Forum Elite
Topics: 17
Posts: 282
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GASTRITIS:
QNO 41:WHAT ARE THE 2 TYPES OF GASTRITIS?
QNO 42:WHAT ARE THE CAUSES OF 2 TYPES OF GASTRITIS?
Q NO 43:HOW DOES THE PATIENT WITH GASTRITIS PRESENT WITH?
QNO 44:WHAT IS THE BEST INITIAL DIAGNOSTIC TEST FOR GASTITIS?
QNO 45:WHAT IS THE GOLD STANDARD TEST TO DIAGNOSE GASTRITIS?
Q NO 46:WHAT OTHER TESTS ARE DONE IN DIAGNOSIS OF GASTRITIS?
QNO 47:WHAT IS THE TREATMENT FOR TYPE A GASTRITIS AND THEN LIST THE TREATMENT FOR TYPE B GASTRITIS?
QNO48:WHAT ARE THE LONG TERM COMPLICATIONS OF GASTRITIS?
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| zianab
Forum Elite
Topics: 17
Posts: 282
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HERE ARE SOME SURGERY RELATED TOPICS FOR GI:
ABDOMINAL AORTIC ANEURYSM:
QNO 49:WHAT ARE THE RISK FACTORS FOR AAA?
QNO 5O:WHAT IS THE INITIAL DIAGNOSTIC STEP TO DIAGNOSE AAA?
QNO 51:WHAT IS THE GOLD STANDARD TO DIAGNOSE AAA?
QNO 52:WHAT IS THE TREATMENT OFAAA?
MESENTERC ISCHEMIA:
QNO 53WHAT ARE THE CAUSES OF MESENTERIC ISCHEMIA,PLEASE LIST THEM?
QNO54:HOW DOES THE PT WITH MESENTERIC ISCHEMIA PRESENT WITH?
QNO55:WHAT IS THE INITIAL DIAGNOSTIC STEP FOR MESENTERIC ISCHEMIA?
QNO56:WHAT IS THE GOLD STANDARD TEST TO DIAGNOSE MESENTERIC ISCHEMIA?
QNO57:WHAT IS THE TREATMENT?
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| npas
Forum Senior
Topics: 8
Posts: 198
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Dear Dr Pumpkin and Zainab
I have checked CMDT,SHWARTZ SURGERY and QUICK ACCESS..
ANSWER 29..Tx FOR PLUMMER VINSON IS DILATATION WITH A BOUGIE(>16mm) AND FOR THOSE WHO REQUIRE REPEATED DILATATION OR THOSE HAVING REFLUX WE HAVE TO PRESCRIBE PPIs..
I'am cross checking everything so that we don't give any sort of wrong information to anybody viewing this and all three of us have to be crystal clear about everything to ace..right?
Today is the last day of paeds...I must complete it..Tomarrow I will do more questions..
I will take psychiatry next so that I can be with u guys..we can start surgery together.
Guys..I will be posting the answers later 'coz if I don't study now I will procrastinate for the whole day.
gooooood luck with ur studies..Zainab sometimes have fun with ur kid..u deserve it..and Dr pumpkin thanks again
npas
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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dear npas, zianab
thnx guys for making such an effort in making n answering questions to the max precision..
i too try to answer by cross checking with watever sources i have..
zianab, for the plummervinson synd i think i wuld go for wat npas has mentioned. Her sources i guess r a bttr deal..( i answered on the basis of kaplan notes )
newys,,i had started with peds yesterday. Today i completed abt 9 chapters, was quite slow...( i don`t knw but it somtimes happens with me unreasonably )...peds is definiitely vast !! gud tht u ll be soon done wid it npas ..i wuld be starting questions once i start systemic peds .
i think i ll be doing ques frm pretest/ nelson`s reveiew ( watever i find bttr )..
so frns,,catch u tomm..going off to sleep nw...zianab , will answer ur quest tomm , my brain`s neurotransmitters refusing to get out of their vesicles
take care both of u n happy studying...
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| npas
Forum Senior
Topics: 8
Posts: 198
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Zainab..the 9 chapters was completed by Dr Pumpkin not me ..read whose post was that..I too think 9 chapters is not a bad speed.keep it up Dr Pumpkin.
I have too much of tit bits left in paedia here and there..still!!!I will look into that plus I have my week end get togethers to attend..and also have to pick up some books..
I used some online question bank for paeds..and let me see what else I can get from the library..will let u know tomarrow.Since I don't have paeds lectures(complete) I'am using wide reference books.
let me know what u guys r doing..and by the way do check out the exam experiences of Tolito and studying..very helpful and an alert sign for all of us..
good luck
npas
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| zianab
Forum Elite
Topics: 17
Posts: 282
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oops,that message for dr pumpkin ,I wrote your name npas as a reflex.
What online test bank are u using for paeds.do u know any other good source for paeds qs???
I have started paeds just did 3 chapters ,I think it is going very slow.I need to study harder.
dr pumpkin you have not posted yet.how far along are u in studies.Guys keep on posting answers we need to revise medicine fast.These are the qs we will get hit in the exam.I hope !!!!!
take care npas and have fun at get together and hear from u soon dr.pumkin
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| zianab
Forum Elite
Topics: 17
Posts: 282
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ABDOMINAL AORTIC ANEURYSM:
QNO 49:WHAT ARE THE RISK FACTORS FOR AAA?
ans49:atherosclerosis,aneurysm greater than 5 cm.
QNO 5O:WHAT IS THE INITIAL DIAGNOSTIC STEP TO DIAGNOSE AAA?
ans 50:MRI AND CT SCAN WITH IV CONTRRAST
QNO 51:WHAT IS THE GOLD STANDARD TO DIAGNOSE AAA?
ANS 51:ANGIOGRAM
QNO 52:WHAT IS THE TREATMENT OFAAA?
ANS 52:PATIENTS SHOULD HAVE IMMEDIATE IV ACESS,TYPE AND CROSS MATCH BLOOD AND EMERGENT SURGICAL REPAIR
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| zianab
Forum Elite
Topics: 17
Posts: 282
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MESENTERC ISCHEMIA:
QNO 53WHAT ARE THE CAUSES OF MESENTERIC ISCHEMIA,PLEASE LIST THEM?
ANS53:ATHEROSCLEROSIS,ATRIAL FIBRILLATION,ACUTE HYPER COAGULABILITY,LOW FLOW STATE(HYPOTENSION AND POOR CARDIAC OUTPUT)
QNO54:HOW DOES THE PT WITH MESENTERIC ISCHEMIA PRESENT WITH?
ANS 54:SEVERE PAIN OUT OF PROPOTION,GNAWING ABDOMINAL PAIN AFTER EATING,LABS MAY SHOW INCREASE LACTATE AND METABOLIC ACIDOSIS
QNO55:WHAT IS THE INITIAL DIAGNOSTIC STEP FOR MESENTERIC ISCHEMIA?
ANS 55:SPIRAL CT SCAN WITH PO AND IV CONTRAST,MRA.
QNO56:WHAT IS THE GOLD STANDARD TEST TO DIAGNOSE MESENTERIC ISCHEMIA?
ANS 56:ANGIOGRAPHY
QNO57:WHAT IS THE TREATMENT?
ANS 57:MAINTAIN TISSUE PERFUSION WITH FLUIDS AND BY PASS SURGERY
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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Hi npas, zianab..
sorry guys,,didn`t post earlier...act haven`t studied since yesterday n don`t feel like doing it nw too...i m way behind my schedule,,seems i have forgotten watever i have studied...i donno wat`s got into me, i feel like skipping topics...
my apprehensions r taking over me, i can`t even complain cos it was my choice to giv this exam....
i m sorrrry frns...i shuldn`t be talking like this to u cos we r in the same boat wid sooo many uncertainities arnd...culdn`t hold myself today...
i just hope i get bttr....
zianab, i m posting the answers to gastritis.....
may god give us all strength to get over this...
god bless all...
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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No#41 TWO TYPES OF GASTRITIS
TYPE A GASTRITIS/ AUTOIMMUNE GASTRITIS ( nonerosive gastritis)
TYPE B GASTRITIS ( erosive gastritis )
No#42 causes of each type of gastritis
TYPE A GASTRITIS : associated with perinicious anemia
TYPE B GASTRITIS : occurs d/t 1. H . PYLORI
2. NSAID induced
3 . STRESS ( burns,trauma,sepsis, CNS injury, pt on mechanicalventilation , multi organ failure) ,
4 . ALCOHOL induced
No#43 symptoms
mostly asymptomatic , may present with epigasrtic pain , nausea vomitting.
erosive gastritis may present wid upper gi bleeding ( hematemesis, malena )
No#44 Best initial diagnostic test
ENDOSCOPY
No#45 gold standard test to diagnose gastritis
TYPE A GASTRITIS : antiparietal antibodis , anti intrinsic factor Ab
H.pylori gastritis : Biopsy with histology
No#46 other tests done
H.pylori gastritis : serology, urea breath testing , stool antigen testing.
Type A gastritis : Vitamin B12 Levels( decreased ) , serum gastrin levels ( increased ) , methyl malonic acid level ( increased)
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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No#47 treatment of TYPE A gastritis
vitamin b12 replacement.
No# 48 treatment of Type B gastritis
H.pylori gastritis : PPI combined with clarithromycin and amoxicillin for 14 days.
if patient fails this therapy : do a urease breath test to see if the org is eradicated
IF ORG STILL PRESENT : use PPI with tetracycline and metronidazole , also add bismuth subsalicylate.
NSAID induced gastritis : mild symp 1 ;decrease to the lowest effective dose / discontinue / take med wid meals.
2 ; Sucralfate with H2 blockers / PPI`S
Stress induced gastritis : Intravenous H2 blokers / Intravenous PPI`S ARE BEING GIVEN TO PATIENTS WITH RISK FACTORS FR STRESS RELATED BLEEDING
in case the bleeding occurs : IV PPI`S , Sucralfate suspension
No#48 complications of gastritis
chonic H.Pylri infec : assoc with 1.Peptic Ulcer disesae
2.gastric adenocarcinoma
3.MALToma
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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zianab,,,please check my answers n add if they r insufficient....thnx frnd...
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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guys,,please do check question 48 ...n do correct me ,,,cos i think it culd be answred better....zianab, plz check ur inbox...
so,, gud luck n take care both of u...
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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hi guys,,
do check this link..i found it in this forum
http://www.positivepause.com/
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| dr.pumpkin
Forum Newbie
Topics: 4
Posts: 168
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hi npas , zianab
hw r u guys doing ? zianab, nice to see u chilling out wid ur family ,,nw u must be all freshened up to start the week in a great way...
npas,, hws the weekend get together ?...hope it had been gud fr u too...
i m doing better nw ( n hopefully do that fr long....) thnx zianab fr ur support ...its really gud to have npas n u arnd...god bless u both..
i started wid systemic peds today, have done the respi sys , wid questions..( have skippd a few chaps in b/w)...plan to do cardio as well...
so, hw much both of u have covered ?
npas, have u finished peds n start psych ?
zianab , hw many chaps of peds have u done ? r u doing ques n lectures along wid them ?
so,,gud luck guys...may u both have a great day ahead...
take care...
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