multifactorial
Forum Guru
Topics: 28
Posts: 546
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mcsteamy!i am planning to go through step up.shall definitely post here as to how helpful i found the book.
Feyza!thankyou very much.ya i know it is better to go through FA as it is such a worshipped book lol.i didnt do it for step1 and when my results came back with an 88 people blamed everything on not reading FA lol.better go through it than accumulate undue pressure.all the best with everything.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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okay so i am starting the day exceptionally late but i hope i make the best of whatever time i have on my hands.planning to finish pediatric oncology,respiratory,and neurology.help me Allah Mian.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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only managed to finish pediatric oncology today.revised gynae alongside but really,i sort of wasted a lot of time today.have to really start it early tomorrow and try and finish paeds.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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okay so here i am at 1 in the afternoon,planning to take the bull by the horns.lol.have to finish the stuff that i couldnt yesterday and then move ahead.i wasted so much time yesterday,i am all sulky now.please Allah Mian help me.
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| njcjzy
Forum Guru
Topics: 20
Posts: 740
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multifactorial, you are moving along with your study. Be happy with that. We may waste some of time while studying, but we can do nothing for those lost time. The only time we can grasp is NOW. Wish you a productive day today!
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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thanks a ton njcjzy! you are absolutely right.when i compare my current performance with what it was a month back,i cant help thanking the Almighty for motivating me.thanks to friends like yourself who inspire and encourage me.
well,learnt pediatric respiratoy system and revised benign gynae and reproductive endocrinology.have to do pediatric neurology,child abuse,ENT,eye and syndromes tomorrow.may Allah be with me.
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| faraym
Forum Addict
Topics: 23
Posts: 793
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Keep going GL.
___________________
"Bindu ki maa, Jab Jab jo jo hona hai ,tab tab so so hota hai." from Padosan.90/85/pass
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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thanks faraym!so it is 8 in the morning and i am settling down to study.be with me Allah Mian.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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okay so i really worked my butt off and managed to finish pediatric neurology at the end of 2 and a half hours.thankyou Allah Mian.that finishes my pediatric systems.now i have to do what i find the most dreadful,the itsy-bitsy paeds.help me Allah
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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so i finished pediatric eye,ENT,mouth and teeth and syndromes.now i shall finish the itsy-bitsy that i am so scared of.may Allah be with me.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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okay rounded off the day with some gynecology revision.tomorrow i have to finish what remains of paeds.be with me Allah.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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okay so i spent the morning revising pediatric infectious diseases(ID)
FEVER CLASSIFICATION IN A CHILD
1.fever without a focus
2.fever with a focus
3.fever of unknown origin lasting for more than 14 days in a child and more than 21 days in an adult.
FEVER WITHOUT A FOCUS
WE do not know the cause here exactly so we try to give a good gram +ve and gram -ve coverage therefore for kids >2 mths we give ceftriaxone and < 2 mths we give cefotaxime and ampicillin.(mind,these are only generalizations and limited to fever without a focus).
OCCULT BACTEREMIA
by definition this is bacteria in the blood without overt signs and symtoms,the S/S do not correlate with the bacterial load.Risk factors for occults bacteremia are fever >39C,WBC count >15,000 with absolute band count <1500,elevated PMNs.
MENINGITIS
in the immediate postnatal period this could be due to organisms that colonize the vagina, so we divide the age groups into two
<3 mths old babies(infected with listeria,GBBS,E.Coli)
>3 mths old babies(infected with S.pneumoniae,H.influenza)
IMPORTANT POINTS FOR MENINGITIS
1.recurrent or persistent meningitis should be investogated with latex particle agglutination test.
2.steroids should be given in the treatment of meningitis as they prevent the formation of adhesions and lead to decreased incidence of hearing loss.
3.complications of untreated or partially treated meningitis are behavioral problems,mental retardation,strokes,palsies,ataxia,cerebral and cerebellar herniation,subdural effusions,hearing loss,seizures,SIADH.
4.for H.influenza and Neisseria give rifampin to close contacts as prophylaxis.
ARBOVIRAL ENCEPHALITIS
types are
1.california virus
2.eastern equine
3.western equine
4.colorado tick fever
5.st louis
only eastern equine has a bad prognosis extending on to death.others resolve with supportive treatment.
OSTEOMYELITIS
1.commonest bug S.Aureus
2.sicklers have S.Aureus,Salmonella
3.dog and cat-bites P.multocida
4.penetration through the skin is of P.Aeruginosa
5.a periosteal bone culture is the gold standard while a bone scan is better than an X-Ray.
SEPTIC ARTHRITIS
again divide them nito three age groups
1.neonates(GBBS,E.Coli,anaerobes)
2.under 5 years(staph,strep,H.influenza)
3.above 5 years(gram +ve)
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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PERTUSSIS
1.Has a catarrhal stage,paroxysmal stage,convalescence stage
2.chest X-Ray findings are perihilar infiltrates,atelectasis,pneumothorax,pneumomediastinum,air in the soft tissues,edema,
3.complications canbe encephalopathy,seizures,death,apnea,pneumothorax,pneumonia,atelectasis
4.treatment is erythromycin which does not decrease the duration of the disease,only reduces the communicability.
5.close contacts should also be given erythromycin.
close contacts <7years old who had their third pertussis vaccine before 6 months should be given a booster.
close contacts <7 years old who received their fourth pertussis vaccine three years before should get a booster.
CAT SCRATCH DISEASE
1.can sometimes present with PARINAUD OCCULOGLANDULAR SYNDROME(unilateral conjunctivitis,preauricular lymphadenopathy,cervical lymphadenopathy)
2.is diagnosed with a special stain,the warthin starry stain
3.complications can be encephalopathy,seizures,altered sensorium,lymphocytoclastic vasculitis,thrombocytopenic purpura,macular retinopathy.
LYME DISEASE
stage 1:erythema migrans(treated with doxycycline,amoxicillin.if the pt cant tolerate this then erythromycin and cefuroxime)
stage 2:myocarditis and neuropathy(treated with ceftriaxone and penicillin G)
stage 3:arthritis(treated like stage 1 but for 30 days)
ERYTHEMA INFECTIOSUM(FIFTH DISEASE,SLAPPED CHEEKS)
Can cause hydrop fetalis,aplastic anemia in a sickler)
Its rash characteristically spares the palms and soles and has a slapped appearance on the face and a lacy pattern on the body.
MEASLES (RUBEOLA)
maculopapular rash.starts from the head and then spreads downwards.
Koplik's spots are a feature.
can have devastating sequelae like subacute sclerosing panencephalitis,meningitis,OM,sinusitis
ROSEOLA(EXANTHEM SUBITUM)
papular rash appears everywhere at the same time.
rash is rose-coloured(roseola)
occipital lymphadenopathy
RUBELLA(GERMAN MEASLES)
a woman should be vaccinated against rubella atleast three months before she conceives.ideally she should have timely immunizations.
starts from behind the ears and then becomes generalized.
is contagious before two days and after seven days of the appearance of the rash.
forschemier's spots and rose spots are characteristic.
retroauricular and postoccipital lymphadenopathy.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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ROCKY MOUNTAIN SPOTTED FEVER
triad of headache,fever,a blanching rose-coloured maculopapular rash.
treatment is tetracycline or doxycycline(cloramphenicol for people who cant take doxy or tetra)
complication is acral gangrene.
VARICELLA(CHICKEN POX)
papules,vesicles,crops and crusts are the hallmark.
can predispose to latent herpes infection(shingles)
complications are scarring,GBS,congenital infections,pneumonia,cerebellar ataxia,encephalitis)
SCARLET FEVER
caused by group A beta hemolytic strep
S/S are circumoral pallor,sandpaper rash,miliary sudamina,pastia lines,desquamation,strawberry tongue,inflamed tonsils,pharyngitis.
complications are post strep glomerulonephritis,rheumatic fever,meningitis,pneumonia,sinusitis,OM
penicillin is the drug of choice
MUMPS
complications are orchitis,ooporitis,pancreatiis,parotitis,hearing loss,dacroadenitis,thyroiditis,myocarditis,arthritis.
AIDS
N group
child <18 mths of age with
negative HIV PCR
negative HIV p24 Ag
negative HIV culture
A group
1.lymphadenopathy
2,parotitis
3,hepatomegaly
4,splenomegaly
5,dermatitis
6,recurrent URIs
B group(alphabetically)
anemia,neutropenia,thrombocytopenia
bacterial pneumonia,meningitis,sepsis
candida
CMV
cardiomyopathy
diarrhoea
herpes stomatits
herpes meningitis,bronchitis,esophagitis
hepatitis
herpes zoster
leiomyosarcoma
LIP
nocardiosis
nephropathy
persistent fever
toxoplasmosis
varicella zoster
C group
recurrent bacteria infections
CMV
candida
cryptosporidiosis
coccidiodomycosis
candidiasis
cryptococcosis
encephalopathy
herps simplex
histoplasmosis
kaposis's
lymphoma brain
non-hodgkin's
MTB
M avium intercellulare
pneumocystic
progressive multifocal leukoencphalopathy
salmonella
toxoplasmosis
wasting syndrome
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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now i am off to revise some more.may Allah be with me.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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so finished paeds and did about a 100 UW MCQs also.shall finish the remaining MCQs in the evening.be with me Allah
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
|
okay here is a brief go-through for neurology(only the big important things)
MYELOMENINGOCELE
1.flaccid paralysis
2.los of DTRs
3.loss of pain and touch
4.Arnold-Chiari type 2
5.subluxed hips
6.club foot
To prevent neural tube defects women in reproductive age and planning a pregnancy should be taking 0.4 mg folic acid daily 3 months prior to conceiving.for high-risk patients this is 4mg/day.during pregnancy this should be 0.4mg/day.
the simplest neural tube defect is spina bifida occulta and its only complication is recurrent meningitis.
AGE OF ONSET AND RESOLUTION OF DIFFERENT SEIZURES IN KIDS
febrile seizures:9months to 5 years.
absence seizures:after 5 years
myoclonic epilepsy:start from infancy and resolve by 2 years of age
Rolandic seizures:5-10 years is the onset and then resolve in adolescence
infantile spasms:4-8 mths.
CEREBRAL PALSY
types are:
1.spastic (diplegia,quadriplegia,hemiplegia)
2.extrapyramidal
3.atonic or cerebellar ataxic
4.mixed
FREIDRICH'S ATAXIA
1.dysarthria
2.nystagmus
3.loss of vibration and position sensation
4.hammer toes
5.high-arched foot
6.kyphoscoliosis
7.HOCM
8.ataxia
LESH NYHAN SYNDROME
1.choreoathetosis
2.psychomotor delay
3.urinary calculi
4.gouty arthritis
5.self-mutilation
6.spasticity
WILSON DISEASE
1.tremor
2.drooling
3.fixed smile
4.choreoathetosis
5.hepatomegaly
6.dysarthria
RETT'S SYMDROME
1.purposeless movements
2.wringing of the hands
3.acquired microcephaly
4.apnea
5.sighing
6.social withdrawal
7.autism
HYDROCEPHALUS
in infants
1.bulging fontanelle
2.dilated scalp veins
3.cracked pot sign(macewan sign)
4.setting sun eyes
ARNOLD CHIARI MALFORMATION TYPE 1
forshortened occiput with hydrocephalus
manifests in adolescence as headache,neckpain,urinary frequency
WERDNIG HOFFMAN DISEASE
1weakness,paralysis and hypotonia of the intercostal,bulbar and proximal and distal limb muscles
2.patients assume a frog-leg position
CHARCOT MARIE TOOTH DISEASE
1.stork legs
2.claw hand
3.onion bulbs around nerves(hypertrophic interstitial neuropathy)
4.decreased motor and sensory conduction
DUCHENNE
1.gower's sign by age 3
2.pseudohypertrophy of the calf
3.hip girdle weakness
4.trendelenberg's gait
5.poor cough
NF 1
criteria for diagnosis are
1.more than 5 cafe-au-lait spots atleast 5 mm in dm in a preubertal child and more than 6 atleast 15 mm in a postpubertal child
2.>2 iris lisch nodules
3.>2 neurofibromas or atleast one plexogenic neurofibroma
4.axillary/inguinal freckling
5.optic gliomas
6.kyphoscoliosis,sphenoid dysplasia
TUBEROUS SCLEROSIS
1.pulmonary hamartomas
2.retinal hamartomas
3.facial angiofibromas
4.renal angiomyolipomas
5.cortical tubers
6.shagreen spots
7.sebaceous adenomas
8.ash-leaf spots
9.epilepsy
10.mental retardation
11.cardiac rhabdomyomas
12.subungual fibromas
STURGE WEBER
1.unilateral port-wine nevus
2.contralateral hemiparesis
3.intracranial calcifications
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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ok so i finished paeds today.did all the questions without explanations from UW.shall be going through twenty explanations each day from tomorrow and shall inshAllah start off with medicine from tomorrow.
have to do GIT,Endo in medicine tomorrow.be with me Allah Mian.
also did psychiatry from CRUSH with a friend.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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settling down to do some IM.have to finish GIT and ENDO today.may Allah help me.
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| Ivonne
Find a way or make one
Topics: 57
Posts: 1,615
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Hi, thanks for info. You are doing great. Best of luck
___________________
"The question isn't who is going to let me; it's who is going to stop me. " ~ Ayn Rand
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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hey thanks Ivonne.i hope i manage to finish what i have planned for today.
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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watched gynae dvd 2 and finished GIT from kaplan.i hope i retain everything.
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| njcjzy
Forum Guru
Topics: 20
Posts: 740
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hi multi, you are making great progress! Keep reviewing all those you have learned, I believe you will get a dream score this time!
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| multifactorial
Forum Guru
Topics: 28
Posts: 546
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thanks njcjzy!you guys are so supportive that i work with more vigor and determination.thanks for all the encouragement.
going to sleep.only managed to do GIT from IM.may Allah Mian let me do more tomorrow.
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| neuroblastoma
Forum Guru
Topics: 101
Posts: 1,023
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hey buddy...you are doing awesome... you will do great this time..keep urself in track always.
when u plannaing to take exam again??
Goodluck..
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