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9th bb
egophony present
following are sm findings in consolidtion
Signs of consolidation (alveolar exudate)
Dullness to percussion
Increased vocal tactile fremitus
Sound is transmitted well through alveolar consolidations.
Inspiratory crackles (air moving through exudate in the alveoli)
Egophony
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10th=aa
all discribed signs s/o brain death
brain-dead individual has no clinical evidence of brain function upon physical examination. This includes no response to pain and no cranial nerve reflexes. Reflexes include pupillary response (fixed pupils), oculocephalic reflex, corneal reflex, no response to the caloric reflex test and no spontaneous respirations and no EEG activity
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11th-CC
ace inhibitors decreases aldosteron and increases renin and bradykinin
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12==ee pralidoxime
13=during muscle contraction A band remains constant
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14-ee becoz PTT prolonged; BT prolonged; abnormal ristocetin
Classic von Willebrand disease (vWD)
Autosomal dominant disorder
Most common hereditary coagulation disorder
Pathogenesis
Decreased vWF and factor VIII:C activity
Clinical findings in vWD
Menorrhagia, epistaxis, easy bruisability
Association with angiodysplasia of the right colon.
Laboratory findings in vWD
Increased PTT and a normal PT
Increased bleeding time
Due a platelet adhesion defect
Abnormal ristocetin cofactor assay
Decreased vWF antigen
Decreased VIII:Ag and VIII:C activity
Treatment of vWD
Desmopressin acetate (increases vWF and VIII:C activity)
Oral contraceptive (estrogen has a similar action as desmopressin)
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15-- pic of cafe au lait spot
Neurofibromatosis type 1 (also known as "von Recklinghausen disease" is the most common form of NF, accounting for up to 90% of the cases. NF 1 has a disorder frequency of 1 in 3,000 making it more common than neurofibromatosis type 2, with a frequency of 1 in 45,000 people.
It occurs following the mutation of neurofibromin on chromosome 17q11.2. Neurofibromin is a tumor suppressor gene whose function is to inhibit the p21 ras oncoprotein.
In absence of this tumor suppressor's inhibitory control on the ras oncoprotein, cellular proliferation is erratic, and uncontrolled resulting in unbalanced cellular proliferation, and tumor development
The diagnosis of NF1 is made if any two of the following seven criteria are met:
1- Two or more neurofibromas on or under the skin or one plexiform neurofibroma (a large cluster of tumors involving multiple nerves); Neurofibromas are the subcutaneous bumps that are characteristic of the disease and increase in number with age.
2-Freckling of the groin or the axilla (arm pit).
3 =Café au lait spots (pigmented, light brown macules located on nerves, with a smooth edges("coast of California") birthmarks).
4-=Six or more measuring 5 mm in greatest diameter in prepubertal individuals and over 15 mm in greatest diameter in postpubertal individuals.
5=Skeletal abnormalities, such as sphenoid dysplasia or thinning of the cortex of the long bones of the body (i.e. bones of the leg, potentially resulting in bowing of the legs)
6=Lisch nodules (hamartomas of iris), freckling in the iris.
7=Tumors on the optic nerve, also known as an optic glioma.
8=Macrocephaly in 30-50% of the pediatric population without any hydrocephalus.[5]
9=Epilepsy (seizures)
10=Juvenile posterior lenticular opacity
NF 1 also increases the risk of tumor development, particularly, meningiomas, gliomas and pheochromocytomas.
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16- CC-- dresselers syndrome which is autoimmune
Rx with NSAIDS
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17 --e
Cysticercosis refers to tissue infection after exposure to eggs of Taenia solium, the pork tapeworm. The disease is spread via the fecal-oral route through contaminated food and water, and is primarily a food borne disease. After ingestion the eggs pass through the lumen of the intestine into the tissues and migrate preferentially to the brain and muscles.human is dead end intermediate host
Rx- albendazole
steriods to reduce brain oedema
and lifelong antiepileptics
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18- EE diagnosis septic shock
cytokines --TNF alpha and IL 1
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19--dd
X linked recessive the proband has affected band from mum and sister 2 also has same band .
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