Myxoma

Diastolic gradient present in left atria and ventricle due to mitral stenosis (Absent in normal heart)
•MC in left Atria of females
•MC benign tumour of heart

Familial myxoma :-
Carney Syndrome
•Myxoma of Breast or skin
•Spotty pigmentation
•Endocrine overactivity

C/F :-
Renal artery/ coronary artery embolism
Examination:-
•Loud and split 1st heart sound
•P2 accentuated
•Tumour plop diastolic sound

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Osteoarthritis and Charcot's foot/joint

Joints involved in Osteoarthritis :-
• DIP (not involved in RA)
• PIP
• Only 1st CMC
• Doesn't involve MCP, wrist, CMC joints

D/d :-
•Charcoat's joint (loss of pain sensations and proprioception)

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Causes :-
TRICK LSD on Table
L - Leprosy
S - Syringomyelia
D - Diabetes Mellitus
Table - Tabes Dorsalis

•Findings in Charcoat's:-
1. Fragmentations
2. Eburnation
3. Osteophyte formation
4. Intraarticular loose bodies

C/F :-
Involves single joint
Joint become unstable
Crepitus

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Various cases of Charcoat's foot

Allergic Bronchopulmonary Aspergillosis

Characterised by :-
• Pre-existing Asthma
• Pulmonary Infiltrate
• Increased Eosinophils in blood
• Elevated serum IgE
• Central Bronchiectasis

Cause :-
•Hypersensitivity to Aspergillus Fumigatus

C/F :-
•Excessive mucus production (mucus plugs)
•Aspergillus doesn't invade the blood stream
•Development of Bronchiectasis

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Radiologic features :-
•B/L Flecting opacities (mainly in Upper lobe)
•Central Ring Shadows
•Tram track bronchial walls
• Finger in glove sign

Finger in glove sign

Finger in glove sign

Imp note :-
• Aspergilus Niger - Fungal ortis externa
• Cavitary lesions - Absent in ABPA
• Cavitary lesions with fungal balls - Aspergilloma

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Fungal ball evident

Cavitary lesion with fungal ball

Fungal corneal ulcer

Mode of infection
Mc vegetative mat. Crop leaf thorn

         Agent
        Mc  aspergillus fumigatus
        Candia albicans

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CF
Symptom.     less marked
Signs.            Very prominent

           Sign.    Trick.    non greyish feathery ring 
           Greyish white. 
           Margins  Feathery hyphyate
           Immune rings. wessely
           Non sterile

Tt
Doc for aspergillus  nataymcin
Doc for candida.       Ampho B

          Contraindications
          Topical   steroids

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Acanthosis Nigricans

     

Neck region

  Def
Hyperpigmentation

Colour - brown black velvety

            Location
            Body folds
            Axilla groin

            Armpit

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Age
Less than 40yr

           Histopathology
           Characteristic - paillomatosis +nt
           But.  Hypermelanosis  -nt

Association
trick  the (Da) HBO

      D - diabetes(insulin resistance)
      A- adenocarcinoma (gastric)
      H- hypothyroidism
      B - bloom syndrome
      O- obesity (MC)

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Arm pit region 

Atopic dermatitis

INFANT CHEEK 

Def
Pruritic disease

       Associated disease
        TRICK 3 allergies plus AHU (aaahuuu)

Allergic.  Rihinits
Allergic. Conjunctivitis
Allergies food

          A asthma
          H. Hayfever
          U. Urticaria

Age + location pattern
Infantile.      Facial lesion
Childhood.  Flexural lesion
Adult.           Lichenoid

          CF
          MC SYMPTOM  ITCHING
          Rash appears after scratching

Special
Morgan fold. - horizontal fold below lower eye lid

            Associated condition
TRICK HEAD KE UPPAR ANTENA PE HASSOGE

HEAD.        Head light sign
ANTENA    Antena  sign
HASSOGE. Hertoghe's sign

            Diagnosis.  Criteria
TRICK HEINKEN BEER PLUS RAJMA
HEINKEN.  HANIFIN
RAJMA.      RAJKA

            Major   pruritis
            Minor   dry skin plus Morgan fold

DENNY MORGAN FOLD 

Erythroderma

Def
Exfoliating dermatitis

                 Location
                 90% or more cutaneous surface

Causes 

TRICK
PLANE RED SORE BY DERMA DRUGS

PLANE.                 LICHEN PLANUS
RED.(RUBRA).     PITYRIASIS RUBRA
SORE.                   PSORIASIS
DERMA.               DERMATITIS
DRUGS.   .           GOLD PHENYTOIN PENICILLIN

                    TREATMENT
                    TOPICAL STEROID
                    ANTIHISTAMINICS

SYSTEMIC STEROID. In severe disease

Acritretin or methotrexate in psoriatic erythroderma

Trachoma

BOILED SAGO GRAIN FOLLICLES 

Def
Keratoconjunctivitis
Also k/a Egyptian opthalmia

         Causative agent
         Chamydia trachomatis
         Serotype A,B,Ba,C

CF
conjuctival signs
Pathognomonic -follicles(boiled sagograin) on bulbar conjuctiva
Papillary hyperplasia
Scarring (conjuctival) k/a ARLT's line

ARLT'S LINE 

            Corneal sign 

TRICK HARBAR PAN SE ULCER AUR OPACITY HOTTI

HARBAR.  HERBERT PITS ND FOLLICLES
PAN.           PANNUS
ULCER.      CORNEAL ULCER .
OPACITY.   CORNEAL OPACITY

            Complication
            Dryness nd blindness
            ENTROPION

Classification
Trick
TRACHOMA CALL ME BY MAC PHONE
1 Mccallan classification

             2 WHO classification (fisto)
             Folliular Intense Sarring Trichiasis Opacity

Bronchiectasis

• Permanent dilatation of bronchi and bronchioles
• Affects lower lobe on left side

Etiopathogenesis :-
• Obstruction
• Infection

C/F :-
• Cough and formation of tenacious sputum
• History of frequent bronchitis

Diagnosis :-
• HRCT - Investigation of choice
Airway dilatation - Tram track/Signet Ring sign
Lack of bronchial tapering
Tree in bud pattern

Conditions associated :-
TRICK - hey YOUNG Squeeze the ALLERGIC FIBROUS MAL INTO YELLOW KART.
Young syndrome
Pulmonary Sequestration
Allergic bronchopulmonary aspergillosis
Cystic fibrosis
Broncomalacia
Yellow nail syndrome
Kartagener syndrome

Complications :-
TRICK - PHERA
• Pericarditis
• Hemoptysis (massive)
• Empyema
• Respiratory failure
• Amyloidosis

Spring Catarrh

COBBLE STONE APPEARANCE 

Def
Allergic inflammation of conjunctiva

                   Also k/a
VERNAL OR WARM WEATHER keratoconjunctivitis

                 Season
                 Spring nd summer

Type
Type 1 hypersensitivity Rx (immediate type)

                 Age
                 4 to 20

CF
Marked itching
STRINGY ROPY DISCHARGE

                Clinical  TYPES
1 Palpebral. MC TYPE
   √ COBBLE STONE APPEARANCE

2 BULBAR FORM
    √ TRANTA'S. SPOT

TRANTA'S SPOT AROUND LIMBUS 

                CORNEAL SIGN
TRICK  SPRING ME PSEUDO BOW AUR SHIELD USE KRO

Pseudo      PSEUDOXANTRON
Shield.        SHIELD ULCER
BOW.          CUPID BOW

PSEUDOXANTRON (CUPID BOW) around LIMBUS 

                 T/t
Trick spring me mast ola cab me steroid le jaao

Mast.          Mast cell stabilizer
Ola.             Olapatadine
Steroid.      Steroids

ARDS / Shock Lung/ Acute Lung Injury

• Acute Diffuse Alveolar Injury
• Non Cardiogenic Pulmonary Edema

Diagnostic criteria :-
• Acute onset
• PaO2/FiO2 < 200mm of it
• Chest X-ray - B/L pulmonary infiltrate
• PCWP < 18mm hg

Pathophysiology :-
Exudative phase - Damage to capillary endothelium & type 1 and 2 alveolar cells -> Pulmonary edema -> 👇 compliance -> Stiff lung

C/F :-
• Type 1 Resp failure
• Coarse rales, Diffuse ronchi
• Right to left shunting
• Pulmonary hypertension

Diagnosis :-

B/L diffuse alveolar and reticular opacities

T/t :-
• Airway pressure release ventilation
• +ve end expiratory pressure

Supracondylar Humerus Fracture

Keypoints:-
• MC elbow # in Children.
• Cause - Hyperextension

Types:-
•Extension - MC
  Distal fragment is tilted posteriorly.

Garland Type 3 Fracture

•Flexion - Distal fragment tilted anteriorly.

CF:-
• S Shaped deformity.

S Shaped deformity

• 3 point bony relation maintained.

T/t:- Gartland classification
• Type1 - Immobilization
• Type2 - Percutaneous pinning
• Type3 - Open reduction and internal fixation

Complications:-
• Early:-
▪Injury to Brachial artery (may lead to         Volkmann's Ischemic Contracture).
▪ Median nerve injruy
• Late:-
▪Malunion (MC) which results in Gun Stock Deformity.

T/t for Gun Stock Deformity- Lateral close wedge osteotomy.

This is High Tibial Osteotomy
Similar to Lateral closed Wedge Osteotomy

▪Myositis Ossificans and elbow stiffness
▪Volkmann's Ischemic Contracture.

Garland Type 1 fracture

Anterior shoulder dislocation

Keypoints:-
•MC joint to dislocate - Shoulder
•MC shoulder dislocation - Anterior (Subcoracoid)

       Cause:-

       •Abduction, Ext rotation, Extension

CF:-

The resting position after dislocation:-

Abduction and external rotation

Squared off shoulder (R)

Tests:-

• TRICK Durga Called Hamilton for Biryani and Bandage.
 Durga - Dugas test
  Called - Callway test
   Hamilton - Hamilton test
    Biryani - Bryant test
     Bandage - Regiment badage test

      Complication:-
      •Axillary Nerve injury

T/t:-
•Kocher's maneuver - TEAM
T - Traction
E - External
A - Adduction
M - Medial rotaion of arm

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Hypopyon corneal ulcer

Causative organism
Staph. Strepto.

Gonococcal fungi
Puesdomonas Pneumococcal

         Special term
         Ulcer serpens  k/a ulcer caused by   Pneumococcus 

Nature of hypopyon
Bacterial         Sterile
Fungus.          Non sterile

          New
Reverse hypopyon k/a :silicon oil in ant.chamber

Overwear syndrome

Causative organism
MC pseudomonas  40% cases
2nd MC acanthamoeba

      Pathogenesis
      Oxygen availablity     -         Restricted
      Glucose utilisation      -        Reduced

CF
Watering
Photophobia

           Treatment
            Discontinuation of lens
            TopicalAntibiotics

Pityriasis alba

Def
Childhood Hypopigmetation

Age
6-12 yrs

Clinical features
White macules /patch
Scaling +nt

Location
Cheeks

Pattern
Reoccurance frequently

Treatment
Not required

Drug
Tacrolimus
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Vitiligo

Def:Absence of melanocytes
Lesion are nonpigmented

Cause
MC Genetic 20-30%
Antimelanocyte autoantibodies
Free radical accumulation

        Age
        MC 10 -30 yrs

Disease association
Trick      man become Mota(diabetic) by adding anemia

Man                 MEN
Motto(Mota)  hashimoto thyroiditis     
Diabetic          diabetes mellitus
Add the.         Addison dis.
Anemia          pernicious anemia

          CF:
          Hallmark depigmented macule

Location
Any part of body

       Pattern
       MC vitilgo vulgaris

Treatment
PUVA  mainstay     trick { vitiligo ka puvva)

        Drug
        Topical steroid
        Tacrolimus

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Hangman Fracture / C2 Pars Interarticularis Fractures

Keywords:-
• B/L fracture of pars Interarticularis of axis.
• Spondylolisthesis of axis over C3.
• 2nd MC type of axis fracture.

Cause:-
• Extension with distraction and hyper extension.

•Death is common.
•No neurological deficit.

T/t:-
• Successful healing of C2 spondylolisthesis is about 95%.
• Undisplaced fracture - Semi rigid orthosis
• Displaced fracture - Close reduction with Halo-vest.

Molluscum contagiousm

Causative agent 
•Pox virus

Finding
•Multiple pearly white papule
•Umbilicated centrally

Inclusion bodies
•Henderson Paterson bodies

Location
•MC face in children

Treatment
Curretage 
Electrocautery

Drug
Imiquimed

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Jefferson Fracture / Atlas Ring Fracture

Keyfeature:-
• Fracture of Ring Of Atlas.
• Axial compression fracture.
• Most common Fracture of Atlas.

Complications:-
• No neurological damage (except pain or loss of sensation in greater occipital nerve distribution).

Diagnosis:-
• X-ray features :-
> Open mouth view - Overhanging lateral masses of C1 on C2.

• CT is defining.

T/t:-
•Mainly conservative.
> Undisplaced but stable - Semirigid cervical collar / Halo-vest
> Unstable with transverse ligament rupture - Halotraction followed by halo-vest immobilization.
> Late instability/ Non union - atlanto axial arthrodesis and atlanto occipital fusion.

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