Syphilis characterized by 4 stages-primary ,secondary ,latent ,tertiary!!

 

Primary syphilis-PRAISE
P-painless lesion
R-regional lymphadenopathy
A-cArtilagenous consistency of lesion
... I-indurated lesion
S-single lesion
E-exudation with discharging serous fluid

Secondary-CAMP
C-condylomata lata
A-associated lesions(opthalmic,osseous,meningeal)
M-mucocutaneous lesion,mucous patches
P-pruritic papules

Latent-+ve serology;no clinical manifestation

Tertiary-CLASS
C-cardiovascular disorder
L-late benign sypillis(gummata)
A-asymptomatic nuerosyphilis
S-symptomatic nuerosyphillis

Systemic Lupus Erythematosus (SLE) diagnostic criteria

MD SOAP BRAIN

• Malar rash – butterfly rash, sparing of nasolabial folds
• Discoid rash – basement membrane involved, may cause scarring

• Serositis – pleuritis/pericarditis
• Oral ulcers
• Antinuclear antibody (ANA) – very sensitive test
• Photosensitivity – skin rash to sunlight

• Blood – haemolytic anaemia, leukopaenia, thrombocytopaenia
• Renal disorder – proteinuria and cell casts
• Arthritis – symmetrical, involving 2+ small or large peripheral joints
• Immunological disorder – anti-dsDNA
• Neurological – seizures, psychosis

American College of Rheumatology, 1997: requires 4 out of 11

Upper GI endoscopy indications

How Gastroenterology Doctors Visualise Inside The Duodenum

• Haematemesis
• Gastric biopsy (?cancer)
• Dyspepsia
• Vomiting, persistent
• Iron-deficiency anaemia
• Therapeutic e.g. banding, sclerotherapy, stent, laser therapy
• Duodenal biopsy

Dyspepsia symptoms

ALARM Symptoms

• Anaemia (iron deficiency)
• Loss of weight
• Anorexia
• Recent onset of progressive symptoms
• Melaena / haematemesis

• Swallowing difficulty

If dyspepsia and either >55yrs or ALARM Symptoms then ENDOSCOPY

Hyperkalaemia causes

7 A‘s

• Artifact

• Aldosterone antagonist

• Addison’s disease

• Acidosis

• ACE inhibitors

• Angiotensin receptor blocker

• Anti-inflammatory

Treatment (if >7mmol/L) is 10mL of 10% calcium gluconate IV over 1 minute; to stabilise the action potential of the cell membrane.

Ulcerative colitis treatment options

SAACS

• Steroids – oral prednisolone or IV hydrocortisone if severe
• 5-Aminosalicyclic acid (5-ASA) e.g. mesalazine, sulfasalazine
• Azathioprine (immunosuppressant)
• Cyclosporin (immunosuppressant)
• Surgery if perforation, cancer or poor response to medical therapy

Ulcerative colitis (UC) complications

How To Perform Gi Colonoscopy

• Haemorrhage
• Toxic megacolon
• Perforation / Pseudopolyps
• Gallstones / Gangrene
• Colorectal carcinoma (if extensive and lasting >10 years)

Ulcerative colitis (UC) features

ULCERS IN ABDomen

• Ulcers (mucosal and submucosal)
• Large intestine involved (rectum always involved)
• Clubbing of fingers
• Extra-intestinal manifestations (e.g. Erythema nodosum)
• Remnants of old ulcers (pseudopolyps)
• Stools bloody

• Inflamed, red granular mucosa/submucosa
• Neutrophil invasion

• Abscesses in crypts
• Biochemical markers of inflammation e.g. ESR raised
• Diarrhoea (esp. in pancolitis)

Target Cells

HOT LIPS

Haemoglobinopathy, Obs jaundice, Thallasaemia
Liver abscess, Iron def., Polycythaemia, Sideroblastic anaemia

Lymphoma treatment

Hodgkin’s Lymphoma
ABVD

• Adriamycin
• Bleomycin
• Vinblastine
• Dacarbazine

Non-Hodgkin’s Lymphoma
R-CHOP

• Rituximab
• Cyclophosphamide
• Hydroxydaunorubicin
• Oncovin (Vincristine)
• Prednisolone

Splenomegaly causes

CHINA

• Congestion – portal hypertension
• Haematological – haemolytic anaemia, sickle cell disease
• Infection – malaria, EBV, CMV, HIV
• Neoplasm – CML, myelofibrosis, lymphoma
• Autoimmune – RA, sarcoidosis, amyloidosis

Causes of Massive splenomegaly (three M’s):

• chronic Myeloid leukaemia
• Myelofibrosis
• Malaria

Nephrology

Chronic –vs- Acute renal disease SNAB
Small kidney, Neuropathy (periph), Anaemia, Bone disease

Chronic Renal Failure GLAD SHOP
Glomerulonephritis, Lupus, Analgesics, DM
Systemic vascular disease, Hypertension, Obstruction, Polycystic kidney disease

Nephrotic Syn GLADDER
Glomerulonephritis, SLE, DM, Eclampsia, Renal vein thrombosis

Unilateral palpable kidney Wilms HARP
Wilms, Hydronephrosis, Acute Renal Vein thrombosis, acute pylonephritis, Renal Cell Ca,
PKD, pyonephrosis

Guillain-Barre Syndrome

A- Acute , Ascending
B- Bilateral
C- cyto-albumin dissociation
D- Demyelination
E- Elevated protein count , EMG for accurate test
F- Flacid paralysis
G- Guillain-Barre
H- Hyporeflexia or absent 

CANCER, NINE WARNING SIGNS

CAUTION

C hange in blood bowel or bladder habits
Anemia (unexplained)
U nsual bleeding or discharge, Unexplained weight loss
T hickening or lump in breast or elsewhere
I ndigestion or difficulty in swallowing
O bvious change in wart or mole
N agging cough or hoarseness, No healing of sore.

Non GIT causes of Vomiting :

ABCDEFGHI:
Acute renal failure
Brain [increased ICP]
Cardiac [inferior MI]
DKA
Ears [labyrinthitis]
Foreign substances [Tylenol, theo, etc.]
Glaucoma
Hyperemesis gravidarum
Infection [pyelonephritis, meningitis]

Cardiovascular risk factors

FLASH BODIES:

Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking

Causes of gastric carcinoma:

JAPAN'S SHAME:

Japanese
A Blood group
Pernicious anemia
Anemia-chronic atrophic gastritis
Nitrates
Smoked,Salted food,Scurvy,Surgery gastric
H.pylori
Adenomatous polyp
Menetrier's disease:glanduar hyperplasia,

Drugs causing pancreatitis

 

GLAD Organ Pancreas iS Traumatised n Destroyed Very Much

Glucocorticoids
L-asparaginase
Alcohol
Diuretics
Ocp's
Pentamidine
Sulfonamides
Didanosine
Tetracyclines
Valproate
Methyldopa

WBC Count:

 

"Never Let Monkeys Eat Bananas"

"60, 30, 6, 3, 1"

Neutrophils 60%
Lymphocytes 30%
Monocytes 6%
Eosinophils 3%
Basophils 1%

Tabes Dorsalis features

DORSALIS:

Dorsal column degeneration
Orthopedic pain (Charcot joints)
Reflexes decreased (deep tendon)
Shooting pain
Argyll-Robertson pupils
Locomotor ataxia
Impaired proprioception
Syphilis