1. The document provides an overview of various topics in psychiatry, psychology, pharmacology, and related fields. It includes definitions of psychiatric disorders, assessment tools, prognostic factors, medications, and emergency situations.
2. Details are given for diagnostic criteria, symptoms, and management of conditions like delusions, obsessions, hallucinations, alcohol withdrawal, heroin toxicity, and autism spectrum disorder. Common psychiatric medications and their indications, side effects, and toxicities are also summarized.
3. The document briefly outlines areas like dermatology, radiology, forensic medicine, orthopedics, anesthesia, ophthalmology, ENT, and their associated topics in a condensed format.
An 18-year-old male presented with one week of high fever followed by three days of jaundice, vomiting, and abdominal pain, and six hours of unconsciousness. Physical examination found jaundice and hepatomegaly. Laboratory results showed elevated liver enzymes and hepatitis C positivity. The patient was diagnosed with acute fulminant viral hepatitis based on laboratory findings and treated supportively.
A 56-year-old Syrian woman presented with progressive brainstem and frontal syndrome symptoms. MRI showed a lesion in the lower midbrain along with smaller subcortical lesions. She developed coma but recovered consciousness with steroids, though remained with severe frontal deficits. The clinical picture is best explained by granulomatous angiitis of the nervous system.
A 23-year-old male presented with delayed developmental milestones, diminished vision since childhood, and poor genital development. Examination found short stature, obesity, polydactyly, retinal degeneration, and small testes. Investigations showed hypogonadism. He was diagnosed with Bardet-Biedl syndrome based on meeting diagnostic criteria of obesity, polydactyly, retinal degeneration, learning disabilities, and hypogonadism. This is a rare genetic disorder caused by defects in basal body and cilia function.
This patient presented with acute confusion, ataxia, and falls. She has a history of bipolar disorder treated with lithium. Initial workup showed encephalopathy of unclear etiology. Differential diagnoses include acute disseminated encephalomyelitis (ADEM), various autoimmune and paraneoplastic encephalitides, and lithium toxicity. ADEM is an autoimmune demyelinating condition often preceded by infection that presents with subcortical white matter lesions on MRI. Lithium intoxication can cause neurological symptoms including delirium, ataxia, and renal impairment. In rare cases, lithium toxicity can cause the syndrome of irreversible lithium-effectuated neurotoxicity (S
1. A 40-year-old man presented with left-sided weakness and slurred speech for 10 days. On examination, he had left hemiparesis and facial weakness. Brain CT showed ring-enhancing lesions. He tested positive for HIV and toxoplasma antibodies.
2. He was diagnosed with cerebral toxoplasmosis due to reactivated infection from his immunocompromised state due to HIV infection. He responded well to anti-toxoplasmosis treatment with pyrimethamine, sulfadiazine and steroids.
3. Toxoplasmosis is a common opportunistic infection in HIV patients that typically presents as multiple ring-enhancing brain lesions. Diagnosis involves
in this slide set, the author describes 3D in the elderly and how to diagnose each separately and diagnose them without getting confused. Useful for emergency physicians and internal medicine neuro students
Male gonadal function and dysfunction (male hypogonadism). Emphasis where made on the causes, types of male hypogonadism, diagnosis and treatment methods.
A 20-year-old male presented with headaches, double vision, difficulty swallowing and nasal regurgitation over the past 1-3 weeks. On examination, he had neck stiffness and multiple cranial nerve palsies. Imaging showed diffuse pachymeningeal enhancement and bilateral papilledema. Cerebrospinal fluid analysis was consistent with basal meningitis. He was started on antitubercular treatment but developed severe anemia and splenomegaly, and was ultimately diagnosed with acute lymphocytic leukemia involving the central nervous system.
An 18-year-old male presented with one week of high fever followed by three days of jaundice, vomiting, and abdominal pain, and six hours of unconsciousness. Physical examination found jaundice and hepatomegaly. Laboratory results showed elevated liver enzymes and hepatitis C positivity. The patient was diagnosed with acute fulminant viral hepatitis based on laboratory findings and treated supportively.
A 56-year-old Syrian woman presented with progressive brainstem and frontal syndrome symptoms. MRI showed a lesion in the lower midbrain along with smaller subcortical lesions. She developed coma but recovered consciousness with steroids, though remained with severe frontal deficits. The clinical picture is best explained by granulomatous angiitis of the nervous system.
A 23-year-old male presented with delayed developmental milestones, diminished vision since childhood, and poor genital development. Examination found short stature, obesity, polydactyly, retinal degeneration, and small testes. Investigations showed hypogonadism. He was diagnosed with Bardet-Biedl syndrome based on meeting diagnostic criteria of obesity, polydactyly, retinal degeneration, learning disabilities, and hypogonadism. This is a rare genetic disorder caused by defects in basal body and cilia function.
This patient presented with acute confusion, ataxia, and falls. She has a history of bipolar disorder treated with lithium. Initial workup showed encephalopathy of unclear etiology. Differential diagnoses include acute disseminated encephalomyelitis (ADEM), various autoimmune and paraneoplastic encephalitides, and lithium toxicity. ADEM is an autoimmune demyelinating condition often preceded by infection that presents with subcortical white matter lesions on MRI. Lithium intoxication can cause neurological symptoms including delirium, ataxia, and renal impairment. In rare cases, lithium toxicity can cause the syndrome of irreversible lithium-effectuated neurotoxicity (S
1. A 40-year-old man presented with left-sided weakness and slurred speech for 10 days. On examination, he had left hemiparesis and facial weakness. Brain CT showed ring-enhancing lesions. He tested positive for HIV and toxoplasma antibodies.
2. He was diagnosed with cerebral toxoplasmosis due to reactivated infection from his immunocompromised state due to HIV infection. He responded well to anti-toxoplasmosis treatment with pyrimethamine, sulfadiazine and steroids.
3. Toxoplasmosis is a common opportunistic infection in HIV patients that typically presents as multiple ring-enhancing brain lesions. Diagnosis involves
in this slide set, the author describes 3D in the elderly and how to diagnose each separately and diagnose them without getting confused. Useful for emergency physicians and internal medicine neuro students
Male gonadal function and dysfunction (male hypogonadism). Emphasis where made on the causes, types of male hypogonadism, diagnosis and treatment methods.
A 20-year-old male presented with headaches, double vision, difficulty swallowing and nasal regurgitation over the past 1-3 weeks. On examination, he had neck stiffness and multiple cranial nerve palsies. Imaging showed diffuse pachymeningeal enhancement and bilateral papilledema. Cerebrospinal fluid analysis was consistent with basal meningitis. He was started on antitubercular treatment but developed severe anemia and splenomegaly, and was ultimately diagnosed with acute lymphocytic leukemia involving the central nervous system.
This document presents a case of a 47-year-old male who presented with symptoms of falls, leg edema and pain, fatigue, headaches, shortness of breath, and weight gain. Laboratory tests found very high TSH levels consistent with severe hypothyroidism. The patient was diagnosed with myxedema coma, a life-threatening complication of longstanding, untreated hypothyroidism. Treatment for myxedema coma involves intensive care admission, parenteral thyroxine replacement, electrolyte management, and avoiding sedation to prevent further deterioration.
Precocious puberty can be caused by central or peripheral conditions. Central precocious puberty is gonadotropin dependent and caused by organic brain lesions or idiopathically. Peripheral precocious puberty is gonadotropin independent and caused by conditions like McCune-Albright syndrome or adrenal tumors. Hypothyroidism can also cause precocious puberty by elevating TSH levels and interacting with FSH receptors. Evaluation involves assessing pubertal progression, growth, hormonal levels, and imaging. Treatment depends on the underlying cause, and may involve surgery, medication like GnRH agonists, or treating the primary condition in cases of hypothyroidism.
This document discusses the evaluation of short stature in children. It begins by outlining the relevant history to obtain, including perinatal history, family history, past medical history, and systemic reviews. The physical examination focuses on assessing proportionate versus disproportionate short stature and examining for dysmorphic features or other abnormalities. Investigations outlined include bone age, hormonal assays, karyotyping, and tests to investigate for underlying chronic illnesses. Treatment involves treating any identified cause, such as growth hormone deficiency, as well as supportive measures like nutrition, vitamins, and psychological support.
Din Muhammad, a 65-year old laborer, presented with altered sensorium, fever, and a body temperature of 106 degrees for 1 day. He has a history of hypertension and diabetes. Initial examinations revealed an unconscious patient with abnormal vital signs. Laboratory investigations showed metabolic acidosis and elevated liver enzymes. Imaging showed diffuse brain edema. He was diagnosed with exertional heat stroke due to his profession involving sun exposure.
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease characterized by progressive supranuclear ophthalmoplegia, gait disturbance, postural instability, and cognitive and behavioral changes. It is caused by tau protein deposits in the brain and is the most common form of atypical parkinsonism. There is no cure for PSP and treatment aims to manage symptoms, though investigational therapies targeting tau are being explored. The prognosis is poor, with most patients becoming dependent within 3-4 years and median survival of 6-12 years after diagnosis.
Mr. Lewis, a 79-year-old retired man, is brought to the outpatient clinic by his wife due to memory problems making living with him difficult. Upon examination, Mr. Lewis scores poorly on memory tests indicating dementia. Investigations show cerebral atrophy consistent with Alzheimer's disease. He is started on donepezil but later develops delirium requiring admission. In the hospital he is found to have pneumonia and irregular heart rhythm treated with antibiotics and digoxin. Upon recovery, the ability for Mr. Lewis to return home safely is discussed considering his and his family's needs and preferences.
This patient presented with fever, headache, seizures and altered mental status. Examinations revealed neck rigidity and CSF analysis showed high protein and low sugar. Imaging studies were normal. While atypical for its presentation without white blood cells in CSF or focal deficits, a diagnosis of acute pyogenic meningitis was made given the clinical picture of fever, neck stiffness, and CSF profile. The patient ultimately succumbed to raised intracranial pressure and aspiration pneumonia.
The document describes a case of a 40-year-old male who presented with sudden weakness in both lower limbs for 4 hours. On examination, he had reduced tone, power and absent reflexes in both lower limbs. Investigations revealed hypokalemia of 1.3 meq/l. He was diagnosed with Bartter's syndrome type III based on hypokalemic metabolic alkalosis, hyperreninemic hyperaldosteronism and high urinary chloride and potassium levels. Intravenous potassium supplementation led to complete recovery.
This is a case presentation of a 12-year-old girl who presented with bilateral ptosis, facial weakness, difficulty swallowing, and some hearing impairment that developed over 7 years. Examinations and tests showed signs of bulbar motor neuron involvement but normal muscle enzymes and nerve conduction studies. A review of literature on spinal muscular atrophy types suggests this patient has Type I bulbar SMA, characterized by sensorineural deafness and slow progression of bulbar palsy and weakness. Genetic testing may help confirm the diagnosis. Supportive management focuses on physical therapy and assisted ventilation if needed.
Epilepsy and other seizure brain disorders were discussed. Generalized seizures are caused by near simultaneous activation of the entire cerebral cortex from an electrical discharge originating deep in the brain. Partial seizures are due to electrical discharges beginning in a localized brain region. Status epilepticus refers to prolonged seizure activity lasting more than 5 minutes or multiple seizures without regaining consciousness. Seizures have various types and presentations depending on their origin and spread in the brain. Physical examination, history, and diagnostic workup are important for evaluating patients presenting with seizures.
The patient is a 40-year-old female who presented with breathlessness, fatigue, arthralgia, weight loss, and swelling in the legs. Investigations revealed hypothyroidism, pulmonary hypertension, anemia, and signs of autoimmune disease. Over time she developed additional symptoms affecting multiple organs. Based on her symptoms and test results, she was diagnosed with POEMS syndrome, a rare paraneoplastic condition characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma proliferation, and skin changes. She was treated with steroids, thyroid medication, diuretics, and pain medications.
The document describes a case of a 47-year-old female patient presenting with generalized weakness, giddiness, and other symptoms. After extensive examination and testing, she was diagnosed with Polyglandular Syndrome Type 2 (Schmidt's Syndrome), which involves autoimmune failure of multiple endocrine glands. Key findings included hypothyroidism, adrenal insufficiency, hypogonadism, and anemia. She was started on hormone replacement therapy and other treatment.
This document presents the case of a 70-year-old man who presented with progressive left greater than right sensorineural hearing loss and gait instability over 3-4 months. His medical history includes diabetes, hypertension, COPD, prostate cancer, and a total colectomy. Physical exam revealed horizontal nystagmus to the left, decreased hearing on the left, and an inability to perform tandem gait. MRI showed diffuse hyperintense nodular lesions involving the cerebellum, brainstem, and spine. The differential diagnosis discussed includes neurosarcoidosis, metastatic disease, primary CNS tumors such as glioma, and leptomeningeal metastases.
This document provides guidance on evaluating and managing ill-appearing neonates in the emergency department. Key points include:
1) Treat all ill-appearing neonates for sepsis initially with antibiotics such as ampicillin and gentamicin until infection is ruled out. Perform diagnostic tests including blood cultures and lumbar puncture if stable.
2) Check bedside glucose in all ill-appearing neonates and treat hypoglycemia.
3) Consider various differential diagnoses remembered by the acronym "NEO SECRETS" including infections, inborn errors of metabolism, electrolyte abnormalities, etc.
4) Neonates presenting with bilious emesis require workup to rule out volvulus
This case presentation describes a 42-year-old man who presented with progressive weakness, spasticity, and pseudobulbar palsy in his upper and lower limbs over the past 6 months. Clinical examination revealed features of both upper and lower motor neuron involvement. Investigations including MRI, CSF analysis, and EMG were consistent with a diagnosis of motor neuron disease. The patient was found to be HIV positive. Given his clinical presentation and HIV status, he was diagnosed with HIV-associated generalized motor neuron disease. The pathogenesis of motor neuron disease in the context of HIV is not fully understood but may involve retroviral myelopathy or reactivation of endogenous retroviruses. Treatment involves continuation of HAART and supportive measures
a very concise , palatable guide to clinical practice in patients with cardiovascular disease in no more than 37 slide with each slide taking no more than half minute reading , surely you well like it , please leave us your impressions bellow this will encourage us .
A 20-year-old female presented with fever, abdominal pain, altered mental status, and was found to have a blood sugar level of 21.9 and temperature of 34 degrees. On examination, she had a blood pressure of 85/60, heart rate of 110, cool pale dry skin, and was alert. Key findings included anxious appearance, clear lung sounds, heart rate of 110, respiratory rate of 28, and labored breathing. Differential diagnoses included sepsis, diabetic ketoacidosis (DKA), and amphetamine use. Though amphetamines could affect insulin control, the presenting problems and further lab results at the emergency department make DKA the most likely diagnosis, potentially representing the first presentation of type 1
A 24-year-old male student with known sickle cell anemia presented with 4 days of generalized body pain, 2 days of fever, and 1 day of loss of consciousness. On examination, he was unconscious and tachycardic. Investigations showed anemia, leukocytosis, and thrombocytopenia. He was admitted to the ICU and treated for possible vaso-occlusive crisis or chest syndrome based on his history and exam findings. Brain CT was normal. He received blood transfusions and IV fluids and antibiotics, and was evaluated by neurology with no focal deficits found.
CapTechTalks Webinar Slides June 2024 Donovan Wright.pptxCapitolTechU
Slides from a Capitol Technology University webinar held June 20, 2024. The webinar featured Dr. Donovan Wright, presenting on the Department of Defense Digital Transformation.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
This document presents a case of a 47-year-old male who presented with symptoms of falls, leg edema and pain, fatigue, headaches, shortness of breath, and weight gain. Laboratory tests found very high TSH levels consistent with severe hypothyroidism. The patient was diagnosed with myxedema coma, a life-threatening complication of longstanding, untreated hypothyroidism. Treatment for myxedema coma involves intensive care admission, parenteral thyroxine replacement, electrolyte management, and avoiding sedation to prevent further deterioration.
Precocious puberty can be caused by central or peripheral conditions. Central precocious puberty is gonadotropin dependent and caused by organic brain lesions or idiopathically. Peripheral precocious puberty is gonadotropin independent and caused by conditions like McCune-Albright syndrome or adrenal tumors. Hypothyroidism can also cause precocious puberty by elevating TSH levels and interacting with FSH receptors. Evaluation involves assessing pubertal progression, growth, hormonal levels, and imaging. Treatment depends on the underlying cause, and may involve surgery, medication like GnRH agonists, or treating the primary condition in cases of hypothyroidism.
This document discusses the evaluation of short stature in children. It begins by outlining the relevant history to obtain, including perinatal history, family history, past medical history, and systemic reviews. The physical examination focuses on assessing proportionate versus disproportionate short stature and examining for dysmorphic features or other abnormalities. Investigations outlined include bone age, hormonal assays, karyotyping, and tests to investigate for underlying chronic illnesses. Treatment involves treating any identified cause, such as growth hormone deficiency, as well as supportive measures like nutrition, vitamins, and psychological support.
Din Muhammad, a 65-year old laborer, presented with altered sensorium, fever, and a body temperature of 106 degrees for 1 day. He has a history of hypertension and diabetes. Initial examinations revealed an unconscious patient with abnormal vital signs. Laboratory investigations showed metabolic acidosis and elevated liver enzymes. Imaging showed diffuse brain edema. He was diagnosed with exertional heat stroke due to his profession involving sun exposure.
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease characterized by progressive supranuclear ophthalmoplegia, gait disturbance, postural instability, and cognitive and behavioral changes. It is caused by tau protein deposits in the brain and is the most common form of atypical parkinsonism. There is no cure for PSP and treatment aims to manage symptoms, though investigational therapies targeting tau are being explored. The prognosis is poor, with most patients becoming dependent within 3-4 years and median survival of 6-12 years after diagnosis.
Mr. Lewis, a 79-year-old retired man, is brought to the outpatient clinic by his wife due to memory problems making living with him difficult. Upon examination, Mr. Lewis scores poorly on memory tests indicating dementia. Investigations show cerebral atrophy consistent with Alzheimer's disease. He is started on donepezil but later develops delirium requiring admission. In the hospital he is found to have pneumonia and irregular heart rhythm treated with antibiotics and digoxin. Upon recovery, the ability for Mr. Lewis to return home safely is discussed considering his and his family's needs and preferences.
This patient presented with fever, headache, seizures and altered mental status. Examinations revealed neck rigidity and CSF analysis showed high protein and low sugar. Imaging studies were normal. While atypical for its presentation without white blood cells in CSF or focal deficits, a diagnosis of acute pyogenic meningitis was made given the clinical picture of fever, neck stiffness, and CSF profile. The patient ultimately succumbed to raised intracranial pressure and aspiration pneumonia.
The document describes a case of a 40-year-old male who presented with sudden weakness in both lower limbs for 4 hours. On examination, he had reduced tone, power and absent reflexes in both lower limbs. Investigations revealed hypokalemia of 1.3 meq/l. He was diagnosed with Bartter's syndrome type III based on hypokalemic metabolic alkalosis, hyperreninemic hyperaldosteronism and high urinary chloride and potassium levels. Intravenous potassium supplementation led to complete recovery.
This is a case presentation of a 12-year-old girl who presented with bilateral ptosis, facial weakness, difficulty swallowing, and some hearing impairment that developed over 7 years. Examinations and tests showed signs of bulbar motor neuron involvement but normal muscle enzymes and nerve conduction studies. A review of literature on spinal muscular atrophy types suggests this patient has Type I bulbar SMA, characterized by sensorineural deafness and slow progression of bulbar palsy and weakness. Genetic testing may help confirm the diagnosis. Supportive management focuses on physical therapy and assisted ventilation if needed.
Epilepsy and other seizure brain disorders were discussed. Generalized seizures are caused by near simultaneous activation of the entire cerebral cortex from an electrical discharge originating deep in the brain. Partial seizures are due to electrical discharges beginning in a localized brain region. Status epilepticus refers to prolonged seizure activity lasting more than 5 minutes or multiple seizures without regaining consciousness. Seizures have various types and presentations depending on their origin and spread in the brain. Physical examination, history, and diagnostic workup are important for evaluating patients presenting with seizures.
The patient is a 40-year-old female who presented with breathlessness, fatigue, arthralgia, weight loss, and swelling in the legs. Investigations revealed hypothyroidism, pulmonary hypertension, anemia, and signs of autoimmune disease. Over time she developed additional symptoms affecting multiple organs. Based on her symptoms and test results, she was diagnosed with POEMS syndrome, a rare paraneoplastic condition characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma proliferation, and skin changes. She was treated with steroids, thyroid medication, diuretics, and pain medications.
The document describes a case of a 47-year-old female patient presenting with generalized weakness, giddiness, and other symptoms. After extensive examination and testing, she was diagnosed with Polyglandular Syndrome Type 2 (Schmidt's Syndrome), which involves autoimmune failure of multiple endocrine glands. Key findings included hypothyroidism, adrenal insufficiency, hypogonadism, and anemia. She was started on hormone replacement therapy and other treatment.
This document presents the case of a 70-year-old man who presented with progressive left greater than right sensorineural hearing loss and gait instability over 3-4 months. His medical history includes diabetes, hypertension, COPD, prostate cancer, and a total colectomy. Physical exam revealed horizontal nystagmus to the left, decreased hearing on the left, and an inability to perform tandem gait. MRI showed diffuse hyperintense nodular lesions involving the cerebellum, brainstem, and spine. The differential diagnosis discussed includes neurosarcoidosis, metastatic disease, primary CNS tumors such as glioma, and leptomeningeal metastases.
This document provides guidance on evaluating and managing ill-appearing neonates in the emergency department. Key points include:
1) Treat all ill-appearing neonates for sepsis initially with antibiotics such as ampicillin and gentamicin until infection is ruled out. Perform diagnostic tests including blood cultures and lumbar puncture if stable.
2) Check bedside glucose in all ill-appearing neonates and treat hypoglycemia.
3) Consider various differential diagnoses remembered by the acronym "NEO SECRETS" including infections, inborn errors of metabolism, electrolyte abnormalities, etc.
4) Neonates presenting with bilious emesis require workup to rule out volvulus
This case presentation describes a 42-year-old man who presented with progressive weakness, spasticity, and pseudobulbar palsy in his upper and lower limbs over the past 6 months. Clinical examination revealed features of both upper and lower motor neuron involvement. Investigations including MRI, CSF analysis, and EMG were consistent with a diagnosis of motor neuron disease. The patient was found to be HIV positive. Given his clinical presentation and HIV status, he was diagnosed with HIV-associated generalized motor neuron disease. The pathogenesis of motor neuron disease in the context of HIV is not fully understood but may involve retroviral myelopathy or reactivation of endogenous retroviruses. Treatment involves continuation of HAART and supportive measures
a very concise , palatable guide to clinical practice in patients with cardiovascular disease in no more than 37 slide with each slide taking no more than half minute reading , surely you well like it , please leave us your impressions bellow this will encourage us .
A 20-year-old female presented with fever, abdominal pain, altered mental status, and was found to have a blood sugar level of 21.9 and temperature of 34 degrees. On examination, she had a blood pressure of 85/60, heart rate of 110, cool pale dry skin, and was alert. Key findings included anxious appearance, clear lung sounds, heart rate of 110, respiratory rate of 28, and labored breathing. Differential diagnoses included sepsis, diabetic ketoacidosis (DKA), and amphetamine use. Though amphetamines could affect insulin control, the presenting problems and further lab results at the emergency department make DKA the most likely diagnosis, potentially representing the first presentation of type 1
A 24-year-old male student with known sickle cell anemia presented with 4 days of generalized body pain, 2 days of fever, and 1 day of loss of consciousness. On examination, he was unconscious and tachycardic. Investigations showed anemia, leukocytosis, and thrombocytopenia. He was admitted to the ICU and treated for possible vaso-occlusive crisis or chest syndrome based on his history and exam findings. Brain CT was normal. He received blood transfusions and IV fluids and antibiotics, and was evaluated by neurology with no focal deficits found.
CapTechTalks Webinar Slides June 2024 Donovan Wright.pptxCapitolTechU
Slides from a Capitol Technology University webinar held June 20, 2024. The webinar featured Dr. Donovan Wright, presenting on the Department of Defense Digital Transformation.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
A Free 200-Page eBook ~ Brain and Mind Exercise.pptxOH TEIK BIN
(A Free eBook comprising 3 Sets of Presentation of a selection of Puzzles, Brain Teasers and Thinking Problems to exercise both the mind and the Right and Left Brain. To help keep the mind and brain fit and healthy. Good for both the young and old alike.
Answers are given for all the puzzles and problems.)
With Metta,
Bro. Oh Teik Bin 🙏🤓🤔🥰
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
3. General Psychiatry
Delusion is a disorder of thought-
Obsession is a disorder of thought-
Hallucination is a disorder of-
MC delusion:
Capgras-
Fregoli -
DeClerembaut syndrome-
Othello syndrome-
Cotard syndrome-
Ganser syndrome-
Transference
MC obsession:
MC compulsion:
Association of OCD, anorexia:
ORIENTATION ATTENTION CONCENTRATION
Digit span test Serial 7 subtraction
OCD:
D-Displacement
U-Undoing
R-Reaction formation
I-Inhibition
I-Isolation of affect
CAGE:
SCOFF:
PANSS:
Confusion assessment method (CAM):
SPIKES:
PEARLS:
4. GOOD PROGNOSTIC FACTORS BAD PROGNOSTIC FACTORS
Acute onset Insidious onset
Advanced age at onset (>35 yrs) Early onset (<20 yrs)
Catatonic, paranoid subtype Simple, disorganised,
hebephrenic
Female sex Male sex
Prominent positive symptoms Prominent negative symptoms
Presence of affective symptoms Absence of affective symptoms
Family history of mood disorders Family history of schizophrenia
DOC:
RESISTANT: OCD-related disorders:
Hoarding disorder
Body dysmorphic D
Olfactory reference D
Body focused repetitive behavior D:
Trichotillomania
Excoriation D
AUTISM SPECTRUM DISORDER
-Social interaction impaired
-Repetitive behaviors
+/- Language delay
Vaccine:
Regression in girl >6mon:
Gene:
Drug:
Regression in any gender >2yrs:
Vs catalepsy
5. Psychi-pharmacology
-Max EPS :
AD
A
P
T
-Min EPS, Max metabolic s/e, DOC for refractory psychoses:
-Seizure, Myocarditis,Agranulocytosis :
-QT prolongation, Retinal pigmentation:
-PD induced psychosis DOC:
-Mc side effect of SSRI:
-SIADH, vivid dreams, dry mouth, sweating:
-SPARI:
-Serotonin modulator-5HT1A +, 1B PA, 1D, 3, 7-)
-Antidepressant of choice in pregnancy:
-Min sexual s/e:
-Min wt gain, sedation, Seizures in bulimic, Anti-smoking:
-Priapism:
-TCA toxicity DOC: Hemodialysis:
-Approved for Postpartum depression:
-Drugs with anti-suicide ability:
-Lecanemab:
5HT2A-:
5HT2c-:
31. Glaister-keene rods:
Posterolateral (4-7) hymenal tear:
Medicolegal autopsy, accused examination, emergency:
Res ipsa loquitor:
Doctrine of common knowledge:
Medical maloccurence:
Res Judicata:
Heat stroke:
Abrasion, Contusion, Laceration:
Haase, Morrison rule-
Ashley rule-
Durhan (Product test), Curren, Brawner-
Leading questions-
Superfetation VS Superfecundation:
Barberio test-
Paradoxical undressing-
Charring
Singeing
Blackening
Blisters+
Splashing+
Line of redness+
Ulcers+
Distinct
colouration +
Police inquest: Minimum rank
Sub-inspector-Sexual offences
Head constable-Others
Custodial death/ rape/ disappearance:
Dowry death:
Exhumation:
Sexual Assault case: Duties of doctor
1) Inform police
2) Consent for examination-Age:
3) Psychological counselling
4) Written refusal
5) Provide diagnosis and treatment
Time limit:
Vaginal swab-
Semen sample-
32.
33.
34. PELVIS
All large and wide in
females except:
O
S
A
Features Hanging Strangulation
Direction Oblique Transverse
Continuity Non- continuous Continuous
Level in the neck Above thyroid At or below thyroid
Base Pale, hard,
parchment-like
Soft and reddish
Hyoid fracture Abduction # Adduction #
Change Disease
Complete loss Burns, Celiac disease
Permanent impairment RT, Electrical injury, Leprosy,
Change in distance Acromegaly, Rickets
Ridge alteration Scleroderma, Eczema,
Acanthosis nigricans
SKULL
All large and wide in males except:
-F/P eminence
-Nasal aperture
-Female forehead, orbit, chin round
Putrefaction
delay:
Strychnine,
metallic poison,
Carbolic acid
PM caloricity:
Heat stroke
Pontine
hemorrhage
Sepsis
NOT BURNS
Canthardin
Priapism
Indian red scorpion –
Mesobuthus
Autonomic storm
DOC-
Tactile Hallucination CEA Garlic Odour:
35. CARRY NO RIGHT
No torniquet/incision/cautery/sucking/coffee/alcohol
R-Reassure
I-Immobilize
G-Go to
H-Hospital
T-Tell symptoms Neostigmine + Atropine:
Specific antidote: Polyvalent ASV: effective against Cobra,
Krait, Russel’s viper & Saw scaled viper Given within 4 hrs
41. COMPLICATIONS OF FRACTURES
Dyspnea, Confusion, Petechiae:
Hyperkalemia, hypocalcemia, decreased UO post limb trauma:
Wrist flexion leading to spontaneous extension of fingers:
Fasciotomy indication:
Last sign:
Pain and burning of hand with patchy osteoporosis:
H/o Massage:
Stoss therapy:
Supracondylar fracture displacement:
Gunstock deformity:
Fish-tail:
Dinner-fork: FOOSH in:
Order of correction:
Garden-spade: FOOSH in:
42. FABER:
Synovitis
Septic arthritis
Iliotibial band contracture
Anterior dislocation
FADIR:
TB hip arthritis
Posterior dislocation
Phemister’s triad:
Periarticular osteopenia
Erosions
Reduced joint space
O’Donogue triad:
MCL
ACL
Medial meniscus
Terrible triad of elbow:
Elbow dislocation
Radial head #
Coronoid #
BONE FORMATION:
ALP
Osteocalcin
Osteonectin
BONE RESORPTION:
Hydroxyproline
Hydroxylysine
Deoxypridinoline
TRAP
Telopeptide
43. Kites method – Followed
earlier
Ponseti method
now preferred
At birth Manipulation by mother
initial weeks
Manipulation and
cast
Change of cast Every 2 weeks Weekly
Correction order C-A-V-E C-AV-E
Fulcrum while
manipulating
Calcaneocuboid joint Head of talus
Duration of
treatment
6 - 9 months 6 - 8 weeks
50. MR
Depolarising, Hyperkalemia, RSI-
Most cardiostable-
Hoffman elimination(safe in RF/LF)- Byproduct-
Reversal- Sugammadex-
LA: Causing Hypertension:
Most cardiotoxic:
Max dose of lignocaine:
DOC for LAST:
MethHb:
IV anesthetic agents:
DOC for day care/ liver/ kidney/ neuroSx/TIVA/malignant hyperthermia, porphyria
Dissociative anesthesia, DOC in asthma, Cyanotic HD, Shock
CI in hypertension / epilepsy/ glaucoma
DOC in cardiac surgery, S/E Adrenal suppressant
DOC in hyperthyroidism, seizures
MAC 0.2
MAC 0.75
MAC 104
Blood/gas partition coefficient Min:
Max:
Concentration effect, second gas effect, diffusion hypoxia
51. MC circuit in spontaneous:
MC circuit in controlled:
Rate of breathing in CPR
Adults:
Children:
Neonates:
Epinephrine in ACLS:
60. Angle subtended by
topmost letter when
viewed from 6m:
It has 14 lines of 5
Sloan letter
optotypes in each
line in logarithmic
progression. The lines
are of equal difficulty,
and there is a
geometric
progression (LogMar)
in letter size.
70. SCM:
Digastric:
Meatal:
MC:
Indications of Simple Cortical
Mastoidectomy (Schwartz Operation)
CANAL WALL UP
Acute coalescent or masked
mastoiditis
Acute otitis media with reservoir sign
As a initial step to perform:
Endolymphatic sac surgery,
Decompression of facial nerve
Indications of Radical
Mastoidectomy=CANAL WALL DOWN
Residual cholesteatoma
Glomus tumour
Carcinoma middle ear
72. Hyperactive: Same side
Hypoactive: Opp side
Erosion of horizontal SCC
Fenestration surgery
Post-stapedectomy fistula
A false negative fistula :
A false positive fistula :