Target for medical PG

13/11/2022

- Squamous cell carcinoma
⭐ Given Histopathological slide of verrucous lesions saw the keratin pearls /h***y pearls and atypical squamous cell
⭐ Express cytokeratins 1 and 10
⭐On examination everted margin of lesions
🌟SCC is second most skin cancer (m/c is BCC)
🌟Lesion are nodular, verrucous , papillomatous,ulcerate, everted edges,surrounded by inflamed ,indurated skin

Surgical excision is treatment of choice
🌟Risk factors for squamous cell carcinoma
👉UV exposure
👉Male s*x- due to more sun exposure
👉Environmental factors-
1. Psoralen and UVA (PUVA)
2. Physical agents such as ionizing radiation
3. Chemical agents such as arsenics
HPV-16 & 18
👉Immunosuppression
👉Smoking
👉Chronic nonhealing wounds, burn scars, and chronic dermatosis
👉Hereditary conditions such as xeroderma pigmentosum, epidermolysis bullosa, and oculo-cutaneous albinism
👉Premalignant conditions like actinic keratosis, Bowen's disease, erythroplasia of Queyrat

04/09/2022

💫must know GCS SCORE for all prospective

20/08/2022

🎯AIIMS MAY 17
TOPIC - Alopecia areata
👉It is a localised loss of scalp hair in round or oval area(patchy loss of hair) with no apparent Inflammation
👉Pathogenesis
1) autoimmunity attacks the hair follicles
(Alopecia areata may be protective against type 1DM)
2) genetic factors (*history of atopic disease)
👉 Presentation -
🌟Mostly young adults are affected, round or oval circumscribed patches of hair loss,
Scalp first affected site ,then beared , eyebrows and eyelashes can be involved
🌟 Exclamation mark hair ( these is diagnostic and characteristic -distal end is broader than proximal end )
It is seen at margin of hair loss area
🌟 Alopecia universalis - loss of total body hair
🌟 Characteristic feature is sparing of gray/white hair and preferantially affecting pigmented (black/brown) hair
*Going white overnight phenomenon (dramatic change in hair colour)
🌟 Nail involvement seen fine stippled pitting (10-15% ) also called hammer brass

👉 Treatment
Topics corticosteroid
*Topical minoxidil ( antihypertensive drug)
Topical psoralen +UV A

19/08/2022

💫important

17/08/2022

🎯 (JIPMER nov 2018)
👉Posterior dislocation of the left hip joint
🌟 X ray shows
👉 Loss of continuing of acetabulum to head of femur( break in shenton's line )
🌟 Shenton's line is drawn from medial border of the femoral neck to the superior border of the obturator foramen
👉femoral head displaced superiorly and laterally and out of acetabulum
👉Left femoral head appear slightly smaller than right and lesser trochanter is not visualised
👉 Limb is addicted and internally rotated pl

🌟 Posterior dislocation is the most common
🌟 Also known as dashboard injury
🌟 Typical deformity of flexion, adduction and internal rotation
🌟Marked shortening of limb
🌟 Head palpable in gluteal region is diagnostic and it rotates with rotation of limb
🌟 Vascular sign of narath (femoral artery pulsation will be feeble or even may not be palpable against the head of the femur).
👉 Complications -
🌟 Injury to sciatic nerve
🌟Avascular necrosis of femoral head

👉 Treatment -
🌟 Dislocation should be reduced by close reduction (Most of time)under general anaesthesia as soon as possible
🌟

🎯Om shanti 🎯

28/06/2022

🎯Topic- JNA
(PYQ- AIIMS 18,15)
👉 Juvenile nasopharyngeal angiofibroma
🌟Benign*,locally agressive, highly vascular tumor*
🌟 Blood supply of tumor from the internal maxillary artery*
🌟 Exclusively in male *,second decades (7-19) year
🌟 Testosterone dependent
🌟Site of origin- sphenopalatine foramen (bilobed or dumbbel shaped)
🌟 Vessel are just endothelial lined with no muscle coat *,
🌟No ability to contract and leads to
Severe and recurrent epistaxis * and cannot controlled by application of adrenaline and a potent vasoconstrictor
👉Staging -
1A- limited to pasterior nares
🌟1B- extension into one or more paranasal sinuses*
2A- minimal medial pterygomaxilary fossa
🌟2B- full occupation of pterygomaxilary fossa, antral sign , superior extension
2C- into cheek and temporal fossa
3- intracranial extension
C/F
🌟Nasal obstruction MC symptoms
👉Denasal speech,hyposmia,broadening of nasal bridge
🌟 Spontaneous profuse and recurrent epistaxis is 2nd MC Symptoms
👉CHL,serous otitis media due to Eustachian tube obstruction
👉 Proptosis,diplopia and diminished vision
🌟 Frog face deformity*, swelling of cheek and fullness of face
👉Trismus,bulge of parotid ,2,3,4,5,6 cranial nerve can involve
Investigation -
🌟Soft tissue lateral film of nasopharynx
🌟CT scan of head with contrast- IOC*
Antral sign or Holman-miller sign-anterio bowing of posterior wall of maxillary sinus
👉MRI, Carotid angiography for extention and feeding vessels
Treatment -
🌟 Surgical excision is treatment of choice*
🌟Preoperatively embolization and estrogen therapy or cryotherapy or radiotherapy reduce blood loss in surgery*
🌟Approaches- 1) transpalatine*
2)transmaxillary(le fort 1 )*
3)Extended lateral rhinotomy * via facial incision or degloving approches
Other -endoscolic ,infratemporal fossa,
Transpalatine+ sublabial(sardana approach)
🌟 Recurrence is not uncommon after surgery

27/06/2022

19/06/2022

✍ om Shanti ✍
💫Ocular signs