CSF : TOTAL VOLUME:150ML
TOTAL SECRETION PER DAY :550 ML
TURNOVER :3-4 TIMES PER DAY
PRESSURE:5-15% .PH :7.33 ,ACIDIC COMPARED TO BLOOD PH, EXCEPTCLORIDE ALL OTHER ELECTROLYTES ARE LESS THAN THAT OF PLASMA
SECRETION: CHOROID PLEXUS :50%, VENTRICULAR WALLS :50%

FLOWS INTO SASPACE THROUGH :FORAMEN OF MEGENDIE AND LUSHKA
ABSORPTION : ARACHNOID VILLI :90%,CEREBRAL VENULES:10%

Psychiatry

IMP.Psychiatric Topics.
1) "ANXIETY---anxiety is usually viewed as repressed or forgotten -fear ,features--hyperventilation,cold extremities,palpitations,pupillary dilatation,…..ANXIETY NEUROSIS---acute restlessness & fear of impending doom , anti -anxiety effect--chlorpromazine,TCA,BZD.,"------------((5))

2) "COCAINE---coined by FREUD.,jet black pigmentation of tongue with tactile hallucination ,creeping sensation,COCAINE-BUGS---sensation of bugs crawling all over the body"-----------((5))

3) "DELIRIUM---illusions with loss of consciousness,acute delerium-impaired consciousness, visual hallucination, hyperactivity& Fragmentary Delusions,"-------------((5))

4) "FREUD---introduced ---Cocaine , Psychoanalysis , concept of ""SUPER-EGO"" , free association , "" OEDIPUS COMPLEX""--by sigmund freund"----------((5))

5) "ANOREXIA NERVOSA---amenorroea-100%,phobic avoidance of normal wt.,wt.loss seen,over perception of body image,self induced vomiting ,excessive exercise,evident psychosis,least characteristic--decreased physical activity,false-decreased appetite,"-----------((4))

6) "CANNABIS---medical purposes/uses-in-Epilepsy ,glaucoma,nausea,Flash black phenomenon,.CANNABIS ADDICTION---symptomatic,Rx not req.,JHAGNAN phenomenon seen,"-------------((4))

7) "DEFENSE MECHANISIMS---MATURE defense mech.-->Projection & Altruism,IMP.defense mech.-->Repression,RATIONALIZATION-->drinks due to quarrel with wife ,"------------((4))

8) "DELIRIUM TREMENS---altered cons. ,tremors & visual hallucinations ,DOC.-diazepam."---------((4))

9) "EGO---works on realitiy principle , EGO DEFENSE MECHANISMS---""undoing""-seen in--OCN, Picasso synd.--Sublimation, Projection , Conversion,Reaction formation, "-----------((4))

10) "FUGUE---& DISOCIATIVE FUGUE--- seen in Schizophrenia , hysteria,epilepsy,wandering purposefully with some amnesia, "-----------((4))

11) "KORSAKOFF'S PSYCHOSIS---long term memory loss ,fes.--loss of Intellectual function but preservation of memory, lack of insight, unable to understand the disability, it is a REVERSIBLE state, CONFABULATION seen,Rx--VIT.B1(THIAMINE)"-------------((4))

12) "MENTAL RETARDATION---commonest cause--Birth Asphyxia ( Intellectual deficiency ),MENTALLY ILL---commonest mental illness in Chlidren --Neuroses,"------------((4))

13) "NEUROSIS---defective childhood experiences & adjustments & mild mental disorder , NEUROTIC DISORDERS---Anxiety, Hysteria, Phobia, OCN, "-------------((4))

14) "BULIMIA NERVOSA---episodes of excessive&uncontrolled eating , carries teeth , inducing vomiting,"----------((3))

15) "CATATONIA---FES.-automatic obedience,cataplexy,negativism,is seen in Schizophrenia,CATATONIA STUPOROUS---waxy flexibility is characteristic."---------((3))

16) "CONFABULATION---making stories to fill up gaps in memory loss , seen in alcoholism ,korsakoff psychosis"--------((3))

17) "FLASH BACK PHENOMENON---seen in Cannabis , Psilocybin , LSD.,"---------((3))

18) "HYPERKINETIC DISORDER---LOW I.Q., low Attention SPAN, poor impulse control, increase in Anger outburst, DOC-AMPHETAMINE.,"------------((3))

19) "LSD--Flash Blacks & Bad Trips , LSD Intoxication--> panic,confusion,Hyperreflexia, "------------((3))

20) "NOCTURNAL ENURESIS---DOC.-Imipramine, occurs in Stage IV sleep , "------------((3))

21) "OPIOID WITHDRAWAL---Rx nonaddicting drug -->Clonidine is used, OPIUM WTHDRAWAL---fes.-Lacrimation"---------((3))

22) "ORGANIC BRAIN SYND.---Visual Hallucination, Disorientation seen , bender gestalt test"---------((3))

23) "PANIC DISORDERS---DOC.--Diazepam, sudden attacks of anxiety with fear"-----------((3))

24) "PSYCHOANALYSIS---coined by Freud , this Tech. Used in Hypnosis,"-------------((3))

25) "SUICIDAL TENDENCIES---least in married person, Due to Withdrawal from Cocaine,Amphetamine,Alcohol, SUICIDE---most prone among -Adolecscent Girls,"-----------
Psychiatry-Topics Asked more than Twice
1) "AKATHISIA---restlessness/irresitible urge to move about & increased motor activity,Rx-amantadine,benzhexol,propranolol,"----------((2))

2) "ALZHEMER'S DISORDER---Ach.-biochemical cause ,predisposing factors--down's synd.,head trauma,low edu.group,"---------((2))

3) "ANTIPSYCHOTICS---longacting -Fluphenazin,"----------((2))

4) "BEHAVIOUR---TYPE A---time urgency ,impatiency,hard driving ,career orientation,ambitiousness, COINED BY friedman & rosenman ,"---------((2))

5) "BEHAVIOR THERAPY---indicated for Phobia,cardinal elements--Systemic desensitization & Flooding,"----------((2))

6) "BUSPIRONE---anti-anxiolytic,newer NONSEDATIVE ,non hypnotic axiolytic,"---------(2)

7) "CLOZAPINE---assosiated with agranulocytosis , causes sialorrhyroea,"-----------(( 2))

8) "EEG---alpha waves--> awake & eyes closed ( stage I sleep) ( ATKD'S-MNEMONIC-B,,,,A1,T1K2,D34(NREM),,,B-REMS)"-----------((2))

9) "FEAR---due to abnormal experiences of childhood , over consciousness & excess perception of danger , least common in depressive psychosis ,"-----------((2))

10) "FLUOXETINE---mech. of action--inhibition of serotonin uptake , side-effect--Anxiety,loose stools,Nause is troublesome"-----------((2))

11) "GPI(GENERAL PARESIS OF INSANE) ---fes. Confabulation, Grandiose, Delusions, Mental deterioration, "-----------((2))

12) "HALLUCINOGENS---Cocaine, Mescaline, LSD, Phencyclidine, "----------((2))

13) "HALOPERIDOL----acute drug dystonia after> 1day, causes Akathesia , used in BALLISMUS aswell,"---------((2))

14) "HYPOCHONDRIASIS---Preoccupation with body diseases, Over conscious about some illness, "----------((2))

15) "IMPOTENCE---it is also seen in D.M., diff. Between psy.Impotence & Organic I.--is diagnosed by monitoring of Penile TUMESCENCE during sleep ,"-----------((2))

16) "INTELLIGENCE QUOTIENT---I.Q.= (mental age X 100)/ chronological age (%), I.Q. Test = Binet Stanfort Test"------------((2))

17) "NEUROLEPTICS---blood levels checked for toxicity , commonest side-effect--Sedation , "---------((2))

18) "OEDIPUS COMPLEX---coined by sigmund Freud, seen in boys 3-5yrs of age,"------------((2))

19) "PHENOTHIAZINEs---involuntary perioral movement , used in Rx of depression , tardive dyskinesia is the side-effect,"------------((2))

20) POST-TRAUMATIC STRESS DISORDER---most common after major life threatening event/ e.g. any CAR accident,rape,earthquake,.. etc.-----------((2))

21) "PREMATURE EJACULATION --- Rx-SQUEEZE Technique, "------------((2))

22) "PSYCHONEUROSIS---diagnosis by VERBAL ACCOUNTS.,"------------((2))

23) "PSYCHOSOMATIC DISORDERS---e.g.--HTN,Peptic Ulcer disease, Bronchial Asthama, Hyperventilation"------------((2))

24) "THOUGHT---DISORDERS--loosening of Association, THOUGHT INSERTION---this is SCHEIDNER'S FIRST RANK SYMP."--------------((2))

25) "WITHDRAWAL SYMP.---PHYSICAL--absent-in Cannabis, Present in Pethidine,Opium,Haloperidol,Alcohol, Rx required in for withdrawal symp.--Cannabis, Cocaine,Alcohol,"-----


















1) ABREACTION---used in Rx of phobia,-----------((1))

2) "AFFECT---disorders of affect , disturbances of affect--panic , apathy , phobia,"---------((1))

3) "AFFECTIVE DISORDERS---depression ,reaction form'n ,adjustment reaction ,"-------((1))

4) "AGGRESSION ---PASSIVE AGG.--spills half,"-------((1))

5) "AGORAPHOBIA---fear of open spaces , DOC.--alprazolam,"-------((1))

6) "ALEXITHYMIA---inability to recognize & describe feelings,"--------((1))

7) "AMBIVALENCE---coined by EUGEN BLEULER,"---------(1))

8) "AMNESIA---anterograde amnesia--caused by giving ECT.,good prognostic indicator of head injury.,"---------((1))

9) "AMOTIVATIONAL SYNDROME---seen in cannabis,"------((1))

10) "AMOXAPINE---antidepressant with side effects like -tardive dyskinesia & neuroleptic malignant synd.,"-------((1))

11) AMPHETAMINES--- ,-----((1))

12) "ATTENTION DEFICIT DISORDER---seen with phenobarbitone ,"--------((1))

13) "AUTISTIC DISORDER---lesion is in Temporal lobe ,"-------((1))

14) "BALLISMUS---Rx haloperidol ,"-------((1))

15) "CHLORPROMAZINE---?rigidity,mask like face,tremors,(uses/side effects),"------(1))

16) "CLAUSTROPHBIA---fear of CLOSED spaces ,"-------((1))

17) "COGNITVE BEHAVIORAL THERAPY---is the Rx for Depression ,"-------((1))

18) "COPROLALIA---seen in TOURETTE'S SYND.,"-------((1))

19) CYCLOSERINE---anti -TB.-shows NeuroPsychiatric manifestation,--------((1))

20) "DÉJÀ VU---seen in normal persion ,temporal lobe epilepsy,psychosis,"--------((1))

21) DISORIENTATION---seen in Organic brain synd.,------------((1))

22) Diethyl Propion---1st. Choice in wt. reduction prog.,---------((1))

23) "DRUG DEPENDENCE---is due to withdrawal symptoms ,"---------((1))

24) "EXHIBITIONISM---shameless exposure of genitals ,"-------((1))

25) "FETISHISM---obtaining Sexual excitement with inanimate objects , "--------((1))

26) FREE ASSOCIATION---coined by FREUD.,------((1))

27) "GANSER'S SYND.---inappropriate answer...... , "--------------((1))

28) HASHISH---active substance—TetraHydroCannabinol,----------((1))

29) "HEROIN---withdrawal fes.--Yawing, muscle cramps, Hypersomnia, HTN.,"---------((1))

30) "HICCOUGH---Intractable--DOC-chlorpromazine/Largactil , "--------((1))

31) ILLUSIONS---,------((1))

32) "IMIPRAMINE---antidepressant ,DOC--in nocturnal enuresis , "--------((1))

33) INSOMNIA---Familial Fatal Insomnia--seen in PRION disease,-------((1))

34) KLEPTOMANIA---Irresistible ure to STEAL things of LITTLE value,---------((1))

35) "La Belle Indifference---seen in Dissociative disorders ,"--------((1))

36) LUCID INTERVAL---seen in INSANITY,------------((1))

37) least addictive---DihyroxyPropoxyphene,-----------((1))

38) MAOIS---induced hypertensive crisis-Rx-->reversed with Phentolamine,----------((1))

39) "MANDRAX---is combination of HYPNOTIC + ANTI-HISTAMINE,"----------((1))

40) "MASOCHISM---sexual partner are aroused & gratified by whipping ,"------------((1))

41) "MEMORY---RECENT--CENTRE--HIPPOCAMPUS ,"-------------((1))

42) "METHADONE---used in maintainance of Rx of opium dependence/ ?Withdrawal ,"-------------((1))

43) "MORPHINE---addiction , Withdrawal is done with Clonidine ,"---------------((1))

44) MYXEDEMA---ass. with depression ,-----------((1))

45) "MUNCHAUSEN SYND.---factitious disorder ,"---------((1))

46) "NARCOLEPSY---symp.--Cataplexy , Sleep acttacks, Sleep paralysis, "-----------((1))

47) "NIGHT TERRORS-seen in NREM sleep--TOC.-clonazepam,"-------------((1))

48) "NYMPHOMANIA---not a compulsive & habit forming disorder , "---------((1))

49) ORGANIC AMNESTIC SYND.---most common cause—Concussion,----------((1))

50) OTHELLO SYND.---Delusion of Infidelity on part of Sexual partner,-----------((1))

51) PARANOID DISORDER---Pseudocommunity,---------((1))

52) PERSONALITY DISORDERS---BORDERLINE-sucidal tendencies,--------((1))

53) PHENCYCLIDINE---ass. With DEPERSONALISATION,-----------((1))

54) "PICASSO SYND.---painter obsession developed into artistic painting, "--------((1))

55) PROJECTION---mature defense mech.,---?---------((1))

56) "PSYCHIATRIC MANIFESTATION---seen in Hypothyroidism, Hyperthyroidism, Acute Intermittent Porphyria, Inability for Erection, Inability to take deep breath , Pain,"--------((1))

57) "PSYCHOTHERAPY---PSYCHOANALYTICAL---Insight therapy, Behavioral therapy & SUPPORTIVE therapy, "--------------((1))

58) PUNISHMENT---inflicting pain to get rid of a bad habit ,--------------((1))

59) "PUNCH DRUNKENNESS ---is ass. With BOXING.,"--------------((1))

61) REINFORCEMENT---+ve R.-? Conditioned learning,----------------((1))

60) BRIEF REACTIVE PSYCHOSIS---after loss of loved-one's,--------------((1))

62) "SLEEP DEPRIVATION---leads to decreased mental altertness,"----------((1))

63) SLEEP-WALKING-somnabulism--seen in NREM STAGE 3/4 Sleep,-------(1))

64) "STUPOR---DEPRESSIVE--loss of power in all 4 limbs, Waxy Flexibility of muscle tone in limbs,"-------------((1))

65) "SUPERSTITION---a False belief unexplained by reality ( Shared by a number of persons/people ) ,"---------((1))

66) SUPER-EGO---coined by Sigmund Freund,--------((1))

67) "TARDIVE DYSKINESIA---due to Reserpine,HALOPERIDOL,"--------((1))

68) "THINKING---ABSTRACT--similarity between chair & table->both has 4 legs,"-------((1))

69) "THIORIDAZINE---side-effect--Pigmentary Retinopathy,"--------((1))

70) "THERMATIC PERCEPTION TEST---by Wechslers , "---------((1))

71) WERNICKE'S ENCEPHALOPATHY----Rx-Thiamine supplement,---------((1))

72) EIGHT STAGE CLASSIFICATION OF HUMAN LIFE---BY ERIKSON ,-------











3) "MOOD DISORDERS---seen in Schizoid state , MANIA---is a mood disorder, fes.--Mood Congruent delution, Delution of Grandeur, Neologism characteristic, Euphoria, Suicidal tendencies, pressure of Speech, Insomnia, Basic disturbance--ELATION, ass. With Good Humour, Physical Overactivity,

Rx of acute mania--is Lithium, drugs used--Haloperidol, Lithium,Carbamazepine,Chlorpromazine

4) "OBSESSIVE COMPULSIVE DISORDER/ NEUROSIS---characterised by Eleborate, checking, Repeated hand washing, Execessive Slowness, Irresistant Irrational behavior ,
Fixed at ANAL Stage, Persistance Irrational thought resisting the Data.
Mostcommon complication--is Depression

DOC.-Clomipramine, Rx-Dugs+Behavior therapy.
Rx of severe intractable OCN--is Cingulotomy, DOC.-Fluoxetine, DOC(OCN)--Imipramine"

5) "DELUSIONAL DISORDERS---DEF.-firm false /unshakeable belief ,seen in schizophrenia, mania, delirium, psychosis,psychotic depression ,it is comprehensible.
It is a Disorder of THINKING, MOOD CONGUENT DELUSIONS--MANIA & DEPRESSION ,DELUSION-OF-PERSECUTION---seen in schizophrenia.,"

6) "HALLUCINATIONS---disorder of false perception,
Visual hallucinations--seen in Alcoholism & Organic brain synd./lesion,
Auditory H.--seen in Schizophrenia, Mania, Amphetamine toxicity
Hypnagogic H.--arises when a pt. is falling a sleep"------------((12))

7) "ALCOHOL—
morbid jealously seen,ALCOHOL WITHDRAWAL SYND.
DOC.-chordiazepoxide,early morning drinking ,delirium,secretiveness about the amount taken,obessions,delusions,tremulousness,hallucination,hyperactive state,amnestic disorder,delirium tremens,epileptic seizures,
ALCOHOL ADDICTION---direct evidence-withdrawal symptoms,
ALCOHOLIC BLACK-OUTS-chare. by amnesia for events during drinking. ALCOHOLIC HALLUCINATIONS---occurs within 24hrs.of alcohol intake. ALCOHOLISM---auditory hallucinations,visual hallucinations,delirium ,&amnestic reaction."--------------((11))

8) "ECT / ELECTROCONVULSIVE THERAPY---
CI--in Brain Tumour ,Pergnancy ,Absolutely CI-in-increased ICT.
commonest side-effect--Amnesia,it is used in the Rx--of depression with sucidal - -tendencies, Req.>80Mvolts,
memory disturbance-recovers in few days to few wks.,antegrade amnesia of short duration occurs after ECT.
ECT is not useful in Rx of acute & chronic Schizophrenia, Unilateral ECT--less memory disturbance ,

9) "LITHIUM---Prophylactic Rx-MDP(manic depressive psychosis),used for Rx of Mood disorders,used in prophylaxis-Bipolar MDP,commonest symp.of lithium toxicity --is POLYURIA,chronic use of lithium--> HYPOTHYROIDISM, side-effects--hypothyroidism,Leucocytosis,Polyuria, Organs affected in Lithium toxicity--are Brain,Heart,Kidney(but not liver), Serum Li2+ levels=0.7-1.2meq/l , Lithium induced tremors--Rx Propranolol , "--------------((11))

10) "DEMENTIA---head injury, alzheimer's,huntington's chorea, multiple infarctions,deficiency of Niacin, Fes.--impaired memory, loss of judgment, loss of learned function,, Reversible cause--post encephalitis,Common in old age >60yrs. SUBCORTICAL DEMENTIA---Tactile agnosia,causes-parkinsonism,wilson's disease ,huntington's chorea,"-------------((10))

11) "PHOBIAS---is a type of neurosis, AGORAPHOBIA--Fear of OPEN Places, Animal Phobia--occurs at 8yrs. Of age, SOCIAL Phobia--Fear of public/seniors, IRRATIONAL Fear of Normal Instances,
Mx--Systemic Desensitization, Rx--Behavioural Therapy & Flooding , "-------------((10))

12) "PSYCHOSIS---Acute<2wks., auditory Hallucination seen, Major Psychosis--Endogeneous depression, Acceptance of other persons delusion-is the characteristis fes., ORGANIC Psychosis--Disorientation in time ,place,&person, Clouding of consciousness, Hallucination, Itellectual Impairment, Loss of insight, Rx-drugs used--Chlorpromazine,PUERPERAL Psychosis---, PSYCHOTIC DISORDERS---Schizophrenia, Mania, Psychotic depression"---------------((10))

13) "DISSOCIATIVE DISORDER---loss of Memory of all modalities , DISSOCIATION---seen in Fugue,Multiple personalities , Hysterical conversion, Somnabulism, dissociation hysteria leads to Amnesia , "----------((7))

14) "HYSTERIA---commonest symp.--motor or sensory phenomenon, Fixation of Hysteria--occurs at Phallic stage, uncommon symp.-Palpitation, Hysterical Somatization--Hemiplegia, Blindness, Fugue, Normal Intelligence, Rx--Psychoanalysis ,HYSTERICAL FITS---diff.fromm that of Epileptic Fits --Hyst.Fits occurs when people are Wachting , Incontinence of urine occurs,"--------------((7))

15) "TCA---ANTIDEPRESSANTS---TCA overdose-Rx-amitryptilline,safest TCA in HTN-Fluoxetine, TCA are CI. in angle closure glaucoma, Indications-gastric ulcer,depression,anxiety,…TCA adversly interact with Trnaylcypromine , TCA-causing Tardive dyskinesia-is-AMOXAPINE, side effects of TCA--metallic taste,dry mouth,epigastric discomfort,"

Acrophobia- Fear of heights. Hypsiphobia- Fear of height.
Agliophobia/Algophobia- Fear of pain.
Agoraphobia- Fear of open spaces or of being in crowded, public places like markets. Fear of leaving a safe place.
Automysophobia- Fear of being dirty.

Claustrophobia- Fear of confined spaces.
Cleptophobia- Fear of stealing.Kleptophobia- Fear of stealing.

Didaskaleinophobia- Fear of going to school.

Gerascophobia- Fear of growing old.
Glossophobia- Fear of speaking in public or of trying to speak.

Hydrophobia- Fear of water or of rabies.Hydrophobophobia- Fear of rabies.

Iatrophobia- Fear of going to the doctor or of doctors.

Kosmikophobia: Fear of cosmic phenomenon

Paraskavedekatriaphobia- Fear of Friday the 13th.
Phasmophobia- Fear of ghosts.

Sciophobia: Fear of shadows

Thanatophobia or Thantophobia- Fear of death or dying.

Xanthophobia- Fear of the color yellow or the word yellow

Zelophobia- Fear of jealousy.
Zoophobia- Fear of animals.
Most IMP. Psychiatry Topics
1) "SCHIZOPHRENIA(SP).----

Fes.--Thought Alienation, Thought Insertion & Broadcasting, Suspiciousness, Conspire against him, Hallucination of VOICES, Paranoid Delusion, Passivity, Delusions in CLEAR CONSCIOUSNESS, Los of insight occurs ,-ve Symp ,
Auditory H ,Visual H. ,Delusions of persecution, Increased Psychomotor activity,AMBIVALENCE-seen,Personality deterioration seen, Delusion of Presentation, Delusions of Reference, Delusion of Control,waxy flexibility,Fes. of Affect seen, NIHILISTIC IDEAS seen.

FIRST RANK SYMP.--Thought Insertion, Delusion of Perception, Hallucination, Thought Alienation phenomenon, ass. with ASTHENIC personalities

SP.is a side-effect of Amphetamine, Incidence in India 5-10 per1000,
Most common /Pathognomonic Hallucination--AUDITORY H., auditory H.-commanding the pt., Autism,Ass.Defect,Ambivalence,Cortisone,&ACTH-causes SP.

Prognosis of SP.is improved by/Good prognosis is due to->ATYPICAL SYMP.
Neurotransmittors involved are =PGE1,NorEpinephrine,5-HT, DOPAMINE is also found in increased quantity, Early SP.-resembles Anxiety neurosis, SP.is more common in low socioeconomic group/class, good prognosis is indicated by Early Onset, alsp good prognosis--is seen in Affective disorder, BLEULER'S Emphasis--is on Flattened affect, Loose associations, Ambivalence,

Rx of SP. ---DOC--FLUPHENAZINE, /Rx of Auditory H.-CLOZAPINE, /
Rx of Chronic Resistant SP.-CLOZAPINE,

CATATONIC SP. --- Grimacing , Defect in Conation, First symp. to disappear after Rx/Symp. with Best prognosis--Auditory H., C.SP.-mostly occurs in Adolescents, Fes.--Mannerism, Increased Psychomotor activity ,Rigidity, Negativism, Waxy flexibility,Echolalia is also seen,

HEBEPHRENIC SP--BAD/WORST Prognosis, Gross disorganiza/severe deterioration

PARANOID SP -Caused by Amphetamine, GOOD PROGNOSIS & LATE ONSET, Psychosis due to chronic amphetamine intake-resembles->SP."-----------((47))

2) "DEPRESSION---most common D.-post partum psychosis.
--pseudodementia seen in D by drugs --Methyldopa,Reserpine,O.C.pills,Propranolol,
Rx of acute D.->ECT.
Neurotransmittor Involved is =GABA & DOPAMINE,due to DEFICIENCY OF 5HT.

MAJOR D.-- death of loved person,UNIPOLAR MAJOR D.--more common in females, Lithium carbonate -least likely to cause serious D.

NEUROTIC D.-- commonest psychiatric illness in INDIA, Ravenous appetite , INCREASED libido , common risk is-Fatigablity ,NIHILISTIC DELUSIONS & early morning Insomnia
,
ENDOGENOUS D.---middle age 40-60 yrs.,sucidal tendecy most common,
Rx.of D.--Cognitive Theraphy ,DOC.-imipramine
DOC.for Rapid cyclers in Bipolar illness--valproic acid / Carbamazepine . DOC.for D.+CAD(coronary artery disease)--is-MIANSERIN."-------------((20))

Radiology

ROENTGEN SIGNS OF LYMPHATIC CHANNEL OBSTRUCTION

1. Backflow
2. Collateral circulation
3. Dilatation of lymph vessels
4. Extravasation
5. Stasis of lymph flow


LEFT TO RIGHT SHUNT IN CONGENITAL HEART DISEASE

1. Atrial septal defect (ASD)
2. Atrioventricular (AV) canal defect, partial or complete
3. Patent ductus arteriosus (PDA)
4. Ventricular septal defect (VSD)


RIGHT-TO-LEFT SHUNT CONGENITAL HEART DISEASE

1. APVC, total (above the diaphragm)
2. Double outlet right ventricle (DORV)
3. Left to right shunt progressing to reversal or high resistance vascularity (Eisenmenger Physiology )
4. Tetralogy of Fallot
5. Transposition of great vessels
6. Tricuspid atresia
7. Truncus arteriosus


TYPES OF DEXTROCARDIA

1. Situs inversus (all visceral organs opposite of normal; slightly increased incidence of cardiac anomalies in 5% to 10% of patients)

2. Dextroposition with situs solitus (cardiac apex displaced into right hemithorax—e.g., hypoplasia of right lung; venolobar S.)

3. Dextroversion with situs solitus (anatomic relations are normal, but cardiac apex is in right side of chest—due to abnormal rotation of embryonic cardiac loop)

4. Dextrocardia with situs ambiguus in asplenia S. (bilateral right-sidedness—absent spleen; three lobes in each lung; left lobe of liver same size as right lobe; malrotation of bowel; cardiac apex in either hemithorax—cardiac anomalies include common atrium; single ventricle; PS; transposition of great vessels; and TAPVR)

5. Dextrocardia with situs ambiguus in polysplenia S. (bilateral left-sidedness—each lung has two lobes; hepatic segment of IVC is absent; cardiac apex is in right hemithorax in 50% of patients—cardiac anomalies include ASD; PAPVR; and interruption of IVC with azygos continuation)


COMPLICATIONS OF MYOCARDIAL INFARCTION REQUIRING RADIOLOGICAL EVALUATION

1. Heart failure
2. Left ventricular aneurysm
3. Pericardial effusion
4. Ruptured interventricular septum
5. Ruptured papillary muscle


COMMON CARDIAC CONDITIONS DIAGNOSED BY ECHOCARDIOGRAPHY

1. Aortic stenosis or insufficiency
2. Bacterial endocarditis
3. Cardiac tumor (esp. myxoma of LA)
4. IHSS
5. Mitral stenosis or insufficiency
6. Mitral valve prolapse (MVP)
7. Myocardiopathy
8. Pericardial effusion
9. Shunts (with evaluation of flow and direction by pulsed Doppler)


COMPLICATIONS OF CENTRAL VENOUS (SUBCLAVIAN, JUGULAR) OR PULMONARY ARTERY CATHETERIZATION

1. Arterial insertion with perforation (esp. subclavian or carotid artery)
2. Catheter embolism; broken, trapped, or occluded catheter
3. Extravascular infusion (e.g., mediastinal; intrapleural; subcutaneous)
4. Infection (local or sepsis)
5. Malpositioned or dislodged catheter (e.g., in RV, IVC, hepatic vein, jugular vein)
6. Perforation of vessel with hematoma, hemothorax, hydrothorax, hemopericardium, or hemomediastinum
7. Pneumothorax
8. Thrombosis (e.g., SVC); thrombophlebitis; pulmonary thromboembolism


ROENTGEN SIGNS OF ALVEOLAR DISEASE (CONSOLIDATION, AIR SPACE PATTERN)

1. Acinar or peribronchiolar nodules
2. Air alveologram and bronchiologram
3. Air bronchogram
4. Butterfly or “bat’s wing” distribution
5. Coalescence (early)
6. Fluffy, ill-defined margins
7. Perihilar, diffuse, segmental or lobar distribution
8. Present soon after onset of symptoms; rapid change


REVERSE BUTTERFLY PATTERN

1. ARDS
2. Contusion of lung
3. Eosinophilic pneumonia (PIE; Löffler syndrome)
4. Pneumonia
5. Sarcoidosis


ROENTGEN PATTERNS OF INTERSTITIAL DISEASE

1. Bronchial disease (e.g., peribronchial thickening; mucoid impaction; bronchiectasis)
2. Discrete miliary nodules
3. Honeycomb lung
4. Kerley lines
5. Small irregular shadows (reticular or reticulonodular pattern)
6. Vascular abnormality (incl. pulmonary arterial, pulmonary venous, or bronchial arterial)


ACUTE DIFFUSE FINE RETICULAR OPACITIES (KERLEY LINES, ACUTE— A, B, AND C)

1. Pneumonia (esp. interstitial—infectious mononucleosis, cytomegalovirus, H. influenzae;
Mycoplasma; atypical mycobacterial; Pneumocystis carinii)
2. Pulmonary edema (esp. heart failure; myocardial infarction; valvular heart disease; renal failure; uremia; fluid overload; drug reaction)
3. Transient tachypnea of the newborn (retained fetal lung fluid); Wilson-Mikity S.; bronchopulmonary dysplasia


KERLEY LINES, CHRONIC—A, B, AND C

1. Bronchogenic carcinoma (lymphangitic spread of tumor)
2. Idiopathic pulmonary fibrosis (IPF)
3. Lymphangitic metastases
4. Pneumoconiosis (esp. silicosis)
5. Mitral stenosis


GROUND-GLASS OPACITIES ON HRCT

1. Hypersensitivity pneumonitis (extrinsic allergic alveolitis) (e.g., farmer’s lung, bagassosis)
2. Nonspecific interstitial pneumonia (NSIP) (idiopathic or associated with collagen vascular disease or AIDS)
3. Acute interstitial pneumonia (AIP)
4. Idiopathic pulmonary fibrosis (IPF) and active phase
5. Pulmonary hemorrhage (e.g., bronchitis; bronchiectasis; pulmonary thromboembolism; bronchogenic carcinoma; contusion of lung; vasculitis—Wegener granulomatosis, Goodpasture S., lupus erythematosus; aspergilloma; anticoagulation; bleeding diathesis; arteriovenous malformation; DIC; vascular metastases
6. Connective tissue disease (esp. lupus erythematosus; scleroderma)
7. Sarcoidosis
8. Bronchiolitis obliterans with organizing pneumonia (BOOP)
9. Bronchiolitis obliterans
10. Infection
a. Pneumocystis carinii pneumonia
b. Viral (esp. cytomegalovirus in immunocompromised patients)
c. Bacterial
d. Tuberculosis; atypical mycobacterial infection (“tree-in-bud”)


MASS IN A PULMONARY CAVITY (MENISCUS OR [bleep]’S EYE SIGN)

1. Fungus ball (esp. Aspergillus; rarely Cryptococcus; Candida; Coccidioides)
2. Hydatid cyst


BLURRING OF THE HEART BORDER ON PA CHEST FILM

1. Idiopathic
2. Infiltrate or edema in left lingula, right middle lobe, or anterior segment of an upper lobe
3. Mediastinal lesion, anterior (e.g., thymoma; thymic cyst; thymolipoma; teratoma; lymphoma; pericardial cyst; lipoma; mediastinitis; fibrosis)
4. Normal or congested blood vessels (esp. right heart border)
5. Pericardial fat pad
6. Pleural fluid
7. Pleuropericardial adhesion; postinfarction myocardial scar
8. Pneumoconiosis (esp. asbestosis)


TYPE OF PLEURAL FLUID— TRANSUDATE (Protein <>

1. Cirrhosis
2. Fluid overload
3. Heart failure
4. Renal failure; uremia


TYPE OF PLEURAL FLUID—EXUDATE (Protein > 3 g/dl)

1. Lymphoma; leukemia
2. Metastases to pleura (esp. bronchogenic carcinoma)
3. Pneumonia (esp. bacterial); lung abscess
4. Pulmonary thromboembolism
5. Tuberculosis


UNILATERAL ELEVATED HEMIDIAPHRAGM

1. Atelectasis
2. Distended stomach or splenic flexure of colon
3. Eventration
4. Idiopathic; normal variant
5. Inflammatory disease in abdomen (e.g., subphrenic, perinephric, hepatic, or splenic abscess; pancreatitis; cholecystitis; perforated ulcer)
6. Interposition of colon between liver and right hemidiaphragm (Chilaiditi S.)
7. Paralysis (e.g., phrenic nerve palsy or paralysis, esp. from bronchogenic carcinoma; primary or metastatic mediastinal malignancy; extrinsic pressure from intrathoracic goiter or aortic aneurysm; trauma; iatrogenic-surgical transection)
8. Pleural disease (e.g., acute pleurisy; fibrosis; old empyema, hemothorax or pleural tuberculosis; mesothelioma)
9. Postoperative (e.g., lobectomy; pneumonectomy); postpericardiotomy S. (post-CABG)
10. Ruptured spleen or liver (esp. subphrenic hematoma)
11. Scoliosis (on side of concavity)
12. Splinting of diaphragm or guarding from acute process (e.g., fractured rib; chest wall trauma; pulmonary infarct; pneumonia)
13. Subphrenic mass (e.g., enlargement, tumor, cyst, or abscess of liver or spleen; carcinoma of stomach)
14. Trauma to phrenic nerve, thorax, cervical spine, or brachial plexus


EGGSHELL CALCIFICATIONS IN THE CHEST (ESP. MEDIASTINAL LYMPH NODES)

1. Aneurysm of great vessels
2. Idiopathic
3. Silicosis; coal-worker’s pneumoconiosis

DOUBLE-BARREL ESOPHAGUS*

1. Dissecting intramural hematoma or hemorrhage
a. Severe vomiting (e.g., Boerhaave S. with esophageal perforation, or Mallory-Weiss S. with esophageal tear)
b. Trauma
c. Instrumentation (e.g., nasogastric intubation; endoscopy)
d. Ingestion of sharp foreign body
e. Spontaneous (e.g., bleeding diathesis)

* Barium opacification of an intramural dissecting channel separated from the normal esophageal lumen by an intervening radiolucent mucosal stripe.


DUODENAL OBSTRUCTION IN AN INFANT (DOUBLE BUBBLE SIGN)

COMMON
1. Annular pancreas
2. Congenital peritoneal bands (Ladd’s bands)
3. Duodenal atresia or stenosis, esp. with trisomy 21 S. (Down S.)
4. Midgut volvulus with malrotation

UNCOMMON
1. Choledochal cyst
2. Diaphragm or web; intraluminal diverticulum
3. Duplication cyst
4. Intramural hematoma
5. Preduodenal portal vein
6. Retroperitoneal tumor (e.g., teratoma) or lymphadenopathy


SENTINEL LOOP (LOCALIZED DILATATION OF SMALL AND/OR LARGE BOWEL)

1. Acute appendicitis (right lower quadrant)
2. Acute cholecystitis (right upper quadrant)
3. Acute diverticulitis (left lower quadrant)
4. Acute pancreatitis (upper or mid-abdomen)
5. Acute ureteral colic (stone)
6. Infarction or ischemia of bowel
7. “Paralytic ileus”
8. Perforated peptic ulcer (upper abdomen)


“THUMBPRINTING” OF THE GASTROINTESTINAL TRACT (MULTIPLE INTRAMURAL DEFECTS)

1. Crohn’s disease
2. Diverticulitis
3. Ischemic colitis with hemorrhage into bowel wall
4. Ulcerative colitis


B.U.L.L.’S EYE LESION (SOLITARY OR MULTIPLE NODULES IN THE GASTROINTESTINAL TRACT WITH LARGE CENTRAL ULCERATION)

1. Gastrointestinal stromal tumor (esp. leiomyoma; leiomyosarcoma; neurofibroma)
2. Lymphoma
3. Metastatic melanoma
4. Peptic ulcer

STRUCTURES THAT SONOGRAPHICALLY MIMIC THE GALLBLADDER

1. Abscess (esp. near ligamentum teres)
2. Choledochal cyst
3. Dilated cystic duct remnant
4. Fluid-filled duodenal bulb
5. Hepatic cyst
6. Omental cyst
7. Renal cyst


LIVER LESION CHARACTERIZED BY B.U.L.L.’S EYE APPEARANCE

1. Fungus disease (e.g., candidiasis, usually in immunocompromised individual); other opportunistic infections
2. Kaposi sarcoma
3. Lymphoma; leukemia
4. Metastasis
5. Sarcoidosis
6. Septic emboli


DAMPING OF HEPATIC VEIN DOPPLER WAVEFORM (US)

1. Budd-Chiari syndrome
2. Cirrhosis
3. Extrinsic compression of hepatic veins
4. Passive hepatic congestion
5. Various parenchymal abnormalities of liver


ALTERATION IN DENSITY OF THE MESENTERIC FAT ON CT (“Misty Mesentery”)

1. Hemorrhage (e.g., trauma)
2. Inflammation (e.g., Crohn’s disease)
3. Lymphedema
4. Mesenteric edema
5. Neoplasm, e.g., carcinomatosis; mesothelioma (esp. after chemotherapy)
6. Retractile mesenteritis (chronic fibrosing mesenteritis; mesenteric lipodystrophy; panniculitis; Weber- Christian disease)


“PSEUDOKIDNEY” OR “B.U.L.L.’S EYE” SIGN IN THE ABDOMEN (US)

1. Gastroesophageal junction
2. Hypertrophic pyloric stenosis
3. Inflammatory bowel disease with wall thickening (e.g., amebiasis; Crohn’s disease; diverticulitis; Whipple’s disease)
4. Intussusception (multiple concentric rings)
5. Malignant neoplasm with thickening of bowel wall (e.g., carcinoma; lymphoma; leiomyosarcoma; metastasis to serosa)

HYPOTHALAMIC LESIONS ON MRI

1. Ectopic posterior pituitary gland
2. Germinoma
3. Glioma
4. Hamartoma of tuber cinereum
5. Langerhans cell histiocytosis
6. Lymphoma, primary
7. Sarcoidosis; tuberculosis
8. Wernicke’s encephalopathy

CEREBELLOPONTINE ANGLE MASS ON CT OR MRI

1. Acoustic schwannoma (neurinoma)
2. Aneurysm or ectasia of basilar or vertebral artery
3. Epidermoid (congenital cholesteatoma)
4. Lateral extension of adjacent tumor (e.g., pontine glioma; ependymoma or other fourth ventricular tumor; choroid plexus tumor; cerebellar neoplasm {astrocytoma; hemangioblastoma}; chordoma)
5. Meningioma

PERIVENTRICULAR HYPERINTENSE (BRIGHT) LESION ON T2-WEIGHTED MRI

CHILDREN AND YOUNG ADULTS
1. Acute disseminated encephalomyelitis (ADEM) (postviral leukoencephalopathy)
2. Ependymitis granularis (anterior and lateral to frontal horns in normal individuals)
3. Leukodystrophies
a. Adrenoleukodystrophy
b. Alexander’s disease
c. Canavan’s disease
d. Krabbe disease (globoid cell leukodystrophy)
e. Metachromatic leukodystrophy
f. Pelizaeus-Merzbacher disease
4. Migraine
5. Mucopolysaccharidoses
6. Multiple sclerosis
7. Vasculitis (lupus erythematosus; sickle cell disease; Behçet S.)
8. Virchow-Robin spaces in putamen

ELDERLY
1. Ischemia of deep white matter (e.g., ischemic cardiovascular disease; hypertension; smoking)
2. Lacunar infarction

PATIENTS WITH AIDS
1. Lymphoma
2. Progressive multifocal leukoencephalopathy (PML)
3. Subacute white matter encephalitis (esp. due to HIV or cytomegalovirus infection)
4. Toxoplasmosis


AVASCULAR INTRACRANIAL MASS

1. Abscess
2. Contusion
3. Edema
4. Epidural hematoma, hygroma, or empyema
5. Hematoma (intracerebral)
6. Neoplasm (low grade glioma {astrocytoma; oligodendroglioma; metastasis)
7. Subdural hematoma, hygroma, or empyema

ECHOGENIC BRAIN LESIONS ON ULTRASOUND

1. Calcification
2. Hemorrhage (e.g., subependymal)
3. Infarction
4. Normal (choroid plexus; caudothalamic groove)

INCREASED INTRACRANIAL PRESSURE

COMMON
1. Brain abscess
2. Cerebral edema, contusion, hemorrhage, or infarction
3. Hematoma (intracerebral, extradural, subdural); hygroma
4. Hydrocephalus, obstructive
5. Lead encephalopathy
6. Malignant hypertension
7. Meningitis, meningoencephalitis (e.g., tuberculosis; cryptococcosis {torulosis}; toxoplasmosis)
8. Metastatic neoplasm (e.g., bronchogenic carcinoma; neuroblastoma)
9. Primary brain tumor

UNCOMMON
1. Aqueductal stenosis
2. Arnold-Chiari malformation
3. Craniostenosis, severe
4. Dandy-Walker S. (Dandy-Walker malformation)
5. Drug therapy (e.g., tetracycline)
6. Emphysema, severe with cough
7. Hyperthyroidism
8. Hypervitaminosis A
9. Hypoparathyroidism
10. Increased venous pressure
11. Leukemia; lymphoma
12. Meningocele
13. Parasitic disease (e.g., cysticercosis; hydatid disease; paragonimiasis)
14. Pseudotumor cerebri

RADIOLOGIC FEATURES OF INCREASED INTRACRANIAL PRESSURE

1. Increased craniofacial ratio
2. Increased digital markings of calvarium (“hammered silver” appearance)
3. Sellar changes
a. Decalcification of floor and dorsum of sella
b. Pointed anterior clinoid
c. Sellar enlargement
d. Thinning or loss of posterior clinoid
4. Sutural diastases; unusually deep sutural interdigitations
5. Thinning of calvarium

ENT

1) "TONSILS---/ TONSILITIS / TONSILLECTOMY --- infec. by group A & B streptococcal / strepto.pyogenes-(common org.)

Rx penicillin for 10 days

Pain in the post 1/3 tongue after tonsillectomy is due to injury to / throat pain radiating to the ear following tonsillectomy is due to IX cr. Nerve,

Tonsil develop embryologically from 2nd.pharyngeal pouch,

Hard elongated swelling in the tonsillar fossa after tonsillectomy --elongated styloid process,

Tonsillectomy--indications-(1) F.B. tonsil, (2) unilateral enlargement of tonsil with suspected malignancy, (3) atrophic tonsillitis, (4) Recurrent acute tonsillitis, (5) recurrent quinsy, postop.

Complication hemorrhage--Rx antibiotics + saline wash, sec.hemorrhage(5-8days)-is due to- infection,& it is the common postop. Complication hemorrhage after 6hrs --reactionary H., main blood supply to tonsil is facial artery,

Tonsillectomy is contraindicated in polio epidemic,

Palatine tonsils have Efferents but no afferents,

After Quincy interval tonsillectomy is done after 6 wks.,

Commonest L.N. to enlarge in acute tonsillitis is Jugulodiagastric L.N.

Tonsils reach their max. Size by 5yrs.,"

2) "OTOSCLEROSIS / OTOSPONGIOSIS ---A.D. more in Females, affects Oval window/stapes, Conductive Hearing Loss, color of T.M.=FLAMINGO PINK, Paracusis willisii, Schwartz sign seen, Gelle's test -ve, Carhart's notch/ dip=2 kHz,

TOC=Stapedectomy with prosthesis/Fluorides--cochlear otosclerosis

3) "VOCAL CORD(S) --- lined by stratified sq. epithelium, REINKI'S layer seen, post traumatic web formation.

Can be prevented by MC NAUGHT'S KEEL,

Unilat.V.C. palsy-- commonest cause-Idiopathic,

Left unilat. V.C. palsy-cause-esophageal ca.,

Precancerous lesion in V.C.-leukoplakia, localized nodule vocal cord of sq.cell ca. vocal cord-Rx-Excision,

Earliest symptom of Ca. vocal cord--Hoarseness,

MOUSE NIBBLED APPEARANCE of V.C.--seen in T.B. of V.C.,

Granuloma of V.C.-is due to Intubations, unilat.complete paralysis of V.C. can be corrected by--Teflon inj., cricoarytenoid arthrodesis, implant procedures,

T1N0M0 Ca of V.C. - Rx--radical radiotherapy

Internal tensor lengthening mucosa of V.C. is Cricothyroid,

Primary etiological factor in contact ulcer of larynx--Vocal Abuse,

V.C. paralysis—respiratory obstruction, aphonia by adductor paralysis can be overcome by Arytenoidectomy,

19yrs.old female with aphonia has bilateral abductor paralysis cause is functional

4) CANCER OF LARYNX---Squamous cell cancer of larynx is commonest presentation, it is the commonest cause of Hoarseness of voice in Elderly man of more than 2mths.duration / Laryngeal Stridor in a 60yrs.man,

Early features of Ca larynx= Hoarseness of voice,

NO neck secondary-->Rx only Radiation,

STAGE-III-->SURGERY+RADIATION,

Rx of Glottic cancer

-- TOC.-for (T1N0M0) - EXTRENAL BEAM RADIOTHERPY,

---Ca larynx with Fully Mobile Cords - TOC. -->RADIOTHERAPY.

---Rx of Ca larynx with Stridor -- PLANNED TRACHEOSTOMY,

Glottic cancer has least chance of Nodal Mets.,

Glottic Vocal Cancer has Best Prognosis, and Hoarseness is Early in Glottic Cancer,

INFRAGLOTTIC CA. -->Commonly Spreads to Mediastinal L N'S,

Ant. Commissural growth – Rx -->Conservative Laryngectomy, post cricoid growth

5) CSOM (CHRONIC SUPPURATIVE OTITIS MEDIA) --- attico antral (dangerous type of ear), Schwartz op. done,

CSOM with cholesteatoma with acute onset of vertigo – Rx - immediate exploration, Rx-cholesteatoma- radical mastoidectomy

6) "ACOUSTIC NEUROMA---Auditory defect, sensory aphasia, changes in audiometry, commonly affects-8 Cr. N. & that too Superior Vestibular Nerve, early symptoms - Unilateral hearing loss, it is most common (CPA) Cerebello-Pontine Angle tumors, Numbness of Face, Deafness, Internal Hydrocephalus, Ac. Nr. of 1 cm-IOC/diag.of choice=C.T. SCAN, hypoesthesia of the post. aspect of the ext. auditory canal-this is an early sign,

7) "MENEIRE DISEASE / ENDOLYMPHATIC HYDROPS--- Ass. with Presbycusis, FES.-- Tinnitus, Recurrent Vertigo, Deafness, Low Frequency SNHL/SND.-on pure tone Audiogram, GLYCEROL TEST is done in this, CODYTACK OPERATION is done, Cochlear type M.D.--Cochlear Deafness, Rx – Vasodilators --> increase Endolymph reabsorption, vasodilators of internal ear-is-Nicotinic acid

8) "ANGIOFIBROMA (NASOPHARYGEAL)---Juvenile angiofibroma is locally enlarging tumor producing destruction of bony structures without producing distal secondaries, Young Males(10 yrs boys), Bilateral Nasal Obstruction, bleeding from nose/ Intermittent profuse Epistaxis, firm pinkish mass in nasopharynx, Inv.=X-ray base of skull, carotid angiography, C.T.SCAN(IOC), Benign but potentially malignant

9) "EPISTAXIS---most common site--AnteroInferior Part of the Nasal Septum, this is also called as ' LITTLE'S AREA ‘,

in Elderly pt.--commonest cause-HTN., Rx give NTG to-decrease B.P., Recurrent epistaxis in a 15 yrs. female--most common cause-Hematopoietic disorder,

Epistaxis in 5 yrs. old Boy is due to Bleeding Disorder,

Recurrent Epistaxis=causes--DNS, Atrophic Rhinitis, Maxillary Ca.

IMP TOPICS

1) "FACIAL NERVE---secretomotor N.fibres of SphenoPalatine Ganglion supply the Lacrimal gland,

Injury to Facial N.at Geniculate Ganglion--Dryness of eyes,

Site of lesion of F.N. causing Lacrimal gland involvement is Mastoid Foramen,

FACIAL NERVE PALSY---common cause--Bell's Palsy, F.N.P.-due Trauma, Immediate Rx—Decompression

2) "MIDDLE MEATUS OF NOSE---Frontal air cells, Ant. Ethmoids, Maxillary sinus opens in it, BULLA-ETHMOIDALIS, HIATUS SEMILUNARIS are seen

3) "NAOPHARYNGEAL CANCER---EBV is a causative agent, Spreads to Lymph nodes, commonest Presentation--Cervical adenopathy, there is High Incidence of NODAL METASTASIS,

4) "OTITIS MEDIA---ASOM -- commonest cause--Pneumococcus --very serious O.M., Pulsatile Otorrhea seen, 3yrs. Child with Fever, Ear ache, Congested T.M. with slight Bulge, it is the commonest cause of hearing loss?, Rx--Penicillin ( Myringotomy+ penicillin)"

5) "NASAL POLYP---ANTROCHOANAL P. ---& POLYPECTOMY-intranasal & ext.approach--arises from maxillary sinus, single & unilateral

6) "ATROPHIC RHINITIS---Sx young operation done., ozaena is seen, anosmia, alkaline douche sol'n=NaCl, Na-borate, NaHCo3

7) "STRIDOR---effect of BILAT. RLN damage, most common cause in adult--malignancy,

Rx of congenital laryngeal stridor =reassurance to parents,

Most common cause pf stridor in newborn—laryngomalacia

8) "TRACHEOSTOMY- - complication commonly occur in children-is-difficult decannulation, indication--stridor, coma of long duration , diphtheria, laryngeal obst., flail chest, tetanus(cyanotic spells) , It is not used in F.B. / Obst. of post basal lobe /bronchus, commonest complication of pediatric--Pneumothorax,

9) "TYMPANIC MEMBRANE---Blue Drum--seen in Secretory otitis media, nerve supply auriculotemporal nerve, T.M.-mobility--most mobile part-central

10) "LITTLE'S AREA--- arterial supply= Ant.Ethmoidal art., Septal branch of facial art., Nasal branch of Sphenopalatine art., it is the commonest Bleeding site of nose / EPISTAXIS, or KIESSELBACH'S PLEXUS---Bleeding Area of nose is situated in the AnteroInferior surface of septum/medial wall of nasal cavity ,”

11) "HEARING LOSS---SENSORENEURAL H.L.---(SNHL)--causes-old age, Cochlear Otosclerosis,Loud sound, Rx--COCHLEAR IMPLANT, Hydrops of Endolymphatic system-seen-in Alport's synd.,Usher's synd.,Pendred's synd.,"----------((5))

12) "MIDDLE EAR CAVITY---Nerve supply--Glossopharyngeal nerve,Floor--formed by INTERNAL JUGULAR BULB, In middle ear desease-there is - increased Threshold of AC & decreased BC (BC>AC), Resistance in middle ear-is-tested by IMPEDENCE Audiometry, Prominent Emenece over medial wall of midlle ear-is formed by-COCHLEA( BASAL TURNS),"----------((5))

13) "NASAL CAVITY---Function--Warming, Moistening, Filtration, NASAL SEPTUM---is formed by Vomer bone, Perpendicular bone of Ethmoid, Rostrum of Sphenoid, APPLE-JELLY NODULES on nasal septum--is due to Lupus Vulgaris, NASAL CARTILAGE-- 3 Paired & 1 Unpaired cartilages, NASAL MUCOSA---supplied by mainly Ext.Carotid artery,"-----------((5))

14) "RECURRENT LARYNGEAL NERVE---partial RLN palsy produces Vocal cord in PARAMEDIAN position, closely related to Inf.thyroid artery, BILAT.RLN PALSY=ADDUCTED position & stridor, supplies all except cricothyroid( SLN),"----------((5))

15) "RHINOSPORODIOSIS---russel bodies seen, Rx- Dapson, fungal infec.,max.in Tamil nadu, Rx excision with cautery at base,"-----------((5))

16) "DNS / DEVIATED NASAL SEPTUM ---sharp DNS--Epitaxis, SPUR, recurrent sinusitis, Newborn with DNS= 20%, inf.tubinate hypertrophy, COTTEL'S TEST--patency of nares in DNS,"------------((5))

17) "FRONTAL SINUS--F.S. develops from ant. Ethmoidal cells, PNEUMATOCELE--fracture of F.S., not present at birth, FRONTAL MUCOCELE--"-----------((5))

18) "EPIGLOTTITIS---ACUTE--Commonest Organism causing it is -Hemophilus Influenze, DOC.in children--Ampicillin,commonest cause death-is-Respiratory obstruction,"------------((4))

19) "MYRINGOTOMY---done on POSTERO-INFERIOR Quadrant of T.M., commonest indication--Serous Otitis Media, a child with otitis media with Bulging T.M. with dull look, PUS in middle ear under tension,"-----------((4))

20) "PLUMMER VINSON'S SYND.---ass. With oesophageal ca., post cricoid growth, IDA, females, premalignant ( for hypopharyngeal ca., "---------((4))

21) "QUINSY---PERITONSILLAR ABSCESS---org.-streptococcus, quinsy+trimus--> Rx for 48 hrs. antibiotics only & then oral drainage,"----------((4))

22) "SEPTAL PERFORATION---of Cartilagenous nasal septum--septal abscess,leprosy ( ant. Septal perf.), Bony septal perforation--syphilis, Mucosa; inv. With nasal septum perforation in jaws-is-known as GANGOSA, "--------((4))

23) "MAXILLARY SINUSITIS---commonest / chronic sinusitis in children,"---------((4))

24) "PATCH IN THROAT--- / MEMBRANE IN THROAT --- (1) vincents angina, Black colour patch in mouth, (2) candida , (3) diptheria, (4) streptococcus, & IN THROAT OF ADULT----> Hemophilus, streptococcus, Neisseria, organism are seen but not E-Coli, "----------((4))

25) "GLUE EAR---8 yrs. Old child, Bilateral Conductive Deafness, seen in SECRETORY OTITIS MEDIA, or SEROUS OTITIS MEDIA---FLAT Tympanogram , "--------((4))

26) "MYRINGOPLASTY---Plastic Repair of T.M., note- initially audiometry done & then Sx done, or TYMPANOPLASTY---before T.plasty surgeon look for cochlear reserve, temporal fascia is used -it's metabolic rate is low, "-----------((4))

27) "BRAIN OTOGENIC ABSCESS---Mx-drainage of abscess followed by mastoidectomy, commonest site--temporal petrosal lobe, TEMPORAL LOBE ABSCESS---occurs in unsafe otitis media with high fever , convulsions "---------((3))

28) "ADENOIDECTOMY--- Indication--Recurrent Otitis Media, Sleep Apnoea synd., Middle ear infec. With deafness, C I --Submucous Cleft Palate, control of Hemorrhage--by Post.Nasal PACK, " ---------((3))

29) "ARNOLD'S NERVE---is a Branch of VAGUS Nerve, Irritation of this causes Ear Cough, Cough response caused while cleaning ear canal is mediated by stimulation of X Cr.N."----------(3)

30) "CARDIOSPASM / ACHALASIA CARDIA---difficulity for swallowing Liquids but not for solids, ass.with DEGENERATION of nerve plexus in the oesophagus, Barium Swallow-shows-Dilatation with smooth narrow ending, "--------((3))

31) "ENDOLYMPH---most imp. Constituent-K+ , is seen in Scala Media , Drains into Virchow Robin Space,"-------((3))

32) "EUSTACHIAN TUBE---most common cause of E.T. disease--ADENOIDS, LENGTH=36mm( 3.6 cm),"-------((3))

33) "GLOMUS TUMOUR---in middle ear, Location--Hypotympanum, Pulsatile Tinnitus ,Pulsatile tumour in EAM which Bleeds to Touch,"---------((3))

34) "GRADENIGO'S SYND.---abducent VI Nr. Palsy, Retroorbital Pain, pain over face, Aural discharge/ otorrhoea, Pralysis of Ext./lat Rectus, Nr. Inv.= 5,6, GRADENIGO'S TRIAD---Mastoiditis, Petrositis, L R palsy,"--------((3))

35) "MULTIPLE PAPILLOMA OF LARYNX---Rx Excision with Laser, common in Infants & Children, Laryngeal papilloma are usaually Multiple & VIRAL in origin, usual site of papilloma is larynx, Rx of single P.= Removal by Direct Laryngoscopy, "---------((3))

36) "TUBERCULOSIS OF LARYNX/TUBERCULOUS LARYNGITIS--- KISS ULCER of Larynx, common site of T.B. Larynx is POST.COMMISSURE OF L."-------((3))

37) "OTITIS EXTERNA---MALIGNANT--caused by P.Aeroginosa, common in D.M., & OLD age,"----------((3))

38) "RHINOSCLEROSIS / RHINOSCLEROMA--- bacilli infec., Mickulitz & Russel bodies seen,"-------------((3))

39) "RINNE'S TEST---+ve seen in presbycusis, -ve(BC>AC)-->middle ear disease,"--------((3))

40) "CSF RHINORRHOEA--- ant.cranial fossa fractures / Cribriform plate fracture , most imm. Rx-prophylactic antibiotics& x-ray, "-----------((3))

41) "ETHMOIDAL SINUS--First sinus to appear after Birth, ETH.S. Adenocarcinoma--seen in WOOD workers & Nickel workers,"--------((3))

42) "MAXILLARY SINUS---maxillary antrum commonest malignancy=sq.cell ca., secondary deposits from M.S.-->submandibular L.N.'S,this is present at birth,"----------((3))

43) "SINUSITIS---bloood stainded rhinorrhoea, nasal blockage, facial edema, complication=orbital cellulitis, Sx-proof puncture,"---------((3))

44) "STAPEDIAL MUSCLE---supplied by facial cr. Nerve, STAPEDIAL REFLEX---protective against loud sound , mediated by VII & VIII CR. N.,"---------((3))

45) "SUPRAMEATAL SPINE OF HENLE---landmark on lat.surface of temporal bone which acts as a guide to surgery to the antrum,"----------((3))

46) "VOCAL FOLDS---& VOCAL FOLD CA.---Vocal folds are abducted by post.cricoarytenoid, in CA. L.N.'Smets never seen,,has good prog.,"----------((3))

47) "FRACTURES OF ZYGOMA--- undisplaced fracture--no specific Rx,"--------((3))

Topics Asken more than Twice

1) BEZOLD ABSCESS---located in digastric fossa/ sternomastoid muscle,-------------((2))

2) "CALDWELL-LUC OP.---commonest complication=Infra orbital nerve Palsy, used for removal of AntroChoanal Polyp,"------------((2))

3) "CALORIC test---done with Warm & Cold water, has Slow & Fast Component, Tests function of Lat.Semicircular canal,"----------((2))

4) "CHOLESTEATOMA---filled with Keratinised Stratified sq. epithelium, deafness, Erodes bone,"------------((2))

5) "COCHLEAR NUCLEI---appreciation of sound, COCHLEAR IMPLANTS--- used in SNHL/ SND.,"--------((2))

6) "EXTERNAL AUDITORY MEATUS/ EAM---normal length=24 mm ( 2.4 cm),Cartilaginous portion is smaller than Bony portion,"--------------((2))

7) "FISTULA TEST---+VE after OPeration.of Labyrinth fenestration, FALSE +VE F.T.--seen in Hypermobile Ossicular chain, Labyrinthine Fistula, Post fenestration op.,"-------------((2))

8) "FOREIGN BODY OF NOSE---Unilateral Blood Stained & Fetid , Unilat. Nasal Obst., Nasal Discharge,"-----------((2))

9) "FRACTURE OF MAXILLA---fes. CSF Rhinorrhoea, Anasthesia of upper lip, Sugical emphysema cheeks,Not seen is malocclusion"------------((2))

10) "FURUNCLE OF EAR CANAL---Rx ear pack with 10% ICTHAMOL in GLYCERINE wick, most common site-EXT.cartilaginous auditory canal,"----------((2))

11) "LABYRINTH---destruction of Rt. Labyrinth causes nystagmus to Lt.side, Labyrinthine Artery is a branch of Ant. Inf. Cerebellar art.," ---------((2))

12) "LARYNGOSCOPY---KEY HOLE APP. of glottis is seen in PHONASTHENIA, the procedure that should precede microlaryngoscopy is laryngo-endoscopy, "-------------((2))

13) "LARYNGOMALACIA---most common Congenital Anamoly of larynx, most common cause of congenital stridor & inspiratory stridor is normal on crying,"-----------((2))

14) "LARYNX---Important function of Larynx is Protection of Lower Respiratory Tract, Narrowest part of Infantile Larynx=SUBGLOTTIS,"--------------((2))

15) PRECANCEROUS LESIONS OF LARYNX---KERATOSIS LARYNGITIS/ LARYNGIS SICCA?-PRECANCEROUS LESION,”------------((2))

16) "MAC EWEN'S TRIANGLE / SUPRAMEATAL TRIANGLE---felt thru. CYMBA Conche, Landmark for Mastoid Antrum"----------((2))

17) "MASTOIDECTOMY---commonest Extra-Cranial complication--Facial nerve Palsy, RADICAL MASTOIDECTOMY---inv.lowering of facial ridge, scrapping of middle ear ,removal of all ossicle except foot plate of stapes,"------------((2))

18) "MASTOIDITIS---ACUTE--clouding of air cells, deafness, obliteration of retroauricular sulcus, Complications-- Subperipsteal abscess-mastoid infec. Erodes outer cortex of bone,"----------((2))

19) "MAXILLARY SINUS -ANTRAL CARCINOMA---T3NOMO-Rx-->SURGERY+RADIOTH.,Malignant tumour arisis commonly from maxillary sinus,"-----------((2))

20) "NASOPHARYNGEAL FIBROMA---Rx Surgery, NASOPHARYNX---Oval shaped Space,"---------------((2))

21) "ORGAN OF CORTI---situated in SCALA MEDIA, along Inner edge of membrane"-------------((2))

22) "OTOTOXIC DRUGS---kanamycin, streptomycin, vincristine, gentamicin, "------------((2))

23) "PARACUSIS WILLISII---pt. Hear better in NOISE, cinical otosclerosis,"--------------((2))

24) "PAROTID---& TUMOURS OF PAROTID---NERVE commonly sacrificed is facial n. "-----------((2))

25) "PHONASTHENIA---KEY HOLE APP. OF GLOTTIS ON LARYNGOSCOPY,& PUBOPHONIA--- a boy failed to develop the crackling of voice which normally occurs in adolescence,"------------((2))

26) "PYRIFORM FOSSA/ SINUS---lymphatic drainage to upper cervical L.N.'S, malignant lesions of P.S. pain is reffered to Ipsilateral ear via vagus nerve,"------------((2))

27) REINKE'S OEDEMA---oedema of the free margin/edge of the Vocal cord ,”---------((2))

28) "ALLERGIC RHINITIS---test used intracutaneous test, scratch test, rash test, common cause of nasal discharge,"----------((2))

29) "VASOMOTOR RHINITIS---Sx Vidian Neurectomy, autonomic imbalance,"-------((2))

30) "CORYZA / VIRAL RHINITIS---PARCEL viruses, "----------((2))

31) "RHINOLALIA CLAUSA---seen in gross adenoid hypertrophy, voice abn.,"---------((2))

32) "RHINOSCOPY---ANTERIOR--Bulla Ethmoidalis, inf. Tubinates, little's area,are seen , not seen is sup.tubinate, POSTERIOR-- Eustachian tube, inf.meatus, middle meatus, not seen is sup. Concha,"--------((2))

33) "SPENOID SINUS---opens into sphenoethmoidal recess,"--------((2))

34) "ACUTE FRONTAL SINUSITIS---chronic periodic headache, disapears with sunset, "-----------((2))

35) "SUBMUCOUS FIBROSIS---premalignant,"--------------((2))

36) "SMR / SUBMUCOUS RESECTION---done > 16yrs. , DNS, "----------((2))

37) TRACHEA---begins at the level of lower border of cricoid cartilage,---------((2))

38) "TRAUMATIC RUPTURE OF T.M.---Rx conservative / No active Rx, pin-prick injury to eardrum-Rx-antibiotics,"----------((2))

39) "VINCENT'S ANGINA---ulcerative lesion of fusiform bacillus, / anaerobic, spirochaete, "----------((2))

40) "WEBER TEST--- in conductive deafness -W.T. lat. to deaf ear, note=both ear rinne's +ve & W.T. lat.to left I.e. left sided conductive deafness, "----------((2))

41) "IDDM WITH SEPTAL PERFORATION WITH BROWISH BLACK DISCHARGE / COLOUR OF INF.TURBINATE--- diagnosis is MUCOR MYCOSIS, "-----------((2))

ENT:-- Occasionally Asked Topics

1) "ABC / ABSOLUTE BONE CONDUCTION---shortened in SNHL / Perceptive deafness

2) "ACOUSTIC REFLEX DECAY TEST--- +VE in Lesions of Auditory Cortex

3) "ADENOID FACIES--- Fes.-- Open mouth, Pinching of nose, Crowding of teeth, "--------((1))

4) "ANOSMIA----complete-Responda to inhalation of ammonia,"--------------------((1))

5) "ANTRAL WASH---for drainage of maxillary sinus is thru. Inferior meatus,"---------------

6) AUDIOGRAM-U-shaped A.--congenital deafness, FLATTENED A.- serous Otitis media

7) "AUDIOMETRY---IMPEDANCE,"------------------((1))

8) ALLODYNIA---increased perception of Painful stimulus,----------------((1))

9) "BELL'S PALSY---Mx-Steroids & Surgical Decompression,"---------------(1))

10) "BRONCHOSCOPY---indicated in persisitent Wheeze,"------------------((1))

11) BLAST INJURY---most common organ affected -Ear Drum,---------------((1))

12) "CARHART'S NOTCH---seen at 2000 Hz., & in otosclerosis,"-------------((1))

13) "CHOANAL ATRESIA---BiLateral Complete-->life threatening complication,"-----------((1))

14) "CHORDITIS TUBEROSA---is due to Chronic Laryngitis,"--------------((1))

15) "CRICOID CARTILAGE---is Signet Ring shape, "-------------------((1))

16) "CRICOTHYROID MUSCLE---is supplied by SUPERIOR Laryngeal nerve( SLN ), & rest by RLN.,"---------((1))

17) "CONE OF LIGHT---is formed on ANTERIO-INFERIOR Quadrant,"----------------((1))

18) "CSF.---is similar to PERI-LYMPH,"------------(1))

19) "DIPHTERIA---Membranes firmly Attached & Bleeds on Touch, " ----------((1))

20) "DYSPHAGIA---SIDEROPENIC DYSP.--seen in Iron Def. Anemia,"---------------((1))

21) "DYSPHONIA PLICA VENTRICULARIS---is producing sounds with false cord,"------------((1))

22) "CAULIFLOWER EAR---is due to Hematoma of Auricle," -----------------((1))

23) "ENCEPHALOCELE---Herniation of Brain tissue with its Dural covering into the Nasal cavity, "-----((1))

24) "EPITYMPANUM---includes--head of Malleolus , Body of Incus,"----------((1))

25) "FITZGERALD-HALLPIKE TEST---uses Temp. at 30oC& 44oC, also called as caloric test?,"------((1))

26) "LE FORT'S FRACTURE---inv's ZYGOMA, MAXILLA, & NASAL BONES,"----------((1))

27) "Oblique & Horizontal Fracture of nasal septum--- is called as JARJAVAL FRACTURE,"------------((1))

28) "GLOBUS HYSTERICUS---lump in throat not interfering with swallowing,"----------------((1))

29) "GROMMET INSERTION---is done in anteroinferior quadrant,"------------((1))

30) GELLE'S TEST---done in Otosclerosis,-----------------((1))

31) "Great Auricular Nr. ---supplies Skin at Angle of JAW,"---------------((1))

32) "GLOSSOPHARYNGEAL NEURECTOMY--- Route of Approach -Tonsillectomy approach,"------((1))

33) Hearing impairment due to noise starts at 4000 Hz.,----------------((1))

34) "HEMANGIOMA---Bleeding Polyp of nose--arises from septum,"-----------((1))

35) HYPERACUSIS---normal sound are heard as loud & painful.,--------------((1))

36) "HYPERNASALITY---caused by Cleft palate, Submucous celft, Bifed Uvula,"--------------------((1))

37) HYPOPHARYNEAL CANCER---predisposing factors -Plummer Vinson's Synd.,----------------((1))

38) "INVERTED PAPILLOMA---of Rt.side of nasal cavity -TOC.=Total Maxillectomy,"-----------------((1))

39) "INNER AUDITORY MEATUS---facial nerve is lateral to superior vestibular nerve,"

40) "JUVENILE PAPILLOMA---Rx-Surgical excision,"-----------------((1))

41) "KERATOSIS OBURANS---is a Premalignant condition,"------------------((1))

42) KOBARK TEST---used for Minimal Caloric Stimulation,-------------------((1))

43) "KARTAGENER'S SYND.---Ass.with Sinusitis, Dextrocardia, Bronchiectasis, "----------------((1))

44) "LARYGEAL MIRROR---warmed before use by placing glass surface on Flame,"--------------------((1))

45) "LARYNGOFISSURE---Opening the larynx in midline,"-------------------((1))

46) "LARYNGECTOMY---after laryngectomy Voice is from Oesophagus,"--------------------------((1))

47) "LARYNGOCELE---Gas filled sac in neck region after VALSALVA MANOEURVE,"--------------((1))

48) "ANAESTHESIA OF LARYNX---occurs with Diptheria, Lead Poisoning, Multiple sclerosis,"---------(1))

49) "LYMPH NODE METASTASIS IN NECK --- is seen in SupraGlottic Ca., Ca.of Tonsil, Papillary Ca.of thyroid, NEVER seen in Ca.of Vocal Cords, "--------------------((1))

50) "MASKING---is applied for inability to hear,"-----------------((1))

51) "MASTOID TEMPORAL BONE AIR CELL GROUPS---include Petrosae, Retrofacial, Hypotympanic, Sublabyrinthine."-----------------((1))

52) "MASTOID TIP---appears by 2yrs. of age,"----------------((1))

53) "INFERIOR MEATUS OF NOSE---NasoLacrimal duct/ Frontonasal duct opens," ------------((1))

54) "MONOAURAL DISPLACUSIS---due to Lesions of Cochlea,"------------((1))

55) "MYIASIS OF NOSE---MAGGOTS OF NOSE, Rx-TOC.--CHLOROFORM Water,"---------((1))

56) "MYRINGITIS BULLOSA---caused by Virus,"--------------((1))

57) "NASAL DEPRESSED BRIDGE--- caused by Syphylis, Septal Abscess, Injury,"--------------------((1))

58) CROOKED NOSE---due to Deviated Tip & Septum ,---------------------((1))

59) "SADDLE SHAPED NOSE---due to Destruction of nasal septum," --------((1))

60) "OESOPHAGUS---cervical oesophagus receives its blood supply from Inf.Thyroid Artery, "-----------(1)

61) "BENIGN NEOPLASMS OF OESOPHAGUS---commonest --is Intramural Tumour of oesophagus--LEIOMYOMA,"-------------------((1))

62) "CARCINOMA OF OESOPHAGUS---RAT TAIL APP. on Barium swallowing,"------------------((1))

63) "OLFCTORY AREA---Looks YELLOW in colour,"-------------------((1))

64) "OSSICULAR RATIO = 1.3:1 , " -------------------((1))

65) "TUBERCULAR OTITIS MEDIA---Multiple perforations of T.M., "-------------((1))

66) "ACUTE NON SUPPURATIVE OTITIS MEDIA---Retracted drumhead with a hiar-line or air bubbles on otoscopy," ------------------((1))

67) "OTOMYCOSIS---most common fugas aspergillus fumigatus,"----------((1))

68) CSF OTORRHOEA--- fracture of petrous ridge/ petrous temporal bone,--------------((1))

69) "PENDRED SYND.--Thyroid swelling + nerve deafness,"------------------((1))

70) PARAPHARYNGEAL ABCESS---swelling in post. Part of middle1/3 of sternomastoid & tonsil is pused medially,----------------((1))

71) "PAROSMIA---PERVERSION OF SMELL,"------------((1))

72) "PHARYNGITIS- MEMBRANOUS---causes--streptococcal, ludwig's angina, diptheria, "-----------((1))

73) PHARYNGOMAXILLARY ABSCESS---medial bulge of pharynx ,----------((1))

74) "PLEOMORPHIC ADENOMA---most common tumour of parotid gland,"-------------((1))

75) PNEUMATOCELE--seen in fracture of frontal sinus,--------------((1))

76) PROCESSUS COCHLEARIFORMIS--attaches to handle of mallues,---------------((1))

77) "RESP.ALLERGY--house dust,"------------------((1))

78) "RANADIER'S OPERATION---done in Petrositis,"---------------((1))

79) CHRONIC RETROPHARYNGEAL ABSCESS--due to caries spine,-----------((1))

80) "SICCA RHINITIS--anterior nares inv.,",------------------((1))

81) "RHINOLITH--- deposition of calcium around the F.B. in nose,"-----------((1))

82) RHINOPHYMA---hypertrophy of sebaceous gland,------------------((1))

83) "SINGERS NODULE---Voice abuse,"-------------------(1))

84) "SCALA MEDIA ---shows endolymph,"----------------((1))

85) "SCHIRMER'S TEST---for lacrimal secr. To test facial nerve,"------------((1))

86) "SEMICIRCULAR CANALS--senses Angular movements,"--------------((1))

87) "SCHWARTZ SIGN ---seen in otosclerosis,"----------------((1))

88) "SCHWARTZE OPERATION---done in CSOM,"-----------((1))

89) "SPEECH DISCRIMINATION SCORE---lowest in retrocochlear SND

90) "ALPORT'S SYND.---SNHL+Hereditary nephritis,"--------------((1))

91) "TEMPORAL BONE---petrous part-inner ear,"------------------((1))

92) "TONE DECAY TEST---done to fineout retrocochlear lesions,"------------((1))

93) "TOBEY AYER TEST---Lateral sinus thrombosis,"----------------((1))

94) "TRACHEOSTOMY TUBE---double tube, made of Titanium silver alloy, cuffed tube is used for IPPV, "--------((1))

95) "TROTTER'S TRIAD---seen in nasopharyngeal ca.,"-----------((1))

96) "UMBO---most reliable landmark on otoscopy,"-------------((1))

97) "VERTIGO---peripheral/ labyrinthine V. fes--unidirectional nystagmus, marked vertigo, ass.central abn.absent,"--------------((1))

98) "VESTIBULE---IS present in nose, larynx, pharynx,"--------------((1))

99) "VESTIBULAR SCHWANOMMA---IOC--GADOLINIUM ENHANCED MRI,"------------------((1))

100) VIDIAN NERVE---/ NERVE OF PTERYGOID CANAL---, ---------------((1))

101) "VOCAL NODULES---present at junction of anterior 1/3 & post. 2/3, "--------------------------((1))

102) "WOODRUFF'S AREA---post. End of inferior turbinate, "-----------------((1))

103) "WALDERYER'S RING ---inner w.group of L.N.=tonsils, lingual tonsils, adenoids,"-----------------((1))

104) "WARTHIN'S TUMOUR---Rx superior paratidectomy,"------------------((1))

105) ZENKER'S DIVERTICULUM --- it's asymp.-------------------((1))

106) "AT BIRTH---following structures are of adult size--tympanic cavity, malleus, tympanic ring , except -mastoid antrum,"-------------------((1))

107) "The ADDUCTION OF V.C. cannot occur while talking , but can occur with good cough --is a condition ass. With functional aphonia,"--------(1))

108) "SUPRAGLOTTIS--- include -aryepiglottic folds, false cords, laryngeal surface of the epiglottis,"---------------((1))

109) "TRANSBRONCIAL BIOPSY---is thru. Fiber-optic bronchoscopy,"----------------((1))

110) "NORMAL RANGE OF frequency of human haering = 20-20,000 hz,"--------------((1))

111) "AUDIBLE SOUND FOR NORMAL HUMANHEARING = 40-45 db,"---------------((1))

112) "PROLONGED EXPOSURE TO NOISE LEVELS > 85 db can impair hearing permanently,"---------------((1))

113) "RUPTURE OF T.M. /EAR DRUM occur at noise level > 160 db,"--------------((1))

114) "40 db COMPARED TO 20 DB is 100 TIMES,"-------------((1))

115) "RHINITIS SYNDROME---in mast cell mediator release category are categorised by sneezing , marked postnasal discharge, lacrimation,"----------------((1))

116) "WATER'S VIEW ( OCCIPITOMENTAL )--- provides good visualization of maxillary sinus, orbitofrontal sinus, frontal sinus,"--------------((1))

117) "CHILD WITH COMPRESSIBLE SWELLING ROOT OF NOSE---MENINGOMYELOCELE,"------------((1))

118) "STRUCTURES PASSING between the upper border of the superior constrictor muscle & base of the skull are levator palati muscle & the cartilagineous eustachain tube,"--------------------((1))

119) QUALITY OF VOICE--- not changed in total adductor palsy

120) "FAMILIAL PREDISPOSITION of malignancies--- are seen in -breast, leukaemia, thyroid,"----------------(1))

121) "GLOSSOPHARYNGEAL NERVE---supplies sensation to the middle ear mucous memb.,& tongue (post1/3)"-------------((1))

122) MICROPHONIC POTENTIALS ORIGINATING IN COCHLEA are resistant to Ischemia

123) "IVORY OSTEOMA--- sen in fronto-ethmoidal region,"-------------((1))

124) "PLICA SEMILUNARIS---is situated in Tonsillar area,"----------((1))

125) "SUBMANDIBULAR GLAND SURGERY---may result in damage of 7,11,12 Cr.N

126) "MICROLARYNGOSCOPY---size of lens used is 400mm

127) "VOCAL FREMITUS ---decreased in Emphysema , thick pleura, Pleural effusion,"

128) "common site of F.B. in lower respiratory tract is --Rt.Main Bronchus,"------------------((1))

129) "IMPAIRMENT OF hearing due to noise starts at ---4000 hz.,/ 4khz.,"-----------------((1))

130) "EAM=24 mm, / 2.4 cm.,"-------------------((1))

131) "E.T / PT.TUBE=36 mm., / 3.6 cm.," -----------((1))

132) "U-SHAPED AUDIOGRAM---CONGENITAL DEAFNESS,"----------((1))

133) FLAT AUDIOGRAM---SEROUS OTITIS MEDIA,---------------((1))

134) "CARHART'S NOTCH ---2000 hz., / 2Khz.,"--------------((1))

135) "WAX IN EAR ---commonest cause of deafness,"-----------((1))

Adie's pupil

A weak light reaction with segmental palsy of iris sphincter, a strong slow near response. an idiopathic postganglionic denervation of the parasympathetically innervated intraocular muscles, usually complicated by signs of aberrant regeneration of these nerves: See Also: tonic pupil. Syn: Adie's pupil, Holmes-Adie pupil, Holmes-Adie syndrome, pupillotonic pseudotabes.

Argyll Robertson pupil( absent reaction to pupillary light reflex & present reaction to accomodation ) a form of reflex iridoplegia characterized by miosis, irregular shape, and a loss of the direct and consensual pupillary reflex to light, with normal pupillary constriction to a near vision effort (light-near dissociation); often present in tabetic neurosyphilis. Syn: Robertson pupil.

Marcus Gunn pupil relative afferent pupillary defect. Syn: Gunn pupil.

Marcus Gunn jaw-winking is a form of synkinetic ptosis. An aberrant connection exists between the motor branches of the trigeminal nerve (CN V3) innervating the external pterygoid muscle and the fibers of the superior division of the oculomotor nerve (CN III) that innervate the levator superioris muscle of the upper eyelid. Electromyographic studies demonstrate this synkinetic innervation by showing simultaneous contraction of the external pterygoid and levator muscle. In these cases, the eyelid elevates on closing the mouth and clenching the teeth. jaw-winking ptosis. Jaw winking worse in downgaze o Decreased vision secondary to amblyopia o Strabismus + Vertical deviation, usually a hypotropia on involved side

Horner's pupil constricted pupil due to impairment of sympathetic nerve innervation of the dilator muscle of the pupil. See Also: Horner's syndrome.

causes of horners synd. include: -post. inf. cerebellar artery or basilar artery occlusion -MS -Hypothalamic lesions -cavernous sinus thrombosis -cervical cord, mediastinal or pancoast's tumour -Aortic aneurysm -Klumpke's paralysis -cervical lymph adenopathy

Horner synd. Shows= MAPEC.

M=Miosis,

A=Anhidrosis

P=Ptosis

E=Enphthalmoses

C=Loss of Ciliospinal reflex.

Amaroutic pupil:-pupil in an eye that is blind because of ocular or optic nerve disease; this pupil will not contract to light except when the normal fellow eye is stimulated with light.

Cat's eye pupil-

distorted, elongated pupil; usually due to anterior segment anomaly.

Hutchinson's pupil dilation of the pupil on the side of the lesion as part of a third nerve palsy; often due to herniation of the uncus of the temporal lobe through the tentorial notch.

Tonic pupil

a general term for a pupil with delayed, slow, long-lasting contractions to light and to a near vision effort, often with light-near dissociation; due to denervation and aberrant reinnervation of the iris sphincter; seen in various autonomic neuropathies and in Adie syndrome.

Tadpole-shaped pupil

n intermittent, brief distortion and dilation of a pupil that draws one part of the iris into a peak so that the pupil resembles a tadpole; a temporary, benign condition associated with migraine that may leave the patient with a Horner's syndrome.

LASIK

LASIK

Laser Assisted in-Situ keratomileusis (LASIK)

USED FOR: -

1. Myopic correction of = -1 to –20.00 diopters (-2 to –12 D; Parsons’), with up to 5 diopters of astigmatism

2. Hypermetropic corrections for +4.00

3. Central cornea thickness should be at least 500 microm.

CI: -

1. Unstable refractive error.(Refraction must be stable for 12-18 months)

2. Age less than 18 years.

3. iritis or scleritis, conjunctivitis, severe dry eye

4. Keratoconus. Cornea should not be excessive flat or steep.

5. Presence of a pacemaker

Preop’ly: -

Contact lens wear should be discontinued

--3 days before for soft contact lens wear prior to Lasik

--2 weeks before for rigid gas permeable lens wear prior to Lasik

PROCEDURE

1. A suction ring placed on the eyeball elevates IOP to about 60 mmHg (temporary blackout of vision occurs).

2. The microkeratome advances and creates an epithelial flap, which is hinged usually nasally.

3. EXCIMER LASER is used.

4. Leave behind residual corneal thickness of at least 250 microns.

5. Irrigate bed with saline and close the flap. No sutures. It sticks by itself.

6. Use antibiotics and steroid drops for about 1 week.

ENHANCEMENTS

• Enhancement LASIK (i.e. repeat procedure) can be performed but usually after 3 months of table refraction. Ref- internet notes and edited by drkbravva

PseudoMembranous conjunctivitis causative organisms

bacterial

corynebacterium diphtheriae of low virulence

staphylococi aureus

streptococcus pneumoniae (pneumococcus)

H.influenza

H.aegyptus

viral

herpes simplex

adenoviral epidemic keratoconjunctivitis

chemicals

acids

ammonia

lime

silver nitrate

copper sulphate