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Essentials of Postgraduate Medicine (MD Examination Oriented Topics)
SK Rajan, S Chandrasekar
1:
Acute Myocardial Infarction
ACUTE MYOCARDIAL INFARCTION
Clinical Features
Killip Classification
Diagnosis
ECG
Cardiac Enzymes
Non Invasive Cardiac Imaging
Coronary Angiography and Left Ventriculography
ACUTE MANAGEMENT
A. Fibrinolytic Therapy
B. Primary PTCA
Indications
C. Emergency CABG
Indications
Subsequent Management of MI
High Risk
Low Risk
2:
Role of Thrombolysis, PTCA, and Surgery in the Treatment of Myocardial Infarction
INTRODUCTION
Management of Myocardial Infarction–Goals of Treatment
Indications for reperfusion therapy.
Advantages of Reperfusion
Types of Reperfusion
Thrombolytic Therapy
Advantages
Disadvantages
Contraindication to Thrombolytic Therapy
Fibrin Specific
Alteplase (rt-PA)
Reteplase - (rPA)
Tenecteplase (TNk-tPA)
Fibrin non-specific SK
Success of Thrombolytic Therapy
Primary Percutaneous Coronary intervention (PCI)
Recommendations for Primary Angioplasty
Coronary Artery Bypass Graft
3:
Primary Prevention of Coronary Heart Disease
INTRODUCTION
PHARMACOLOGIC TREATMENT/PREVENTION OF ATHEROSCLEROSIS
Treatment Decisions Based on LDL Cholesterol Level
Positive CHD Risk Factors
4:
Rheumatic Fever
AETIOLOGY
Diagnosis
CARDITIS
MIGRATORY POLYARTHRITIS
SYDENHMAS CHOREA
SC NODULES AND ERYTHEMIA MARGINATUM
Evidence of Antecedent Streptococcal Infection is by
Management
Antibiotic
Following this, Secondary Prophylaxis is by
MEDICAL THERAPY FOR THE MANIFESTATION OF RH FEVER
5:
Current Concepts in Essential Hypertension
INTRODUCTION
Role of Renin in Essential Hypertension
Low Renin Essential Hypertension
High Renin Essential Hypertension
Chloride and Calcium Ions in Hypertension
Role of Insulin Resistance in Essential Hypertension
Management Guidelines of Essential Hypertension
Current Concepts in the Drug Therapy for Hypertension
Diuretics
Antiadrenergic Agents
Beta Adrenergic Receptor Blockers
Calcium Channel Antagonists
ACE Inhibitors
Vasodilators
6:
Hypertrophic ObstructiveCardiomyopathy
CLINICAL MANIFESTATIONS
Symptoms
Physical Examination
Heart Sounds
Associated MR
Murmur of HCM
Diagnosis
ECG
Ventricular Arrhythmias Common
CXR
Echo Cardiography
Cardinal Echo Features
Other Echo Findings
Radionucleotide Scanning
Cardiac Catheterisation
Angiography
Management Aim
β-Blockers
Calcium Antagonists
Other Non Surgical Measures
Surgical Treatment
7:
Community Acquired Pneumonia (CAP) vs Hospital Acquired Pneumonia
DEFINITION OF CAP
DEFINITION OF HOSPITAL ACQUIRED PNEUMONIA
Spectrum of Organisms
CAP
HAP
Predisposing Factors
CAP
HAP
Clinical Features of CAP
ATYPICAL PNEUMONIA
Diagnosis
Radiological Examination
Negative CXR
Sputum Examination
Others
Severity of Pneumonia and Hospitalisation
Management
ANTIBIOTICS
Uncomplication CAP
Severe CAP
Complications
8:
Acute Lung Injury (ALI)
INTRODUCTION
Aetiology
Pathophysiology
Pathology
Clinical Features
TREATMENT
Complications of Treatment
PROGNOSIS
9:
Non-Cardiogenic Pulmonary Oedema
INTRODUCTION
AETIOLOGY
Imbalance of Starling Forces
Altered Alveolar—Capillary Membrane Permeability (ARDS)
Lymphatic Insufficiency
Unknown
Pathogenesis
Pathology
Clinical Features
Diagnosis
Management
10:
Acute Pulmonary Embolism
INTRODUCTION
Clinical Syndromes
Symptoms and Signs
Classical Signs
Diagnosis
Nonimaging Diagnostic Modalities
ECG
NONINVASIVE IMAGING MODALITIES
Chest Radiography
Venous Ultrasonography
Lung Scanning
INVASIVE DIAGNOSTIC MODALITIES
Pulmonary Angiography
Depends on
Contrast Phlebography
INTEGRATED DIAGNOSTIC APPROACH
Differential Diagnosis
Treatment
ADJUNCTIVE THERAPY
ANTICOAGULATION
Heparin
LMW Heparin
Warfarin
Dose
Duration of Anticoagulation 6 Months
IVC Filters
THROMBOLYSIS
PULMONARY THROMBOENDARTERECTOMY
11:
Interstitial Lung Disease
INTRODUCTION
CLASSIFICATION
History
Symptoms and Signs
Investigations
Treatment
12:
Bronchial Asthma
AETIOLOGY, PATHOGENESIS AND MANAGEMENT
Definition
Etiology
Two Broad Types
Pathogenesis of Asthma
Mediators of the Acute Asthmatic Response
Management
Approach to Long-term treatment
Pharmacologic Agents for Asthma
Long-term Control Medications
Corticosteroids
Long-acting Bronchodilators
Leukotriene Modifiers
Desensitisation
Quick Relief Medications
13:
Aetiology, Clinical Features and Management of Dementias
INTRODUCTION
Aetiology
Most Common Causes
Clinical Features
Alzheimer's Disease
Vascular Dementias
H/o Hypertension
Chronic Alcoholism and Thiamine Deficiency
Vitamin B12 Deficiency
Deficiency of Nicotinic Acid and Pyridoxine
HIV and AIDS
CREUTZFELDT JAKOB DISEASE
Limbic Encephalitis
Normal Pressure Hydrocephalus
DEMENTIA PUGILISTIC (PUNCH DRUNK SYNDROME)
Management
Non-drug Behavioural Therapy
14:
Movement Disorders
INTRODUCTION
Types
Pathology
15:
Multiple Sclerosis
INTRODUCTION
Clinical Features
Common Presentations in Multiple Sclerosis
Mode of Onset
Motor
Sensory
Cerebellar Signs
Ocular
Paroxysmal Symptoms
Events Influencing the Course
Criteria for Diagnosis
Investigations
Treatment
16:
Myasthenia Gravis
INTRODUCTION
MYASTHENIA GRAVIS AND THYMOMA
Clinical Features
Modified Osserman Scale
MYASTHENIC CRISIS
Diagnosis
Treatment
Medical Treatment
Adverse Effects
Immunological Treatment
Plasma Exchange
I.V. Immunoglobulin
Azathioprine
Indications
17:
Neurological Complications of Systemic Disease
INTRODUCTION
CARDIOVASCULAR DISEASES AND CNS
INFECTIONS AND HIV
VASCULITIS AND CONNECTIVE TISSUE DISORDERS
DIABETES AND CNS
LIVER DISEASES AND CNS
HAEMATOLOGICAL DISORDERS AND CNS
Neurological Complications of Uremia
METABOLIC ENCEPHALOPATHY–CAUSES
SYSTEMIC CANCER AND NERVOUS SYSTEM
NEUROLOGIC PARANEOPLASTIC SYNDROME
18:
Acute Pancreatitis
19:
Chronic Pancreatitis
AETIOLOGY
Pathophysiology
Clinical Features
Diagnostic Evaluation
Pancreatic Enzymes in Body fluids
Studies Pertaining to Pancreatic Structure
Tests of Exocrine Pancreatic Function
Complications of Chronic Pancreatitis
Treatment
Approach
20:
Malabsorption Syndromes
DEFINITION OF MALABSORPTION
Etiopathogenesis
Intraluminal Digestion
Terminal Digestion
CLASSIFICATION (AETIOPATHOGENESIS)
Defective Intraluminal Hydrolysis or Solubilisation
Primary Mucosal Cell Abnormalities
Reduced Small Intestinal Surface
Infection
Lymphatic Obstruction
Iatrogenic
Drug-induced
Unexplained
Clinical Features
Alimentary Tract
Hematopoietic System
Musculoskeletal System
Endocrine System
Skin
Nervous System
Therapeutic Approach
21:
Diarrhoeal Disorders Encountered in the Tropics
INTRODUCTION
Pathobiology of Causative Agents
Toxin Producers
Enteroadherent
Cytotoxin - Producers
Invastive Organisms
ACUTE DIARRHOEA
Travellers
Consumption of Certain Foods
Immunodeficient Persons
Day Care Participants and their Family Members
Treatment of Acute Diarrhoea
MAJOR CAUSES OF CHRONIC DIARRHOEA
Secretory Causes
Osmotic Causes
Steatorrheal Causes
Inflammatory Causes
Dysmotile Causes
Factitial
Treatment of Chronic Diarrhoea
22:
Glomerulonephritis
INTRODUCTION
MECHANISM
Glomerulonephritis: Types and Causes
Minimal Change
Focal Segmental Glomerulosclerosis (FSGS)
Focal Segmental (Necrotising) Glomerulonephritis
Membranous Nephropathy
IgA Nephropathy
Type I
Type II
Post-Infectious
GOODPASTURE’S DISEASE (ANTI-GBM)
23:
Acute Tubular Necrosis
24:
Osteoporosis
DEFINITION
Etiology
Clinical Features
Investigations
Primary Hyperparathyroidism
Clinical Features
Localisation of Parathyroid Tambour
Management of Hypercalcaemic Crises
Investigation
Radiological
Management
25:
Rheumatoid Arthritis
INTRODUCTION
Criteria for Diagnosis of Rheumatoid Arthritis
Aetiology
Potential Mechanisms for Persistent Antigen Stimulation and Altered Immune Reactivity in RA
Pathology
Clinical Features
Extra-articular Manifestations of RA
Systemic
Musculoskeletal
Hematological
Lymphatic
Nodules
Ocular
Vasculitis
Cardiac
Pulmonary
Neurological
Management
General Treatment in Active Phases
Local Measures in the Active Phase
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Disease–Modifying Anti-rheumatic Drug
Immunomodulators
Drugs
Medical Synovectomy
Surgical Treatment and Rehabilitation
26:
Hyperlipoproteinemias
DEFINITION
Structure
Classification of Lipoproteins and Their Composition
Fredrickson's Classification of Hyperlipoproteinemias
Primary Hyperlipoproteinemias Resulting from Single Gene Mutations
Pathogenesis of Pancreatitis
Differential Diagnosis Include
SECONDARY HYPERLIPOPROTEINEMIAS
Treatment
Bile Acid Sequestrants
Mechanism of Action
Dose
Side Effects
Drug Interation
NICOTINIC ACID
Mechanism of Action
Dose
Indications
Side Effects
Laboratory Abnormalities
Contraindications
HMG CoA Reductase Inhabitors
Mechanism of Action
Effects
Dose
FIBRATES
27:
Hypercalcaemia
HYPERCALCAEMIA
Causes
Parathyroid Related Hypercalcaemia
Primary Hyperparathyroidism
Clinical Features
Diagnosis
Treatment
Lithium
Familial Hypocalciuric Hypercalcaemia
HYPERCALCAEMIA OF MALIGNANCY
Mechanisms: By
Vit D Related Hypercalcaemia
Treatment
Vit D Intoxication
Treatment
High Bone Turnover States
THIAZIDES
Vit A Intoxication
Treatment
RENAL FAILURE
Treatment
DD of Hypercalcaemia
Treatment of Hypercalcaemia
28:
Clinical Features/Diagnosis Treatment of Toxoplasmosis
OCULAR INFECTIONS
Infection of the Immunocompromised Person
Congenital Toxoplasmosis
Diagnosis
Immunocompromised Host
Congenital Infection
Treatment
FOR CONGENITAL INFECTION
For Immunocompromised Patients
Prevention
29:
Amoebiasis
INTRODUCTION
Pathogenesis
Clinical Features
Intestinal Amoebiasis
Amoebic Liver Abscess
Extraintestinal Sites
Investigations
DD
Management
30:
Lymphatic Filariasis
LYMPHATIC FILARIASIS
Etiopathogenesis
Pathology
Clinical Features
Investigations
Treatment
Prevention
31:
Leukaemias
ACUTE MYELOID LEUKAEMIAS
Acute Iymphoid Leukaemia
CHRONIC MYELOID LEUKAEMIA
Clinical Features
Diagnosis
Blood
Bone Marrow
Disease Acceleration
Blast Crisis
Chromosomal Findings
Prognostic Factors
Management
Blast Crisis
32:
Transfusion Reactions
IMMUNE MEDIATED
1. Acute Haemolytic Reactions
Signs and Symptoms
Management
2. Febrile Non Haemolytic Reactions
3. Allergic Reactions
4. Anaphylactic Reactions
5. Graft vs. Host Reaction
Prevention
ACUTE LUNG INJURY
Non-immunologic Reactions
Fluid Overload
Hypothermia
Electrolyte Toxicity
Iron Overload
Hypotension
Infections
Viral
Bacterial
Parasites
33:
Acute Aortic Regurgitation
34:
Unstable Angina
INTRODUCTION
Unstable Angina Patients Fall into Three Groups
Five Mechanisms for Unstable Angina have been Described
35:
Dilated CMP
36:
Stunned Myocardium
INTRODUCTION
37:
Endomyocardial Fibrosis
INTRODUCTION
Pathology
Clinical Manifestations
Right Ventricular EMF
Left Ventricular Emf
Diagnosis
Treatment
38:
ATT Induced Hepatitis
INTRODUCTION
Drugs Causing Hepatitis
Treatment
39:
Torsades De Pointes
40:
Ebstein's Anomaly
41:
Cystic Diseases of Lung
42:
Primary Complex
INTRODUCTION
Clinical Features
Complications
PLASMA PHERESIS
43:
Pontine Haemorrhage
INTRODUCTION
Primary Pontine Haemorrhage have been Divided into Three Clinical Types
44:
Drugs Used in Tuberculosis
45:
Lacunar Infarcts
INTRODUCTION
Pure Motor Hemiplegia
46:
Tropical Pulmonary Eosinophilia
INTRODUCTION
Clinical Features
Pathology
Differential Diagnosis
Treatment
47:
Spontaneous Bacterial Peritonitis (SBP)
INTRODUCTION
One Variant of SBP is
Treatment
48:
Cystic Fibrosis
49:
Allergic Broncho Pulmonary Aspergillosis (ABPA)
50:
Lung Diseases in Acquired Immunodeficiency Syndrome
I. BACTERIAL INFECTIONS
Pneumocystitis Carini Infection
Mycobacterium Tuberculosis Infection
II. FUNGAL INFECTIONS
III. IDIOPATHIC INTERSTITIAL PNEUMONIA
IV. NEOPLASTIC DISEASE
51:
Parkinson's Disease
INTRODUCTION
Definition
Anatomy
Pathogenesis
Clinical Features
Differential Diagnosis
52:
Dystonias
INTRODUCTION
Types
Secondary Dystonia
53:
Brainstem Death
INTRODUCTION
Preconditions
Exclusion
Absence of Brainstem Reflexes viz
54:
Hepatic Osteodystrophy
INTRODUCTION
Causes
Clinical Features
Treatment
55:
Chronic Hepatitis
56:
Dysequilibrium Syndrome
INTRODUCTION
Treatment
57:
Wilson's Disease
58:
Gastro-oesophageal Reflux Disease
59:
Renal Amyloidosis
CLINICAL MANIFESTATIONS
Investigative Approach
60:
Renovascular Hypertension
INTRODUCTION
The Diagnostic Work up of Patients Involve
Management of Renovascular Hypertension
Diagnosis
Goals of Therapy
Surgical Management
Percutaneous Transluminal Renal Angioplasty (ptra)
Indications
Procedures
Response to Surgery
Medical Treatment
Indications
61:
Renal Osteodystrophy or Metabolic Bone Disease
62:
Eating Disorders
INTRODUCTION
Anorexia Nervosa
Clinical Features
Bulimia Nervosa
Clinical Features and Diagnostic Criteria
63:
Maniac Depressive Psychosis
INTRODUCTION
Differential Diagnosis
Etiology and Pathophysiology
Treatment
64:
Lithium Induced Diabetes Insipidus
65:
Tropical Endocrine Problems other than Pancreatic Diabetes
HYPOPITUITARISM
Pituitary Diabetes Insipidus
Hypothyroidism
Thyrotoxicosis
Cushing's Syndrome
Adrenal Insufficiency
66:
Alport Syndrome
INTRODUCTION
Four Forms Seen
Incidence
Molecular Defect
Clinical Feature
Treatment
67:
Gestational Diabetes
INTRODUCTION
Treatment
68:
Diseases Produced in Human Beings by Rodents
69:
Deposition Arthropathy
70:
Odynophagia
INTRODUCTION
71:
HIV Associated Nephropathy
72:
Paraneoplastic Syndromes
INTRODUCTION
Common Paraneoplastic Endocrine Syndrome
Paraneoplatic Haematologic Syndromes
73:
Neurological Features of HIV/AIDS
MENINGITIS
PERIPHERAL NEUROPATHIES
MYELOPATHIES / RADICULOPATHIES
ENCEPHALITIS LOCAL DISEASE INFECTION
NONINFECTIOUS
74:
Potassium Channel Activators
75:
Reactive Arthritis: (Reiter's Syndrome)
DEFINITION
Pathogenesis
Clinical Manifestations
Evaluation
Differential Diagnosis
Treatment
Outcome
76:
Leukemoid Reactions
AETIOLOGY
Lab Investigations
Differential Diagnosis
Leukaemia
77:
Postpartum Psychosis
78:
Pathophysiology and Management of Resistant Malaria
PATHOPHYSIOLOGY OF MALARIA
Mechanisms of Resistant to Drugs
Treatment of Resistant Malaria
Uncomplicated Malaria
Severe Malaria
Chloroquine resistant Malaria
Important Points
79:
Tropical Sprue
AETIOLOGY
Diagnosis
Treatment
80:
Seizure Disorder in Tropics
INTRODUCTION
Tuberculosis Involving Brain
Neurocysticercosis
81:
Leptospirosis
INTRODUCTION
Pathogenesis
Clinical Manifestations
Anicteric Leptospirosis
Severe Leptospirosis: (Weil's Syndrome)
Investigations
Diagnosis
Treatment
82:
Endemic Fluorosis
83:
Neurocysticercosis
84:
Tropical Splenomegaly
85:
Bubonic Plague
86:
Sheehan's Syndrome
87:
Scorpion Sting
88:
Giardiasis
89:
Complications of Snake Bite
90:
Brucellosis
AETIOLOGY
Caused By 4 Species
Clinical Features
Investigations and Diagnosis
Brucella Antibody Titre
Treatment
91:
Tropical Pyomyositis
INTRODUCTION
92:
Tumourlysis Syndrome
93:
Antiretroviral Therapy
INTRODUCTION
When to Start Antiretroviral Therapy
94:
Fish Oil
INTRODUCTION
95:
Sedative Poisoning
INTRODUCTION
Benzodiazepines
Miscellaneous Sedative Hypnotics
96:
Gene Therapy
INTRODUCTION
Approaches
Gene Transfer
Techniques of Gene Therapy Include
Applications
97:
Catatonic Schizophrenia
INTRODUCTION
Clinical Forms
Excited Catatonia
Stuporous Catatonia
Signs
Catatonia Alternating Between Excitement and Stupor
98:
Blood Component Therapy
99:
Drugs and Thrombocytopenia
INTRODUCTION
Underproduction
Increased Destruction
Heparin-induced Thrombocytopenia (HIT)
Diagnosis
Treatment
Drug Induced Platelet Dysfunction
100:
Trace Elements
INTRODUCTION
Zinc
Copper
Selenium
Chromium
Fluoride, Manganese and Ultrace Elements
101:
ObsessiveCompulsive Disorder
102:
Subarachnoid Haemorrhage
103:
LE Phenomenon
INTRODUCTION
104:
Syndrome “X”
INTRODUCTION
Features Include
Pathogenesis
Cysticercosis (Except Neurocysticercosis)
Epidemiology/Pathogenesis
Subcutaneous and Muscular Cysticercosis
Definitive Diagnosis
Treatment
Medical Treatment
105:
Proteinuria
INDEX
TOC
Index
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