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gbeja
Aim Canada

Posts which r totally irrelevant to the topic of discussion
u re quite right


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gbeja
Aim Canada

just helping


shrutarshi
Aim NEET PG

hi


shalabhsaxena
Aim NEET PG

Diference between PQLI & HDI
Please clarify what is the difference between PQLI and HDI (Human Development Index) icon_question.gif icon_question.gif icon_question.gif


jesusrules
Aim PLAB Part 2

gbeja wrote:
u re quite right
Migraine patient, had CT, Wants MRI, Counsel him


sawbones
Aim Andhra Pradesh PG

hi friends
hi every body [/b]


snithin
Aim AIIMS

hi how are preparations for entrance exam? which exam is in this year?


damigem
Aim UPSC

me too


moon22
Aim USMLE Step 1

what is the alternative of warfarin


moon22
Aim USMLE Step 1

antidote for organophosphorus compounds and hw it is administered means to say direct i/v or in infusion .In what dosage


moon22
Aim USMLE Step 1

i m looking for a female study partner in Lahore


drsurat
Aim NEET PG

any one in surat lokking out to aus
any one in surat wantint to go to aus and can help me decideing --please help


dg_ash
Aim Canada

Hi i am preparing for AMC MCQ exam and currently i am in UK, could any one help me with how to prepare for it, and where to get the study material
thanks


ranipal
Aim Australia

antidote for op poisoining is atropine and it is given IV in dose of 0.4 - 2 mg every 15 min till atropinsation is acheived and pulse is 140/min


salih
Aim PLAB Part 2

Some point about crainail nerve examination

Cranial Nerve Examination 1. Cranial nerve I:
Ask patient about smelling. Test with different flavours (rarely require
in the ophthalmology examination)

2. Cranial nerve II.:

visual acuity
visual field
colour vision
optic disc appearance

3. Cranial nerve III, IV and VI:

eye movement
ptosis (III nerve) and pupil reaction to light (II & III nerve)
4. Cranial nerve V:
jaw power
sensation of face
corneal and jaw reflexes
5. Cranial nerve VII:
facial power (orbicularis oculi, blink lag, buccinator, orb oris)
upper or lower motor lesion

6. Cranial nerve VIII:

hearing
Weber/Rinne tests

7. Cranial nerve IX:

gag reflex

8. Cranial nerve X:

soft palate elevation and deviation
gag reflex
9. Cranial nerve XI:
shoulder elevation (trapezius and sternomastoid)
10. Cranial nerve XII:
tongue function; wasting / fasciculation
The most common case of multiple cranial nerve palsies in the MRCOphth
/MRCS setting is cavernous sinus fistula. Rarely, you have patient with old
basal skull fracture with seventh and sixth nerves palsy. However, the examiner may simply ask you to perform the cranial nerves examination just to see
how slick you are in perform this test.


salih
Aim PLAB Part 2

Tips for clinical examination
Always introduce yourself and be courteous to the patients
Ask for permission before examination
Avoid hurting the patient
Listen to the instruction carefully
Do not forget to observe the patient first for examples hearing aid or dermatitis etc.
Learn to describe the physical findings before giving the likely diagnosis
Do not rush in the examination. Remember more than one signs may be present. (This may be associated or coincidental)
Do not panic if you do not know the diagnosis. Give the physical findings and provide a list of differential diagnosis (you may want to classify the pathology as congenital or acquired; congenital may be inherited or non-inherited and acquired may be traumatic, nepotistic, inflammatory, iatrogenic etc.)
Present your findings confidently and look the examiner in the eyes. Avoid using words "may be, I think, could be"
Treat each case as new and do not let a bad case affect your subsequent examination.
Avoid derogatory such as syphilis, cancer or multiple sclerosis. Use euphemism or medical jargons instead such as St.Louise's disease, neoplasm or demyelinating diseases.
Thank the patients and examiners at the end of the examination even if the whole thing go badly.


salih
Aim PLAB Part 2

Pupillary Examination
Observe:
anisocoria ( the most cases being Horner's, Adie's, third nerve palsy.
Less commonly siderosis bulbi and traumatic. Although physiological
anisocoria is the most common cause, it seldoms appear in the examination.)
heterochromia (congenital Horner's syndrome and siderosis bulbi)
ptosis (Horner's syndrome and third nerve palsy )
2. Differences in pupil size in light and shade.
3. Reaction to direct and consensual light.


Why is the above technique frowned upon by
the examiner?
Answer at the bottom.
--------------------------------------------------------------------------------


4. Swinging light test for afferent pupillary defects.

Left afferent pupillary defect.

5. Reaction to accommodation
6. Additional examination depends on the above findings


RAPD (this indicate optic nerve disease or extensive retinal dysfunction.
Look for optic disc pallor, advanced glaucoma cupping or total retinal detachment.)
Horner's syndrome (neck or chest scar )
Third nerve (ocular motility )
Adie's pupil (slit-lamp for vermiform iris movement and knee jerk )
Argyll-Robertson's pupil ( interstitial keratitis, deafness )

In the absence of anisocoria, the most likely case is relative afferent pupillary defect and less commonly light/near dissociation.

In the presence of anisocoria, you are likely to be asked about differential diagnosis and the pharmacological diagnosis of anisocoria. Always have a list of causes for abnormal small or large pupil and learn the pharmacological diagnosis for Horner's syndrome and Adie's pupil well.

Answer to the question:
Miosis occurs with accommodation.
To see clearly the pupil reaction to light, the patient should be
instructed to look at a distant object to reduce accommodation.
By standing in front of the patient, the candidate stimulates
accommodation and hence miosis.


seenappa
Aim NEET PG

surgery-patho
relation of smoking in to the etiology of cervical and breast cancer


awadwilliam
Aim PLAB Part 2

hi there
I am an Australian doctor


famma
Aim NEET PG

whats the scope of physiology in near future in india


seenappa
Aim NEET PG

hi
hey good thought

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