Page 1 of 14: TOPICS MOST REPEATED from Medicine in the past AIPGE exams

BGM · Credits: 104516 My Scrapbook

BGM · Credits: 104516 My Scrapbook

As the AIPGE is near... one cannot spend his/her time reading Harrison..

So i believe one must cruise through the most commonly repeated topics at least once...

HERE'S THE LIST

01. Viral Hepatitis –Repeated 20 times
Refer 16th edition Harrison Vol 2 page no 1845-1851

02. Acid base balance – Repeated 15 times
Refer 16th edition Harrison Vol 1 page no 263-270

03. CA lung – Repeated 14 times
(Ref: 16th edition Harrison vol 1 page no 506-514)

04. Migraine/Temp Arteritis/Cluster Head Ache – Repeated 14 times
(Ref: 16th edition Harrison vol 1 page no 87-93)

05. Intracranial Haemorrhage – Repeated 13 times
(Ref: 16th edition Harrison vol 2 page no 2387)

06. Hyperparathyroidism –Repeated 11 times
(Ref: 16th edition Harrison vol 2 page no 2252)

07. Cardiac Tamponade -Repeated 11 times
(Ref: 16th edition Harrison vol 2 page no 1415)

08. CSF in meningitis – Repeated 10 times
(Ref: 16th edition Harrison vol 2 page no 2476-Table 360-1)

09. HOCM – Repeated 10 times
(Ref: 16th edition Harrison vol 2 page no 1410)

10. Antiphosholipid antibody syndrome – Repeated 10 times
(Ref: 16th edition Harrison vol 2 page no 1681-1682)

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11. Multiple myeloma- Repeated 10 times
(Ref: 16th edition Harrison vol 1 page no 656)

12. Coarctation of aorta – Repeated 9 times
(Ref: 16th edition Harrison vol 2 page no 1387)

13. HSP – Repeated 9 times
(Ref: 16th edition Harrison vol 2 page no 2010)

14. Psoriatic/Osteo/Rheumatoid Arthritis – Repeated 9 times
(Ref: 16th edition Harrison vol 2 page no 1998/2036/1968)

15. Thymoma leading to Hypogammaglobulinaemia – Repeated 8 times
(Ref: 16th edition Harrison vol 2 page no 1946)

16. MEN – Repeated 8 times
(Ref: 16th edition Harrison vol 2 page no 2231)

17. Phaeochromocytoma – Repeated 8 times
(Ref: 16th edition Harrison vol 2 page no 2148)

18. No infective endocarditis in ASD- Repeated 8 times
(Ref: 16th edition Harrison vol 2 page no 1385)

19. Polycythaemia – Repeated 7 times
(Ref: 16th edition Harrison vol 1 page no 335)

20. Vit B12 deficiency – Repeated 7 times
(Ref: 16th edition Harrison vol 2 page no 2404)

drctvs · Credits: 13212 My Scrapbook My Reading List 1 Books

great job bgm .. thanks...

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IMPORTANT POINTS

VIRAL HEPATITIS

Clinical & Laboratory features of Chronic Hepatitis
Refer 16th edition Harrison Vol 2 page no 1845-1851

Chronic Hepatitis B
*Diagnostic Test – HbsAg, IgG anti-HBc, HBeAg, HBV DNA
*Auto antibodies – Uncommon
*Therapy – IFN alpha, Lamivudine

Chronic Hepatitis C
*Diagnostic test – Anti HCV, HCV RNA
*Auto antibodies – Anti – LKM1
*Therapy – PEG IFN-alpha plus Ribavirine

Chronic Hepatitis D
*Diagnostic test – Anti HDV, HDV RNA, HBsAg, IgG anti-HBc
*Auto antibodies – Anti – LKM3
*Therapy – IFN alpha

Auto immune Hepatitis
*Diagnostic test – ANA (homogenous), antiLKM, hyperglobulinaemia
*Auto antibodies – ANA, Anti - LKM1, Anti – SLA
*Therapy – Prednisolone, Azathioprine

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ACID BASE BALANCE

Refer 16th edition Harrison Vol 1 page no 263-270

AG = Na – (Cl + HCO3) –Normal = 10-12 mmol/L

Causes of high Anion Gap Metabolic acidosis (Table 42.3)
• Lactic Acidosis
• Keto Acidosis – DM /starvation/alcoholic
• Toxins –Ethylene Glycol, Methanol, Salicylates
• Renal Failure(A/C & C/C)

Causes of Non anion Gap Acidosis (Table 42.4)
• Gastrointestinal bicarbonate loss – Diarrhea, External Pancreatic or small bowel drainage, Uretrosigmoidostomy ,Drugs – Calcium chloride, Magnesium sulphate,Colestyramine.
• Renal Acidosis – *Hypokalemia – a . Proximal(Type2)RTA b. Distal(Type1)RTA *Hyperkalemia – generalized distal nephron dysfunction(type4RTA)
• Drug induced Hyperkalemia – Potassium sparing diuretics, Trimethoprim, Pentamidine, ACE inhibitors, NSAIDs, Cyclosporine.
• Other – Acid loads, Loss of potential bicarbonate, Expansion acidosis, Hippurate, Cation exchange resins.

Treatment of severe Acidosis (Metabolic)
Severe acidosis (pH<7.20) warrants iv administration of 50-100meq of NaHCO3

Treatment of Lactic Acidosis
Then underlying condition that disrupts lactate metabolism must first be corrected: tissue perfusion must be restored when it is adequate.

AG in DKA
>17mmol/L accompanied with Hyperglycemia

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CA LUNG

(Ref: 16th edition Harrison vol 1 page no 506-514)

Frequency of CA lung (Table 75-1)
• Adeno CA – 32%
• Squamous cell CA – 29%
• Small cell CA – 18%
• Unspecified – 11%
• Large cell CA – 9%
• Bronchoalveolar – 3%
• Carcinoid – 1%
• Muco epidermoid CA – 0.1%
• Sarcoma & other soft tissue tumors – 0.1%
• Adenoid Cystic CA - <0.1%

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HEAD ACHE

(Ref: 16th edition Harrison vol 1 page no 87-93)

Temporal arteritis
• Common disorder of the elderly i.e. 50yrs or older.
• Average age of onset 70yr
• 65% occurs in women.
• 50% untreated patients cam develop blindness
• Symptoms – Headache (50%pts site- temoporal) with malaise & muscle aches, Polymyalgia Rheumatica, Jaw claudication, Fever & Weight loss
• Pain usually appears gradually over a few hours before peak intensity is reached – Usually Dull & Boring with superimposed ice pick like lancinating pains.
• Scalp tenderness – present
• Head ache – worse at night & is often aggravated by exposure to cold
• ESR – is often, though not always: elevated

Tension Head Ache
• Chronic head pain syndrome characterized by a bilateral tight, band like discomfort.
• Pain typically builds up slowly, fluctuates in severity & may persist more or less continuously for many days.
• Exertion does not worsen the head ache.
• Episodic/Chronic headache
• Common in women
• Occurs in all age groups
• In some patients – anxiety or depression may co-exist with tension head ache.

Migarine
• Occurs in 15% women & 6% men
• Nausea, Photophobia, Light headedness, Scalp tenderness, Vomiting, Visual disturbances, Paraesthesias, Vertigo, Alteration of consciousness, Diarrhoea
• Activators – Red wine, Menses, Hunger, Lack of sleep, glare, Estrogen, Worry, Perfumes, Let-down periods)
• De-Activators – Sleep , pregnancy, Exhilaration, triptans.

Cluster Head ache
( Raeders syndrome, Histamine cephalagia , sphenopalatine neuralgia)
• Usually episodic
• Men affected 7-8 times often than women
• 1-3 short lived attacks of Periorbital pain per day over a 4 to 8 week period, followed by a pain free interval that averages 1 year
• Peri-orbital or less commonly,temporal pain begins without warning & reaches a crescendo within 5 min.
• Pain is usually excruciating in intensity and is deep non fluctuating and explosive in quality
• Pain is strictly unilateral & usually affects the same sides in subsequent months
• Attacks last from 30min to 2 hours
• Associated symptoms – Homolateral Lacrimation, Reddening of the eye, Nasal stuffiness, Lid ptosis & nausea
• Alcohol provokes attack in 70% patients
• Periodicity occurs in 85% patients
• Onset is nocturnal in 50% cases which awkens the patients within 2 hours of falling asleep.

spaw12345 · Credits: 3814 My Scrapbook

gret job bjm.
thnx a lot!!!!

tornado97 · Credits: 6380 My Scrapbook My Reading List 14 Books

really good

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