Medicine

Reference: Davidson 23rd, Page: 1160
Explanation: most common site of SAH are Anterior communicating artery (30%)

Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae. The disease affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes.

Reference: Davidson 23rd; P-137

ACE inhibitor and ARB are contraindicated 

Davidson Box: 16.72

Hepatitis B and C testing. This should be done prior to therapy with rituximab in NHL

Ref: Davidson 23rd; P-944, box: 23.32

Reference: Davidson 23rd Box 21.37

chronic type 2 respiratory failure, marked by hypoxemia (PaO2 <60 mmHg) and hypercapnia (PaCO2 >45 mmHg), commonly results from COPD, ankylosing spondylitis, sleep apnoea, myopathies, muscular dystrophies. 

Acute gout is treated with colchicine, NSAIDs, or steroids. Allopurinol (xanthine oxidase inhibitor) is for chronic prophylaxis, not acute attacks.

Answer: D
Explanation: Nephritic syndrome is characterised by hematuria, hypertension, oliguria, and azotemia. Davidson emphasises that hyperlipidemia is a feature of nephrotic syndrome, not nephritic syndrome. Nephritic syndrome results from glomerular inflammation, leading to red blood cell leakage into the urine. Harrison explains the differences between nephritic and nephrotic syndromes, noting that nephritic syndrome also causes renal insufficiency and fluid retention.

ALL peaks between ages 2–5 and presents with anemia, thrombocytopenia, and lymphadenopathy.

Reference: Davidson 23rd, Box-3.4

Reference: Davidson 23rd; P-837

Ref: Davidson 23rd; P-971

Burrows + nocturnal pruritus are pathognomonic for scabies (caused by Sarcoptes scabiei mite).

Explanation: Headache, drowsiness, fever and neck stiffness are the usual presenting features. In severe bacterial meningitis the patient may be comatose, later developing focal neurological signs

TP is characterised by a pentad of findndings, although few patients have all five components:
 thrombocytopenia  microangiopathic haemolytic anaemia  neurological sequelae  fever  renal impairmen

Reference: Davidson 23rd; P-813

Reference: Davidson 23rd; P-514

In acute stroke, the priority is to differentiate ischemic stroke from hemorrhagic stroke is the main concern & it is done by Non-contrast CT brain.

Reference: Davidson 23rd, Page: 1133
Explanation: The diagnosis may be confirmed by lumbar puncture, which shows raised normal CSF constituents at increased pressure ( usually > 30 cmH2O CSF )

Reference: Davidson 23rd; P-802
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-482

Reference: Davidson 23rd; P-813
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

AFP is elevated in up to 70% of patients with HCC and used as a screening and diagnostic tool.

Explanation: Ulcerative colitis is associated with PSC

Reference: Davidson 23rd; P-637, box: 18.8

Vitamin C is essential for the hydroxylation of proline and lysine during collagen synthesis. This hydroxylation is critical for forming stable collagen triple helices, which are fundamental to the structural integrity of skin, blood vessels, bones, cartilage, and gums.

Complications
 Laryngeal obstruction or paralysis
 Myocarditis  Peripheral neuropathy

IgM anti-HBc indicates acute or recent infection. HBsAg shows current infection but doesn’t differentiate acute from chronic.

HbA1c reflects average blood glucose over 2–3 months, making it the standard for monitoring long-term glycemic control in diabetes. Fasting and random glucose tests assess acute levels, and the oral glucose tolerance test is for diagnosis, not monitoring.

Reference: Davidson 23rd, Box-13.12

From lateral to medial, the four deep cerebellar nuclei are the dentate, emboliform, globose, and fastigii.

Hypercarotenaemia occurs due to excessive ingestion of carotene-containing vegetables or in situations of impaired metabolism such as hypothyroidism or anorexia nervosa.

A yellowish discoloration is seen on the face, palms and soles but not the sclera or conjunctiva, and this distinguishes it from jaundice 


Macledo 14th/P-26

Reference: Davidson 23rd; P-800

Reference: Davidson 23rd; P-800

CLL is caused by a monoclonal proliferation of B-cell lymphocytes

Reference: Davidson 23rd; P-351

Reference: Davidson 23rd , Page : 717 , Box : 19.34

Stem Breakdown:

Chronic fatigue, pruritus (itching), and dry eyes: These are common symptoms in cholestatic liver disease, particularly in autoimmune liver conditions.
Isolated elevation in ALP: Alkaline phosphatase elevation suggests cholestasis, where bile flow is impaired, leading to liver dysfunction.
Positive antimitochondrial antibodies (AMA): This is the hallmark serological finding in primary biliary cholangitis (PBC).
Option Analysis:

A) Primary biliary cholangitis (PBC): This is the correct diagnosis. Davidson explains that PBC is an autoimmune disorder characterised by chronic inflammation and destruction of small bile ducts in the liver. The presence of AMA is highly specific for PBC, and ALP is typically elevated due to cholestasis. Harrison notes that PBC often presents with fatigue and pruritus and is associated with other autoimmune conditions like Sjögren's syndrome (dry eyes).
B) Autoimmune hepatitis: Autoimmune hepatitis typically presents with elevated aminotransferases (ALT/AST) and is associated with autoantibodies such as ANA or SMA, not AMA. It does not cause isolated cholestasis.
C) Primary sclerosing cholangitis (PSC): PSC is another cholestatic liver disease, but it is associated with inflammatory bowel disease (usually ulcerative colitis) and typically shows beading of the bile ducts on imaging. AMA is negative in PSC.
D) Hepatitis C: Chronic hepatitis C can cause liver damage, but it usually presents with elevated ALT/AST rather than isolated ALP elevation, and it is not associated with AMA positivity.

Explanation: Echocardiography is a pivotal investigation for vulvular heat disease

Passive transfer of maternal antibodies: can mediate autoimmune disease in the fetus and newborn, including SLE, Graves' disease, and myasthenia gravis.

Hypovolaemia (e.g., from dehydration or haemorrhage) is a classic cause of pre-renal AKI due to reduced renal perfusion. The others are intrinsic or post-renal causes.

Ref: Davidson 23rd; P-1015