Medicine

Reference: Davidson 23rd; P-361

A Specific Phobia is marked fear or anxiety about a specific object or situation (e.g., heights, animals, injections, flying). The fear is out of proportion to the actual danger, is persistent (typically 6 months or more), and leads to immediate anxiety response and often avoidance.

ECG changes in Hypokalemia 
T wave flattening and  inversion
·Prominent U wave
·Increased amplitude and  width of the P wave
·Prolongation of the PR  interval
·ST depression
·Apparent long QT interval
(= long QU interval)

·Supraventricular  tachyarrhythmias: AF, atrial  flutter, atrial tachycardia
·life-threatening ventricular  arrhythmias, e.g. VT, VF and  Torsades de Pointes

Dissociative disorders present with amnesia, identity alteration, or functional neurological symptoms without organic cause.

Dorsalis pedis pulse
Using the pads of your middle three fingers, feel at the origin of the first web space just lateral to the tendon of extensor hallucis longus 

Reference: Davidson 23rd; P-784
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation: Fever with night sweats is Associated with particular infections (e.g. TB, infective endocarditis)

Reference: Davidson 23rd; P-565

Reference: Davidson 23rd; P-854
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-634

Hypokalemia is the most common electrolyte abnormality associated with prolonged vomiting. Davidson explains that vomiting leads to loss of gastric acid (hydrochloric acid), which triggers renal potassium excretion to maintain acid-base balance. Harrison adds that the body responds to the loss of hydrogen ions by increasing bicarbonate reabsorption, further promoting potassium excretion and hypokalemia.

Pleural fluid analysis using Light’s criteria is the gold standard to differentiate transudative from exudative effusions. Criteria include pleural fluid/serum protein ratio >0.5, pleural fluid/serum LDH ratio >0.6, or pleural fluid LDH >2/3 the upper limit of normal serum LDH, indicating an exudate.

Reference: Davidson 23rd; P-463
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation: the most serious cause of viral encephalitis is herpes simplex which probably reaches the brain via the olfactory nerves. Varicella zoster is also an important cause.

Explanation:

Reference: Davidson 23rd; P-136

Reference: Davidson 23rd; P-626

Reference: Practical Manual in Clinical Medicine by Professor ABM Abdullah; P-168

Reference: Davidson 23rd; P-412

Explanation: Osteoclasts are multinucleated cells of haematopoietic origin, responsible for bone resorption. Osteoblasts are mononuclear cells

Reference: Davidson 23rd, Box-22.38

Explanation

Sudden onset of Unilateral pleuritic chest pain with absent breath sound & resonant hemithorax: Tension pneumothorax.

Reference: Davidson 23rd, Box-21.84

Explanation: Abdominal pain is the most common symptom and is usually in the right upper quadrant, sometimes with radiation to the right shoulder. The pain may be pleuritic in nature.

Nephritic syndrome is characterized by haematuria (often with dysmorphic RBCs), hypertension, and oliguria due to glomerular inflammation. Massive proteinuria and hyperlipidaemia are features of nephrotic syndrome.

Ref: Davidson 23rd; P-989

Explanation: Calcium is the most abundant cation in the body and powerful homeostatic mechanisms control circulating ionised calcium levels.

Diethylcarbamazine (DEC)—6 mg/kg in three divided doses for 2 weeks

Panic disorder is defined by recurrent, unexpected panic attacks, which are abrupt surges of intense fear or discomfort that reach a peak within minutes, accompanied by a cluster of physical and cognitive symptoms (as listed). The "unexpected" nature is key for panic disorder diagnosis.

Reference: Davidson 23rd; P-585
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Explanation: ‘Koplik’s spots’ seen on buccal mucosa in the early stages of clinical measles, is pathognomonic for measles

Explanation: see question no: 5

: ITP is an autoimmune disorder characterized by isolated thrombocytopenia due to increased platelet destruction and/or impaired platelet production. The hallmark lab finding is a significantly low platelet count (often below 100,000/µL, and sometimes below 20,000/µL), while other cell lines (red blood cells and white blood cells) remain normal. Options a, c, and d are more indicative of other conditions: elevated PT/PTT suggests coagulation factor deficiencies, schistocytes suggest microangiopathic hemolytic anemia, and a positive direct Coombs test indicates autoimmune hemolytic anemia.

Scleritis (inflammation of the sclera) and episcleritis are significant ocular manifestations of RA, indicating more severe systemic disease. Other extra-articular features of severe RA include rheumatoid nodules, vasculitis, Felty's syndrome (RA, splenomegaly, neutropenia), and lung involvement (e.g., interstitial lung disease, pleural effusion).

Symmetric small joint (MCP/PIP) involvement and morning stiffness suggest rheumatoid arthritis (RA). Anti-CCP is highly specific for RA (more than rheumatoid factor). Anti-dsDNA is seen in SLE, anti-Jo-1 in polymyositis, and anti-centromere in CREST syndrome.

Reference: Davidson 23rd; P-841
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-834
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-491
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

In the vast majority of patients, CAD is caused by atherosclerosis but rarely it can occur as the result of aortitis, vasculitis and autoimmune connective tissue diseases

Reactive arthritis (Reiter’s syndrome) presents with arthritis, conjunctivitis, and urethritis (classic triad) after GI/GU infections (e.g., Chlamydia, Shigella). HLA-B27 is strongly associated. HLA-DR4 is linked to RA, HLA-DQ2 to celiac disease.

The most evident symptom is fatigable muscle weakness; movement is initially strong but rapidly weakens as muscle use continues.
Worsening of symptoms towards the end of the day or following exercise is characteristic. There are no sensory signs or signs of involvement of the CNS, although weakness of the oculomotor muscles may mimic a central eye movement disorder. The first symptoms are usually intermittent ptosis or diplopia but weakness of chewing, swallowing, speaking or limb movement also occurs. Resting of the eyelids (looking downwards)
may be followed by increased reflex elevation with up-gaze (so-called Cogan's lid twitch sign). Any limb muscle may be affected, most commonly those of the shoulder girdle; the patient is unable to undertake tasks above shoulder level, such as combing the hair, without frequent rests. Respiratory muscles may be involved and respiratory failure is an avoidable cause of death.

The standard 12-lead ECG is central to confirming the diagnosis and deciding immediate management of ACS Patients

Reference: Davidson 23rd , Page : 505
Explanation : The most common cause of aortic aneurysm is atherosclerosis.

Reference: Davidson 23rd; P-577

Answer: A
Explanation: The "butterfly" or malar rash is a hallmark feature of systemic lupus erythematosus (SLE), described in both Davidson and Harrison. This rash typically spares the nasolabial folds and is often triggered by sun exposure. SLE is a multisystem autoimmune disease, and skin manifestations like the malar rash are part of the diagnostic criteria.

Explanation: Fragile X syndrome is the most common inherited cause of intellectual disability. Davidson explains that the condition is caused by an expansion of the CGG trinucleotide repeat in the FMR1 gene on the X chromosome, leading to abnormal brain development. Harrison adds that Fragile X syndrome typically presents with developmental delay, intellectual disability, and characteristic facial features, such as a long face and large ears.

Combination of co-amoxiclav (amoxicillin + clavulanic acid) and a macrolide like clarithromycin for severe community-acquired pneumonia. This regimen covers Streptococcus pneumoniae, atypical organisms (e.g., Mycoplasma pneumoniae, Chlamydia pneumoniae), and other common pathogens.

Explanation: The cardinal symptoms are rectal bleeding with passage of mucus and bloody diarrhoea.

Silvery scale is found in psoriasis

Explanation: All are the causes of bradycardia, Option A, B, D are pathological cause.

Ref: Davidson 23rd; P-971

Isolated systolic hypertension: 
1. Calcium channel blockers (dihydropyridine)
2. Thiazides or thiazide-like diuretics