Medicine

Explanation: Treatment should be continued for 14 days

(Ref : Davidson 23rd ,p-703 )

About one-third of those who develop an acute schizophrenic episode have a good outcome. One-third develop chronic, incapacitating schizophrenia, and the remainder largely recover after each episode but suffer relapses. Most affected patients cannot work or live independently. Schizophrenia is associated with suicide and up to 10% of patients take their own lives

Explanation: Osteoarthritis (OA) is by far the most common form of arthritis and is a major cause of pain and disability in older people. It is characterised by focal loss of articular cartilage, subchondral osteosclerosis, osteophyte formation at the joint margin, and remodelling of joint contour with enlargement of affected joints.

Less common sign in hypothyroidism
Goitre with bruit
Atrial fibrillation
Systolic hypertension/increased
pulse pressure
Cardiac failure
Hyper-reexia
Ill-sustained clonus
Proximal myopathy
Bulbar myopathy

Less common sign in hyperthyroidism
Hoarse voice
Facial features:
Purplish lips
Malar flush
Periorbital oedema
Loss of lateral eyebrows
Anaemia
Carotenaemia
Erythema ab igne
Bradycardia hypertension
Delayed relaxation of reexes
Dermal myxoedema

Reference: Davidson 23rd; P-825

Diabetic nephropathy is the leading cause of CKD globally, driven by the high prevalence of diabetes. The others are less common causes.

IV drug use-associated endocarditis often involves the tricuspid valve

Reference: Davidson 23rd; P-569
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-496

Reference: Davidson 23rd; P-612

The low-dose dexamethasone suppression test is the best screening test for Cushing’s syndrome. Davidson explains that in Cushing’s syndrome, cortisol secretion fails to be suppressed by dexamethasone, indicating autonomous cortisol production. Harrison adds that a 24-hour urine cortisol measurement can also be used to confirm the diagnosis, but the dexamethasone suppression test is more sensitive for detecting mild hypercortisolism.

Lactulose reduces ammonia absorption via colonic acidification.

Davidson 23rd; P-1118

Ref: Davidson 23rd; P-992 , box : 24.10

IBS is a functional disorder with abdominal discomfort that improves post-defecation. No alarm features like bleeding or weight loss.

Reference: Davidson 23rd; P-563

Myxomas are the most common type of primary cardiac tumor in all age groups, most commonly in third to sixth decade, with a female predilection.

Langerhans’ cells have the primary function of antigen presentation to lymphocytes.

Leukemia is a group of cancers affecting the blood-forming tissues, primarily the bone marrow. It is characterized by the uncontrolled proliferation of abnormal, immature white blood cells (blasts) that accumulate in the bone marrow, peripheral blood, and sometimes other organs, impairing the production of normal blood cells.

Reference: Davidson 23rd Fig. 21.19 most common cause of Upper GIT bleeding is PUD

( Ref : Davidson 23rd ,p – 700 )

A) Retinal artery occlusion: This is the correct diagnosis. Davidson and Harrison explain that central retinal artery occlusion is caused by an embolus or thrombus blocking blood flow to the retina, leading to sudden, painless vision loss. The pale retina and "cherry red spot" are classic fundoscopic findings.
B) Retinal vein occlusion: Retinal vein occlusion causes painless vision loss, but the fundoscopy would show "blood and thunder" appearance with dilated veins, hemorrhages, and cotton-wool spots, not a pale retina with a cherry red spot.
C) Diabetic retinopathy: Diabetic retinopathy causes vision loss over time due to microvascular damage from diabetes. Fundoscopy reveals microaneurysms, hemorrhages, and neovascularization, not the findings described here.
D) Acute glaucoma: Acute glaucoma causes sudden, painful vision loss due to increased intraocular pressure. It is associated with a red, painful eye and a hazy cornea, not the fundoscopic findings described.

Regular moderate-intensity exercise (including aerobic and strengthening exercises) and weight loss (for overweight or obese individuals) are the most effective non-pharmacological interventions for managing OA pain and improving function. They reduce joint load, strengthen supporting muscles, and improve joint mobility.

Reference: Davidson 23rd; P-852
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-669

Ref: Davidson 23rd; P-1020

PE can cause hemoptysis due to pulmonary infarction, often with sudden dyspnea and pleuritic pain

Tophi are pathognomonic (distinctive) subcutaneous or articular deposits of monosodium urate crystals that occur in chronic, untreated hyperuricemia. They are characteristic of chronic tophaceous gout and can lead to joint destruction and deformity. Heberden's nodes are osteophytes in osteoarthritis.

Molluscum contagiosum is caused by a DNA poxvirus skin infection. It is most common in children over the age of 1 year, particularly those with atopic dermatitis. It also occurs frequently in immunosuppressed patients, including those with HIV. Lesions are dome-shaped, ‘umbilicated’, skin-coloured papules with central punctum . They are often multiple and found at sites of apposition, such as the side of the chest and the inner arm.

Q waves May signify previous myocardial infarction

Explanation: Diseases associated with mosquito bite includes Malaria, dengue fever, Chikungunya, filariasis, tularaemia

Explanation: Viruses are the most common cause of meningitis, usually resulting in a benign and self-limiting illness requiring no specific therapy. It is much less serious than bacterial meningitis unless there is associated encephalitis. A number of viruses can cause meningitis, the most common being enteroviruses

Reference: Davidson 23rd; P-514
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

( Ref : Davidson 23rd ,p - 257 )

Explanation: Felty’s syndrome is a rare complication of seropositive RA in which splenomegaly occurs in combination with neutropenia and thrombocytopenia

Rose spots are faint salmon-colored macules on the trunk and abdomen seen in about 30% of cases

DEC (see above) is curative, in a dose of 9–12 mg/kg daily, continued for 21 days

Reference: Davidson 23rd; P-765
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-835
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Paromomycin is an aminoglycoside that is used to treat visceral leishmaniasis and intestinal amoebiasis. It is not significantly absorbed when administered orally, and is therefore given orally for intestinal amoebiasis and by intramuscular injection for leishmaniasis. It showed early promise in the treatment of HIV-associated cryptosporidiosis but subsequent trials have demonstrated that this effect is marginal at best.

Justification: In patients with pre-existing valvular abnormalities, such as mitral valve prolapse, streptococcus viridans is the most common cause of infective endocarditis. Davidson emphasizes that viridans streptococci typically enter the bloodstream following dental procedures or minor mucosal trauma. Harrison describes the importance of prophylactic antibiotics in high-risk patients undergoing invasive procedures.

Reference: Davidson 23rd; P-592
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-674

Lung fluukes: Paragonimus spp

Explanation: Causes of Central chest pain: Cardiac, aortic, oesophagial, Mediastinal, Pulmonary embolus & Anxiety/emotion. Peripheral chest pain: Lungs/pleura, Musculoskeletal, Neurological.
Ref: Davidson 23rd, Page-177

Reference: Davidson 23rd; P-592

Reference: Davidson 23rd; P-853
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]

Reference: Davidson 23rd; P-746

Reference: Davidson 23rd; P-514
সলভ ক্লাসের জন্য আলোচনা পোস্ট দেখুন - [আলোচনা পোস্টের লিঙ্ক]