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143 Cards in this Set
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Hyperthyroidism due to excess iodine or iodide |
Jodbasedow syndrome |
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Thyrotoxicosis due to excess exogenous thyroid hormones |
Thyrotoxicosis factitia |
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Ovarian tumour or teratoma containing mostly thyroid tissue resulting in thyrotoxicosis |
Struma ovarii |
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Classic triad of goitre, thyrotoxicosis and exophthalmos |
Grave's disease |
Diffuse primary thyrotoxicosis |
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What is diagnostic of Grave's disease? |
Presence of LATS(long acting thyroid stimulator) in serum |
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Which is the most sensitive test of hypothyroidism? |
Serum TSH |
This is raised in primary hypothyroidism and almost undetectable in hyperthyroidism |
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Most useful index of thyroid function |
Serum T3 and T4 |
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Grave's disease |
Hyperthyroidism, exophthalmos and pretibial myxedema (thickening of skin due to mucin like deposits in the lower part of leg) |
Systemic autoimmune condition |
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Lid lag, when the patient is asked to look down, his upper eyelid fails to follow the rotation of the eyeball and thus lags behind |
Von Graffe's sign |
Seen in thyrotoxicosis |
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Absence of wrinkling on the forehead when the patient is asked to look upwards with the head fixed |
Joffroy's sign |
Seen in thyrotoxicosis |
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Failure of convergence of eyeballs |
Moebius' sign |
Seen in thyrotoxicosis |
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Upper sclera seen due to retraction of eyelids |
Dalrymple's sign |
Seen in thyrotoxicosis |
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Staring look, absence of normal wrinkling |
Stellwag's sign |
Seen in thyrotoxicosis |
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Variant of follicular adenoma composed of large acidophilic granular cells |
Hurthle cell adenoma aka askanazy or oxyphil adenoma |
Hurthle cells(no follicle formation) |
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Metastatic enlargement of deep cervical nodes in case of papillary carcinoma was previously called as |
Lateral aberrant thyroid |
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Papillary carcinoma of thyroid |
Most common;lymphatic spread; feature-multicentricity;psammomma bodies;size of the lesion more important than metastasis |
Near total thyroidectomy |
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Follicular carcinoma of thyroid |
Capsular and angioinvasion;blood spread |
Radio iodine treatment |
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Anaplastic carcinoma of thyroid |
Direct spread, feature-presence of mitosis |
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Medullary carcinoma of thyroid |
Equal sex incidence ;presence of amyloid in the stroma ;metastatic lesion-osteoblastic;MEN 2 ;precursor-C cell hyperplasia ;ectopic production of ACTH |
Total thyroidectomy |
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Modified epithelial cells seen in Hashimoto's thyroiditis |
Askanazy cells |
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Deaf and goitrous patient since infancy |
Pendred's syndrome |
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Sudden pain with increase in size of a simple goitre |
Large hemorrhage within a cyst or degenerative nodule |
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Wolff chaikoff effect |
Hypothyroidism caused due to ingestion of excess iodine |
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Treatment of choice for pleomorphic adenoma |
Superficial parotidectomy |
Patey's operation |
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Diagnostic index of warthin's tumor(papillary cystadenoma lymphomatosum ) |
Hot spot in 99m Tc-pertechnate scan |
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Only salivary gland tumor that shows perineural invasion |
Adenoid cystic carcinoma |
Aka cylindroma |
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Reconstruction of the parotid duct in case of a fistula is done by |
Newman or seabrock's operation |
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Tetanus |
Cl. Tetani(gram +ve, anaerobic - drumstick appearance), exotoxin-tetanospasmin and tetanolysin (Gets fixed to anterior horn of motor cells of spinal cord) ;risus sardonicus, opisthotonous |
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Tetanus neonaturum |
Via Contamination of cut surface of umbilical cord |
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Post abortal or puerperal tetanus |
Due to unsterile manipulation during abortion |
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Most often affected nerve in cephalic tetanus |
Facial nerve |
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Gas gangrene |
Cl. Welchii/perfringens(saccharolytic) ;exotoxins-alpha toxin(lecithinase - splits lecithin into phosphocholine and diglyceride), theta toxin( both hemolytic) , collagenase , hyaluronidase, leucocidin. Liberation of sulphurated hydrogen, ammonia and volatile gases |
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Most characteristic feature of gas gangrene |
Profuse discharge of brownish foul smelling fluid between the sutures and presence of crepitus |
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Acute staphylococcal infection of the hair follicle with peri folliculitis |
Furuncle |
Blind boil, stye |
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Firm abscess containing sterile pus |
Antibioma |
Due to continuous administration of antibiotics |
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Secondary foci of suppuration caused due to lodgement of septic emboli |
Pyaemia |
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Condition in which bacteria circulate in the blood stream |
Bacteraemia |
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Develop of clinical manifestations due to liberation of toxins by the bacteria in the blood stream |
Septicemia |
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Conditions in which toxins circulate in the blood stream |
Toxaemia |
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Infective gangrene of the subcutaneous tissue due to staphylococcal infection |
Carbuncle(heals with induration ) |
Sieve like or cribriform appearance, mostly on the back |
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Non suppurative inflammation spreading along subcutaneous and connective tissue planes |
Cellulitis |
Streptococcus pyogenes |
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Acute inflammation of the lymphatics of skin or mucous membranes |
Erysipelas;defense cell-small mononuclear cells;notable absence of pus, rosy raised rash with sharp margin ;streptococcus pyogenes |
Milian's ear sign (spread to the pinna ) |
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Example of degeneration cyst |
Apoplectic cyst |
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Ulcerated sebaceous cyst of the scalp with excessive granulation tissue |
Cock's peculiar tumor |
Resembles fungating epithelioma |
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March fracture |
Stress/fatigue fracture most common in neck of 2nd metatarsal |
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Torus fracture |
One cortex is fractured while the other one is intact with buckling or compaction |
Buckle fracture |
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Angulation force combined with axial compression causing fracture with a separate triangular piece of bone |
Butterfly fracture |
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Healing of fracture |
Haematoma formation - cellular proliferation - callus formation-new bone formation - remodeling |
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Callus |
Mass of new bone formation via endochondral ossification. From 10th day to end of 3rd week |
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Simultaneous healing of wound and fracture |
Winettorr method |
Limb kept completely in plaster |
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Types of shock common in fracture |
Neurogenic and oligaemic shock |
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Fat embolism in fracture |
Due to aggregation of chylomicrons which forms large embolic fat globules |
1st place of lodgement-lung capillaries |
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Fat embolism syndrome |
Abnormalities of lung, brain and skin |
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Collapse after trauma |
Shock-first 3 hours Fat embolism - 3rd day Pulmonary embolism - 3rd week |
Rule of 3s |
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Seddon's elliptical zone of necrosis |
necrosis of an elliptical mass of muscles of the forearm |
Supracondylar fracture of humerus causing injury to brachial plexus resulting in ischaemia of forearm |
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Contracture developing in a necrosed muscle due to fibrosis |
Volkmann's ischaemic contracture |
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Calcium deposition in the muscles or tissues near a joint following fracture causing considerable restriction of movement |
Myositis ossificans traumatica |
Traumatic subperiosteal ossification (common in children) |
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Myositis ossificans progressiva |
Widespread ossification in different muscles of body causing painful hard swellings |
Inflammatory origin |
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Painful osteoporosis of bones following fracture |
Sudeck's atrophy (t/t - intra arterial injection of novocaine) |
Mostly after Colles' fracture |
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Dangerous layer of scalp |
Loose areolar tissue |
Emissary veins connecting dural sinuses with veins of the scalp are present here |
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Scalp suturing in small wounds |
Interrupted 1 layer (SCA) |
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Subperiosteal infection of scalp leading to subperiosteal pus formation and scalp edema |
Pott's puffy tumor |
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What indicates communication between an intracranial dermoid and a dermoid of the head? |
Impulse on coughing |
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Cirsoid aneurysm |
Hemangioma of an artery |
Scalp-most commonly affects superficial temporal artery |
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Horse shoe shaped fracture surrounding calvarium |
Occurs in a tangentially directed violence |
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When does the depressed fracture of a skull becomes significant? |
When the degree of depression is greater than the depth of the inner table |
To be elevated |
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Dural tear |
Interrupted sutures with non absorbable material such as fine silk |
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Closure of defect in a non contaminated dural loss |
Transplant from fascia lata os pericranium |
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Large dural tear involving a dural sinus |
Suture with Temporal muscle graft hammered to a flat sheet |
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Intracranial aerocele occurs in |
Basal fracture of anterior cranial fossa |
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Internal strabismus in fracture of middle cranial Fossa is due to |
Injury to CN VI |
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Fracture of Base of the skull may cause injury to various cranial nerves except |
CN II and CN XII |
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Most important pathological process in contusion |
Brain edema |
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Contrecoup injury |
Severe laceration on the side opposite to that of injury |
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Type of epilepsy occurring as a sequela of brain contusion or laceration |
Traumatic epilepsy of Jacksonian type |
Simple or focal partial seizure |
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Victor Horsley sign |
Higher temperature on the paralysed side in case of cerebral compression |
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Hutchinson's pupil |
Seen in cerebral compression |
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Herniation of contents of the brain |
Coning |
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Extradural hemorrhage |
Lens shaped on CT Lucid interval Hutchinson pupil |
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Main symptom of intraventricular hemorrhage |
Hyperthermia |
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Cleft lip |
Disturbance during 6 weeks of IUL Defect in the fusion of median nasal process with maxillary process Central variety (hare lip) - due to failure of fusion of 2 bulbous extremities of medial nasal processes |
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Cleft palate |
Disturbance during 8 weeks of IUL Defective fusion of premaxilla and 2 palatine processes |
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2 small blind tubes in lower lip lined by squamous epithelium |
Inferior labial sinuses or mandibular recesses |
Associated with upper cleft lip |
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Rule of 10s |
Cleft lip repair |
10lbs weight, 10 weeks old, Hb 10,leucocyte count less than 10,000 |
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Time of repair of cleft palate |
1-1.5 years |
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Surgical techniques for cleft lip repair |
Mirault Blair operation for unilateral Milliards rotation advancement repair |
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Surgical techniques for cleft palate repair |
Langenback's operation Wardills four flap operation |
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Branchial cyst |
Persistent precervical sinus (2nd arch) Congenital, but manifests during 20-25 years Upper and lateral part of the neck Cholesterol crystals |
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Branchial fistula |
Persistent second branchial cleft Opening present in the lower 3rd of neck near anterior border of SCM |
2nd arch fails to fuse with 5th arch or epipericardial ridge |
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Deep seated carcinoma in the neck near the bifurcation of Common carotid artery with no evidence of primary Ca |
Branchiogenic carcinoma |
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Cystic hygroma |
Earliest swelling Multiple locules of clear lymph Brilliantly translucent Posterior triangle of the neck T/T-Injections of boiling water done at weekly intervals |
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Cold abscess |
TB,gumma degeneration, actinomycosis, leprosy Cold abscess secondary to caries spine of cervical region requires immobilisation with Minerva jacket |
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Rib arising from 7th cervical vertebra |
Cervical rib Cervical rib syndrome (muscular wasting in the affected arm, drooping of shoulder girdle ) Positive adson's test, also in scalenus anticus syndrome |
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Pathognomonic of gummatous ulcer |
Wash leather slough |
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Staphylococcal infection in an area of repetitive trauma |
Footballer's ulcer |
Shin |
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Infective ulcer |
Bairnsdale and pyogenic ulcer |
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Arterial ulcer |
Intermittent claudication and discolouration No sign of healing and Pain upon raising the leg above heart level Punched out ulcers |
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Neurogenic ulcer |
Aka perforating ulcers Trophic ulcers - bed sores |
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Tropical ulcer |
Callousness towards healing Slightly raised edge Copious serosanguinous discharge with considerable pain |
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Cryopathic ulcers |
Chilblains and frost bite |
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Martorells ulcer |
Above 50 years, hypertensive or atherosclerosis Punched out Back or outer side of calf |
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Bazins ulcer |
Erythrocyanosis frigida Young females Leg and ankle Sympathectomy advised |
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Cutaneous form of TB affecting face and hand |
Lupus vulgaris |
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Meleneys ulcers |
Seen in post op wounds after operations for perforated viscus or for drainage of empty emergency thoracis |
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Marjolins ulcer |
Carcinoma arising in a old burn scar |
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Only type of shock which can be safely treated with vasoconstrictor drug |
Neurogenic shock |
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Vasogenic or vasovagal shock can be corrected by |
Tredelenburg position |
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Swan ganz catheter is introduced into the CVS by |
Right IJV |
For precise diagnosis and circular derangement of shock |
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Resuscitation in hypovolemic shock should always be started with |
Non sugar, non protein crystalloid solution with sodium concentration approximately that of plasma |
Ringers lactate, ringers acetate or normal saline supplemented with 1 or 2 ampoules of sodium bicarbonate |
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Crush syndrome is associated with |
Oligaemic shock |
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Thready pulse |
Excessive hemorrhage |
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Best method for detecting blood loss |
Weighing of swabs |
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Capillary hemorrhage (oozing) |
Oxycel, gelatin sponge, gauze soaked adrenalin solution, stypven or Russell viper venom |
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Oozing from bone can be stopped by |
Bone wax |
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Blood bag contains |
410 ml of blood out of which there is 75ml of anticoagulant |
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Anticoagulant solutions used to mix with donor blood |
CPD solution - trisodium citrate, citric acid, sodium dihydrogen phosphate and dextrose, shelf life 3 weeks CPDA1-CPD with adenosine to increase shelf life ;5 weeks |
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Temperature at which blood is stored in a blood bank |
4 degree c |
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Contents that are rapidly destroyed in stored blood |
WBCs, platelets, factor V and VIII |
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500 ml of CPD stored blood will raise Hb levels by |
10% |
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Characteristic clinical feature of incompatible blood transfusion |
Pain in the loins |
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Extensive blood transfusion results in |
Metabolic alkalosis |
Due to presence of sodium citrate which becomes sodium bicarbonate once the citrate is consumed |
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Most important danger of massive transfusion |
Failure of natural process of coagulation and DIC |
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Fresh frozen plasma |
Stored at - 20 degrees c |
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Cryoprecipitate |
White glutinous precipitate of FFP Stored at - 40 degree c Rich source of factor VIII Used in haemophilia |
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Platelet concentrate |
Obtained from PRP by centrifugation pH 6.5 |
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Dextran is produced from |
Leuconostoc mesenteroids Induces rouleaux formation, not to be used more than 1l |
Low mol. Wt dextran also known as Rheomacrodex or dextran 40 High mol. Wt dextran 70 |
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Red cell substitute |
Fluorocarbon |
Patient to be placed in hyperbaric environment |
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Only solution that contains more potassium than available in plasma or ECF |
Darrows solution Best to combat hypokalemia |
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Burn |
Coagulative necrosis |
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Port wine colored urine |
Seen after major electrical burns |
Release of hemochromogens into blood from injured musculature |
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Major hallmark of 2nd degree burns |
Blebs or vesicles between epidermis and dermis |
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Commonest cause of death in a burn patient |
Oligaemic shock |
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Abrupt fall in eosinophil count during first 12 hours is characteristic of |
Burns |
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Liver in burns |
Focal areas of necrosis Presence of intranuclear inclusions and councilman bodies |
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Acute ulceration of stomach and duodenum following major thermal injury |
Curling ulcer |
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Wound contraction |
Lag period 3-4 days Period of rapid contraction - completed by 14th day |
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Picture frame area |
Contracting mechanism located in the margins of the wound (contains myofibroblasts) |
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Re-epithilialisation of wound |
Within 48 hours |
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Boyds classification |
Grade I : pain disappears if the patient continues to walk Grade II: pain continues but the patient can walk with effort Grade III: pain compels the patient to take rest |
Intermittent claudication Release of excess P substance |
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Cry of the dying nerves |
Ishemic changes, rest pain |
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Buergers test |
Pallor of the ischaemic limb upon elevation Buergers angle:angle at which the pallor appears (less than 30 ° - severe) |
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Allen test |
To check the integrity of the palmar arterial arch |
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Continuous machinery murmer |
Presence of A-V fistula |
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