Parkland Formula

1. Calculation of area of burn (By using 'Rule of nine')

Burnt area = Anterior chest (9%) + Posterior chest (9%) + Both upper limbs (18%) = Total 36%

Fluid required (By using Parkland's formula) :

Fluid to be given in 24 hours post burn = 4 x Body weight x Percentage of burnt area. = 4 x 50 x 36 = 7200 ml

Half of this amount (3600 ml) should be given in first 8 hours, and remaining half in next 16 hours. But, calculation should be made from the 'TIME of BURN' , and not from the time of hospitalization. So, since this female was hospitalized two hours after getting burnt, she should receive 3600 ml of fluid within 6 hours after hospitalization. (i.e. upto 10 pm).

2. Drops per minute :

['Drop factor' of an i.v infusion set indicates the number of drops falling in its chamber which will make ONE ml of fluid. It is variable (e.g. 10, 15, 16 or 20) for different infusion sets and is printed on the packet.]

Formula : "Drops per minute = (Amount of fluid to be given in ml / Time in minutes) X Drop factor"

Here, you have to infuse 3600 ml fluid in 6 hours (and not in 8 hours)

So, Drops per minute = (3600 ml/ 360 min) x 10 = 100

Final answer : 3600 ml fluid.... to be given @ 100 drops per minute.

Angiosarcoma

Markers of angiosarcoma
 Factor VIII related Ag
 UEA-1
 CD31(most sensitive and specific)
 CD34
❄Osmolarity of plasma: 290 mosm/l
❄Osmolarity of WHO ORS: 311 mosm/l
❄Osmolarity of low osmolar ORS: 245 mosm/l
❄Osmolarity of Resomal: 300 mosm/l
D/D os short 4th & 5th metacarpal
〰 Post traumatic
〰 Ischemic ds like sickle cell anemia
〰 Pseudohypoparathyroidism
〰 Pseudopseudohypoparathyroidism
〰 Turners syndrome
Austrian syndrome

Pneumonia➕endocarditis➕meningitis

Doc- ceftriaxone

Typical cells of pathology... -

1) Ascoff giant cells in rheumatic heart disease.
      Also called caterpillar cells
2)Asteroid bodies - sarcoidosis
3)Armani ebstein cells- epithelial cells of PCT in patients with diabetes
4)Burr cells-abnormal RBC having spines in uraemia ..
5)Creola bodies in sputum of bronchial asthma patient ..
6)Colloid or civatte bodies in LICHEN PLANUS-a disorder of skin n              mucous membrane..
7)Councilman body-yellow fever
8) Clear cells-adeno carcinomas.
9)Classic RS cells-mixed cellularity type.
10)clue cells-bacterial vaginosis
11) Dutcher bodies ( in nucleus)in multiple myeloma
12)Dohle bodies & pseudo-pegler-huet cells in myelo dysplastic syndrome
13)Foam cells ( lipid laden macrophages and smooth cells) ..... Seen in  atherosclerosis
14)Ferruginous bodies- asbestosis
15)Flame cells-multiple myeloma
16)Gamma gandy bodies -CVC spleen
17)Glitter cells-pathognomonic of pyelonephritis,leukocyte with visible movement of cytoplasmic processes.
18)Gitter cells/hortega cells-modified microglia in CNS that form complex     granular corpuscles.
19)Halberstaedar prowazek bodies- trachoma
20)Heart failure cells-CVC lung, hemosiderin-laden macrophages) also in Pulmonary edema
21) Heinz bodies, bite cells, spherocytes - hereditary spherocytosis
22)Hirano bodies in Alzheimer's disease
23)Hobnail cells-clear cell tumour of ovary
24)Hofbauer- placenta(early pregnancy)
25)Hurthle cells-hashimoto's thyroiditis (autoimmune)
       Hurthle cell in follicular carcinoma
26)Ito cell - present in space of disse in liver
27)Lacunar cells-nodular sclerosis subtype of HL.
28)Langhans cells-a type of giant cell seen in epitheloid granuloma. 29)Langerhans cells-antigen presenting cells in epidermis (modified macrophages)
30)Leishman donovan bodies- kala azar
31)Leventhal Cole Lillie bodies- psittacosis
32)LE cell-neutrophil in SLE
33)Lewy bodies are neurons containing intra cytoplasmic , eosinophilic elongated inclusions in parkinsonism
34)Mallory bodies- alchoholic hepatitis
35)Merkle cells-lower layer of epidermis.
36)Miyagawa bodies- LGV
37)Muller cells-neuroglia present in retinal epithelium.
38)Negri bodies in rabies
39)Osteoclast like giant cells - pancreatic cancers
40)Psammoma bodies seen in meningioma , papillary cystadenocarcinoma of ovary, papillary carcinoma of thyroid
41)Pick cells in pick disease a neurodegenerative disorder.
42)Popcorn cells-lymphocyte predominance type.
43)Reed Sternberg cells-Hodgkin's lymphoma
44)Rusell bodies in multiple myeloma
45)Schistocytes , burr cells , helmet cells , triangle cells - microangiopathic hemolytic anaemia
46)Sickle cells , target cells , Howell jolly bodies -sickle cell anemia
47)Signet ring cells-krukenburg tumour
48)Smudge cells - CLL/ SLL
49)Spider cells-rhabdomyoma.
50)Tadpole cells-seen in pap smear of SQCC of cervix.
51)Tart cell lymphocyte in SLE stave cells - spleen
52)Tear drop cells in megaloblastic anemia ,primary myelofibrosis
53)Virchow cells or lepra cells-lepromatous leprosy
54)Verocay bodies in schwammoma
55)Weibel Palade bodies- EM findng in tumors of vascular origin

Translocations

(x : 17 ) - alveolar soft part tumour

t(x: 18 ) - synovial sarcoma
t(11:14) - mantle cell lymphoma
t(14:18) - follicular cell lymphoma
t(11:18) - maltoma , extranodal marginal zone lymp.
t(15:17) -AML M3
t (8:21) - AML M2
t(14:4) ,t(14:11) ,t(14:6) , t(14:16) - multiple myeloma
t(8:14) .t(2:8) ,t(8:22) - burkitt's lymphoma
t(2:5) - anaplastic large cell lymphoma
t(3q:v) - diffuse large B-cell lymphoma (v-variable)
t(2:13) - alveolar rhabdomyosarcoma
t(2:16) - myxoid liposarcoma
t(11:22) - pnet , askins tumour( ewings)
t(3:8) - renal adenocarcinoma , mixed parotid tumour
t(6:14) - cystadeno carcinoma of ovary
t(10:17) - papillary thyroid carcinoma
t(x:1) - peadiatric papillary RCC
t(9:22) - philadelphia chromosome
t(12:21) - ALL 

High yield

DNB/NEET TERMED POINTS

Pringle maneuver is clamping of porta hepatis to control hemorrhage. placing an atraumatic clamp across the foramen of winslow .

Gunther’s disease is AR congenital erythropoietic porphyria from decreased URO synthase activity - hemolytic anemia - cutaneous lesions.

Marshall - vein of is oblique vein of left atrium.

Syme’s amputation is amputation at the ankle with removal of the malleoli and placement of the heel pad over the end of the remaining tibia.

Jod-Basedow phenomenon is thyroid hyperfunction induced by excess iodine ingestion in patients with various thyroid disorders.

Rasmussen’s encephalitis is progressive childhood disease characterized by severe epilepsy - hemiplegia - dementia - and inflammation of the brain potentially from autoantibodies to GluR3 antigen.

Carney syndrome (or triad) is nonfamilial disorder the includes combination of three rare tumors: gastric leiomyosarcoma - pulmonary chondroma - extraadrenal paraganglioma but no cardiac manifestations; unrelated to Carney complex.

Bergmann gliosis is in ethanol abuse - proliferation of astrocytes adjacent to lost Purkinje cells between depleted granular cell and molecular layer of cerebellum.

Prehn's sign is elevation of painful testicle decreases pain of epididymitis.

Parinaud syndrome

PARINAUD'S SYNDROME---( dorsal midbrain syndrome)
Supranuclear vertical gaze disorder caused by damage to the posterior commissure.
Causes include hydrocephalus from aqueductal stenosis,pineal region tumors, cysticercosis, and stroke.
Features include loss of upgaze, convergence-retraction nystagmus on attempted upgaze, downward ocular deviation ("setting sun" sign), lid retraction (Collier's sign), skew deviation, pseudoabducens palsy, and light-near dissociation of the pupils
PARINAUD'S OCULOGLANDULAR SYNDROME--- Granulomatous conjunctivitis, swollen painful preauricular lymph nodes
Causes include infections like Bartonella henselae,Francisella tularensis..

Alcohol

In alcohol intoxication, motor incoordination and judgement errors occur at blood alcohol
levels of
a.  30-80 mg/dL
b.  80-200 mg/ dL
c.  200-300 mg/dL
d.   More than 300 mg/ dL
Ans. (b)

Ethanol intoxication
Measurement of levels in exhaled air is the primary method of assessing the level of intoxication.
Blood alcohol levels are necessary to confirm the presence or absence of alcohol intoxication.
Blood ethanol levels of 20-30 mg/dL
An increased reaction time, diminished fine motor control, impulsivity, and impaired judgment
become evident when the concentration of ethanol in the blood is 20-30 mg/dL.
Blood ethanol levels of about 80 mg/dL
Blood levels of 80 mg/dL are associated with slurred speech, incoordination, unsteady gait, and
potential impairments of attention.
Levels between 80 and 200 mg/dL
Levels between 80 and 200 mg/dL are associated with mood lability and cognitive deficits,
potentially accompanied by aggressiveness, and anterorgrade amnesia (an alcoholic blackout).
Levels >200 mg/d
Blood ethanol levels >200 mg/dL can produce nystagmus and unwanted falling asleep.
Levels of 300 mg/dL and higher
Levels of 300 mg/dL and higher can produce failing vital signs, coma, and death.  In fatal cases,
the average concentration is about 400 mg/dL, although alcohol-tolerant individuals often can
withstand comparable blood alcohol levels.
Acute Ethanol Intoxication. Goodman & Gilman's The Pharmacological Basis of
Therapeutics, 12e > Chapter 23. Ethanol and Methanol
K.S Narayana Reddy: The essentials of forensic medicine and toxicology.