Monday, 19 December 2016

Urease positive organisms

Urease positive organisms
PUNCH:
Proteus (leads to alkaline urine)
Ureaplasma (renal calculi)
Nocardia
Cryptoccocus (the fungus)
Helicobacter pylori

Thursday, 15 December 2016

ACUTE PANCREATITIS

ACUTE PANCREATITIS
RansonRanson’s Criteria on Admission : age greater than 55 years
a white blood cell count of > 16,000/ µL
blood glucose > 11 mmol/L (>200 mg/dL)
serum LDH > 350 IU/L
serum AST >250 IU/L

Ranson’s Criteria after 48 hours of admission :
fall in hematocrit by more than 10 percent
fluid sequestration of > 6 L
hypocalcemia (serum calcium < 2.0 mmol/L (<8.0 mg/dL))
hypoxemia (PO2 < 60 mmHg)
increase in BUN to >1.98 mmol/L (>5
mg/dL) after IV fluid hydration
base deficit of >4 mmol/L
The prognostic implications of Ranson’s criteria are as follows :
Score 0 to 2 : 2% mortality
Score 3 to 4 : 15% mortality
Score 5 to 6 : 40% mortality
Score 7 to 8 : 100% mortality

APACHE
“Acute Physiology And Chronic Health Evaluation” (APACHE II) score > 8 points predicts 11% to 18% mortality
Hemorrhagic peritoneal fluid Obesity
Indicators of organ failure
Hypotension (SBP <90 mmHG) or
tachycardia > 130 beat/min
PO2 <60 mmHg
Oliguria (<50 mL/h) or increasing BUN
and creatinine
Serum calcium < 1.90 mmol/L (<8.0
mg/dL) or serum albumin <33 g/L
(♥.2.g/dL)>




Balthazar Scoring for the Grading of
Acute Pancreatitis
Grade A – normal CT
Grade B – focal or diffuse enlargement of the pancreas
Grade C – pancreatic gland abnormalities and peripancreatic  inflammation
Grade D – fluid collection in a single location
Grade E – two or more collections and/or gas bubbles in or adjacent to pancreas

Wednesday, 14 December 2016

Mnemonics

Grieff stages death
Denial
Anger
Bargaining
Depression
Acceptance

Hypercacemia causing tumors-ROSA
R RCC
O Ovarian Ca
S Squamous cell lung Ca
A Adult T cell leukemias/lymphomas

Acanthosis Nigricans characteristically
seen in GLU
G Gastric Ca
Lung Ca
Uterine Ca

Acrodermatitis enteroathica -DAD
D Dermatitis
A Alopecia
D diarrhea

Sister mary joseph nodules r seen in
SCOP
S Stomach cancer
C-Colln Ca (large)
O-Ovarian Ca
P-Pancreatic Ca

Drugs metabolized by P-Glycolization
COLD"
C Cyclosporine
O Oseltamavir
L Loperamide
D Digoxin

KAN(ear) are ototoxic
K Kanamycin
A Amikacin
N Neomycin

Clavipectoral fascia piercing
structures ACL
A Acromio thoracic artery
C Cephalic vein
L Lateral pectoral nerve

C causes neutropenia
Clozapine
Captopril
Clopidogrel
Chlorpropamide
Carbimazole

BAP in Nazer Index( parameters
checked in Nazer index for Wilsons
B Bilirubin
A AST(not albumin*)
P PT

Saturday, 10 December 2016

Disorders with Café-au-lait Spots

Disorders with Café-au-lait Spots
• Neurofibromatosis
• McCune-Albright syndrome
• Russell-Silver syndrome
• Ataxia telangiectasia
• Fanconi anemia
• Tuberous sclerosis
• Bloom syndrome
• Basal cell nevus syndrome
• Gaucher disease
• Chédiak-Higashi syndrome
• Hunter syndrome
• Maffucci syndrome
• Multiple mucosal neuroma syndrome
• Watson syndrome.

Monday, 5 December 2016

Radiology- CVS


Radiology- CVS
________________________________________
1) egg on side appearance-- uncorrected TGA.
2) boot shaped heart--TOF.
3) BOX shaped-- ebstein anomaly
4)flask shaped-- pericardial effusion.
5) egg in cup appearance--constrictive pericarditis
6)snowman/figure of 8 / cottage loaf sign-- TAPVC.
7)Docks/figure of 3/E- sign= coarctation of aorta. jug handle appearnce = primary pulm HTN.
9) MALADIE DE ROGER DEFECT= SMALL VSD
10) Hilar dance = ASD.
11) goose neck sign= endocardial cushion defect.
12)schimitar sign= partial anamolous pulmonary vein return.
13)convex left heart border= L-TGA.
14)straight left upper cardiac border= ebstein anomaly.
15) concave main pulmonary segment & right aortic arch= persistent truncus arterious
16) calcifiction of heart= carcinoid syndrome.
17)cardiothoracic ratio should be <0.5
18)lamda sign= small ascending aorta in hypoplastic left heart syndrome.
19)severe stenosis - mitral valve diameter < 1 sq.cm
20) uhl disease= parchment right ventricle
21) IOC for aortic dissection-- MRI
22) IOC for pericardial effusion= M- mode ECHO.
23)IOC for valvular disease = 2 D -ECHO.
24) INVERTED MOUSTACHE SIGN= MITRAL STENOSIS.
25) IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY
26)small heart
*normal variant
*emphysema
*addisons disease
*dehydration/malnutrition
*constrictive pericarditis.
27) CARDIAC SHADOW
*right= superior venacava,right atrium,inf venacava
*left=aortic knuckle,pulm artery,left atrial appendage,RV,LV
28)mitral stenosis
*straightening of the left border of the cardiac silhouette
*double atrial shadow.
29) non obstructive TAPVC
*cardiomegaly with plethoric.
*snow man or figure of 8 configuration.
30)obstructive TAPVC
*normal sized heart
*ground glass appearance of lung
due to severe pulmonary HTN.
31)m.c calcification of aorta= syphilitic aortitis.
32)ascending aorta commonest site of calcification.
33)CCF
*enlarged cardiac silhouette.
*ground glass appearance
*kerley b lines
*prominence of upper lobe blood vessel.
*pleural effusion, usually bilateral.
34)even quantities as small as 20-50 ml of pericardial fluid can be diagnosed by echocardiography
35) spring water cyst also k/a pleuro- pericardial cyst or pericardial coelomic cyst.
36)SMALL VSD
*normal
*minimal cardiomegaly
*minimal increase in pulmonary vasculature
37) LARGE VSD
*gross cardiomegaly
*dilatation of both ventricles, left atrium,pulm artery.
*increased pulmonary vascular marking,pulmonary edema &pleural effusion
38)gross cardiac enlargement
*multiple valvular disease.
*pericardial effusion
*ASD
*cardiomyopathy
*ebstein anomaly

Friday, 2 December 2016

Musculoskeletal Radiology Signs

Musculoskeletal Radiology Signs
Absent in posterior dislocation of the
shoulder-Half Moon Sign
ACL Tear-Anterior Drawer Sign
ACL Tear-Bone Bruise Sign
ACL Tear-Deep lateral femoral notch sign
ACL Tear - Segund fractureLateral Capsular Sign
Acromegaly-Heel Pad Sign
Aneurysmal bone cyst-Blister of Bone
Aneurysmal bone cyst-Fluid Fluid Level
Ankle effusion-Teardrop Sign (ankle)
Ankylosing Spondylitis-Bamboo Spine
Ankylosing Spondylitis-Dagger Sign
Ankylosing Spondylitis-Trolley-track sign
Avascular Necrosis-Bite Sign
Avascular Necrosis-Crescent Sign
Avascular Necrosis-Intravertebral Vacuum Cleft
Blowout fracture-Tear Drop Sign (Orbits)
Bucket-handle tear of the menisci- Absent Bow Tie Sign
Bucket-handle tear of the menisci- Double PCL Sign
Bucket-handle tear of the menisci- Fragment-in-Notch Sign
Calcaneonavicular coalition-Anteater Nose
Chronic renal failure-Rugger Jersey Sign
Degenerative disk disease-Vacuum Phenomenon
Discoid Meniscus-Bow Tie Sign
Elbow effusion-Elbow Fat Pad Sign
Elbow effusion-Sail Sign
Enthesopathy-Tooth Sign
Eosinophilic granuloma-Button Sequestrum
Hemolytic anemia-Hair on End
Inferior subluxation of the shoulder- Drooping Shoulder Sign
Intraosseous lipoma-Cockade Image
Lipohemarthrosis-FBI Sign
Loosening prosthesis-Pedestal Sign
Mets, Paget, Lymphoma-Ivory - Vertebra Sign
Normal - No joint effusion-Pneumoarthrogram Sign
Normal spine-Cupid's Bow Contour
Osteopenia-Fish Vertebra
Osteopetrosis-Bone in Bone Sign
Paget's Disease-Blade of Grass Sign
Paget's Disease-Brim Sign
Paget's Disease-Cotton Wool Sign
Post traumatic bone cyst-Tumbling Bullet Sign
Posterior shoulder dislocation-Rim Sign
Posterior shoulder dislocation-Trough Line
Psoriasis-Ivory Phalanx Sign
Psoriasis-Sausage Digit
Rheumatoid arthritis-Boutonniere Deformity
Rheumatoid arthritis-Swan Neck Deformity
Rotary subluxation-Cortical Ring Sign
s/p anterior shoulder dislocation-Hill- Sachs Sign
Scapholunate dissociation-Terry- Thomas Sign
Short 4th Metacarpal\Metacarpal Sign
Sickle cell anemia-H Vertebra
Sickle cell, Gaucher's DiseaseStep-Off Vertebral Body Sign
Spondylolisthesis-Inverted Napoleon Hat Sign
Spondylolysis-Incomplete ring sign
Spondylolysis-Scotty Dog Sign
Subtalar coalition-C Sign
Unicameral bone cyst-Fallen Fragment
Volar Perilunar dislocation-Crowded Carpal Sign
Wrist Fracture-Pronator Sign

Thursday, 1 December 2016

• IMP RADIOLOGICAL FEATURE

• IMP RADIOLOGICAL FEATURE
• Spider leg appearance----polycystic kidney
• Cobra head appearance---ureterocele
• Flower vase appearance of ureters---horse shoe kidney
• Sandy patches---schistosomiasis of bladder
• Soap bubble appearance---hydronephrosis
• Apple core lesion on barium ---ca colon
• Claw appearance on barium enema —intussusception
• Saw tooth appearance----diverticula of colon
• Birds beek appearance of esophagus on ba meal---achalasia
• Cork screw appearance of esophagus on barium meal---diffuse esophageal spasm
• String sign of cantor----crohn's dis
• Thumb printing sign---ischemic colitis
• EGG SHELL CALCIFICATION---- silicosis , sarcoidosis , scleroderma , histoplasmosis , amyloidosis , lymphoma following radiotherapy