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  1️⃣ Introduction & Inspection Introduce yourself, confirm patient identity, and explain the procedure. Ask about weakness, numbness, tingling, or pain. Observe for muscle wasting, fasciculations, tremors, or contractures . Inspect hand posture for signs of ulnar claw, wrist drop, or resting tremors . 2️⃣ Muscle Tone Passively move the shoulder, elbow, wrist, and fingers to assess resistance. Spasticity → UMN lesion (e.g., stroke, MS). Rigidity → Extrapyramidal disorder (e.g., Parkinson’s). Cogwheel rigidity → Intermittent resistance in Parkinson’s disease. 3️⃣ Muscle Strength (Power) Use the MRC scale (0-5) to test key muscle groups: Shoulder abduction (C5, C6) → Raise arm sideways. Elbow flexion (C5, C6) → Bend elbow against resistance. Elbow extension (C7, C8) → Straighten elbow against resistance. Wrist extension (C6, C7) → Extend wrist against resistance. Finger flexion (C8, T1) → Grip strength test. Finger abduction (T1) → Spread fingers ...

1️⃣ Introduction & Inspection Introduce yourself, confirm patient identity, and explain the procedure. Ask about weakness, numbness, tingling, or pain. Observe gait for abnormalities (e.g., foot drop, spasticity). Inspect for muscle wasting, fasciculations, tremors, or contractures. 2️⃣ Muscle Tone Passively move the hip, knee, and ankle to check for resistance. Spasticity → UMN lesion (e.g., stroke, MS). Rigidity → Extrapyramidal disorder (e.g., Parkinson’s). Clonus → Sustained beats at the ankle suggest UMN pathology. 3️⃣ Muscle Strength (Power) Use the MRC scale (0-5) to test key muscle groups: Hip flexion (L2, L3) → Lift thigh against resistance. Hip extension (L5, S1) → Push thigh backward. Knee extension (L3, L4) → Straighten leg against resistance. Knee flexion (L5, S1) → Bend knee against resistance. Ankle dorsiflexion (L4, L5) → Lift foot up. Ankle plantarflexion (S1, S2) → Point foot down. Big toe extension (L5) → Lift big toe against res...

Sepsis is a life-threatening medical emergency that occurs when the body's response to an infection triggers widespread inflammation. This condition can lead to tissue damage, organ failure, and death if not promptly treated. Sepsis is a major global health concern, responsible for millions of deaths annually. Understanding its causes, symptoms, diagnosis, and treatment is crucial for early intervention and improved survival rates. Causes Sepsis can develop from any infection, but the most common sources include: Bacterial Infections : Pneumonia, urinary tract infections (UTIs), abdominal infections, and skin infections. Viral Infections : Influenza, COVID-19, and other viral illnesses can trigger sepsis in immunocompromised individuals. Fungal Infections : Invasive candidiasis and other systemic fungal infections. Parasitic Infections : Malaria and other parasitic diseases may also cause sepsis in endemic areas. Symptoms Sepsis symptoms vary based on severity and the un...

Introduction Chronic Liver Disease (CLD) refers to progressive liver damage lasting more than six months, leading to fibrosis, cirrhosis, and liver failure. It is often caused by viral infections, metabolic disorders, or long-term alcohol consumption. If left untreated, CLD can result in life-threatening complications such as liver cancer and portal hypertension. Causes Chronic liver disease can be classified based on its underlying causes: Infectious Causes Hepatitis B and C : Long-term viral infections lead to inflammation and fibrosis. Metabolic and Genetic Causes Non-Alcoholic Fatty Liver Disease (NAFLD) : Common in obesity and diabetes. Hemochromatosis : Excess iron accumulation in the liver. Wilson’s Disease : Copper buildup causing liver toxicity. Toxic Causes Alcoholic Liver Disease : Chronic alcohol consumption leads to cirrhosis. Drug-Induced Liver Injury (DILI) : Caused by certain medications (e.g., acetaminophen overdose). Autoimmune Causes Aut...

Introduction Acute Kidney Injury (AKI) is a sudden decline in kidney function that can occur within hours or days. It results in the accumulation of waste, fluid imbalances, and electrolyte disturbances, potentially leading to life-threatening complications. Causes AKI is classified into three main categories: Prerenal Causes (Due to decreased blood flow to the kidneys) Severe dehydration Heart failure Sepsis Blood loss Intrinsic Causes (Damage within the kidneys) Acute tubular necrosis (ATN) Glomerulonephritis Nephrotoxic drugs (NSAIDs, aminoglycosides, contrast agents) Postrenal Causes (Obstruction in urine flow) Kidney stones Enlarged prostate Bladder tumors Symptoms Decreased urine output Fluid retention (swelling in legs, ankles, or around the eyes) Shortness of breath Confusion Nausea and vomiting Fatigue Diagnosis and Treatment Diagnosis: Blood tests (Serum creatinine, BUN) Urinalysis Kidney ultrasound or CT scan Electrolyte ...

  What is Idiopathic Pulmonary Fibrosis? Idiopathic Pulmonary Fibrosis (IPF) is a progressive lung disease characterized by scarring (fibrosis) of lung tissue , leading to difficulty in breathing and reduced oxygen supply to the body. The term "idiopathic" means the exact cause is unknown. The disease is chronic and worsens over time , ultimately leading to respiratory failure . Causes & Risk Factors of IPF Possible Causes Abnormal Wound Healing – Overproduction of collagen causes thickened lung tissue. Genetic Mutations – Some cases are linked to inherited gene mutations. Environmental Exposures – Long-term exposure to dust, fumes, and pollutants. Risk Factors Age – More common in people over 50 years . Smoking – Increases the risk significantly. Occupational Exposure – Farmers, construction workers, and factory workers are at higher risk. Gastroesophageal Reflux Disease (GERD) – Acid reflux may contribute to lung damage. Viral Infections – Som...

What is Rheumatoid Arthritis? Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily affects the joints , causing pain, swelling, stiffness, and eventual joint damage. Unlike osteoarthritis, RA is caused by an overactive immune system that attacks the synovium , the lining of the joints, leading to inflammation and potential long-term damage. RA can affect multiple joints, including the hands , wrists , knees , and feet . It can also impact other organs in the body, making it more complex and dangerous if left untreated. Causes & Risk Factors of Rheumatoid Arthritis Primary Causes of RA Autoimmune Reaction – The immune system attacks the synovium in the joints, causing inflammation. Genetics – People with a family history of autoimmune disorders have an increased risk. The presence of certain genes, such as HLA-DRB1 , increases susceptibility to RA. Environmental Triggers – Smoking , exposure to pollutants, and viral infections can trigger RA in gen...

  What is Osteomalacia? Osteomalacia is a metabolic bone disease characterized by impaired bone mineralization due to vitamin D deficiency . This leads to soft, weak bones , increasing the risk of fractures and chronic pain. Unlike osteoporosis, which affects bone density, osteomalacia results in poorly mineralized bones that are more prone to deformities. Causes & Risk Factors Primary Causes Vitamin D Deficiency – Due to inadequate sun exposure, poor diet, or malabsorption. Chronic Kidney Disease (CKD) – Impaired activation of vitamin D. Gastrointestinal Disorders – Celiac disease, Crohn’s disease, and other malabsorption syndromes. Certain Medications – Long-term use of anticonvulsants, antacids, and corticosteroids. Liver Disease – Reduces vitamin D metabolism. Who is at Risk? Older Adults – Reduced ability to synthesize vitamin D. People with Limited Sunlight Exposure – Individuals living in regions with low sun exposure or those who wear excessive co...

✅ What is Polycythemia Vera? Polycythemia Vera (PV) is a rare blood disorder in which the bone marrow produces too many red blood cells, leading to thicker blood, increased clot risk, and potential organ damage . It is classified as a myeloproliferative neoplasm (MPN) and can progress to leukemia if untreated. ✅ Causes & Risk Factors 🔹 Causes: ✔️ Genetic Mutation ( JAK2 gene mutation is present in 95% of cases). ✔️ Primary PV : Caused by the bone marrow disorder itself. ✔️ Secondary PV : Can be triggered by chronic hypoxia (e.g., lung disease, high altitude). 🔹 Risk Factors: ✅ Age Over 60 (though it can occur at any age). ✅ Male Gender (higher prevalence). ✅ Family History of Myeloproliferative Disorders . ✅ Symptoms to Watch For 🚨 ✔️ Headaches & Dizziness ✔️ Itchy Skin (Especially After Hot Showers) ✔️ Red or Flushed Skin (Plethora) ✔️ Unusual Blood Clots or Bleeding ⚠️ Serious Complications: Stroke, heart attack, or deep vein thrombosis (DVT). ✅ How...

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✅ What is Pneumonia? Pneumonia is a lung infection that causes inflammation and fluid-filled alveoli , leading to breathing difficulties and systemic symptoms . It can be bacterial, viral, fungal, or aspiration-related . ✅ Common Causes & Risk Factors 🔹 Causes (Pathogens): ✔️ Bacterial: Streptococcus pneumoniae , Haemophilus influenzae , Staphylococcus aureus , Mycoplasma pneumoniae ✔️ Viral: Influenza, SARS-CoV-2 (COVID-19), RSV, Adenovirus ✔️ Fungal: Pneumocystis jirovecii (in immunocompromised patients) ✔️ Aspiration Pneumonia: Due to inhalation of food, liquids, or vomit (common in stroke patients, alcoholics) 🔹 Risk Factors: ✅ Elderly (>65 years) & Infants ✅ Smoking & Chronic Lung Diseases (COPD, Asthma) ✅ Weakened Immunity (HIV/AIDS, Cancer, Diabetes) ✅ Hospitalization & Mechanical Ventilation (Ventilator-Associated Pneumonia) ✅ Poor Oral Hygiene & Alcoholism ✅ Key Symptoms to Watch For 🔹 Typical Symptoms: ✔️ Fever & Chills ...

    ✅ What is Peptic Ulcer Disease (PUD)? Peptic Ulcer Disease (PUD) is a condition where painful sores or ulcers develop in the lining of the stomach or duodenum due to acid-related damage. ✅ Common Causes & Risk Factors 🔹 Major Causes: ✔️ Helicobacter pylori (H. pylori) infection ✔️ Chronic NSAID use (Aspirin, Ibuprofen, Naproxen) ✔️ Excessive gastric acid production (Zollinger-Ellison Syndrome) 🔹 Risk Factors: ✅ Smoking & Alcohol Consumption ✅ Chronic Stress (May exacerbate symptoms) ✅ Steroid & Anticoagulant Use ✅ Spicy & Irritating Foods (Aggravate symptoms, but not primary cause) ✅ Key Symptoms to Watch For 🔹 Classic Symptoms: ✔️ Epigastric pain (burning, gnawing, occurs between meals & at night) ✔️ Pain relief after eating (Duodenal ulcer) or worsened by food (Gastric ulcer) ✔️ Bloating, nausea, early satiety 🔹 Severe Symptoms (Complications): ⚠️ Hematemesis (Vomiting blood) ⚠️ Melena (Black, tarry stools) ⚠️ Perforation...

✅ What is Hypothyroidism? Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, leading to slowed metabolism and various systemic effects . ✅ Common Causes & Risk Factors 🔹 Primary Hypothyroidism (Thyroid gland dysfunction) ✅ Hashimoto’s Thyroiditis (Autoimmune destruction) ✅ Iodine Deficiency or Excess ✅ Post-Thyroidectomy or Radioactive Iodine Therapy ✅ Congenital Hypothyroidism (Cretinism) 🔹 Secondary/Tertiary Hypothyroidism (Pituitary or hypothalamic dysfunction) ✅ Pituitary tumors or damage ✅ Hypothalamic disorders 🔹 Risk Factors ✔️ Female gender (5-8x more common in women) ✔️ Age >60 years ✔️ Family history of thyroid disorders ✔️ History of neck radiation ✔️ Autoimmune diseases (Type 1 Diabetes, RA, Lupus) ✅ Key Symptoms to Watch For 🔹 General: Fatigue, weight gain, cold intolerance 🔹 Skin & Hair: Dry skin, hair thinning, brittle nails 🔹 Cardiovascular: Bradycardia, hypotension 🔹 Neurologi...

Proper nutrition plays a crucial role in managing and preventing diseases. A well-balanced diet tailored to specific conditions can improve health outcomes and quality of life. Below is a detailed guide on disease-specific diets to help healthcare professionals and patients make informed dietary choices. 🩸 1. Diabetes Mellitus (Type 1 & Type 2) 🔹 Goal: Maintain stable blood glucose levels & prevent complications. ✅ Recommended Diet: ✔ Low Glycemic Index (GI) Foods – Whole grains, legumes, non-starchy vegetables 🍞🥦 ✔ High Fiber Diet – Fruits (in moderation), vegetables, lentils 🍎 ✔ Healthy Fats – Olive oil, nuts, seeds, avocados 🥑 ✔ Lean Proteins – Fish, skinless chicken, tofu, beans 🐟🥩 💧 Plenty of Water to prevent dehydration. 🚫 Foods to Avoid: ❌ Refined sugars – Soda, sweets, white bread 🍬🥤 ❌ High-fat dairy – Cream, butter, full-fat cheese 🧈 ❌ Deep-fried and processed foods 🍟 📌 Special Considerations: Gestational Diabetes: Follow a contro...

Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Human Immunodeficiency Virus (HIV) 🛡️ Pre-Exposure Prophylaxis (PrEP) 🩺 🦠 HCV & HIV 🚫 No pre-exposure prophylaxis available for HCV or HIV . 💉 Hepatitis B (HBV) Vaccination 👨‍⚕️ All healthcare workers (HCWs) should be immune to HBV! 📅 Approved vaccination schedules: ✔ Engerix-B (Smith-Kline) → 1.0 mL (20 mcg) at 0, 1, 6 or 0, 1, 2, 12 months ✔ Recombivax-HB (Merck) → 1.0 mL (10 mcg) at 0, 1, 6 months 🩸 Follow-Up Testing After Immunization 📊 After the final dose, test anti-HBs in 1-2 months 🛑 If anti-HBs < 10 mIU/mL : 🔍 Check HBsAg ✔ If HBsAg positive → Evaluate for chronic HBV ✔ If HBsAg negative → Repeat vaccine series ❌ No boosters needed for immunocompetent HCWs! 🚑 Post-Exposure Prophylaxis (PEP) 💊 ⚠️ Definition of Exposure 🔪 Percutaneous injury (e.g., needle stick, sharp object cut) 🧪 Mucous membrane or broken skin contact 🩸 Exposure to high-risk body fluids 🦠 HBV Exposure Manage...

Summary Testing : All pregnant women should be tested for HIV as early as possible in pregnancy. Repeat testing is recommended in the third trimester for those at risk. Infant Testing : HIV-exposed infants should be tested for HIV infection and provided specialty care if positive. Antiretroviral Therapy (ART) : All pregnant women with HIV should receive ART as early as possible, regardless of CD4 count or viral load. ART should be administered during the antepartum, intrapartum, and postnatal periods. Breastfeeding : Not recommended unless replacement feeding is not feasible. Basics Definition Human immunodeficiency virus (HIV) is a retrovirus that infects CD4 T cells, leading to HIV infection and potentially acquired immunodeficiency syndrome (AIDS). Pregnancy in women with HIV is complicated by the infection itself and associated medical and psychosocial comorbidities. Epidemiology Global : Approximately 18.2 million women are living with HIV worldwide, making up half of...

Author: Dr. Muhammad Ismail Quick Review for FCPS / MRCP / USMLE Table of Contents Cardiology Acute Coronary Syndromes Post-MI Complications Pericarditis and Myocarditis EKG Buzzwords Murmur Buzzwords Pulmonology CXR Buzzwords Pleural Effusions Pulmonary Embolism ARDS PFTs COPD Asthma Restrictive Lung Diseases Pulmonary Nodules Lung Cancer Gastroenterology Inflammatory Bowel Disease Liver Function Tests and Lab Buzzwords Esophageal Disorders Gastric and Duodenal Ulcers Biliary and Pancreatic Disorders Diarrhea Infectious Disease Meningitis Pneumonia Tuberculosis Endocarditis HIV Neutropenic Fever Random Infection Buzzwords Nephrology Electrolyte Abnormalities Acid-Base Disorders Renal Tubular Acidoses Acute Renal Failure Chronic Kidney Disease Hematuria and Proteinuria Kidney Stones Hematology/Oncology Anemia Thrombocytopenia Coagulopathies Leukemia Lymphoma Multiple Myeloma Polycythemia Vera Rheumatology/Derm...

A complete guide to preparing for 12 clinical and diagnostic stations in FCPS IMM. 🩻 Radiology Stations 1. Chest X-Ray Interpretation – Pneumonia Interpretation of chest X-ray to diagnose pneumonia. Clinical Scenario: A 45-year-old male presents with fever, cough, and chest pain. Candidate’s Task: ✅ Identify pneumonia type and location (lobar or bronchopneumonia). ✅ Discuss management (antibiotics, hydration). ✅ Outline risk factors and prevention strategies. 2. CT Brain – Stroke Assessment Interpretation of CT scan to identify signs of stroke. Clinical Scenario: A 60-year-old female with slurred speech and right-sided weakness. Candidate’s Task: ✅ Identify ischemic vs hemorrhagic stroke. ✅ Discuss immediate management (thrombolysis, antiplatelet therapy). ✅ Explain how to differentiate between stroke types. 3. Abdominal Ultrasound – Gallstones Interpretation of abdominal ultrasound to identify gallstones. Clinical Scenario: A 30-year-old female presents with r...

Paracetamol (acetaminophen) overdose is one of the most common causes of drug poisoning worldwide. It can lead to severe liver failure (acute hepatotoxicity) if not treated promptly. Early intervention is critical! 🚑 🔍 Causes of Paracetamol Poisoning Paracetamol poisoning occurs due to: 🔸 Accidental overdose (common in children & elderly) 👶👴 🔸 Intentional overdose (suicide attempts) 😢 🔸 Chronic excessive use (long-term use exceeding safe doses) 💊 🔸 Drug interactions (alcohol, enzyme inducers like rifampin) 🍷💉 🔸 Liver disease (higher susceptibility to toxicity) 🏥 ✅ Toxic Dose of Paracetamol 🔹 Adults: > 7.5 g in 24 hours 🔹 Children: > 150 mg/kg in 24 hours ⚠ Symptoms of Paracetamol Poisoning Symptoms appear in four stages: 🔴 Stage 1 (0-24 hours) – Early Phase ✔ Nausea & vomiting 🤢 ✔ Abdominal pain 🩺 ✔ Loss of appetite 🚫🍽 ✔ Fatigue & sweating 😓 🟠 Stage 2 (24-72 hours) – Hepatic Injury ✔ Liver enlargement & tendern...