List of Monoclonal Antobodies

• Abciximab ReoPro 1994 chimeric inhibition of glycoprotein IIb/IIIa Cardiovascular disease

• Infliximab Remicade 1998 chimeric I inhibition of TNF-a Inflammatory diseases Adalimumab Humira 2002 human inhibition of TNF-a signalling Inflammatory diseases

• Natalizumab Tysabri 2006 humanized T cell VLA4 receptor Inflammatory diseases . (esp autoimmune-related multiple sclerosis therapy)

• Omalizumab Xolair 2004 humanized Ig E Inflammatory diseases . (mainly allergy-related asthma therapy)

• Eculizumab Soliris 2007 humanized complement C5 Inflammatory diseases . (PNH)

• Efalizumab Raptiva 2002 humanized CD11a Inflammatory diseases . (psoriasis)

• Alemtuzumab Campath 2001 humanized CD52 CLL Gemtuzumab Mylotarg 2000 humanized CD33 AML . (with calicheamicin)

• Ri - tuximab Rituxan, Mabthera 1997 chimeric CD20 NHL Ibritumomab tiuxetan Zevalin 2002murine CD20 NHL (with yttrium-90 or indium-111) Tostumomab Bexxar 2003 murine CD20 NHL

• Daclizumab Zenapax 1997 humanized IL-2 receptor Transplant rejection Basiliximab Simulect 1998 chimeric IL-2 receptor Transplant rejection MuromonabOrthoclone OKT3 1986 murine CD3 Receptor Transplant rejection

• Bevaciz umab Avastin 2004 humanized vascular endothelial growth factor Colorectal cancer Panitumumab Vectibix 2006human epidermal growth factor receptor Colorectal cancer Cetuximab Erbitux 2004 chimeric epidermal growth factor receptor Colorectal cancer

• Ranibizumab Lucentis 2006 humanized vascular endothelial growth factor Macular degeneration

• Palivizumab Synagis 1998 humanized epitope of F protein of RSV Viral infection (espRSV)

• Trastuzumab Herceptin 1998 humanized ErbB2 Breast cancer
-mab suffix monoclonal antibody.

if immediately before mab----u--its humane derived
. ---mo--its murine
. ----i----its chimeric.

Types of Tongues in Various Medical Conditions

HUNTERS TONGUE/MOELLERS TONGUE------ PERNICIOUS ANAEMIA

BALD TONGUE OF SANDWITH-----------NIACIN DEFICIENCY(PELLAGRA)

MAGENTA OR BEEFY RED TONGUE-----------RIBOFLAVIN DEFICIENCY

STRAW BERRY (EARLY) AND RASBERRY (LATE)------SCARLET FEVER

SCROTAL TONGUE-----FISSUREE TONGUE

BLACK HAIRY TONGUE------PROLONGED ORAL USE OF ANTIBIOTICS.

CEREBRIFORM TONGUE-----A FEATURE OF PEMPHIGUS VEGETANS.

Named fevers in microbiology

Pontiac fever---Legionella pneumophila

Shanghai fever---Pseudomonas

Brazilian purpuric fever---Hemophilus aegyptius
(pink eye)

Havernhill fever---Streptobacillus monoliformis

Oroya fever---Bartonella bacilliformis
(Carrion's d/s)

Q fever---Coxiella burnetti

Colorado tick fever---Orbivirus

Trench fever---Rochalimaea quintana
(five day fever)

Incubation Periods For Diseases

Disease	Incubation period
Influenza	1 to 3 days
Anthrax	1 to 3 days
Cholera	1 to 5 days
Bacillary Dysentery	1 to 7 days
Tularemia	1 to 7 days
Diptheria	2 to 5 days
Plague	2 to 6 days
Typhoid	5 days
Yellow fever	3 to 10 days
Dengue	3 to 15 days
Tetanus	3 to 21 days
Measles	10 days
Leptospirosis	10 days
Malaria	10 days above ( 14 to 15 Vivax 12 Falciparum)
Pertussis	7 to 14 days
Polio	7 to 14 days and above
Q.fever	7 to 14 days and above
Typhus	12- 14 days
Chickenpox	2 to 3 weeks
Rubella	2 to 3 weeks ( 18 days)
Mumps	2 to 3 weeks ( 18 days)
Bartenellosis	2 to 3 weeks
Brucellosis	3 weeks
Amoebiasis	3 to 4 weeks
Yaws	3 to 4 weeks
Hepatitis-A	15 to 50 days
Hepatitis- B	50 to 160 days
Tuberculosis	Weeks to Months
Sleeping Sickness	Weeks to Year
Kala-Azar	1 to 3 Months ( 10 days to 1 year)
Filariasis	5 to 8 months
LoaLoa	1 year
Elephantiasis	10 years

Antibodies and Immunoglobulins

All Antibodies are Immunoglobulins but All Immnuglobulins are not Antibodies.
 
Ig are glycoprotiens.
 

Source for preparation of Human Gamma Globulins	Placenta
Smallest Ig	Ig G
Largest Ig	Ig M
Heat Labile Ig	Ig E
Reagenic Antibody	Ig E
Earliest Antibody to be Synthesised	Ig M
Ig that crosses Placenta	Ig G
Ig with Minimum Life	Ig E
Ig that protects Surfaces	Ig A
Mainly Intravascular Ig	Ig M
Warm Antibodies	Ig G
Cold Antbodies	Ig M
Ig Present in Milk	Ig G and Ig A
Commonest Ig Deficiency	Deficiency of Ig A.

Colony Appearance in Culture for Organisms

 
 

Colony Appearance in Culture	Organism
1. Draughtsman ( Concentric Rings)	Pneumococci
2. (a) Medusa Head (b) Frosted Glass (C) Inverted Fir Tree in Stab Culture	B. Anthracis
3. Swimming Growth ( Fishy or Seminal Smell)	Proteus
4. Swarm of Gnats Or Fish in Stream, darting motility.	V. Cholerae
5. Stalactite growth, safety pin appearance	Yersinia Pestis
6. Thumb print appearance, Bisected pearls or mercury drops , Aluminium Paint appearance	B. Pertussis
7. Cigar bundle ( globi ) appearance	M.Leprae
8. Fried egg	Mycoplasma
9. Bread crumb	Actinomyces israelii
10. Oil Paint	Staphylococci
11. School of Red fish	H. ducreyi
12. Stately Motility	Clostrida

*Daisy head colonies---------------------------------------- Corynbact gravis
*Frogs egg colonies----------------------------------------- Corynbact intermedius
*Poached egg colonies-------------------------------------- Corynbact mitis

Vitamins

Heat Stable and light sensitive	Vitamin K and Riboflavine
Vitamin required for electron Transport (Coenz. Q)	K1, B2
Dopa and Gaba : Metabolism depend on	Pyridoxine
For the Function of Co.A	Pantothenate
Folic acid is	Pteroyl Glutamic acid
Folinic Acid is	Citrovorum factor
Erythrocyte Maturation Factor	B 12
Vitamins Stored in Liver	A, D, K, B 12, Folate
Vitamin Stored in fat	D
Richest Source of Vitamin A	Codliver Oil
Vitamin E	Halibut Liver oil
Prophylactic Dose of Vitamin A	66,000 Micrograms
Main Source of Thiamine in Indian Diet	Cereals
P.E. T and Achalasia are expected to be due to deficiency of	Thiamine
Yellow Crystalline Substance	Riboflavine
Red Crystalline Substance	B 12
White Crystalline Substance	Ascorbic Acid
Vitamins Which are present in animal Foods only	B12, D
Heat Labile Vitamins	Vitamin C and Folic acid
Vitamins That are synthesised in Gut (Flora)	B2, B12 ( Not useful) and Vitamin K
In body (Skin)	Vitamin D
F.I.G.L.U excretion is secreted in deficiency of	B 12
Methylmalonic acid Excretion is increased in deficiency of	B 12
Worm infestation causing B 12 deficiency	Diphyllobothrium Latum
Vitamin which is an antoxidant	Vitamin E
Vitamin useful in the treatment of methemoglobinemia	Vitamin C ( Methylene Blue also useful)
Vitamins with which Hypervitaminosis occurs	A and D
Vitamin deficiency which leads to convulsions	Pyridoxine
Vitamin useful in treatment of Homocystinuria	Pyridoxine
Vitamin useful in treatment of Alcaptonuria	Vitamin C
Vitamin that is used peripheral vascular disease	Vitamin E. ( For intermittent Claudication)
Vitamins that causes Hemolysis	Vitamin K
Vitamin that causes Neonatal Jaundice	Vitamin K
Vitamin that causes sensory polyneuropathy in megavitamin doses	Pyridoxine
Vitamin deficiency that causes pseudo paralysis	Vitamin C, Vitamin D
Vitamin for wound healing	Vitamin C
Magenta red tongue is due to deficiency of	Riboflavine
Raw beef tongue is due to deficiency of	Niacin
Cataract formation and Corneal vascularisation are due to deficiency of	Riboflavine
Vitamin that does not cross placenta	Vitamin D
Vitamin Destroyed by Ultra – Violet Light	B 12
Folic acid deficiency may be caused by	(A) Phenytoin(B) Primidone( C)Phenobarbitone(D) Aminopterin( E) Methotrexate( F) Pyrimethamine( G) CTM (H) Oral Contraceptives

Inborn Errors of Metabolism

(A) Carbohydrate Metabolism Glycogen Storage Disorders	Deficiency
Type I- Von gierke’s	G 6 Phosphate
Type II- Pompe’s	Alpha glucosidase
Type III Cori or Forbes	Debranching enzyme
Type IV	Branching enzyme
Type V- Mcardle’s	Muscle phosphorylase
Type VI -Her’s	Hepatic phosphorylase

 
 

(B) Lipid Metabolism Disease	Deficiency
Fabry’s	Alpha galactoside- A(Ceramide trihexoside accumulates)
Niemann- Pick’s	Sphingomyelinase (RBC appear as foam cells)
Tay- Sach’s	Hexosaminidase A
Sandhoff disease	Hexosaminidase A and B
Krabbe Leukodystrophy	Galacto Cerebrosidase
Metachromatic Leukodystrophy	Arylsulfatase A
Gaucher disease	Gluco Cerebrosidase
Tangier Disease	Lipid Metabolism Disturbed (Low Alpha lipoprotein)

 
 

(C) Amino Acid Metabolism Disease	Deficiency
Phenylketonuria	Phenylalanine Hydroxylase deficiency
Alkaptonuria	Homogentisic acid oxidase deficiency
Homo cystinuria	Cystathion synthetase deficiency
Hartnup Disease	Decreased trytophan Absorption increased excretion
Oasthouse disease	Methionine malabsorption- fermented by intestinal bacteria and excreted. Oasthouse smell urine.

 
 

(D) Mucopolysaccharidoses Disease	Deficiency
Hurler’s (I)	Deficiency of Alpha iduronidase
Hunter’s (II)	Deficiency of Iduronesulphate Sulphatase
Morquio’s (Type 4)	N- Acetyl galactosamine Sulphate Sulphatase

 

(E) Miscellaneous	Deficiency
Galactosemia	Galactose I Phopsphate uridyl transferase deficiency
Albinism	Tyrosinase Deficiency
Lesch- Nyhan Syndrome	HGPRT Deficiency ( Hypoxanthine guanine phosphoribosyl transferase)
Rate limiting step of catecholamines production	Tyrosine hydroxylase
Rate limiting step of cholesterol production	HMG CoA reductase
Refsum’s disease	Phytanic acid malabsorption treatment- stop vegetable intake
Orotic aciduria	Pyrimidine metabolism is disturbed
Gout	Purine metabolism is disturbed

Milestones in Children

Social Smile	2 months
Recognises mother and head control	3 months
Holds object and takes it to mouth	4 months
Sitting on slight support	5 months
Enjoys mirror	6 months
Sits alone momentarily	6 months
Transfers object from head to hand	6 months
Rolls Over	7 months
Sits steadily	7-8 months
Crawls in bed	8 months
Monosyllabic words ( Mama , Dada)	9 months
Creeps	10 months
Cruises around furniture	10 months
Builds a tower of 2 cubes and pincer grasp	12 months
Can turn two or three pages of a book	13 months
Walks alone	13- 14 months
Walks Sideways and backwards	15 months
Builds a tower of three cubes	18 months
Feeds Self	18 months
Can drop and draw a horizontal or vertical line	2 Years
Can turn one page at a time	2 Years
Able to wear socks or shoes	2 Years
Can remove his pants	2 ½ Years
Can draw a circle	3 Years
Can dress or undress completely and buckle his shoes	3 Years
Knows age and sex	3 Years
Can copy and draw a cross ( Plus Sign)	4 Years
Can draw a rectangle	4 ½ Years
Can draw a tilted cross (Multiplication sign)	5 Years
Can draw a triangle	5 ½ Years
Bladder Control- Diurnal	12- 16 months
Nocturnal	2 ½ Years to 3 Years

Commonest Causes/Conditions

HEART

Commonest Congenital Malformation Without manifestation	Bicuspid aortic Valve
Commonest Congenital heart disease causing hyper tension in neonates	Coarctation of aorta
Commonest Cause of Cyanosis in new born	Transposition of Great Vessels
Commonest disease complicated by SBE	Rheumatic Mitral Regurgitation
Congenital heart disease with rare SBE	ASD
Congenital heart disease with Common SBE	VSD
Congenital heart disease with CHF in new born	Hypoplastic left heart Syndrome (Mitral and aortic atresia)
Heart disease where CHF is rare	Fallot’s Tetrology
Differential Cyanosis	1. PDA with reversal 2. Preductal Coarctation

 
Paediatrics:
 

(A) Commonest Causes
Haemoptysis in child	Pneumonia
Haematemesis in infancy	Acute Duodenal ulcer (Stress Sepsis)
Bleeding per rectum  Infants  Children	fissure in ano  polyp
Common Cause of constant crying in a baby	Hunger
Convulsions in new born	Hypoglycemia
Large intestinal obstruction in infancy	Hirschsprung’s Disease

 
 

(B) Commonest Conditions
Commonest Malignancy in Children	Leukamia
Commonest abdominal tumour in children	Neuroblastoma
Commonest Bone tumour in Children	Osteogeneic sarcoma
Commonest brain tumour in children (Space occupying lesion)	Tuberculoma

 
 

(C) Miscellaneous
Commonest paediatric Complaint	U.R.I
Fever in child Commonly due to	U.R.I
Common cause of continuous dry cough	Eosinophilia
Pneumonia in child commonly due to	Viral
Commonest site of intestinal atresia	ileum, duodenum
Common complication of Ramstedt’s operation	Hypothermia

X Ray Appearances

Paediatrics

Snowman app	TAPVR ( Total Anomalous Pulmonary Venous Return)
Cottage leaf app	TAPVR
Figure of 8 app	TAPVR
COEUR en Sabot(boot app)	Tetrology of Fallot
Box shape app	Ebstein's anomaly
Jug handle app	Primary PAH
Egg on side app	TGV (Transposition of Great Vessels)
Egg in cup app	Constrictive Pericarditis

Neurosurgery
 

Calcification of cerebral cortex(Railroad Calcification)	Sturge Weber Syndrome
Diffuse Nodular calcification	Toxoplasmosis
Amorphous Supracelluler Calcification	Craniopharyngioma
Basal ganglia calcification	Hypoparathyroidism (Commonest)
Rice grain Calcification	Cysticerosis
Periventricular Calcification	CMV Infection
Sunray Calfication with spicules of brain	Meningioma
Bone thickening at site of brain tumour	Meningioma
Punched out Rarefication	Multiple myeloma, sarcoidosis, Gout
Peppr pot or Salt and pepper app	Hyperparathyroidism
Beaten silver app	Raised intracranial pressure
Post clenoid erosion	Raised intracranial pressure
Candle grease dripping or trouser leg appearance	Intramedullary tumours in myelography
Extramedullary Tumours of spinal cord  Meningioma  Neurofibroma	wavy upper border Crescentic border

Commonest Site of Lesions

Erysipelas	Face and scrotum
Cellulitis	Scrotum and scalp
Sebaceous cyst	Scalp, Face, Scrotum
Keloid	Sternum, face and Neck
Lymphangioma and hemangioma	Tongue, lip
Carbuncle	Back, nape of neck and shoulders
Nodular Leprosy	Face, arm
Implantation dermoid	Hand and finger
Dermoid cyst	External angle of eye
Subcutaneous lipoma	Shoulder, back and buttock
Perforating ulcer	Under the base of first metatarsal
Lupus vulgaris	Face and arm
Instrumental perforation of oesophagus	Cricopharyngeal area
Dercum’s disease	Trunk
Soft fibroma	Face
Gangrene by ergot	Fingers. Nose and ear
Phlebolith	Pelvic veins
Molluscum Fibrosum	Neck, trunk and Face
Sclerosing angioma (Dermatofibroma or Sub Epidermal nodular fibrosis)	Limbs
Kaposi’s Sarcoma	Limbs
Granuloma Pyogenicum	Face, fingers, toes
Corn	Toes, feet
Callocity	Hand (Gardener’s Hand)
Malignant Melanoma	Males – trunk Females- leg
Hutchinson’s Melanotic freckle	Sun exposed areas
Sub–ungual exostosis	Great toe
Hyperpigmentation in Addison’s disease	Exposed areas and creases of palms
Pregnancy tumour	Gums and tongue
Pseudo tumour in hyperparathyroidism	Jaws
Erythema Multiforme	Extensor surfaces
Psoriasis	Knee, elbow, scalp
Inverse psoriasis	Body folds (severe itching present)
Miliaria	Covered areas
Chronic discoid lupus	Face (Tacklike scales)
Tinea versicolor	Trunk
Keratoderma blenorrhagicum	Sole of the foot

Drugs of Choice or Drugs Used in Treatment.

Note: Please refer your textbooks for the latest drugs that are now quoted by some textbooks as Drugs of choice for some of these conditions.
 

H. Influenza Meningitis	Chloramphenicol + Ampicillin
H. Influenza Pneumonia	Ampicillin
Plague	Streptomycin
Paratyphoid	Cotrimoxazole
Typhoid	Ceftriaxone/ Chloramphenicol
Klebsiella Pneumonia	Chloramphenicol, Mezlocillin, Cefotaxime
Anthrax	Penicillin
Campylobacter	Erythromycin
Chancroid	Tetracyclines or Streptomycin
Granuloma Inguinale	Streptomycin
LGV	Tetracyclines
Bartonellosis	Tetracyclines
Leptospirosis	Benzyl Pencillin
Chromoblastomycosis	Fluocytosine
Cryptococcus	Fluocytosine and Amphotericin- B
Sporotrichosis	Potassium Iodide
Coccidioidomycosis	Amphotericin B
Toxoplasmosis	Pyrimethamine ( a teratogen)  In Pregnancy- Sulphadiazine
Pnemocystisis carinii	Cotrimoxazole
Giardiasis	Tinidazole
Chagas’ disease	Nifurtimox
Schistosomiasis	Praziquantel
Paragonimiasis	Praziquantel
Clonorchis	Praziquantel
Taenia saginata	Praziquantel
Taenia solium	Niclosamide
Echinococcus	Mebendazole
Diphyllobothrium	Niclosamide
H.Nana	Praziquantel
Enterobius	Mebendazole
Toxocara	Thiabendazole
Larva migrans	Thiabendazole
Strongyloidosis	Thiabendazole
Dracontiasis	Niridazole
Trichuris	Mebendazole
Trichinella spiralis	Thiabendazole
Capillariasis	Mebendazole
Gnathostomiasis	Bithinol
Anaphylaxis	Adrenalin
Angina	Gliceryl Trinitrate (Nitroglycerine)
Supra Ventricular Tachycardia	Verapamil
Ventricular Tachycardia	Lignocaine
Ventricular Fibrillation	D.C.Shock
Complete Heart block	Isoprenaline
Whipple’s disease	Tetracycline
Tropical sprue	Tetracycline
Hypoparathyroidism	Calciferol
Hypercalcemia due to hypervitaminosis D	Steroids
Inappropriate secretion of ADH	Demethyl chlor tetracycline
C.M.L	Busulphan
C.L.L	Chlorambucil
Waldenstorm’s macroglobulinaemia	Chlorambucil
Multiple Myeloma	Melphalan
Burkits lymphoma	Surgery plus Cyclophosphamide
Eaton – Lambert syndrome	Guanidine
Myotonic dystrophy	Phenytoin
Motion sickness ( of Short Duration)	Scopolamine ( Hyoscine)
Narcolepsy	Amphetamine
Cataplexy	Tricyclic antidepressants
Nocturnal eneuresis	Imipramine
Gilles De La Tourette syndrome ( multiple tics)	Haloperidol
Acute intermittent Porphyria	I.V. Hemin
Paget’s disease	Calcitonin, Mithramycin, Etidronate disodium
Gout Acute Attack	Colchicin
Gout prophylaxis and chronic cases	Allopurinol
Kawasaki disease	High Doses of Aspirin
Dermatitis herpetiformis	Dapsone/ Sulfapyridine
Erysipeloid	Penicillin
Urinary analgesic	Phenazopyridine
Malignant hyperthermia	Dantrolene Sodium (induced by Halothane and Succinyl choline)
Carcinoid syndrome with secondaries in liver	5 Fluouracil into the hepatic artery
Carcinoid syndrome with repeated flushes	Predinsolone
Carcinoid lung	Doxorubicin
Strawberry lesion of Rectosigmoid	Acetarsol Suppositary plus VitaminC
Perianal Abscess	Penicillin
Sarcoma vagina	Radiotherapy
Meningococcal carrier state and prophylaxis	Rifampicin
Typhoid carrier state	CTM
Diptheria carriers	Erytromycin
Dequervains thyroiditis	Aspirin
Botulism	Guanidine HCL
Anribiotics for which resistant	Organisms develop less often1. Chloramphenicol  Cloxacillin and Oxacillins  Rifampicin  Erythromycin
Antibiotics safe in renal failure with modified	Dosage 1. Penicillin  Vancomycin  Cephalosporins
Physiological Antagonist to Histamine	Adrenaline
Septicaemia from Pyelonephritis	Gentamycin
Medium and Shortacting barbiturates intoxication	Haemoperfusion with ion exchange resins
Phenobarbitone and Barbitone ( Long Acting) poisoning	Haemodialysis
Drug which may cause and is used in the treatment of Pseudo membraneous enterocolitis	Metronidazole
Phenothiazine Poisoning	Promethazine
Promethazine poisoning	Diphenhydramine

FEVERS

Fever	Causative Organism
Sandfly fever	Arbovirus
Rift valley fever	A virus infecting Sheep
Lassa fever	Arena Virus
Glandular fever	Ebstein Barr Virus
Bartonneuse fever	Rickettsiae Conori
Oroya fever	Bartonella
Pretibial fever	Leptospirosis
Canicola fever	Leptospirosis
Swamp fever	Leptospirosis
Seven day fever	Leptospirosis
Haverhill fever	Streptobacillus Moniliformis
Scarlet fever	Streptococci
Pontiac fever	Legionella

Fever	Alternate Name
Undulant fever	Malta fever, Brucellosis
Oroya fever	Verruga Peruana Carrions Disease
Saddle back fever	Breakbone fever
Gaol fever	Epidemic typhus  Classical typhus
5 day fever	Trench fever
3 day fever	Sandfly fever
Glandular fever	Infectious mononucleosis
Pretibial fever	Fort Bragg fever
Haverhill fever	Ratbite fever

Common Complications

Mumps – Children Adolescents	Meningoencephalitis Orchitis
Rubella	Polyarthritis
Measles	Otitis Media
Meningococcal Meningitis	Arthritis
Haemophillus Influenza Meningitis	Subdural effusion
Typhoid	Paralytic Ileus
Tetanus	Airway obstruction and Anoxia
Whooping cough	Pneumonia
Leprosy	Intercurrent P.T. Amyloidosis
Diptheria	Myocarditis, Toxic Neuritis
Psittacosis	Myocarditis, Secondary Pneumonia
Bartonellosis	Secondary infection with Salmonella
Hypothyroidism	Hypothermia, cardiac complications
Chronic Glomerulonephritis	Myocardial infarction, Infection
Infection in Myeloma	Respiratory – Pneumonia
Commonest drug induced cutaneous lesion	Toxic erythema
Atopic Dermatitis	Kaposis Vericelliform eruption
Lichen Planus	Neoplastic degeneration

Commonest Site Of Intestinal Lesions

Lesion	Area
Lipoma	Caecum
Lymphoma( Non hodgkins)	Stomach (Least : Rectum)
Adenomatous polypi	Sigmoid, rectum
Polypi in Puetzjeghers syndrome	Always Jejunum is involved
Familial Polyposis and Gardener’s syndrome	Colon
ZES gastrinoma	Pancreas
Carcinoma small intestine	Jejunum
Carcinoma Colon	Rectum > Sigmoid colon
Tuberculosis Ulcer	Small Intestine( transverse)
Typhoid Ulcer	Small Intestine ( Longitudinal)
Crohn’s disease	Starts at or near Ileocaecal Valve
Ulcerative Colitis	Starts at rectum
Hirshprung’s Disease	upper limit is Rectosigmoid junction
Diverticulosis	90% in sigmoid ( Rectum is never involved)
Perforation in Typhoid	Small intestine near Ileocaecal Junction
Pneumatosis Cystoides	Small Intestine
Immobile part of Colon	Last 7.5 cms of Pelvic Colon
Loop Colostomy	Transverse Section
Commonest Type of Intussesception	Ileocaecal
Intussesception with gangrene	Ileocaecal
Intussesception in infant	Last 50 cms of ileum
Intussesception in old people	Colocolic By Pappilary Carcinoma
Intussesception in adoloscent	Inverted Meckel’s Diverticulum
Volvulus Neonatorum	Midgut( Whole small intestine and Caecum)
Volvulus Small intestine	Tower ileum
Ischemic Colitis	Splenic flexure
Dilatation of Gut in Chaga’s disease	Oesophagus and Colon
in Blast Injury	Pelvic Colon

Radiotherapy

1. Isotopes: Elements with same Atomic number (Number of protons same, Number of Neutrons Vary) 
2. Most used materials for external irradiation- Cobalt 60 , Cesium 131 ( Gamma rays) 
3. Machine used for electron therapy- Betatron , Material used is Tungsten 
4. Substances used as permanent implant for radiation- 
   • Gold Grains 
   • Radon Seeds 
5. For permanent insertion into cavities 
   • Colloidal Gold 
   • Vitrium 
   • Phosphorus 52
6. Radio active phosphorus is useful in

Diagnosis of

• Eye Cancers 
• Oesophageal Cancer

Treatment of – 

• Polycythemia Vera 
• Multiple Myeloma 
• Secondaries in Bone 
• Ca Prostate after priming with androgen. 
• Malignant ascites 

Effect of Radiation on Tissues
 
<>

Most Commonly affected	Skin
Most Senstive Mucosa	Intestinal Mucosa
Most Sensitive CNS part	Mid Brain, Medulla, Spinal Cord
Most sensitive cell in CNS	Neurone
Most Sensitive blood cells	Lymphocytes
Most resistant Blood cells	Platelets
Most sensitive organ in abdomen	Kidney

Radiology

Radio Isotope Scans
 

Scan	Isotope Used
Liver and Biliary function	Tc99, Tc glycoheptonate
Spleen, Marrow	Tc 99
Lung	Tc 99 macroaggregates
Lung ventilation	Xenon gas
Kidney	Tc 99, Tc Labelled derivatives
Brain, bone	Tc pertechnetate
Myocardial function	Tc albumin
Myocardial infarction	Tc pyrophosphate
Myocardial perfusion	Thalluim Chloride
Tumor or abscess	Gallium citrate
Pancreas scan	Selenomethiomine, Se 75
Thyroid malignancy	Selenium
Thyroid function	Iodine 131

 
Radiation Emitted
 

Gamma rays	Cobalt, Caesium, Technetium.
Beta rays	Strontium, Gold, phosphorus

 
 
Dye used
 

Bronchography	Dianosil
Sialography	Neohydriol
Urethrography	Umbradil Viscous V
Angiography	Urograffin
I.V.P	Sodium diatrizoate
Intestinal obstruction	Gastrograffin
Ventriculography	Metrizamide and
And Myelography	Iopendylate (Myodil)
Cholecsystography	Idopamide, Meglumine Ioglyconate
Sodium Metrizoate	Splenoportography
Hysterosalpingography	50% Diodone with 6 % polyvinyl alcohol in water
Fetography	Ethiodol

Half Life

Iodine 132	2 to 3 hours
Technitium	6 hours
Iodine 123	13 hours
Gold	2.7 days
Thallium chloride	3.1 days
Gallium	3.2 days
Radon	3.8 days
Xenon gas	5.2 days
Iodine 131	8 days
Phosporous 32	14.3 days
Iridium	74.5 days
Tantalum	115 days
Cobalt 69	5 years
Strontium	28 years
Caesium	30 years
Ra	1622 years

 
 
Ultra Sonography
 

M- Mode	For moving parts eg, valves of heart etc.
A Scope	For cerebral lesions. Shift of mid- line structures
B Scope	For 2 dimensional view eg. Obstetrics and abdominal masses
Grey scales	Foe Contrast studies

Hematology

Life Span Neutrophils 2-4 days Lymphocytes 2-3 days Eosinophils 8-12 days Platelets 9-11 days Basophils 12-15 days

Half Life Heparin 60- 90 minutes Factor VIII 8 hours Fibrinogen 100 hours Albumin 20- 26 days

 
 
Haemoglobin

Hb A	Alpha 2, Beta 2
Hb F	Alpha 2, Gamma 2
Hb A 2	Alpha 2, Delta 2
Hb H	Beta 4
Hb S	Beta 6 val- glu
Hb Barts	Gamma 4

  Blood Coagulation factors

1, 2, 5, 7, 9, 10	Produced in liver
2, 7, 8, 9, 10	Levels increased with oral contraceptives
2, 7, 9, 10	Vitamin K required
2, 7, 10	Prothrombin time helps to know the deficiency state
1. 2. 10	Both PTT and PT increased in deficiency
5, 8	unstable in stored blood
5, 10	good for growth of hemophilus organisms

Thrombin time is used to monitor heparin activity

Uraemia	Burr cells are seen
Cirrhosis	Spur cells are seen
Iron depletion	Seen in Iron deficiency anaemia, polycythemia vera
Thalassemia minor	Decreased osmolysis, microcytic hypochromic anaemia, increased HbA2.
Sickle cell anaemia	Tactoids and sickling seen.
Acquired spherocytosis	Schistocytes present, Coombs positive
Hereditary spherocytosis	Coombs negative
Aplastic anaemia	Platelets maximum affected and last to recover, Pancytopenia present
Pernicious anaemia and Folate deficiency anaemia	Anisocytosis, poikilocytosis, fragmented RBC , neutrophil lobes increased, platelets normal. Absolute reticulocyte count low.
Sideroblastic Anaemia  Hereditary  Acquired	Ring Sideroblasts present (These are Iron granules in mitochondria around the nucleus) Microcytic, hypochromis RBC Macrocytic hypo or normochromic RBC
Polycythemia vera	Increased RBCs, platelets and Leukocytes Splenomegaly esent
Myeloid metaplastia and Myelofibrosis	Giant Platelets  Macrocytic Anaemia ‘Tear Drop’ poikilocytes Leukoerythroblastic picture
Warm antibody autoimmune haemolytic anaemia	Polychromasia and Spherocytosis present
Megakaryocytosis marrow seen in	Idiopathic Thrombocytopenic purpura Myeloid Metaplasia Polycythemia vera
Subleukaemic Leukaemia	Abnormal cells present White cell count normal or decreased
Aleukaemic leukaemia	No abnormal cells WBC Count usually decreased below normal Diagnosis from marrow aspiration
Hairy cell leukaemia	Neutropenia, Splenomegaly, hair cells seen.
Acute non- lymphocytic Leukaemia Lymphoblasts Myeloblasts	Total count usually more than 1, 00, 000 Macrocytic Normochromic Anaemia Severe Thrombocytopenia PAS Positive, Sudan black positive,  stains with Romanowski stain
CML	All series of cells seen Myeloblasts greater than 10, Increased Basophils, eosonophils, thrombocytes
C.L.L( B Cell disease)	Small lymphocytes increased. Blasts are rare. Auto immune hemolytic anaemia present.
Pro- lymphocytic Leukaemia	Large lymphocytes with prominent nucleolus
Eosinophillic Leukaemia	Eosnophils increased
Burkit’s lymphoma	"Starry sky" appearance in Lymphnode biopsy

HemophiliasDeficient Factor

<><><>

Hemophilia A	Factor VIII Deficiency
Hemophilia B	Factor IX Deficiency
Hemophilia C	Factor XI Deficiency
Para hemophilia	Factor V Deficiency
Pseudohemophilia	(Vascular Hemophilia)Von Willebrand’s disease