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DP GI FM GE /N EX T DPGIFMGE/NEXT FMGEI MAGEBANK Col le ctedandas sembedby DrOmkarSonawane& DrJas...

DP GI FM GE /N EX T DPGIFMGE/NEXT FMGEI MAGEBANK Col le ctedandas sembedby DrOmkarSonawane& DrJas wantSi ngh F130/ 2,SUDARSHANROAD, GAUTAM NAGAR, NEW DELHI-49 +91- 9354297795, +9560935393  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX T Preventive and Social Medicine National Health Mission 2013 Combined NRHM + NUHM National Tuberculosis By Ministry of Health and Family Welfare, GOI It includes all other health programs of India like Elimination Programme RMNCH+A, NPCBVI, NTEP, NLEP, NPCDCS, NTCP, It is a new name for Revised National Tuberculosis AMB etc. Control Programme (RNTCP) with a new logo. Major targets- Category 1 and 2 are treated with the same regimen a. MMR Sphagetti Scales + SD Agar --> Fried Egg and Meat Ball appearance colonies Kerion Tricophyton mentagrophytes Tinea Cruris Aka Dhobi/Jock Tinea Capitis Itch Favus Tricophyton Tinea Pedis schoenlenii Aka Athlete's Foot Candida albicans Aspergillus H and E stain of Black Colonies of Tissue biopsy- Corn Meal Agar Reynold Braude phenomenon SDAgar- Creamy pasty Aspergillus on Septate hyphae, Chlamydospore formation Germ tube formation colonies culture medium acute angled (45°) and dichotomous branching Oral Thrush Curdy creamy patch Halo Sign on CT Chest in Invasive Vaginal Candidiasis Aspergillosis Crescent sign on Curdy white discharge CT Chest in Invasive Aspergillosis Page 95 of 117 Page 96 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Zygomycetes Dimorphic Fungal Disease T Aseptate hyphae, Obtuse angled Coccidides imitis Causes Coccididomycosis Yeast- Spherule with endospores Mold- Anthroconidial arrangement Paracoccidides brasilensis Causes Para coccididomycosis aka South American disease or Lutz mycosis Yeast- Mickey mouse/Mariner's wheel/Pilot wheel appearance Penicillium marneffi Causes Penicilliosis Brush Conidial arrangement Brick red colour pigment Dermatophytes Dimorphic Fungal Diseases Tricophyton Cylindrical macroconidia and numerous microconidia Histoplasma capsulatum Epidermophyton Causes Histoplasmosis aka Darling's disease Sporothrix schenkii Club/Boat/Pear shaped Causes Sporotrichosis aka Rose Yeast- Narrow based budding macroconidia with no microconidia Mold- Tuberculate macroconidia Gardener's disease Yeast- Cigar shape Mold- Flower like sporulation Microsporum Spindle shaped macroconidia with few microconidia Page 97 of 117 Page 98 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Dimorphic Fungal Diseases Protozoalogy T Chromoblastomycosis Tissue Bx- Medlar bodies (Sclerotic Amoebiasis brown coloured globose bodies) Entamoeba histolytica Copper penny appearance Anchovy sauce/Chocolate pus Quadrinucleate cyst Blastomyces dermatitis Causes Blastomycosis aka North Giardia lamblia American/Chicago/Gilchrist disease Causes Giardiasis Yeast- Figure of 8 appearance Trophozite- Tennis Racquet/Monkey face/Tear drop appearance Falling leaf like motility Trichomonas vaginalis Madura Foot/Mycosis Actinomycetoma- Bacterial Eumycetoma- Fungal Multiple discharging sinuses Rhinosporidiosis Caused by Rhinosporidium seeberi It is a aquatic protozoa Copitis macularis (Strawberry Mulberry like nasal mass Green frothy discharge vagina) Poly Bx- Spherule with endospores Pneumocystis carni/jeroveci Causes PC pneumonia Cannot be cultured Cryptococcus neoformans Causes Cryptococcal meningitis in HIV +ve India Ink stain of CSF Page 99 of 117 Page 100 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Plasmodium species stages T Chagoma/Romana sign American Trypanosomiasis Aka Chagas disease Transmitted by Reduvid Bug Leads to Megacolon, Megaesophagus Toxoplasma gondii Post Kala Azar Dermal Leishmaniasis (PKDL) Causes Toxoplasmosis Due to ingestion of undercooked contaminated meat Sabin feldman dye test Leishmaniasis Leishmania donovani- Kala azar Babesia microti Transmitted by Sandfly Maltese cross arrangement (Phlebotomous) Leishman Donovan (LD) Bodies Causes Babesiosis rk 39 Ag test Transmitted by tick LAMB is DOC Page 101 of 117 Page 102 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Helminthology Schistosoma T Squamous and Transitional cell carcinoma of bladder Katayama fever Diphyllobothrium latum Aka Fish tapeworm Operculated egg Leads to Megaloblastic Anemia Hymenlopsis nana Aka Dwarf tapeworm Neurocysticercosis Non-Bile stained egg Due to Taenia solium Autoinfection Starry sky appearance Trichuris trichiura Echinococcus Aka Whipworm Barrel/Dumbbell shaped egg with granulosus mucus plugs Aka Dog tapeworm Leads to Coconut cake like rectum Water Lily sign on CT Abd (frequent prolapse) Casoni test PAIR therapy Enterobius vermicularis Aka Pinworm/Thread worm/Seatworm Clonorchis sinesis Perianal pruritus Aka Oriental or Chinese Auto infection Liver fluke Non bile stained plano- convex Can lead to egg Cholangiocarcinoma (CT) Tadpole like larvae Page 103 of 117 Page 104 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Bacteriology Ancylostoma duodenale T Aka Hookworm Robert Koch Ground itch Father of Modern Microbiology Causes Fe deficiency anemia Father of Bacteriology Chandler's index (>300 is a social problem) Discovered TB and Cholera bacilli Eggs with blastomeres) Stated Koch's Postulates Ancylostoma brasilensis Causes Cutaneous Larvae Migrans Joseph Lister- Father of Antiseptic Surgery Antony Van Leeuwenhook- Father of Microscopy Paul Ehrlich- Acid Fast stain concept Ascaris lumbricoides Kary B. Mullis- PCR Wuchereria bancrofti Leads to Bancroftian Filariasis Transmitted by Culex mainly Potassium Tellurite Agar DEC provocative test Blood smear- Microfilariae (No nuclei at tail tip) Corynebacterium diphtheria Aka Klebloeffler's bacilli Bipartite toxin Chinese Letter Pattern or Cuneiform Shick test arrangement Leads to Bull's Neck Brugua malayi Pseudomembrane (MC- Faucial) Tail tip shows terminal 2 nuclei Page 105 of 117 Page 106 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Streptococcus T Neisseria gonorrhoeae Gr. A Streptococcus (S. Pyogenes) Aka Gonococcus Scarlet Fever Common cause of Urethritis, Pharyngitis and PSGN (Immuno-fluorescence showing IgG Ophtgalmia neonatorum and C3 deposits) Intracellular kidney shaped Neisseria meningitidis Aka Meningococcus Streptococcus Gr. B Strep A, C, W and Y serogrp pneumoniae (S. Agalactiae) Meningitis and Meningococcemia (Pneumococcus) shows Butterfly Can lead to Waterhouse Friedrichsen MCC of Pneumonia zone hemolysis on syndrome Draughtsman like or Carrom Blood Agar Coin colonies Staphylococcus Bacillus anthracis Gram stain- Bamboo stick appearance Agar Microscopy- Medusa head/Matted Wool like appearance Gelatin Stab Culture- Inverted Fir tree appearance Staphylococcal Impetigo (above) Scalded Skin Furuncle (below) Syndrome (SSSS) Staphylococcus Pin head sized colonies with beta- Cutaneous Anthrax Pulmonary Anthrax hemolysis on blood agar Aka Hide Porter's disease Aka Wool Sorter's disease Page 107 of 117 Page 108 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Clostridium Mycobacterium leprae T Robertson Cooked Meat Causes Leprosy (Hansen's disease) Medium ZN staining- 5% acid-fast with Cigar Stately motility bundle shape arrangement Grows in foot pad of nine banded armadillo (image) Gas Gangrene (Cl. welchii/perfringens) Ptosis Botulism (Cl. botulinum) Opisthotonus Tuberculoid Leprosy Borderline Leprosy Lepromatous leprosy Tetanus (Cl. tetani) Granuloma Inguinale Rhinoscleroma (K. (Donovanosis) rhinoscleromatis) K. granulomatis Ziehl Neelsen (ZN) stain 20% acid-fast M.TB Mycobacterium tuberculosis Klebsiella Rough, tough and buff colonies on LJ Aka Fried Lander's bacilli media Urease positive Klebsiella Pneumonia Gohn's and Ranke's complex on CXR- Bulging fissure sign Chest X-ray Red currant jelly sputum Page 109 of 117 Page 110 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX T Cholera Vibrio cholerae on TCBS media Darting motility Rice Watery Diarrhea Transport- VR media Classical and Eltor types Salmonella typhi Jet Black colonies Causes Typhoid/Enteric fever Pea soup diarrhea (image) Rose spots (image) Yersinia pestis Longitudinal ulcers in Wayson stain- Bipolar staining GIT Spirochaetes (Safety pin app) Classification based in flagella Haemophilus influenzae Legionella BCYE (Buffered Charcoal Blood agar- Satellitism Yeast Extract) Media Pseudomonas aeruginosa Nutrient agar Mechanism of Gene Transfer Page 111 of 117 Page 112 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Inclusion Bodies T Bacterial Growth Curve Cytomegalovirus Infection Owl Eye inclusion bodies Rabies Negri Bodies Measles Warthin Finkeldey Giant Cells Virology Adenovirus-Space Rabies virus- Bullet Ebola virus- Filamentous Vehicle shape shaped Molluscum Contagiosum Pox virus (Brick shaped) Pearly umblicated papules Henderson Peterson bodies Erythema Infectiosum Aka 5th disease Influenza virus structure Parvo virus B 19 HIV structure Slapped Cheek appearance Page 113 of 117 Page 114 of 117  DP GI FM GE DPGI FMGE/NEXT DPGI FMGE/NEXT /N EX Herpes Virus T Mumps Epidemic parotitis IP- 14-21days Vaccine strain- Jerryl Lynn HSV 1 (Oral Herpes) HSV 2 (Genital Herpes) Rubella Aka German Measles IP- 14-21days Vaccine strain- RA 27/3 Herpes Zoster (Shingles) Herpes Zoster Ophthalmicus COVID-19 (SARS CoV2) Novel Corona Virus Hand Foot Mouth Disease Coxsackie virus AnoGenital Warts Human Papilloma Virus (HPV) Page 115 of 117 Page 116 of 117  DP GI FM GE DPGI FMGE/NEXT /N EX T Page 117 of 117  DP GI DPGI FMGE/NEXT FM Bone Age Estimation GE Short Stature /N EX T 3 year old 10 year old For Bone Age estimation- In neonates- Xray Knees In infants- Xray Shoulder 1-13 years- Hand and Wrist Xray Syndromes Dentition Abnormalities Alagille Syndrome Cleidocranial Dysostosis Neonatal cholestasis Absent clavicles Pulmonary stenosis Delayed closure of anterior Butterfly vertebra (image) fontanelle Triangular facies (image) Delayed dentition Supernumerary teeth Seckel Syndrome Microcephaly Elongated bird-like face Beak like nose Congenital Syphilis Dwarfism Hutchinson's triad- Hutchinson's Teeth (Pegged Central Incisors) Osteogenesis Imperfecta Interstitial Keratitis Aka Brittle Bone Disease/Dentinogerous Sensorineural Hearing Loss Imperfecta Triad- Recurrent Fractures/Bony deformity Pierre Robin Sequence Blue Sclera Natal teeth (Born with teeth) Deafness Page 1 of 42  DP GI DPGI FMGE/NEXT FM Achondroplasia GE /N EX T Autosomal Dominant Champagne Glass Pelvis (Xray) Hand abnormality (Trident Hand) Obesity Neurological problems Delayed motor milestones Recognised at birth bOwing of legs Proximal limb shortening LArge head Short stature Increase interpedicular distance Abnormal gene FGFR-3 Page 2 of 42  DP GI DPGI FMGE/NEXT FM GE Pica /N EX Bed Alarm T Technique Used for Nocturnal Enuresis Rett's syndrome X linked dominant MC in girls Acquired microcephaly Autistic symptoms Autism Rooting reflex Moro's Reflex 32 weeks IUL to 1 month 28-37 weeks of IUL to 5-6 postnatal age month postnatal age Asymmetric Tonic Neck Reflex 35 weeks of IUL to 5- Gestational age to Birth months postnatal age weight Palmer/Grasp Reflex Parachute Reflex Orchidometer 28 weeks of IUL to 3 7-8 months postnatal age and Primitive Used to measure testicular volume months persists throughout life Reflexes Page 3 of 42  DP GI DPGI FMGE/NEXT FM GE /N EX T Neonatal Resuscitation Pre-Term Neonate Extended posture Incubator Scarf sign Acrocyanosis Radiant Warmer Kangaroo Mother Care (Peripheral) Neonatal Jaundice Icterus in neonates has a cephalocaudal progression Kernicterus (Stained Basal Ganglia) Photo therapy (Wavelength- 450-470 nm) Capillary Refill Time Normal 15 beats for 2 Late (Type 2)- Placental insufficiency or more times in 20 min Sinusoidal- Fetal ania each for >15 sec Page 13 of 42  DP GI DPGI FMGE/NEXT FM GE /N EX T Cervical Funneling Cervical Cerclage (Mcdonald's Stitch) Ectopic Pregnancy Blighted Ovum Ruptured Ectopic Pregnancy Blood in Cul-de-sac (image) Signs of peritoneal hemorrhage (image) Abortions Chorionicity Scan Mode of Twin presentation and (12-13 weeks) Dichorionic Diamniotic - Delivery Twin Peak or Lambda Sign Both cephalic/vertex- Normal Delivery Monochorionic 1st Cephalic and 2nd Breech- Normal Diamniotic- T-sign Delivery Both Breech/Transverse- Elective C- section Page 14 of 42  DP GI DPGI FMGE/NEXT FM GE /N EX T Partial Mole Pomeroy's Technique Parklands Technique Irving Procedure Tubal Rings/Bands Clips Complete/Vesicular Mole USG- Snowstorm app Gross- Grape-like clusters Uchida's Procedure Cauterization Essure Ring Partogram We can monitor progress of labour (cervical dilatation and descent of head), FHR, Liquor, Contractions, PR, BP, Temp, Urine output, etc Double Decidual Sac Sign on USG Indicates Intra-Uterine Pregnancy Cardiac Output in Pregnancy Starts increasing by 5th week and reaches peak at 32-34 weeks Highest immediately post-partum External Ballotment Around 22-24 weeks Page 15 of 42  DP GI DPGI FMGE/NEXT FM GE Perimetry /N EX Diameters of Fetal Skull T Types of Pelvis Diameters of Female Pelvis Delivery of After Coming Head Loveset's Maneuver Delivery of extended arms Piper's Forceps Pinard's Maneuver Delivery of extended legs Burns-Marshall Maneuver Page 16 of 42  DP GI DPGI FMGE/NEXT FM Shoulder Dystocia Management Breech Presentation GE /N EX T Gaskin's Maneuver Stargazing Sign Mc Robert's Maneuver Breech with extended head Woods Cork Screw Method Uterine Incisions Zavanelli Restitution with C-section Supports of Uterus Adenomyosis Gross appearance- Uniform enlargement MRI- Lakes of endometrial blood USG- Venetion Blind appearance Uterine Prolapse Histopath- Myohyperplasia Endometriosis Powder Burn lesions/Blue spots Chocolate cyst of Ovary Transvaginal Tape Page 17 of 42  DP GI DPGI FMGE/NEXT FM GE /N EX Fibroid Uterus T Aka Leiomyoma Perineal Tears Endometrial Cancer Staging Cervical Cancer Ayre's Spatula and Cytobrush Fusion Defects Vulvar Cancer Key Punch Forceps- Used for biospy Endometrial Biopsy Page 18 of 42  DP GI DPGI FMGE/NEXT FM GE Trichomoniasis /N Colpitis macularis (Strawberry EX Vagina) T Green frothy discharge pH >4.5 Vulvovaginal Candidiasis Curdy white discharge pH