Kussmaul's sign is seen in all EXCEPT -
(B) (Hypertrophic obstructive cardiomyopathy) (330, 1823, 1964 H 18th)Kussmaul's sign is defined by either a rise or a lack of fall of the JVP with inspiration and is classically associated with constrictive pericarditis, although it has been reported in patients with restrictive cardiomyopathy, massive pulmonary embolism, right ventricular infarction, and advanced left ventricular systolic heart failure.Pericardial knock: Seen in heart failure or constrictive pericarditis, as well as a murmur of Tricuspid regurgitation.FLAPPING TREMOR OR ASTERIXIS: is considered a negative myoclonus jerk, this results in sudden loss of maintained posture.Causes:* Hepatic failure (Hepatic, encephalopathy).* Renal failure (Uremic encephalopathy)* Hypercapnia (Carbon dioxide narcosis).* Anticonvulsant medications* Antipsychotic drugs such as lithium, phenothiazines and butyrophenones.Positive hepato-Jugular reflex seen in* Tricuspid regurgitation* Right sided heart failure* Pulmonary stenosisHIGH YIELD POINTS1.Soft Chancre - caused by H. ducreyi - a gram negative coccobacilli, arranged in parallel chains giving "school of fish" or rail road tract appearance.Hard chancre - caused by T. pallidum (Primary syphiles)2.Desmosomes - are the major adhesion complex in epidermis, anchoring keratin intermediate filaments to the cell membrane and bridging adjacent Keratinocytes and allowing cells to withstand trauma.3.Intra-epidermal immunobullous disorders are seen in * Pemphigus vulgaris* Pemphigus vegetans* Pemphigus foliaceus* Pemphigus erythematosus* Intracellular IgA dermatosis* Paraneoplastic pemphigus Sub-epidermal immunobullous disorders * Bullous pemphigoid* Mucous membrane pemphigoid* Pemphigoid gestationalis* Linear IgA disease* Epidermolysis bullosa aquisita* Dermatitis herpetiformis4.Phrvnoderma - homy plugs with perifollicular papules are seen on the elbows, knees neck and posterior axillary fold. Hypovitaminosis A is the most common cause. Other factors such as Essential fatty acids (EFA) calories and vitamins B, C and E have also been incriminated.5.Grattage test, Auspitz sign, Woronoffs ring - are various bed side tests and signs associated with psoriasis.6.Koebner phenomenon - are seen in - Darier's disease, Erythema multiforme, hailey hailey disease, Leukemia, Lichen planus, Lichen-sclerosus, scleromyxoedema, multicentric reticulohistiocytosis, Necrobiosis, lepoidica, Perforating, Collagenosis and folliculitis, Psoriasis, Myxoedema vasculitis, Vitiligo, Xanthoma7.Fluorodeoxyglucose is a radiopharmaceutical used in medical imaging modality positron emission tomography (PET)8."Popcorn calcification" are pathognomic for Fibroadenoma of breast.9.Fully peri hilar opacities projecting into lung parenchyma is seen in Pulmonary edema which gives "Bat- Wing " appearance10.Looser's zone or pseudofracture is pathognomic for osteomalacia. However it may occur rarely also in Paget's disease. Fibrous dysplasia, Hyperparathyroidism, Renal osteodystrophy, Hyperphosphatasia and osteogenesis imperfecta.11.USG Findings of infantile pvloric stenosis are* Target sign - Pyloric muscle wall thickness - > 4 mm* Cervix sign - Pyloric length (segment length) - > 16 mm* Antral nipple sign - Pyloric diameter - > 15 mm12.Bone within a Bone appearance seen in * Normal neonate* Growth arrest/recovery lines* Bisphosphonate therapy* Sickle cell anemia* Osteopetrosis* Acromegaly* Prostaglandin El therapy* Heavy-metal (eg lead) poisoning* Hypothyroidism/Hypoparathyroidism* Hypercalcemia & Hypervitaminosis-D* Rickets/Osteomalacia (Healed phase)* Scurvy (Healed phase)
Constrictive pericarditis
Hypertrophic obstructive cardiomyopathy
Right ventricular infarction
Severe left sided heart failure
C.V.S.