FCPS Discussion Part-1/July 22

𝗛𝗮𝗹𝗹𝗺𝗮𝗿𝗸𝘀 𝗼𝗳 𝗵𝗮𝗲𝗺𝗼𝗹𝘆𝘀𝗶𝘀
(𝖱𝖴𝖧𝖴𝖫)
 ↓ Haemoglobin
 ↑ Unconjugated bilirubin
 ↑ Lactate dehydrogenase
 ↑ Reticulocytes
 ↑ Urinary urobilinogen.

✓Common laboratory changes during pregnancy...
√𝑯𝒆𝒎𝒂𝒕𝒐𝒄𝒓𝒊𝒕 - decrease
√𝑼𝒓𝒆𝒂 & 𝒄𝒓𝒆𝒂𝒕𝒊𝒏𝒊𝒏𝒆 - decrease
√𝑮𝒍𝒖𝒄𝒐𝒔𝒆 - decrease(fasting)
√𝑻𝑺𝑯 - decrease in 1st trimester
√𝑻3 - increase in 1st trimester & decrease in later pregnancy

Rest are increase in pregnancy.

✓ 🇩 🇷 🇺 🇬 treatment of 𝗵𝘆𝗽𝗲𝗿𝘁𝗲𝗻𝘀𝗶𝗼𝗻 𝗱𝘂𝗿𝗶𝗻𝗴 𝗽𝗿𝗲𝗴𝗻𝗮𝗻𝗰𝘆.....
√𝑴𝒆𝒕𝒉𝒚𝒍𝒅𝒐𝒑𝒂
√𝑳𝒂𝒃𝒆𝒕𝒂𝒍𝒐𝒍
√𝑵𝒊𝒇𝒆𝒅𝒊𝒑𝒊𝒏𝒆
√𝑨𝒎𝒍𝒐𝒅𝒊𝒑𝒊𝒏𝒆
√𝑫𝒐𝒙𝒂𝒛𝒐𝒔𝒊𝒏

Motor neuron disease....
®Features
✓limb symptoms(typical presentation) -- foot drop
✓bulber symptoms -- dysarthria,swallowing difficulty, type-2 respiratory failure (this is common terminal event)
✓Upper and lower motor symptoms -- exaggerated jerk, planter extensor, spasticity, fasciculation.

® Sensory symptoms, autonomic symptoms and visual symptoms do not occur.******

® Investigation --
√EMG(confirmatory investigation)
√Genetic testing

Features of parkinsonism (Bradykinesia/Akinesia, Resting tremor, Rigidity, Postural instability) + Visual hallucinations + Dementia= Diagnosis...... Lewy body dementia.

Nail changes in different diseases.......
® Psoriasis
✓ Subungual hyperkeratosis
✓ Periungual involvement
✓ Onycholysis
✓ Thimble pitting
✓ Horizontal ridging
✓ Uncommonly, splinter hemorrhages

® Lichen planus
✓ Longitudinal ridging
✓ Subungual hyperkeratosis
✓ Thinning of nail
✓ Nail loss
✓ Scarring/Pterygium(splitting of nail)
✓ Sandpaper texture (trachyonychia)
✓ Erythematous streaks (Erythronychia)
✓ Pigmentation
✓ Destructive nail dystrophy

® Onychomycosis
✓ Yellow/ brown discoloration
✓ Crumbling
✓ Thickening
✓ Subungual hyperkeratosis

....Causes of
Diffuse scarring alopecia...
✓ Discoid lupus erythematous
✓ Lichen planopilaris
✓ Radiotherapy
✓ Folliculitis
Localized scarring alopecia...
✓ Discoid lupus erythematous
✓ Lichen planopilaris
✓ Tinea capitis/Kerion
✓ Herpes zoster
✓ Morphoea
✓ Idiopathic
✓ Developmental defects

®Dermatology...SBA
White lacy network on buccal mucosa found in....
✓Lichen planus
✓Pemphigus vulgaris
✓Toxic epidermal necrolysis
✓Steven Johnson Syndrome
✓Linear IgA disease