High Yield Revision of Volatile Topics for Medical Exams | BTR Session

[00:00:02]hi guys good evening can you all see me and hear me now I think I think we're live now uh finally I hopefully it'll be sorted now so everything uh which could possibly go wrong did go wrong with their issue with Stephen Keys there's issue with my iPad this issue with YouTube and uh finally we are off and hopefully no more issues fingers are crossed uh all of you just quickly join in I'm so sorry I apologize uh for this uh for wasting your 20 minutes of your time hopefully I will make up for it in the next 60 Minutes uh all right so let's begin then what is BTR first of all BTR is called Buri Tera rato a lot of you know about it now but a lot of you do not know about it so BTR is something that you know back in mbbs when I was in Ames uh our seniors used to Mark our books I'm sure a lot of you guys also get your books marked from senior so Mario seniors so that is the origin of BTR basically and it is just a compilation of stuff for all of you guys that you need to have in mind before going into the example so uh this is what I have basically compiled for you normally you know we ask you key essay when you are going into the example you need to know what are the must know volatile stuff so I've done that hard work for you all you need to do is memorize this stuff learn along with me and hopefully we'll have many more such sessions such that we can compile everything that we need to know from all 19 subjects before going into the exam Hall all right so thank you so much and thank you for thank you to Praveen sir and I think spursor was also in there I briefly could catch a few comments from them thank you sir for for coming into the live chat and engaging the students uh so uh thank you sir thank you sir so here we go with this so what I will be starting off uh with is some Auto antibodies that we need to know from medicine medicine and Allied subjects yeah yeah this session will continue in the the series will continue in the future Also let's see we'll see how it goes and we'll also do this in Hyderabad so one of the reasons why we're doing this is also uh that we are gonna be doing one and a half days of BTR sessions in Hyderabad so imagine you know if we can do itna in one hour how much we'll be doing in one and a half hours so that is the whole idea and uh if we'll have more online sessions as well uh if all goes well okay all right so let's uh begin then so these are all uh the antibodies that we need to know as far as connective tissue diseases are concerned and then we will have a few more antibodies that I'll be talking about so a a remember and I'll tell you all of the relevant points that you need to keep in mind so this will be very rapid this will be very high yield so just keep your ears open if you are writing right quickly but just listen to every single line that I am telling you okay so a a remember is the most sensitive anti antibody right that we have all right so when we talk about SLE when we talk about SLE the most sensitive antibody that we have is a n a in fact according to the new new 2019 criteria which is the Euler criteria this is an entry criteria means you need to have a a positive to start thinking obviously so this is an entry criteria that we need and we need a level of more than one is to 80 the PDF is there on the telegram group all right it's there on the telegram group we post it on the cerebellum Channel as well right now it's there on my channel which is Dr zanabora uh need PG okay so this is the most sensitive antibody for SLE when we talk about anti-ds DNA remember this is the most specific antibody as far as SLE goes not the most specific but a specific antibody and why it is very important clinically is because this correlates very well with the activity so this correlates with the disease activity and this increase is in flares so remember this has the best core foreign [Music] there are a few more issues which were not anticipated and which are happening yes so today's class is also a live lesson in how do you uh stay calm in panic situation you know a lot of times in your exam you will have everything which could possibly go wrong is going wrong like your connection is not working your system is crashing down and still how do you still be in Zen mode and take a class or give your exam that is what is going to be the live demonstration this is a live demonstration of that okay actually my iPad cable is a bit loose I need to get it changed so that is what is happening it's just a little bit of movement and it moves so that is what is happening but you guys know Hannah you guys know so this ntds DNA it correlates with disease activity antihistone antibody we need to know that this is responsible for drug induced lupus tell me drug induced lupus what are the drugs that you would consider we want to consider the ship drugs right so sulfur drugs hydralazine isoniazide Pro canamide these are the four drugs which are responsible for drug induced essay very nice anti-sm is the most specific I told you dsdn is pretty specific correlates with activity more specific but not sensitive is anti-sm antibody okay anti-c1q is another antibody which correlates with disease activity so this also increases in flare so very important medicine question is what are the two things that you will see so one we will look at anti-ds DNA I will look at anti-c1 Cube or the other way round I will look at complement levels going down okay then coming on to neuronal antibody so again very logical neuronal but they'll not ask you this they'll ask you glutamate receptor too so this is the one which correlates with the findings of CNS Loop so this is what is activated in findings of CNS lupus all right anti-ribosomal P for anti-ribosomal p what is it this is the one so P for psychiatric manifestation so when you have CNS psychiatric manifestations of Lupus you will have this antibody which is ribosomal P now why is ribosomal p in red it is in red because it is very important that you do not confuse it with ribonucleoprotein U1 rnp is something which is there in mixed connective tissue disorder right so these are two things which you will confuse so ribosomal ribonucleoprotein so remember ribosomal p p for psychiatric and rnp is ribonucleoprotein all right then we have anti row and we have anti-la all right so anti-roller yes these are both in joggers but as far as SLE is concerned you need to remember SSA or rho yes so from that you can remember row say neonatal lupus all right so neonatal lupus and the baby will have con congenital heart block that correlates with the activity of anti-ssa fine so that is what we know from this anti Joe anti-mi2 these are antibodies which are seen in dermatomyositis right so these are seen in dermatomycitis one recent update for you so anti-jovan traditionally were dermatomyositis but now there is a new syndrome which is anti-synthetic syndrome all right so this is now seen in a new syndrome anti-synthetic syndrome which is a sub part of dermatomyositis the Hallmark I wanted to remember for exam purpose is what is mechanic hands this may mechanic hands milenge along with fever along with ild and stuff okay so this is what you want to remember so anti-syntheticism there is ild and there is mechanic hand so that is what we want to remember ntmi 2 dermatomyocyte is good prognosis Tom Cruise Tom Cruise is good prognosis right so that is good prognosis with mi2 topoisomerase and scl70 are the same thing they are both seen in Scleroderma what kind of Scleroderma diffuse cleroderma generalized Derma when a centromere is Tiny it is limited so it is seen in limited Scleroderma also called as Crest so these are the antibodies as far as connective tissue disorder goes and you at least get one question from this list adding on to these further antibodies that we have other than this in medicine and path one will be a recorded video will be available anti-tpo what is anti-tpo so anti-tpo is seen in Hashimoto thyroiditis right so Hashimoto's thyroiditis or lymphocytic thyroiditis you will have lymphoid follicles you will have germinal follicles which are present so when thyroid looks like a lymph node think Hashimoto's thyroiditis okay and you will have anti-tpo remember it will have transient hyperthyroidism then there will be euthyroidism and then eventually it goes into a hypothyroid phase lats very important so long acting TSH stimulants so this is something which is there in Graves extremely important so grains disease you have tyrotoxicosis Pathways you will have a very beefy looking enlarged thyroid gland Radiology wise you'll have a lot of vascularity on Doppler all right you look at the thyroid on Doctor it looks angry there is so much color okay so that is about grapes histopath wise and grades you see a finding which is called scalloping scalloping of the colloid all right so these are findings of graves apart from that when you do a radio iodine scan grades is gonna show a diffuse uptake diffusely gland in a warm again is showing diffusely increased uptake ordered so you need to remember that there is diffuse increase in uptake on radio iodine uptakes can diffuse gland looking warm okay then anti-sm anti-lkm1 where are these antibodies seen these are seen with autoimmune hepatitis all right so autoimmune hepatitis again very important SM and lkmen smooth muscle and lkm1 liver kidney microsomal antibody in autoimmune empath autoimmune hepatitis is very important I want you to remember a buzzword which is interface interface hepatitis or you will hear the word emperoropolysis you want to think of autoimmune hepatitis all right so very very important buzzwords for aih AMA again very important obstructive jaundice you will have a young female with obstructive jaundice you will have xanthelismas osteopenia think of PBC primary biliary cirrhosis primary biliary cirrhosis where you are having florid duct lesions lots of inflammatory cells fluoride duct lesions on the other hand the differential of PBC is what we have primary sclerosing cholangitis because PSC is associated with ulcerative colitis or IBD inflammatory bowel disease so remember PBC versus PSE primary biliary cirrhosis young female flored duct lesions AMA antibody PSE and the kind of duct lesions you'll have is onion skin all right as far as radio geology is concerned PBC Radiology will be normal MRCP will be normal whereas in PSC on MRCP you will have multi-focal strictures you will have a beaded appearance multifocal biliary strictures giving rise to a beaded sort of an appearance all right so this is PSC versus PBC independent question now going on to Pianka where else will you have Pianka so one is obviously inflammatory bowel disease apart from that now going on to the territory of vasculitis per se collidocal cyst again investigation of choice MRCP see any biliary duct you can remember MRCP is the investigation of choice most of the times okay right so now again remember one more thing PSC very high risk of colangiocarcinoma it has a very high risk of cholangiocarcinoma going into vasculitis small vessel vasculitis small vessel vasculitis microscopic polyangitis and choke Strauss chalk Strauss is now called eosinophilic granulomatosis with polyangitis so this tells me that this has dual mechanism Auto antibody and there is granulomas also fine and C anchor is wagoner's granulomatosis or granulomatosis with polyangitis again granulomatosis so this also has dual mechanism okay this is very very important so we were discussing IBD UC is remember C Crohn's disease will have anti-saccharomyces ceramics okay RF rheumatoid factor I am sure you know most sensitive for ra what is it is the frequently Asked question so this is IGM antibody against the FC part of IGG so is mrf tires we have mrf tires no so remember it is actually IGM antibody against the FC part of IGG what about 20 CCP it is the most specific antibody for rheumatoid arthritis glutamate decarboxylase is seen in type 1 autoimmune diabetes right so type 1 diabetes autoimmune we have glutamate decarboxylase and parietal cell is seen with antiparietal cell antibody scene so this is seen in pernicious anemia wherein you will have B12 deficiency yeah because intrinsic factor and H plus both of them are secreted by the parietal cell intrinsic factors absorption yoga that is why you'll have anemia megaloblastic anemia okay so this in a nutshell like takes care of almost all of the questions on auto antibodies hopefully two to three questions will come from this list all right so now going on to microbio right very very rapid revision of all the microbio eggs first of all you again get one question from all of these eggs so the first egg that you see here is a Plano convex sort of a egg so this is seen in pinworm this is the Egg of enterobius vermicularis so this is seen in enterobius vermicularis it will cause a lot of perianal pruritis in children for Ionic remember an extra Edge point we do an NIH swab test for this condition and there is a scotch shape they install it so there are two tests that we do to pick up these pinworms when they come out of the anal Canal so this is pinworm you can see how it is white it is non-by-stain we'll compile a list of things which are non-bile stain all right so this is one of them here the most commonly has the easiest egg Barrel shapedic mucus plugger this is all right then we have two eggs which are of ascaris the largest nematode that we have so here one is fertilized one is not fertilized how do we remember after fertilization the egg will swell up and a pregnancy we will swell up egg also will swell up so this is fertilized egg round egg so this is fertilized egg of ascaris on the other hand over leg unfertilized so this is unfertilized egg of as guys TK when you see us a round round can you see how there are Round Round blastomias Here new generation the only worm which comes doesn't come as an egg but comes as a worm so what is this this is an Ovo Vivi Paris will form the worm so this is strongly so they can give you this image and ask you what is this so this is strongly lloydus and which form which larva is this so this is rapidity Formula power right this is the rapidity form larva of strongyloidus which will come by in fact via skin so remember strongly lloydus and hookworm both of them are in gonna infect why a skin bakis so this is about nematodes in the nutshell quickly looking at the cystos so systos me when you see these radial radial striations this is tenia we have tinea Solium we have tenia saginata remember for all of the sisters gonna be man so that is clear definitive host is mad tenia has two so one is definitive one is intermediate so when we talk about tinea Solium what so what is the secondary or intermediate host of solia it is pig and for sajanata is cattle all right so this is how we remember tinyavi it causes neurocystic surpluses right so when we have eggs of Tina even vegetarians can have tinea sodium eggs through vegetations and you can have neuro cystic circosis on MRI you will see tiny tiny multiple T2 hyper intense lesions with a central school X called as a Starry Sky appearance do not be under a misconception you can have a single NCC also right so that is something which is very very important then look at this egg can you see how this is not bile stained this is H Nana so H Nana in Gujarati I don't know how many gujaratis are here but nana means small baby so this is also called as dwarf tape firm this is also called as dwarf tape form and this is known bystain because it's a small baby we do not want to stain it with bile right so this is H Nana dwarf paper do you think a baby egg will have more hosts no a baby egg will only have a single hose so only one only one host is present so definitive host is the only host that H Nana has on the other hand this one here is H diminuta so even though its name is diminuta it is not diminuta it is a rat tape form right so this is also called as rat tape one because intermediate Hostess rats okay and finally the one which is an operculum normally or perculum is a feature of trematodes here this is the only cistode which is showing you an operculum like this so this is what what is this egg this is diaphyliobotrium later also called as fish tapeworm right and this is a cystod which has three hosts definitive is always going to be man second is Cyclops third is fish and what is very important this is gonna go into the ilium and it will block the absorption of vitamin B12 so this causes again vitamin B12 deficiency anemia so right now only we've discussed two causes of vitamin B12 deficiency anemia D later and one was pernicious anemia right so this is about the systems now talking about tremitones so Tremor tools remember every egg will look similar they will have this sort of an operculum so they will not ask what they will ask is the exception of the trematodes which are these three what are these they do not have a perculum but they have these spines so your corner sources spine so say yes so these are all then we need to know the type the species of schistosoma based on the spine so when there is a lateral spine this is s mansoni so here we have learned one story that there is a girl called mansues very late it was very Tada she would go to the teacher after class and discuss stuff you know and ask questions and whatever so s mansoni has a lateral spine and what it does such people do not do well in life do they they don't do well they will fall inferior so this affects the inferior misentric Lexus yeah so this is s mansoni inferior mesentric pexus Teddy lateral spine on the other hand when you do not see any spine spine is absent so Japanese people are all very flexible right they're all very flexible because they have no spine so this is s japonicum flexible people without spine no spine do Japanese people do well in life they do very well in life isn't it so what we want to remember they are gonna affect Superior misentric plexus Superior mesenteric plexus and finally when you have a terminal spine like this so when you have a terminal spine are hematological Cancers terminal yes so that is why this is s hematobium and with that same metaphor terminal this will also cause malignancy so this affects the cycle or pelvic plexus and this causes squamous cell carcinoma of bladder spermacell carcinoma of bladder okay it also causes pah this is the only infective cause of pulmonary arterial hypertension while we are talking of pH I would also like to tell you the Dana Point classification of pH ok so we have five types remember type 1 is idiopathic that is where we will use drugs like endothelene receptor antagonist right so type 1 is basically idiopathic type 2 is because of heart failure left ventricular failure says secondary Upstream pH third is because of IND lung disease current pH wherein you want to remember Scleroderma Scleroderma is the most common connective tissue disorders okay Type 4 is when you have chronic thromboembolism and type 5 is without any cause miscellaneous so these are the five point classification just remember Dana Point is okay you want me to go 2x I can do 2x any point of time but just like listen to everything that I am saying all right so this is about it just to compile all of them so non bile stained non bile stencil pneumonica foreign all of it so they will give you image of mature and they will ask you identify this mosquito so when you look at this mosquito this is a mosquito which is at an angle this is an adult right you can see that there's an adult mosquito it is at an angle so the only mosquito adult which lives at an angle is angle a n endophilus okay and anophysics sophisticated sophisticated mature why sophisticated because it only goes into clean water it will go to an intermediate range it won't fly very far already it's a very sophisticated mosquito it'll only live in clean water lay eggs singly and adult is at an angle and you can see that the wings are spotted all right so you will have spotted wings here on the other hand the mosquito which has stripes on body and legs body and leg space stripes and where it lives in artificial water this has the smallest flying range and the adult is parallel yes so this is ADS ads is the adult living parallel that is how you will identify and you look at its body and its legs and you see the stripes so this is the tiger mosquito ads and when the adult is again parallel but has a hunchback as a brownish mosquito hair without any Stripes this is qlex okay so qlex dot T dot t water all right and this can fly the farthest so dirty images it can do anything right so qlex dirty water 10 kilometers okay so this is something which is very very important and with pistia this is mansonia thank you Praveen sir for saying I have good handwriting you are probably the only person who has said that to me so this is mansonia which is a matcha which will have these long legs with and it lives with this plant which is pistia okay so this is what we want to remember these are the four mosquitoes that we have okay will you identify this if you can identify this you can do anything in life I feel and finally the last thing that we have a very very hairy sort of mosquito this is a sand fly all right so this is a sand flying very very important question from Sandfly is that what does it cause what does it spread so one is definitely kala Azar and the other thing is fever all right also called as Sandfly fever but obviously they'll not give you sand fly fever is caused by right so they'll ask you kalasa so kalas army they can give you this image which is a sample of the bone marrow wherein you can see these bodies and they ask you what are these so these are a mastic goats of eldonough which is the organism and you also want to remember kalasar is the rk39 antigen test recent question Hannah so LD bodies 39 antigen you will get a patient who's presenting from Bihar jharkhand with fever hepatocrinomegaly you do the bone marrow and you see a mastic box all right so this is about uh kalasa very quickly very very very important you will not write an exam without one of these propping into the paper when you see these lean here no dulo ulcerative lesions and the person is a rose Gardener Gardener not necessarily Rose Gardener what is this this is poro trichosis so sporotrichosis spread by sporotrix Shanghai which is a dimorphic fungus nodular lesions slow remember from Rose only on histopath you will see this rosette right so this is called as rosette of cornidia appearance so here the buzzword is going to be a rose Gardener who's having these nodulo ulcerative lesions in a linear Fashions pororichosis rosette of cornidia is what we want to remember on the other hand the buzzword 40 lesions Barefoot on the beach and now you have these linear linear lesions which are Watty that is the buzzword very important and what kind of bodies these are bodies which are like so so frequently Asked these are sclerotic bodies also called as Copper Penny bodies also called as mureiform bodies also called as medullar bodies so this is Chrome homo blastomycosis right so what tea lesions is the buzzword ulcerative lesion and when you find foot with discharging sinus right so here the buzzword is discharging sinus this is madhura mycosis right so this is mycitoma or Madura mycosis so mycertoma can be either fungal so this could be Madura mycosis which is because of a fungus or this could be because of actinomyces when you have actinomyces you will have yellow sulfur granules actinomyces is it aerobic or anaerobic it is anaerobic remember actinomyces anaerobic no is it acid fast no on the other hand no cardia is aerobic and it is acid fast all right so remember actino a no anaerobic no acid fast no it will cause a lot of discharge sulfur discharge and it will be from the mandible so they can give you history of mandible message discharge chronic osteomyelitis of the mandible or they can give you a foot here okay so very very important actinomyces black granules more common in the fungal counterpart madhura food Madura my courses okay so this is very very important drug of choice for actinomyces is penicillin drug of choice for no cardia is all right so these are two things which are very important both of them why am I comparing actinomyces and nocardia because both of them are gram positive filamentous bacilli right so they are both filamentous that you may want to remember okay extremely important then yes when you have such a clinical appearance very nice Sanya one more deity is but Tyro mycosis so it's botiro mycosis a misnomer or is it correctly named mycosis means fungal so is it fungal no it is a misnomer but tyromycosis is caused by staph aureus right so whenever you have such a picture three DDS you wanna remember okay all right so that is what you need to learn but pattern is what you need to recognize see what is the pattern and that is what you will be going into all right now going uh into a Maltese cross appearance so we have Maltese cross appearance that you will see in rbcs and you will see in urine so when we see Maltese cross appearance in RBC what is the diagnosis yes it is baby sources can somebody tell me the vector of babies uses hard tick right so it is spread by a hard tick on the other hand I got urine crystals may add a very very important fabries disease and the other differential is nephrotic syndrome nephrotic syndrome say you can have Maltese cross appearance in the urine crystalline so these are two DDS very very important in fact fabries has been asked previously right this is about Maltese cross looking at all of the inclusion bodies we do get a lot of questions from these so when you see this large sort of an inclusion body what is this this is HP Henderson Patterson body HP bodies which are seen where very very important these are seen in molluscum contagious remember are gonna be these umbilicated lesions right so Dome shaped umbilicated lesions pearly white lesions so many times this has been asked the movement you see Central umbilication large bodies Henderson Patterson this is molluscum contagious cellular stain yes so we are on cerebellum infection cellular stain what is this these are negri bodies which are seen in rabies all right so cerebellum foreign are affected and hippocampus is affected right so two areas by rabies and then what do we have here when you have multi-nucleated giant cells you have margination and you have molding three ends margination molding multi-nuclease so this is herpes simplex virus herpes simplex virus remember we'll show you cowdry a bodies all right cowdery chicken what are these this is a cytopathic effect this is not an inclusion body this is a cytopathic effect what is this this is yes so this is HPV which is making coilocytes right so these are coilocytes that you are having in the pap smear so pap smear major peripheral clearing a peri nuclear clearing so this is an effect that human papilloma virus will have HPV virus is a DNA virus RNA virus HPV is a DNA virus right so it's a DNA virus what about molluscum contagious it is a DNA virus RNA virus very very important molluskum contagiosum doesn't have the word box in it but it is a pox virus all pox viruses are DNA viruses box viruses are DNA viruses which have a complex symmetry icosahedral symmetry or type box virus all right what are these These are again these are cells which are intra nuclear plus intracytoplasmic inclusion so these are worthin Finkel D cells I'll give you a hint with fever rash which is spreading from kefallocodals pairing The Palms and souls and he has some sort of spots opposite his molars so he this is yes seen in measles and the spots are complex spots pathognomic of measles and when you see basophilic awoli appearance what is this this is CMV appearance but eosinophilic is read Sternberg cell of Hodgkin's lymphoma cd50 CD cd15 cd30 positive okay so this is about the bodies again very very important Now quickly going into forensic so forensic ballistics is something that causes a lot of problems for you guys so very very quickly I will just simplify it so anytime a gun is fired remember you want to think of three things b b t so from the flame we have burning all right so burning is the hair which gets burnt from the smoke we have blackening and from The Unborn powder we have tattooing so burning would be burnt hair what is blackening blackening is the blackening of the skin and this is something which is smoke so it can be wiped off if I take a cloth this can be wiped off on the other hand tattooing as the name suggests this deep in the dermis so do you think this can be wiped off no this cannot be wiped off so this is how you will know what is it it's blackening or it's tattooing and finally you have the bullet which then enters and it will have a grease collar and an abrasion collar so grease collar abrasion collar so any ballistic wound you want to approach it like whether there's burning blackening tattooing and whether the callers are there or not so when I have a contact injury when I have a contact short so contact skin there will be two main features that you need to remember I have already sent the PDF in the group yes so this is the contact shot wherein you will have a margin which is cruciate so one when you see cruciate margin it is definitely contact when you see C for cherry red when you see cherry red discoloration it is definitely contact will you see any of the BBT burning blackening tattooing no BBT everything will be inside the wound in this case you will see that BBT is inside what is BBT burning black think that one okay then when we go into close injuries close injury can you see how there is blackening there's burning of the hair so I will see everything blackening burning tattooing that is a close range wound when you see that BB is not there burning and blackening is not there but all of these are spots can you see these spot spots and this is the entry wound so these spot spots are the tattooing so this is your near or intermediate any of of these words would be used near or intermediate there is no BB there is just P right so that is how you know that this is near or intermediate and finally when you are not seeing anything BBT message and I am seeing a grease scholar and an abrasion caller this is a distant wound it is so simple we make such a big deal out of this this is so simple so contact siwala Russia and cherry red close and no BBT distant one fine so simple isn't it so this is how we approach ballistics so what are we seeing here these the upper row is all category which is neurotoxin all right so these are all rifles and yeah this is all rifle in shotgun you will have Chota Chota pellets all right you will see multiple pellets in a shotgun so this is about rifle okay right so when we go to the first category which are your neurotoxins so the first two are cobras so when you see this when you see a hood first of all it is Cobra then we look at these spectacles who wear spectacles have you ever seen a king wearing spectacle no right so this is common cobra on the other hand wood is there but no spectacles this is king cobra then we have crates crates so this is a general crate normal crate on the other hand when the bands are yellow it becomes a banded crater it's a banded crate all right so great Cobra neurotoxin okay then what is this all right so this is vasculotoxin right so this has vascular toxin which causes DIC hemolysis that is very important okay and what is this sap you can see only it's lying on a sea and a beach pillitter why so this is a sea snake and sea snake have what kind of toxin they have myotoxin right so they are myo toxic okay so this is about the snakes and their toxins and their poison so neurotoxic Upper Valley category which are all of your illa okay fine going ahead PDF is there on the channel uh neat PG with doctors telegram pillow I post it on the cerebellum group also cerebellum telegram Channel you guys can join it I will post that link also and I'll post the PDF there also okay right now going on to toxico all of these seeds and again these are questions which are gonna come so what is this the first thing this is Abra so I want you to remember ACR American College of radiology is one society that we have already so this is in order of a C and R so the first one very red and very beautiful is abras active principle is going to be very easy active principle is right so this is called as this called as cattle poison um gulati and a lot of other local names it has right so this is abras precatorius it has the toxin which is abrin what is this this is a very rough rough crota on all right so this is a croton which is looking very very rough and what is this this is riskiness proton in Hindi is also called as Jam or Hindi or normal language is called as castor so all of the parts of Caster are toxic except for castor oil which is safe and a castor oil you must have seen babies so castor oil is very safe fine so this is ACR then this is very important all of you will recognize because of this tip it can be used for marking henna so this is marking nut also called as semicarpus right so this is also called as semicarpus the active component is semicarbon or bhilwa nol right so yeah remember artificial blues will have Associated irritation and itching and they'll be associated with Cycles normal bruises or two points it will be itchy it will be itchy and it will have the Cycles got it and finally one one toxin can kill you what is this this is Stitch nin right so what does trichinin do it in it causes yeah so it acts like tetanus isn't it it acts like tetanus because it causes inhibition of glycine it inhibits the release of Gaba and glycine so that is why you will have basically a lot of contraction a lot of contraction postures like opisthotonous pleurous photonas is what you will have okay so this is stitching and even a single crushed seed is gonna lead to death all right so this is pre-synaptic inhibition postsynaptic inhibition of Gaba so this is post synaptic remember tetanus is pre-synaptic p e pre all right so that is how you don't confuse tetanus okay thank you so much for all of the love guys and I'm uh I'm so grateful that you guys stuck around it got late but still you guys stuck around and you are still sticking around so thank you so much right so this is stitching versus tetanus two plants that we have so this is the violet plant that we have what is this very very important so this is aconite is a car add your toxin isn't it monks Devils this has cardiac toxicity right so this will lead to something I like to call as hippo tension potential so this causes hipus and low BP high potential all right so hippos and hypotension and what is this is conium which killed Socrates this is the hemlock okay now going on to STI kit so all right going on to STI kits so very quickly we have all of these colors uh so the gray kit so we have all of these mnemonics that you create for STI hippus is the alternating contraction and dilatation of pupil okay in STI kits we are gonna remove all of the mnemonics that you have heard so far we are just gonna do it very clinically and that is how you will uh remember so the first kit that we have is gray kit so I'd say great it is not great it is great why is it great because one kit can lead to treatment of three things what three things urethritis cervicitis painful scrotal swelling so it can treat your arthritis cervicitis painful throttle swelling so we say great what are the two causes of this the two causes the two causes of this yeah actually my energy is not only inside it is only on the outside as of now so we have urethritis cervicitis Painful scrotal selling so these the two common causes for both of them is chlamydia and gonorrhea chlamydia gonorrhea remember hamesha are treated together they are always treated together so we are gonna treat them with two drugs so azithral one gram stat cefixime 400 mg States and the treatment becomes simpler as it's exam 400 so again the treatment is stat so we say great all right so this is gonna be the common kid that we have great three things going on to the second one which is vaginal so vaginal discharge is green for this we have a mnemonic very new those of you have seen friends you know Rachel Green yeah so Rachel Green is a female so that is how we remember vaginal discharge okay so from now on I've just spoiled friends and Rachel Green for you forever so anytime you think of friends now vaginal discharge green kit okay up so before going into the treatment what you want to remember is the diagnosis drug becomes very easy so whenever you have vaginal distance charge which is pathological three things you want to see I mean three diagnoses are there you see the type of discharge if there is fishy odor no inflammation you are finding these clue cells which are the epithelial cells just upper bacteria when you add Koh you have a whiff test what is the diagnosis this is bacterial vaginosis okay so this is bacterial vaginosis on the other hand when you have greenish discharge inflammation are called as strawberry cervix and you have trichomonas what is this so very clear this is trichomoniasis strawberry cervix strawberry vagina greenish discharge trichomon acids C for cottage cheese C4 candida and this is the only vaginitis wherein the pH is gonna remain normal remember this pH is going to remain normal and we will have pseudo High Faith so now the treatment of D vaginasis and trichomoniasis Dono kahi treatment candida treatment fluconazole so what should we have in the kit two drills only metrogel fluconazole now Metro is a seven day course I do not want to do that I want to give stat treatment so instead of metrogyl we have seconded as well so seconded as well two gram will take care of bacterial vaginosis trichomoniasis and fluconazole 150 mg stat again stat treatment so this is very quickly going on to genital ulcer approach and then we'll come back to the kit so when we are thinking about genital ulcers we have to divide into painful and painless anytime we have Painful ulcers if there are erythematous red sunroof erythematous erosions this is HSV this is herpes simplex virus all right one or two STDs hsv1 or hsb2 this is hsv2 remember hsv1 above the diaphragm herpes labialis gingivostomatitis is HSV one Encephalitis is HSV one okay so this is hsv2 and the other painful erosion right which is very ulcerated undermined edges this is shankaroid shankroid is caused by hemophilus Duke Ray e so from this you remember do cry rora painful so this is caused by i h do you create all right so painful ulcers can either be HSV or it could be shankroid on the other hand painless ulcers when you see this prototype indurated also had induted without any pain this is the primary Shanker of syphilis on the other hand egg them opposite beefy red ulcer this is what this is calimetobacter granulomatosis right so this is granuloma inguinal klebsiella or kalimatobacter inguinal so this is granuloma inguinal or donovanos is also called as donovanosis and finally when the ulcer is painless as well as transient ulcer to decaying but the patient is presenting to me with a lymph nodal swelling like a bubo so this is a blue book which is showing you a Groove signing when a ligament caused by chlamydia LGB right so lymphogranuloma venerium L1 L2 L three zero bars L2 is the most common okay so these are the differentials so now how do we approach the treatment is should be treated separately with acyclobin Bucky bubo is treated separately all these three are the ones which I want to Target syphilis is treated by penicillin and chancroid and granuloma inguinal are treated by azithra so now with this thought let's have a look at the kids know on her petticles I have two options first if there is no allergy to penicillin white peace penicillin is what you will have and you will have azithril so you have benzathine Penicillin and you have a zitra on the other hand if the patient is allergic right if the patient is allergic to penicillin we replace penicillin with Doxycycline and azithril remains as it is hypersensitivity will be become very blue blue okay so that is how you will remember blue kit ticket so remember no one herpetical sir peaceful white penicillin azithral sensitivity on the other hand red were herpes ulcers herpes ulcers were red so the kit is also red so this is gonna be a cyclovir TDS for 70 days all right so herpes is red and finally do you remember we left boobo in a separate category so B for bubo and B for black which is kit seven for bubo you want to remember that bubo is bad it is not a good disease to have right so bad bubo A and D we will give azithral and doxy azithral and doxy and finally the last thing is yellow low for low abdominal pain yellow low abdominal pain is for PID PID remember DCM dilated cardiomyopathy is what you want to remember so doxy cephixine metrogel doxy suffixymetrogel yes this video will be available you can revise it any number of times that you want okay so this is how we remember the kit so very quickly now revise with me gray was great we were treating three things urethritis cervicitis throttle swelling with azithral and cephism Stat so that was great second vagina was green Rachel Green Green vaginal discharge P had secnidazole to treat two things and fluconazole to treat Candida then we went to ulcers painful versus painless clinical approach again you get short short questions from that so there we first want to treat three ulcers which was Shankar shankroid and granulomying granite so for that I am using white fit which has penicillin and azithra if sensitivity to penicillin is there we replace it with doxy and we have doxy azithral in blue kit for red herpes we have acyclobin and finally for bubu bubu is bad black kid as a Thrive doxy and then when we go to Yellow lower abdominal pain we have DCM so doxy suffixime metrogel tell me do you want mnemonics for this or this is done this done right so this is how we will remember STI kids and we will do two very very highly topics along with that so now I I need to stop but I will definitely take more sessions there's a lot of stuff which you know we can do but I'll have to stop here uh it is late and my daughter needs me so I need to go but I will do this and hopefully next time there'll be no technological issues like today I am very sorry for that so next time will be more efficient and we'll sort out our technical issues uh beforehand okay so thank you so much I hope this has been useful I'll try to cover a lot of things in the 30-40 minutes which I had uh next time we'll have more sessions and we'll have a a longer session okay so thank you so much and I'll post this PDF on the group for sure so see you all in Hyderabad very soon guys so we'll be meeting on 29th and 30th I'll be with you on 29th and 30th in Hyderabad wherein will have half a day of radio and one and a half days of BTR wherein will compile all of these hide topics and revise them together thank you so much guys bye