Normal blood calcium level is between 8.5 to 10.5 mg/dL (2.12 to 2.62 mmol/L) and that of ionized calcium is 4.65 to 5.25 mg/dL (1.16 to 1.31 mmol/L).

Raise in amylase level is common in:

Acute pancreatitis, pseudocyst of pancreas, pancreatic trauma, after ERCP.

Amylase is also often increased in other conditions like:
1™ Salivary gland diseases like parotitis
2™ Mesenteric ischaemia
3™ Ruptured aortic aneurysm
4™ Intestinal obstruction
5™ Ectopic gestation, salpingitis
6™ Duodenal ulcer perforation
7™ Ectopic amylase production in cancers of breast, lungs, ovary,
multiple myeloma
8™ Renal failure

Causes of raised serum amylase level other than acute pancreatitis:

● Upper gastrointestinal tract perforation
● Mesenteric infarction
● Torsion of an intra-abdominal viscus
● Retroperitoneal haematoma
● Ectopic pregnancy
● Macroamylasaemia
● Renal failure
● Salivary gland inflammation.

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Pruritus ani:

● Common
● Numerous causes including skin diseases, parasites
(threadworm), anal discharge, allergies, diabetes
● Treat the cause if possible
● Symptomatic treatment is the mainstay.

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Imperforate anus:

● A rare congenital disorder
● Classified as being high or low depending on the site of the
rectal termination in relation to the pelvic floor
● Low defects: relatively easy to correct but prone to
constipation
● High defects: more difficult to correct and prone to faecal incontinence.

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#Pediatrics

The hallmark of Barrett's esophagus is the presence of goblet cells "intestinal metaplasia".

In urinary tract trauma, CT scan with IV contrast is the most important and accurate modality.

Urethral injury is the most common.

Blunt injury is the most common in renal injuries. 80-85٪.

In ureteric injury, iatrogenic injuries are the most common.

Most common presentation in renal tumors are asymptomatic.

Prostate cancer is the most common in men in USA.

The kidney is the commonest urinary organ to have anomalies.

-Oblique lumber incision of Morris is of surgery in kidney stones.

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Triad of chronic pancreatitis

1)Pancreatic calcification
2) Steatorrhoea
3) Diabetes mellitus

Triad is found in less than one-third of patients with CP.

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-TSH is most sensitive for assessment of Thyroid function.

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#Medicine

-Decrease serum calcium level is worst prognostic indicator of acute pancreatitis.

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-Biliary tract disease is the commonest cause of acute pancreatitis.

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-In peritonitis, most common route is local.

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-In T.B peritonitis in female, most common route is or cause is tuberculous salpingitis.

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