Drug of Choice

Focal seizure: Carbamazepine.

Focal seizure in elderly: Lamotrigine.

Trigeminal neuralgia: Carbamazepine.

Typical absence seizure: Ethosuximide.

Atypical absence seizure: Valproate.

Infantile spasm: Ethosuximide

Infantile spasm in TSC: Vigabatrin

West syndrome:- adrenocorticotropic hormone (ACTH), oral corticosteroids (prednisolone/prednisone)

📌 LATEST UPDATES


1. Nikshay Poshan Yojana
- Incentive increased from ₹500 → ₹1000 for TB patients

2. India declared free from Trachoma
- Date: *8th October 2024*

3. Kit 8 (Brown)
- Used for Anorectal discharge

4. IPC renamed
- Now called Bharatiya Nyaya Sanhitha

5. National Health Mission renamed
- Now PM Samagra Swasthya Mission (PM-SSM)

6. Ayushman Bharat Health infra upgraded
- Renamed to Ayushman Arogya Mandir

7. Elagolix Sodium
- Oral GnRH antagonist for Endometriosis, Fibroids, Heavy menstrual bleeding

8. New MDR TB Regimen
- WHO-recommended BPaLM regimen
- Drugs: *Bedaquiline, Pretomanid, Linezolid, Moxifloxacin*



##PM Matru Vandana Yojana
- Incentive: ₹5000
- Updated Installments:
- 1st: ₹3000 (after antenatal checkup)
- 2nd: ₹2000 (after childbirth + 14 weeks immunization)
- *Previously given in 3 installation

Drugs used in endometriosis:
(Mnemonic- GOLD GAP)

》GnRH analog (Leuprolide)
》OCPs
》Letrozole
》Danazol
》Gestrinone
》Anti progesterone
》Progesterone

*Vessels Involved in Hemorrhage*

🔸*Extradural hemorrhage* → Middle meningeal artery

🔸*Subdural hemorrhage* → Bridging & diploic vein

🔸*Subarachnoid hemorrhage* → Berry aneurysm

🔸*Tennis ball injury to eye* → Circulus iridis major

🔸*Epistaxis* → Sphenopalatine artery

🔸*Hemoptysis*→ Bronchial artery

🔸*Duodenal ulcer* → Gastroduodenal artery

🔸*Retropubic Prostatectomy* → Dorsal venous plexus

🔸*Lesser curvature of stomach*→ Left gastric artery

🔸*Posterior wall of stomach* → Splenic artery

🔸*Hemorrhoids* → Submucosal rectal venous plexus (superior & inferior rectal veins)

*IOC ENDOCRINOLOGY*

🩸*Diabetes Incipidus* {Water deprivation test}

🩸*SIADH*: {Water loading test}

🩸*Conn syndrome*: {Saline infusion test}

🩸*Addison syndrome* : {ACTH stimulation test/ Cosyntropin test}

🩸*Pheochromocytoma*: {Plasma free metanephrine levels}

🩸*Carcinoid syndrome*: {Urine for 5HIAA}

🩸*Acromegaly*: {Glucose challange test}

🩸*Prolactinoma*: S. {prolactin level + MRI head}

🩸*Cushing syndrome*: {Low dose dexamethasone suprresion test}

🩸*Parathyroid adenoma* {scaning : Sestamibi scan}

Folic Acid Doses

🔸Prophylaxis → 500 mcg
🔸ANC routine → 500 mcg
🔸Folic acid deficiency → 1 mg
🔸Epilepsy → 5 mg
🔸Previous child with NTD (Neural Tube Defect) → 5 mg
🔸Thalassemia → 5 mg
🔸Sickle cell disease → 5 mg

# *Mnemonic of the day*
*ELEMENTS- Elements of Primary Health Care*

E - Education about health problems and their prevention and control
L - Locally endemic disease prevention and control
E - Essential drugs
M - Maternal and child health care
E - Expanded programme of immunization against vaccine preventable diseases
N - Nutrition and proper food supply
T - Treatment of common diseases and injuries
S - Safe water and sanitation

*Disease names and their respective triads:*
👇👇

*Genetic Disorders*

1. *Alport's Syndrome*
- Sensorineural deafness
- Progressive renal failure
- Ocular anomalies

2. *Bartter's Syndrome*
- Metabolic alkalosis
- Hypokalemia
- Normal or decreased blood pressure

3. *Kartagener's Syndrome*
- Bronchiectasis
- Recurrent sinusitis
- Situs inversus


*Neurological Disorders*

1. *Beck's Triad* (Cardiac Tamponade)
- Muffled heart sound
- Distended neck veins
- Hypotension

2. *Charcot's Triad* (Cholangitis)
- Pain
- Fever
- Jaundice

3. *Hutchinson's Triad* (Congenital Syphilis)
- Hutchinson's teeth
- Interstitial keratitis
- Nerve deafness

4. *Miller Fisher Syndrome* (Variant of GBS)
- Ophthalmoplegia
- Ataxia
- Areflexia


*Infectious Diseases*

1. *Weil's Disease* (Leptospirosis)
- Hepatorenal damage
- Bleeding diathesis
- Pyrexia


*Gastrointestinal Disorders*

1. *Gradenigo's Triad* (Petrous Apicitis)
- Sixth cranial nerve palsy
- Persistent ear discharge
- Deep-seated retro-orbital pain

2. *Murphy's Triad* (Cholecystitis)
- Pain
- Vomiting
- Fever


*Renal Disorders*

1. *Triad of Hypernephroma* (Renal Cell Carcinoma)
- Pain
- Hematuria
- Renal mass

2. *Triad of Wilm's Tumor*
- Fever
- Mass
- Hematuria


*Hematological Disorders*

1. *Hemobilia (Triad of Sandblom)*
- Malena
- Obstructive jaundice
- Biliary colic

2. *Triad of HUS* (Hemolytic-Uremic Syndrome)
- Hemolytic anemia
- Acute renal failure
- Thrombocytopenia


*Endocrine Disorders*

1. *Cushing's Triad* (Increased Intracranial Pressure)
- Bradycardia
- Hypertension
- Irregular respirations

2. *Whipple's Triad* (Insulinoma)
- Hypoglycemia during attacks
- Serum glucose <40 mg%
- Prompt relief on glucose administration


*Other Conditions*

1. *Adams Triad* or *Hakim's Triad* (Normal Pressure Hydrocephalus)
- Urinary incontinence
- Gait disturbance
- Dementia

2. *Bezold's Triad* (Otosclerosis)
- Diminished aural perception of low-frequency tones
- Retarded bone conduction
- Negative Rinne test

3. *Dieulafoy's Triad* (Acute Appendicitis)
- Hyperesthesia of the skin
- Exquisite tenderness
- Guarding over McBurney's point

4. *Hand-Schüller-Christian Disease Triad*
- Exophthalmos
- Lytic bone lesions
- Diabetes insipidus

5. *Osler's Triad* (Hereditary Hemorrhagic Telangiectasia)
- Telangiectasis
- Capillary fragility
- Hereditary hemorrhagic diathesis

6. *Samter's Triad* (Aspirin Sensitivity)
- Aspirin sensitivity
- Bronchial asthma
- Nasal polyp

7. *Trotter's Triad* (Lateral Sinus Thrombosis)
- Conductive deafness
- Immobility of homolateral soft palate
- Trigeminal neuralgia

8. *Unhappy Triad* (Knee Injury)
- Anterior cruciate ligament tear
- Medial collateral ligament tear
- Meniscus tear

9. *Vogt Triad* (Tuberous Sclerosis)
- Mental retardation
- Adenoma sebaceum
- Seizures

10. *Virchow's Triad* (Thrombosis)
- Stasis
- Hypercoagulability
- Vessel injury

Poisoning/Condition=====Postmortem staining

Carbon monoxide=====Cherry red

Cyanides======Brick red/dark pink

Potassium chlorate======Chocolate brown

Phosphorous===Dark brown

Nitrites=======Red brown

Hydrogen sulphide======Bluish green

Opium========Grayish/black

Asphyxia======Dark purple

Hypothermia===Bright pink

_#Mnemonics of the day_
*Vector borne diseases:*

*Diseases transmitted by mite: PSM*
P - Pox rickettsial
S - Scrub typhus
M - Mite

*Diseases transmitted by soft tick: QRST*
Q - Q Fever
R - Relapsing fever
ST - soft tick

*Diseases transmitted by hard tick: Rocky LICK*
Rocky - Rocky Mountain Spotted Fever
L - Lyme disease
I - Indian tick typhus
C - Colorado tick typhus
K - KFD

1. MCC of acute abdomen → Acute
appendicitis
2. MC surgical emergency → Acute
appendicitis
3. MCC of intestinal obstruction i n
adults → Adhesions
4. MCC of intestinal obstruction i n
children → Intussusception
5. MC site o f volvulus → Sigmoid colon
6. Kehr's sign indicates → Splenic injury
7. Boerhaave syndrome → Spontaneous
esophageal rupture
8. Cullen's sign → Periumbilical
ecchymosis
9. Grey Turner's sign → Flank
ecchymosis
10. First invest in acute abdomen →
X-ray abdomen erect

🚨 *New TB Guidelines (2025)*🚨
🫁 Drug-Susceptible Pulmonary TB treatment has changed!

✅ Old regimen (6 months): 2HRZE / 4HR
(H = Isoniazid, R = Rifampin, Z = Pyrazinamide, E = Ethambutol)

✅ New option (4 months): 2HPZM / 2HPM
(H = Isoniazid, P = Rifapentine, Z = Pyrazinamide, M = Moxifloxacin)

🔑 Major shift:
➡️ Ethambutol OUT
➡️ Moxifloxacin