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Brown Sequard Syndrome

Renu Maurya November 7, 2020 0

Brown Sequard Syndrome

Introduction:

→ Etiology: HEMISECTION of spinal cord

→ Features: Ipsilateral (Same side) & Contralateral (Opposite side) to Dorsal & Antero-Lateral Column.

→ NOTE: Dorsal column – IPSILATERAL ONLY in SPINAL CORD; Crosses to OPPOSITE SIDE @MEDULLA

→ 2 pathways – Tractus Cuneatus (From Upper Limb) & Tractus Gracilis (From Lower Limb)
Clinical Presentation – Ex. Lesion on left side of spinal cord

IPSILATERAL to Dorsal Column-Left side loss of Proprioception, Touch & Vibration.

CONTRALATERAL to Antero-Lateral Column-Right side loss of Pain & Temperature

Categories Medicoapps Masterclass Tags AIIMS PG, All India Test, brown Sequard syndrome, hemisection, Medical concept, medicoapps medicoapps masterclass NEET PG, PGI Exam, spinal cord Image-In folder

Blood brain barrier

Renu Maurya November 7, 2020 0

Blood brain barrier

BBB Locations:

→ Formed by TIGHT JUNCTIONS & FOOT PROCESSES OF ASTROCYTES.

→ ABSENT BBB = CIRCUMVENTRICULAR ORGANS (mnemonic – SOAP)

→ S= Subfornical organ; O – Organum Vasculosum of Lamina Terminalis; A – Area Postrema; P – Posterior Pituitary

BBB Permeability:

PERMEABLE Substance:

• Glucose (GLUT-1),

• Water (Aquaporin-4),

• Gases (CO2, O2, N2),

• Lipid soluble hormones (Steroids)

NON-PERMEABLE Substance:

• Protein Hormones,

• Dopamine (L-dopa in Parkinsonism),

• H+ ions

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Best methods of doing medical termination of pregnancy

Renu Maurya November 7, 2020 0

Best methods of doing medical termination of pregnancy

Period of pregnancy	Methods
≤ 7 weeks	Medical method
7-15 weeks	Suction evacuation
≥ 15 weeks	Prostaglandins

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Heading-Auditory pathway

Mnemonic – E C O L I M A
E – EIGHTH Cranial Nerve

C- COCHLEAR Nerve

O – Superior OLIVARY Nucleus

L – Lateral LEMNISCUS

I – INFERIOR Colliculi

M – MEDIAL Geniculate Body

A-Auditory Cortex (Brodmann Area – 41)

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Antiphospholipid antibody syndrome-Management

Renu Maurya November 7, 2020 0

Antiphospholipid antibody syndrome-Management

If APLA is diagnosed based on H/O Abortion then aspirin along with low molecular weight heparin has to be given
Aspirin:
• Aspirin low doses= 50-100mg (80mg)

• Started-Urine Pregnancy Test (UPT) +ve

• Continued throughout Pregnancy

• Stopped 4-6 days before labor

Heparin:

Started- Only after confirmation of IU pregnancy

Continued throughout Pregnancy

Stopped at onset of labor

If APLA is diagnosed based on the criteria of Preterm Labor give only Aspirin @ the end of first trimester ;dose- 50-100mg (80mg).

Categories Medicoapps Masterclass Tags AIIMS PG, All India Test, APLA, Aspirin, Heparin, management, Medical concept, medicoapps medicoapps masterclass NEET PG, PGI Exam

Antiphospholipid antibody syndrome-Diagnosis

Renu Maurya November 7, 2020 0

Antiphospholipid antibody syndrome-Diagnosis

Clinical diagnosis:
1. Arterial/ Venous Thrombosis (Superficial/Deep)

≥3 losses in <10 weeks 3. ≥1 loss in >10 weeks of morphologically normal fetus.
At least 1 Preterm delivery secondary to severe PIH/Uteroplacental insufficiency

Lab Findings:

Presence of Lupus Anticoagulant (LAC)
Presence of IgM / IgG Cardiolipin Antibody Any of these should beresent@2occasions12wksapart
Presence of β2 Micro globulin

Note: In APLA – APTT is prolonged; PT is normal; Russel viper venom time is prolonged.

Categories Medicoapps Masterclass Tags AIIMS PG, All India Test, APLA, clinical, Diagnosis, lab Image-In folder, Medical concept, medicoapps medicoapps masterclass NEET PG, PGI Exam

Antiphospholipid antibody syndrome

Renu Maurya November 6, 2020 0

Antiphospholipid antibody syndrome

• APLA syndrome can lead to thrombosis in vessels. Depending upon which vessels get thrombosed we will get the manifestation like if cerebral vessel get thrombosed manifestation of stroke can be seen. It can even lead to thrombosis in placental blood vessels.

Based on this size of placenta will decrease and there will be placental insufficiency.
Abortion can happen in first trimester due to APLA but it generally causes abortion in second trimester (M/C).
Even if there is 1 abortion due to APLA but for first trimester we need 3 abortion to say it is caused due to APLA.