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@@yamini7073 @drsahilsaha9598 in Foville syndrome the area affected is the Facial nerve and the nearby PPRF(centre in pons responsible for conjugate eye movements)causing horizontal gaze palsy In Millard Gubler syndrome The abducens nucleus is affected causing Diplopia increasing on moving the eye towards the side of lesion and esotropia. So I feel Foville syndrome to be most appropriate here.If any other clues suggestive of MGS was given you can type it out.best wishes.
@parthadey7273 Digoxin is used to control ventricular rate in atrial fibrillation with LV Systolic dysfunction and heart failure..did they give ventricular rate control or some other phrase ?
The exact option was Digoxin is used to control Ventricular rate. Sir but in case of AF the problem is above the ventricles right , why Digoxin is used to correct ventricular rate if QRS is normal inAF.pls guide
@seshagopalan4691 good question.in Atrial Fibrillation the heart rate at the level of atria is around 400/min and if we allow all the impulses to conduct through AV node then it will result in ventricular fibrillation and death.So this highlights the need for rate control in patients with atrial fibrillation.In patients with heart failure and LV dysfunction with AF by giving DIGOXIN we can increase the myocardial contractility and thereby reducing the backpressure and treat the pulmonary edema component in HF.And Digoxin has a vagotomic action by inhibiting the AV node and control the ventricular rate.Hope it helped.If any doubt in this you can ask.best wishes.
Hematocrit should be the answer as the entire treatment guidelines rely on managing the patient with hematocrit parameter and it predicts prognosis at a better level than platelets..it predicts the onset of hemorrhagic fever and shock in dengue.
Answer should be mannitol only As in haemorrhage and increased intracranial pressure,the cellular edema will be there to be treated as fast as possible as failure wud result in cerebral herniation and death.This cerebral edema can be due to three causes vasodilation of cerebral vessels-vasogenic edema ,interstitial edema due to accumulation of fluid in between cells and cytotoxic edema due to accumulation of fluid inside the cells.Mannitol being an osmotic diuretic increases the serum osmolarity by water diuretics and also drags the water within the neurons and interstitium and decreases cerebral edema and thus the intracranial pressure.so mannitol will be the right option
PR interval
Then the answer should be normal only.apologies.
No apologies sir, You r doing a great job. Very crisp and concise explanations. Thank you. Pls do for shift 1 also
Pr interval is given as 0.21 no ecg given a 33 yr old patient came for fitness. Then what is the answer( pr given exactly given as 0.21 s)
answer is first degree heartblock, pr interval given is 0.21s not above or below but just 0.21s
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Great explanation.Thank you sir 😊
Most welcome 🙏🏻
Sir The pediatric case had some respiratory problems. Can we give adenosine in such scenario as it may cause bronchoconstriction??
Any idea of what respiratory problem given ?
Patient had lateral gaze palsy why not Millard then? Involved both 6th and 7th nerve.
I'm also wondering the same
@@yamini7073 @drsahilsaha9598 in Foville syndrome the area affected is the Facial nerve and the nearby PPRF(centre in pons responsible for conjugate eye movements)causing horizontal gaze palsy
In Millard Gubler syndrome The abducens nucleus is affected causing Diplopia increasing on moving the eye towards the side of lesion and esotropia.
So I feel Foville syndrome to be most appropriate here.If any other clues suggestive of MGS was given you can type it out.best wishes.
@@msd-medicinesketchified6386 okay. I don’t remember nystagmus being in the question. It was only lateral gaze palsy
Sur question was something likethat,,,digoxin was used to control sipraventricular rate
@parthadey7273 Digoxin is used to control ventricular rate in atrial fibrillation with LV Systolic dysfunction and heart failure..did they give ventricular rate control or some other phrase ?
The exact option was Digoxin is used to control Ventricular rate. Sir but in case of AF the problem is above the ventricles right , why Digoxin is used to correct ventricular rate if QRS is normal inAF.pls guide
@seshagopalan4691 good question.in Atrial Fibrillation the heart rate at the level of atria is around 400/min and if we allow all the impulses to conduct through AV node then it will result in ventricular fibrillation and death.So this highlights the need for rate control in patients with atrial fibrillation.In patients with heart failure and LV dysfunction with AF by giving DIGOXIN we can increase the myocardial contractility and thereby reducing the backpressure and treat the pulmonary edema component in HF.And Digoxin has a vagotomic action by inhibiting the AV node and control the ventricular rate.Hope it helped.If any doubt in this you can ask.best wishes.
Sir, prognostic marker for Dengue is Hct or platelet??
Hematocrit should be the answer as the entire treatment guidelines rely on managing the patient with hematocrit parameter and it predicts prognosis at a better level than platelets..it predicts the onset of hemorrhagic fever and shock in dengue.
Okay sir, Thanks
Sir in dengue pt platelets was very low.still hematocrit is the answer?
Sir in Rta patient haemorrhage is mentioned.can we give mannitol in this case?
@@monisha7967 what specific type of haemorrhage was given in the question ?
Sir it's just mentioned increased intracranial pressure and hemorrhage.which diuretics given early ?1.mannitol 2.acetazolamide 3.dorzelamide
Answer should be mannitol only
As in haemorrhage and increased intracranial pressure,the cellular edema will be there to be treated as fast as possible as failure wud result in cerebral herniation and death.This cerebral edema can be due to three causes
vasodilation of cerebral vessels-vasogenic edema ,interstitial edema due to accumulation of fluid in between cells and cytotoxic edema due to accumulation of fluid inside the cells.Mannitol being an osmotic diuretic increases the serum osmolarity by water diuretics and also drags the water within the neurons and interstitium and decreases cerebral edema and thus the intracranial pressure.so mannitol will be the right option