This rare disease is characterized by episodic weakness, cardiac arrhythmias, and dysmorphic features (short stature, scoliosis, clinodactyly, hypertelorism, small or prominent low-set ears, micrognathia, and broad forehead). The cardiac arrhythmias are potentially serious and life threatening. They include long QT, ventricular ectopy, bidirectional ventricular arrhythmias, and tachycardia. For many years, the classification of this disorder was uncertain because episodes of weakness are associated with elevated, normal, or reduced levels of potassium during an attack. In addition, the potassium levels differ among kindreds but are consistent within a family. Inheritance is autosomal dominant, with incomplete penetrance and variable expressivity. The disease is caused by mutations of the inwardly rectifying potassium channel (Kir 2.1) gene that heighten muscle cell excitability. The treatment is similar to that for other forms of periodic paralysis and must include cardiac monitoring. The episodes of weakness may differ between patients because of potassium variability. Acetazolamide may decrease the attack frequency and severity.
Source: Harrison’s Principles of Internal Medicine, 19e
Cornelia de Lange syndrome (CdLS) is a syndrome of multiple congenital anomalies characterized by a distinctive facial appearance, prenatal and postnatal growth deficiency, feeding difficulties, psychomotor delay, behavioral problems, and associated malformations that mainly involve the upper extremities. Cornelia de Lange first described it as a distinct syndrome in 1933, although Brachmann had described a child with similar features in 1916. Diagnosing classic cases of Cornelia de Lange syndrome is usually straightforward; however, diagnosing mild cases may be challenging, even for an experienced clinician.
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Howdy! Since many students don’t know what to study for the exam, I decided to post the most important topics to cover.
The most important topics have been made into a list by Dr. Rawa Muhsin, here it is:
You can study these topics in the handouts or a concise book like the Oxford Handbook of Clinical Surgery.
Note: in addition to the above topics, intracranial hematomas, skull fractures & shunts are important for neurosurgery.
Note: the contents (i.e. amount of Na, Cl…etc) of the fluid types are required for this exam.
Instruments & Drains
Dr. Rawa Muhsin’s Handout for the theory.
Dr. Shirwan’s presentation for the images & some notes.
A quick video by Ranj & Rekan:
Some additional urology instuments:
Review the theory in Short Practice of Surgery:
Review the videos from University Hospitals Coventry & Warwickshire:
This Slideshare account contains some of our tutorials, including those of Dr. Aram Baram, Dr. Khalid Shukur…etc
Good luck 🙂
Mirror-touch synesthesia is a condition which causes individuals to experience the same sensation (such as touch) that another person feels. For example, if someone with this condition were to observe someone touching their cheek, they would feel the same sensation on their own cheek. Synesthesia, in general, is described as a condition in which a stimulus causes an individual to experience an additional sensation. Synesthesia is usually a developmental condition, however recent research has shown that mirror touch synesthesia can be acquired after sensory loss after amputation.
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Arithmomania is a mental disorder that may be seen as an expression of obsessive–compulsive disorder (OCD). Individuals suffering from this disorder have a strong need to count their actions or objects in their surroundings.
Sufferers may for instance feel compelled to count the steps while ascending or descending a flight of stairs or to count the number of letters in words. They often feel it is necessary to perform an action a certain number of times to prevent alleged calamities. Other examples include counting tiles on the floor or ceiling, the number of lines on the highway, or simply the number of times one breathes or blinks.
The Cotard delusion (also Cotard’s Syndrome and Walking Corpse Syndrome) is a rare mental illness in which the afflicted person holds the delusion that he or she is dead, either figuratively or literally; yet said delusion of negation is not a symptom essential to the syndrome proper. Statistical analysis of a hundred-patient cohort indicates that the denial of self-existence is a symptom present in 69 percent of the cases of Cotard’s syndrome; yet, paradoxically, 55 percent of the patients might present delusions of immortality.
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Oculogyric crisis (OGC) is the name of a dystonic reaction to certain drugs or medical conditions characterized by a prolonged involuntary upward deviation of the eyes. The term “oculogyric” refers to rotating of eyeballs, but several other responses are associated with the crisis. Epilepsy can manifest as oculogyric seizures, also called versive seizures.
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Salter-Harris classification is used to describe fractures involving the epiphyseal (growth) plate of a bone. This type of fractures are commonly found in children. An easy way to remember the types is:
Salter I: Through physeal plate only
Salter II: Involves metaphysis and physis
Salter III: Involves physis and epiphysis
Salter IV: Extends from metaphysis through physis, into epiphysis
Salter V: Axial force crushes physeal plate
Note: there are an additional 4 types which were added to the original classification, making it a total of 9 types. You can read about them here.
The mini–mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. It is also used to estimate the severity of cognitive impairment and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual’s response to treatment.
In about 10 minutes it samples functions including arithmetic, memory and orientation. Any score greater than or equal to 25 points (out of 30) indicates a normal cognition. Below this, scores can indicate severe (≤9 points), moderate (10-18 points) or mild (19-24 points) cognitive impairment.