Components of pronator drift Progress from distal to proximal: Downward arm drift Forearm pronation Flexion of the wrist and elbow Method of assessment for pronator drift When the patient extends both arms upright in the supinated position and hold them at shoulder height for atleast 10 seconds (Patients should be…
Tag: Internal medicine
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Anatomical basis of Wallenberg (Lateral Medullary) Syndrome : Mnemonic
Before proceeding into the disease itself, let’s review – relevant anatomy of the medulla with a simple mnemonic. The Side (lateral) part of Medulla contains 6 “S“ 1. Spinocerebellar tract Posterior spinocerebellar tract: Ascends and enters to ipsilateral cerebellum via ipsilateral inferior cerebellar peduncle Anterior spinocerebellar tract: Ascends and enters…
Case Reports 
Craniopharyngioma – Case Discussion
Case Summary A 38 year old female came with: Headache for 6 months Diminution of peripheral vision bilatetrally Irregular menstrual cycle for the last 1 year Now, polydypsia and excessive urination Her prolactin level was 115.6 ng/ml (increased), FSH was 1.3 mIU/ml (decreased) and LH was 0.242 mIU/ml (decreased). CT…
Clinical Skills and Approaches 
Clonus : Clinical Examination and Mechanism
Definition of clonus Clonus is a rhythmic sustained involuntary muscular contraction (generally 5-8 Hz) evoked by sudden passive stretch of the muscle and tendon. Eliciting Clonus Clonus is commonly elicited in gastrocnemius (ankle clonus). Other sites where clonus can be elicited are quadriceps (patellar clonus), finger flexors and jaw. 1….
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Principles of Chemotherapy
Master the knowledge of clinically relevant cell cycle to understand the principles of chemotherapy. Tumors that are highly responsive to chemotherapeutic agents (e.g., testicular cancer, lymphomas) tend to have a very rapid doubling time compared to tumors that are less responsive to chemotherapy (e.g., pancreatic and prostate cancers). The tumor doubling time of metastases…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
NG tube insertion
Indications Gastric decompression Gavage (feeding) Gastric lavage (irrigation or dilution of gastric contents) Sampling of the gastric contents for analysis Sometimes used to instil air into the stomach to detect a gastric perforation on erect CXR Contraindications Basilar skull fractures (Risk of NG reaching brain) Facial fractures (risk of cribiform…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Chest Xray – Approach to hilum
Hilum in human anatomy refers to the depression where structures such as blood vessels and nerves enter an organ. The structures contributing to hilar shadows in a Chest X-ray are: Major: Pulmonary artery and veins Minor: Fat, Lymph nodes and Bronchial walls Normal Hilum: Position: Left hilum is slightly higher…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Chest X-ray – Pleural Effusion
Pleura is a mesothelial lined sac that envelopes the lungs and comprises of 2 membranous walls i.e. visceral pleura and parietal pleura that encloses pleural space filled with pleural fluid. Pleural space contains about 0.3 ml/kg body weight of pleural fluid. The pleura is not visible on a normal CXR…