Essential Amino Acids - MNEMONICS

    SYNONIM :
        Indispensable Amino Acid
    DEFINITION :
        An Amino Acid That Cannot Be Synthesized By The Human Body And Therefore Must Be Supplied In The Diet.
        Essential Amino Acids Are "ESSENTIAL" Not Because They Are More Important To Life Than The Others, But Because The Body Does Not Synthesize Them, And Making It Essential To Include Them In One's Diet In Order To Obtain Them.
    DAILY REQUIREMENT :
        WHO Recommended For DAILY AMOUNT Of AMINO ACIDS

MNEMONICS :
        PriVaTe TIM HALL
        P - Phenylalanine ----- V - Valine ----- T - Threonine
        T - Tryptophan ----- I - Isoleucine ----- M - Methionine
        H - Histidine ----- A - Arginine ----- L - Leucine -----L - Lysine

1000 MCQs for DAVIDSON'S - Principles And Practice Of Medicine  (PDF Version)

    SOURCE :
        1000 MCQs for DAVIDSON'S - Principles And Practice Of Medicine - 4th Edition

    AUTHORS :
        Michael J. Ford MD FRCPE (Author),
        A. T. Elder MB ChB FRCPE (Author)

    SUMMARY :
        This volume features multiple choice questions designed to help students acquire the factual knowledge necessary for good medical practice. The questions have been arranged to correspond with the chapters of "Davidson's Principles and Practice of Medicine" (18th edition). The questions are worded to avoid ambiguity and are not designed to trick the unwary. There are annotated answers.

Depositefile      6ybh link 

Differential Diagnosis In Internal Medicine - From Symptom To Diagnosis (PDF Version)

    SOURCE :
        Differential Diagnosis In Internal Medicine - From Symptom To Diagnosis - 2007

    AUTHORS :
        Walter Siegenthaler, MD
            Professor Emeritus of Internal Medicine - University of Zürich - Zürich, Switzerland

    SUMMARY :
        The present book, Differential Diagnosis in Internal Medicine, first appeared as a German edition in 1952 and since then has been translated into 10 other languages. Over the past 50 years 19 German editions have been published, and now the 19th edition of the work, which has become the classic differential diagnosis textbook, is available in English for the first time.
        This book encompasses differential diagnosis across the spectrum of internal medicine, covering dermatology, neurology, and rheumatology, and provides the very latest knowledge including pathophysiological aspects. In contrast to encyclopedically structured textbooks, this book traces the path from symptom to diagnosis, just as the physician encounters the situation in the hospital and in the office.
        With this pragmatic approach—starting from the symptom(s)—the physician will usually succeed in substantiating the suspected diagnosis. Using this method, Siegenthaler’s Differential Diagnosis in Internal Medicine guides the reader through the differential diagnostic challenges in the entire field of internal medicine, including dermatology, neurology, and rheumatology. The book incorporates many relevant and instructive Illustrations, tables, graphics, and algorithms, all contributing to the process of narrowing down a definitive diagnosis.
        The book is intended for medical students, physicians in clinical practice, generalists, and specialists in internal medicine, dermatology, neurology, and rheumatology, and also for all those concerned with the fundamental subjects of medicine, who wish to gain a competent knowledge of internal medicine.
        My thanks are due to all of the colleagues who worked with me on the book, and also to Thieme Publishing Group, in particular Thieme Publishers Stuttgart. I hope that, with the launch of the English edition, this classic textbook of differential diagnosis in internal medicine will now also find its place in the English-speaking world.
Depositfile   6ybh link

Harrison's Principles of Internal Medicine  (CHM And PDF Version)

    SOURCE :
        Harrison's Principles of Internal Medicine 17th Edition
    AUTHOR :
        Anthony S. Fauci, MD
            Chief, Laboratory of Immunoregulation; Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda
        Dennis L. Kasper, MD
            William Ellery Channing Professor of Medicine, Professor of Microbiology and Molecular Genetics, Harvard Medical School; Director, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston
        Dan L. Longo, MD
            Scientific Director, National Institute on Aging, National Institutes of Health, Bethesda and Baltimore
        Eugene Braunwald, MD
            Distinguished Hersey Professor of Medicine, Harvard Medical School; Chairman, TIMI Study Group, Brigham and Women’s Hospital, Boston
        Stephen L. Hauser, MD
            Robert A. Fishman Distinguished Professor and Chairman, Department of Neurology, University of California, San Francisco, San Francisco
        J. Larry Jameson, MD, PhD
            Professor of Medicine; Vice-President for Medical Affairs and Lewis Landsberg Dean, Northwestern University Feinberg School of Medicine, Chicago
        Joseph Loscalzo, MD, PhD
            Hersey Professor of the Theory and Practice of Medicine, Harvard Medical School; Chairman, Department of Medicine; Physician-in-Chief, Brigham and Women’s Hospital, Boston
    INTRODUCTION :
        The practice of medicine has changed in significant ways since the first edition of this book appeared in 1950.
        The advent of molecular biology with its enormous implications for the biological sciences (the sequencing of the human genome), sophisticated new imaging techniques, and advances in bioinformatics and information technology have contributed to an explosion of scientific information that has fundamentally changed the way we define, diagnose, treat, and prevent disease.
        This explosion of scientific knowledge is not at all static as it continues to intensify with time.
        The widespread use of electronic medical records and the Internet have altered the way we practice medicine and exchange information.
        As today’s physician struggles to integrate the copious amounts of scientific knowledge into everyday practice, it is important to remember that the ultimate goal of medicine is to treat the patient.
        Despite more than 50 years of scientific advances since the first edition of this text, it is critical to underscore that cultivating the intimate relationship that exists between physician and patient still lies at the heart of successful patient care.

Filefactory       Pdf    chm

Depositfile       Pdf     chm

Easy share     Pdf    chm

Fileserve           chm

Chronic Liver Disease - MNEMONICS

    DEFINITION :
        A DISEASE PROCESS OF LIVER PARENCHYMA
        Involves A Process Of PROGRESSIVE DESTRUCTION Leading To An Architectural Distortion With The Formation Of REGENERATIVE NODULES
        Results In A NET DECREASE In HEPATOCELLULAR MASS, FUNCTION And An ALTERATION OF BLOOD FLOW
        FINAL COMMON PATHWAY Of Many Types Of Chronic Liver Injury - LIVER CIRRHOSIS
    EPIDEMIOLOGY :
        400,000 Cases - Prevalence In U.S
        Alcoholic Cirrhosis :
            MOST COMMON TYPE (NORTH AMERICA, WESTERN EUROPE, SOUTH AMERICA)
            Only 10 - 15 % Of Individuals With Excessive Alcohol Intake Develop Cirrhosis
        Hepatitis C :
            5,000,000 People (EXPOSED To HEPATITIS C VIRUS) - In U.S
            RULE OF THUMBS :
                80 % - Will Develop CHRONIC HEPATITIS C
                20 - 30 % Of Those 80 % - Will Develop CIRRHOSIS Over 20 - 30 Years
        Hepatitis B :
            OVER 300 - 400 Million People (WORLDWIDE)
                Endemic - Southeast Asia, Sub-Saharan Africa
                1,250,000 People (CARRIERS Of HEPATITIS B) - In U.S
            RULE OF THUMBS :
                5 % - Will Develop CHRONIC HEPATITIS B
                20 % Of Those 5 % - Will Develop CIRRHOSIS
        Primary Biliary Cirrhosis (PBC) :
            100 - 200 People / 1,000,000 Population - PREVALENCE
             FEMALE > MALE
            AGE Median - 50 Years Old
        Cryptogenic Cirrhosis :
            Up To 10 % Of All Patients With Cirrhosis (UNKNOWN Etiology)
    ETIOLOGY :
        Viral (POST HEPATITIC CIRRHOSIS) :
            Hepatitis B Virus, Hepatitis C Virus, Cytomegalovirus (CMV), Epstein Barr Virus (EBV)
        Toxin And Drugs :
            Alcohol (ALCOHOLIC CIRRHOSIS), Amiodarone, Methotrexate, Nitrofurantoin
        Metabolic :
            Non-Alcoholic Fatty Liver Disease, Haemochromatosis, Wilson's Disease
        Autoimmune :
            Autoimmune Chronic Hepatitis, Primary Biliary Cirrhosis, Primary Sclerosing Cholangitis
        Others :
            Right Sided Congestive Heart Failure (CARDIAC CIRRHOSIS), Unknown (CRYPTOGENIC CIRRHOSIS)
        MNEMONICS :
            ABCDEFG
            A - Alfa 1 Antitrypsin Deficiency
            B - Budd Chiary Syndrome, Hepatitis B Virus, Billiary Cirrhosis, Bilharzia
            C - Hepatitis C Virus, Cystic Fibrosis, Copper Overload
            D - Drugs
                Amiodarone, Methotrexate, Nitrofurantoin
            E - Ethanol (Alcoholic Liver Diseae)
            F - Fe Overload
                Hemochromatosis, Hemosiderosis
            G - Glycogen Storage Disease

    TYPE OF CIRRHOSIS :
        Type Of Cirrhosis (Classification)
    DIAGNOSIS :
        CLINICAL MANIFESTATION :

            Asymptomatic - SOME
            Non-Specific Symptoms :
                Anorexia, Weight Loss, Fatigue / Weakness, Reduction In Skeletal Muscle Mass / Muscle Wasting
            Skin And Hair :
                Progressive Jaundice, Spider Angiomas, Palmar Erythema, Pruritus, Xanthelasmas, Xanthoma, Decrease Body Hair, Melanosis (Primary Biliary Cirrhosis)
            Abdomen :
                Firm, Nodular Liver, Splenomegaly, Ascites
            Endocrine :
                Gynecomastia, Testicular Atrophy, Menstrual Irregularities, Signs Of Virilization In Women
            Hematologic / Vascular :
                Caput Medusa, Easy Bruising And Bleeding, Hematemesis / Bleeding From Gastroesophageal Varices, Melena
            Other :
                Encephalopathy, Parotid And Lacrimal Gland Enlargement, Digital Clubbing, Melanosis, Steatorrhea, Edema
            MNEMONICS :
                ABCDEFGHIJ

        LABORATORY :
            Complete Blood Count
                Anemia (Microcytic - Due To Blood Loss, Or Macrocytic - Due To Folate Deficiency)
                Pancytopenia - Due To Hypersplenism
            Serum Transaminases - ELEVATED
                Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)
                Alcoholic Liver Disease - AST / ALT = 2 : 1
            Serum Bilirubin
            Prothrombin Time (PT) - PROLONGED
            Serum Albumin - HYPOALBUMINEMIA
            Serum Electrolyte - HYPONATREMIA, HYPOKALEMIA (Hypokalemic Alkalosis
            Fe OVERLOAD
                Serum Iron, Total Iron-Binding Capacity (TIBC), Serum Ferrition
            Autoimmune Hepatitis
                Antinuclear Antibody, Anti-Smooth-Muscle Antibody
            Antimitochondrial Antibody (AMA) - PRIMARY BILIARY CIRRHOSIS
                Present In Around 90% Of Patients With Primary Biliary Cirrhosis
                Present In < 5 % Of Patients With Other Liver Diseases
            Antineutrophil Cytoplasmic Antibody (P-ANCA) - PRIMARY SCLEROSING CHOLANGITIS
                Positive In About 65% Of Patients With Primary Sclerosing Cholangitis
            Gamma-Glutamyl Transpeptidase And Alkaline Phosphatase - ELEVATED
            Hepatitis Serologies
                HBsAg, Anti-HBs, Anti-HBc, HBeAg, Anti-HBe, HBV-DNA,
                Anti-HCV, HCV-RNA, HCV Genotype
                Anti-HDV
            Alpha-1 Antitrypsin Level
        IMAGING :
            Abdominal Ultrasounds With Doppler, CT Scan, Or MRI
                Cirrhotic Liver, Splenomegaly, Development Of Collateral Vessels
                Venous Thrombosis
            Magnetic Resonance Cholangiopancreatography (MRCP)
                Imaging Technique Of Choice For Initial Evaluation Of Primary Sclerosing Cholangitis
                    Multifocal Stricturing And Beading Involving Both The Intrahepatic And Extrahepatic Biliary Tree
        PROCEDURES :
            Liver Biopsy
                Percutaneous, Transjugular, Or Open Biopsy
                DEFINITIVE DIAGNOSIS
    MANAGEMENT :
        NON-SPECIFIC :
            Alcoholic Liver Disease
                Abstinence Of Alcohol Intake (CORNERSTONE Of Therapy)
                Nutrition And Long Term Medical Surpervision
            Posthepatitic Liver Disease
                Antiviral Therapy - For Chronic Hepatitis B And Chronic Hepatitis C Infection
                Immunosuppresive Therapy - For Autoimmune Hepatitis
            Primary Biliary Cirrhosis (PBC)
                No Specific Therapy
                URSODIOL - Has Been Shown To Improve Biochemical And Histologic Features
                CHOLESTYRAMINE - May Reduce Pruritus And Hypercholesterolemia
            Cardiac Cirrhosis
                Treat The UNDERLYING CARDIAC DIORDER
        SPECIFIC :
            Alcoholic Liver Disease (Alcoholic Cirrhosis)
                Directed To Prevent And To Managed Particular Complications
                OTHERS :
                    Acamprosate (REDUCE Craving For Alcohol), S-Adenosyl Methionine, Anabolic Glucocorticoids (Propylthiouracil, Antioxidants, Colchisine, And Penicillamine), Oral Pentoxifylline, TNF Alpha (Infliximab Or Etanercept),
            Posthepatitic Cirrhosis
                Directed To Prevent And To Managed Particular Complications
                Hepatitis B - Antiviral Therapy
                    Lamivudine, Adefovir, Entecavir, Tenofovir
                    Interferon Alpha
                        Can Also Be Used For Treating Hepatitis B, But Should Not Be Used In Cirrhotics
                Hepatitis C - PEG-Interferon, And Ribavirin
                Autoimmune Hepatitis (AIH) - Immunosuppressive Therapy
                LIVER TRANSPLANTATION - An OPTION For Selected Patients
            Primary Biliary Cirrhosis (PBC)
                Pruritus - Antihistamine, Narcotic Receptor Antagonists (Naloxone Or Naltrexone), Rifampin, Cholestyramine, Plasmapheresis
                Fatigue - Frequent Rest
                Osteoporosis - Biphosphonate
                Ursodiol - Indicated In Patients With Positive Antimitochondrial Antibodies And Elevated Biochemical Markers
            Primary Sclerosing Cirrhosis (PSC)
                NO SPECIFIC PROVEN TREATMENT
                LIVER TRANSPLANTATION - Ultimate Treatment
            Variceal Bleeding
                Acute Hemorrhage
                    Supportive And Resuscitative Management (ICU Monitoring)
                        Fluid Resuscitation (Intravenous Fluid And Blood Product Replacement)
                    Vasoconstrictors
                        Somatostatin Or Octreotide - DIRECT SPLANCHNIC VASOCONSTRICTORS
                        Somatostatin 250 mcg Bolus Followed By 250 mcg / Hour
                        Octreotide 50 - 100 mcg / Hour
                        Vasopressin - NO LONGER COMMONLY USED
                    Balloon Tamponade
                        In Patients Who Cannot Get Endoscopic Therapy Immediately Or Who Need Stabilization Prior To Endoscopic Therapy
                    Endoscopic Intervention
                        FIRST LINE Of TREATMENT
                        Variceal Band Ligation
                            Used To Control Acute Bleeding In Over 90% Of Cases
                            Should Be Repeated Until Obliteration Of All Varices Is Accomplished
                        Sclerotherapy (Variceal Injection Therapy)
                    Transjugular Intrahepatic Portosystemic Shunt (TIPS)
                        Reserved For Those Who Fail Endoscopic Or Medical Management
                        As A Bridge To LIVER TRANSPLANTATION
                        Encephalopathy Can Occur In As Many As 20% Of Patients After TIPS
                    Surgical Esophageal Transsection
                        Rarely Used And Associated With Poor Outcome
                Prevention Of Recurrent Bleeding
                    Repeated Variceal Band Ligation - Until Varices Are OBLITERATED
                    Beta Blockade
                    Portosystemic Shunt Surgery
                    Transjugular Intrahepatic Portosystemic Shunt (TIPS)
                    Liver Transplantation
            Splenomegaly
                Requires NO SPECIFIC TREATMENT - Usually
                Splenectomy
                    SHOULD BE AVOIDED In Patients Eligible For LIVER TRANSPLANTATION
            Ascites
                 Minimum Amounts Of Ascites
                    Dietary Sodium Restriction ( < 2 Grams Of Sodium Per Day )
                Moderate Amounts Of Ascites
                    Spironolactone 100 - 200 mg / day (MAX : 400 mg / day)
                    Furosemide 40 mg / day (MAX : 160 mg / day )
                Refractory Ascites
                    Repeated LARGE VOLUME PARACENTESIS
                    Transjugular Intrahepatic Portosystemic Shunt (TIPS)
            Spontaneous Bacterial Peritonitis (SBP)
                INITIALLY :
                    Empirical Therapy (Gram Negative Aerobic Bacilli And Gram Positive Cocci)
                    Third Generation Cephalosporins
                        Cefotaxime 2 Grams Q 8 Hours Intravenous
                    Broad Spectrum Antibiotics
                        Piperacillin / Tazobactam 3.375 Grams Q 6 Hours Intravenous
                        Ceftriaxone 2 Grams Q 24 Hours Intravenous
                After Organism Is Identified - Treatment Should Target The SPECIFIC PATHOGEN
                Duration :
                    5 Days - If With Negative Blood Cultures, And With Rapid Improvement
                    Up To 2 Weeks - If With Positive Blood Cultures, And With Slow Improvement
                PROPHYLAXIS
                    Given For Patients Who Have Had An Episode Of Spontaneous Bacterial Peritonitis And Recovered
                    Once-Weekly Administration Of Antibiotics For Recurrent SBP
            Hepatorenal Syndrome (HRS)
                DIFFICULT And UNSUCCESSFUL
                Midodrine With Octreotide And Intravenous Albumin
            Hepatic Encephalopathy
                Hydration And Correction Of Electrolyte Imbalance
                Lactulose - 30 To 120 mL Once Daily (OD) Up To 4X A Day (QID)
                    Target : 2 - 3 Bowel Movements / Day
                Antibiotics - ADJUNCTIVE Therapy
                    Neomysin 500 - 1000 mg QID
                    Metronidazole 250 mg TID
                    Others : RIFAMIXIN
                Zinc Supplementation
            Coagulopathy
                Asymptomatic - OBSERVE
                Vitamin K - Intravenous Or Intramuscular
                Bleeding :
                    Platelet Transfusion - If With Thrombocytopenia
                    Fresh Frozen Plasma - If With Prolonged Prothrombin Time
                    Others :
                        Replacement Of Factor VII - Can Correct Factor VII
            Hepatopulmonary Syndrome (HPS)
                No Specific Treatment
                Embolization Of Large Arteriovenous Shunts
                LIVER TRANSPLANTATION - In Selected Patients
    COMPLICATIONS :
        Portal Hypertension
            Clinically Significant Portal Hypertension Is Present In > 60% Of Patients With LIVER CIRRHOSIS
            Further Complications :
                Gastroesophageal Varices (With Hemorrhage), Ascites, Splenomegaly
        Spontaneous Bacterial Peritonitis (SBP) - POOR PROGNOSIS
        Hepatorenal Syndrome (HRS)
            Worsening AZOTEMIA With Avid Sodium Retention And Oliguria In The ABSENCE OF IDENTIFIABLE SPECIFIC CAUSES OF RENAL DYSFUNCTION
        Hepatic Encephalopathy
            Disturbances In Consciousness And Behavior, Personality Changes, Fuctuating Neurologic Signs, Asterixis, Distinctive EEG Changes
        Coagulopathy
            Thrombocytopenia, And Prolongation Of Prothrombin Time (PT)
        Hypoxemia And Hepatopulmonary Syndrome (HPS)
        Hepatocellular Carcinoma
        Cholangiocarcinoma In Primary Sclerosing Cholangitis (PSC)
        Malnutrition
            Due To POOR DIETARY INTAKE, ALTERATION In GUT NUTRIENT ABSORPTION, ALTERATION In PROTEIN METABOLISM
        Osteoporosis
    PROGNOSIS :
        In The U.S - Chronic Liver Disease - 10th MOST COMMON CAUSE OF DEATH In Adults
            40 % - Due To Alcoholic Cirrhosis
        CHILD-PUGH Classification

Atlas Of Pelvic Surgery - OFFLINE Edition (CHM Version)

    SOURCE :
        Atlas Of Pelvic Surgery - ONLINE Edition

    AUTHORS :
        Clifford R. Wheeless, Jr, M.D. (Author),
        Marcella Roenneburg, M.D. (Author)

    SUMMARY :
        This step-by-step guide to pelvic surgery is organized by organ system for easy reference. This edition includes new material on operative procedures such as laparoscopy.

DEPOSIT FILES LINK :

    Atlas Of Pelvic Surgery - OFFLINE Edition.chm

EASY SHARE LINK :

    Atlas Of Pelvic Surgery - OFFLINE Edition.chm

FILE FACTORY LINK :

    Atlas Of Pelvic Surgery - OFFLINE Edition.chm

Junqueira's - Basic Histology Text And Atlas(CHM Version)

    SOURCE :
        Junqueira's - Basic Histology Text And Atlas - 12th Edition - 2010

    AUTHORS :
        Anthony L. Mescher, PhD
            Professor of Anatomy and Cell Biology - Indiana University School of Medicine - Bloomington

    SUMMARY :
        Since its inception, Junqueira's Basic Histology has set the standard for a concise yet thorough presentation of tissue structure and function for students in the health professions and advanced undergraduates. Junqueira treated histology, the study of cellular and tissue biology, not as microscopic anatomy, but as the key to integrating all of anatomy with physiology, cell and molecular biology, and biochemistry and as the foundation of pathology. Translated into many languages, Basic Histology is used worldwide and its concise, integrated style has been imitated in most subsequent histology texts.
        As editor of the twelfth edition of Junqueira's Basic Histology, I undertook to maintain or improve three key features of the book. First, the written text itself has been upgraded in many areas while keeping its clear expository style and its integration with related subjects. All topics have been re-examined in the light of current literature and updated or refined if necessary. The result is a thoroughly modern treatment of cell and tissue biology, focused on the needs of students in the health professions. Students desiring additional information or greater detail on a topic can place the bold terms or other key words into any web-based search engine or into PubMed to access the most recent reviews on that topic. To simplify a preliminary overview or rapid review of chapters, main points for each subject are included in the expanded legends that accompany each figure.
        Second, micrographs have been replaced as needed and now comprise a complete color atlas of tissue sections that include the important features of every tissue and organ in the human organism stained by standard methods. The light microscope photos are supplemented by electron micrographs and specifically stained preparations when these are useful in explaining unusual cells and tissues and their functional significance. Students purchasing the text can also now be linked for the first time to a virtual microscope and a complete collection of normal tissue specimens, most of which were used for the new micrographs in this atlas.
        Finally, new art has been introduced throughout the text in a comprehensive set of modern, full color, three-dimensional drawings prepared by a certified team of medical illustrators. Figures chosen for this new edition include introductory material for each chapter that allows for rapid comprehension of an organ system's basic anatomy. Other illustrations highlight key features of each tissue and organ, along with their functional significance. Especially useful classic illustrations used in previous editions are still present, usually with more color or other new features. For each figure the goals are complete accuracy and sufficient detail to clarify the accompanying text and make learning easier. The result is a comprehensive program of art that strikes a balance between earlier simplistic diagrams and traditional medical illustrations with excessive details.
        The overall organization of the highly successful eleventh edition has been retained. Unlike most histology texts, this includes an introductory chapter on laboratory methods used for the study of tissues, including the most important types of microscopy. Separate chapters focus on the cytoplasmic and nuclear compartments of the cell, followed by chapters on the four basic tissues that form the organs. Individual chapters are then devoted to each of the organ systems. Each chapter utilizes Junqueira's cell biological approach, emphasizing the specialized properties and activities of the basic tissue components as the key to understanding the functions of each organ. Also included is a chapter on the eye and ear, with thorough treatments of the structure and function of these organs at the cellular level. With minor changes in the placement of certain topics, the text covers every tissue of the body and is as up-to-date as possible.

DEPOSIT FILES LINK

EASY SHARE LINK

FILE FACTORY LINK

পুরানো সব 6ybh-লিঙ্ক কে এডিট করতে হবে :

এখানে দেখুন