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A 40Y politician suffered from chest pain diagnosed as angina pectoris. He had a tense personality, resting HR was 96/min, BP 170/104mm Hg but blood sugar & lipid profile were normal. Select the most suitable antihypertensive for the initial therapy:
Anonymous Quiz
31%
Nifedipine
28%
Hydrochlorothiazide
36%
Atenolol
5%
Methyldopa
Case 39 || Solution

The answer to the given question is “Vein of Galen Malformation (VOGM)”

Embryological Remnant of Median Prosencephalic Vein of Markowsky. It is Congenital AV Fistula of Median Prosencephalic Vein

⬇️

Leads to ‘Dilated Vein of Galen’

Characterised by:

Midline Cystic Swelling
Enlarged Fontanelles
Loud Cranial Bruit
Hydrocephalus
Large Head
High Output Cardiac Failure

Diagnosis (Before Delivery): Antenatal USG

IOC: Magnetic Resonance Venography (MRV)
Recent Questions:

Which is risk factor for cholangiocarcinoma:
Anonymous Quiz
11%
Obesity
66%
Primary sclerosing cholangitis
12%
Salmonella carrier state
11%
HBV infection
AI.PG

A 34Y man presents with loss of appetite, nausea, vomiting & fatigue. Laboratory examination confirms the diagnosis of Hep B & he becomes icteric 2 weeks later. This pt may also be particularly vulnerable to development of which of the disorders?
Anonymous Quiz
14%
Berry aneurysm
17%
Coronary artery aneurysm
57%
Polyarteritis nodosa
12%
Giant cell arteritis
Recent Questions:

All of the following are risk factors for carcinoma gall bladder, except:
Anonymous Quiz
25%
Typhoid carriers
15%
Adenomatous gall bladder polyps
15%
Choledochal cysts
45%
Oral contraceptives
AIIMS.MAY

Which of the following is not used in the treatment of pulmonary hypertension?
Anonymous Quiz
19%
Calcium channel blockers
40%
Alpha blockers
25%
Prostacyclins
17%
Endothelin receptor antagonists
AIIMS.MAY

Hormone replacement therapy is beneficial for all of the following conditions except:
Anonymous Quiz
12%
Vaginal atrophy
13%
Flushing
13%
Osteoporosis
63%
Coronary heart disease
Identify the disease based on the symptoms and examination reports 🧐

The more you participate, more you learn💪

Comment in the box below⬇️⬇️
Recent Questions:

Zollinger Ellison syndrome is not caused by tumors from:
Anonymous Quiz
11%
Pancreas
60%
Ovary
18%
Colon
11%
Duodenum
Case 40 || Solution

@medical_times

The answer to the given question is “Tuberous Sclerosis”

Autosomal Dominant Disorder

Neuro-cutaneous Syndrome

Findings of Tuberous Sclerosis:

VOGTS TRIAD: (EPI LO IA)

• EPI- Epilepsy
• LO- Low IQ
• IA- Adenoma Sebacium (Angiofibromas) (Nodules along sebaceous gland distribution)

Subependymal calcific nodules (along the wall of ventricles) showing ‘candle dripping like calcifications’

Cortical Tubers (Seizure Foci): Hamartomatous Lesion in Brain Cortex

Heart: Cardiac Rhabdomyoma

Kidney:

- B/L Angiomyolipoma in Kidney

- Angiomyolipoma are PEComa(s) (Perivascular Epitheloid Cell Tumor)

In Eyes: Retinal Astrocytoma

Skin:

- Ash Leaf Macule (M/C)
- Shagreen patch

In Lungs:

-Cystic Dilatation of Lymphatic vessels called as Lymphangioleiomyomatosis (LAM).

-It is seen sporadically exclusively in females.

Tuberous Sclerosis can be associated with Brain Tumor:

SEGA (Subependymal Giant cell Astrocytoma):

SEGA more commonly located on ‘Foramen of Monro’
Recent Questions:

A highly sensitive and specific marker for detecting intestinal inflammation in ulcerative colitis is:
Anonymous Quiz
22%
CRP
29%
Fecal lactoferrin
41%
Fecal calprotectin
8%
Leukocytosis
Recent Questions:

Two identical specimen of the intestine obtained following colectomy shows on examination hemorrhagic cobblestone appearance; one of them however, shows longitudinal grooving. It is likely to be a specimen of:
Anonymous Quiz
30%
Ulcerative colitis
10%
Ischemic colitis
9%
Multiple polyposis
52%
Crohn’s disease
Recent Questions:

Osteomas, adenomatous polyps of intestine and periampullary carcinomas are seen in which oif the following conditions?
Anonymous Quiz
13%
Cowden syndrome
39%
Peutz Jegers syndrome
15%
FAP
32%
Gardener syndrome
Case 40 Solution Part 2

The answer to the given question is “Tuberous Sclerosis”

Kidney:

- B/L Angiomyolipoma in Kidney [Fat containing Dark areas]

- Angiomyolipoma are PEComa(s) (Perivascular Epitheloid Cell Tumor)

(As shown in the picture)
2025/06/30 20:03:10
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