medical puzzles

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Jeevan Jacob Junior Resident in Pharmacology Calicut Medical college

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Medical puzzle

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Page 1: Medical Puzzles

Jeevan JacobJunior Resident in PharmacologyCalicut Medical college

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• Question 1

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• Answer - Propranolol

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• Propranolol was developed by James W. Black.• While working for Imperial Chemical Industries, ICI, a British

chemical company, Black developed an interest in the way the heart muscle responded to the hormone adrenalin

• He went to work to find a way to block the action of adrenalin and developed the first of the ‘beta-blockers’ which block the action of adrenalin at the beta-adrenergic receptors.

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• Infantile Hemangioma are both the most common benign vascular tumors and the most common soft tissue tumors in children

• Propranolol is now preferred first-line therapy, given that its efficacy, tolerability, and safety are superior to that of oral corticosteroids.

• The period of most rapid proliferation is complete by 8 weeks after birth, suggesting that referral to specialists should occur early, within the first month of life for concerning IH.

Ref: Pediatric Clinics of North America - Volume 61, Issue 2 (April 2014)

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• Question 2

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Courtesy: Dr. Sanjay Ganapathy, Asst. Professor of Cardiology, SCTIMST, Kerala

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• Answer – Artemisinin

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• “Artemisinin is the active principle extract of Artemisia annua (Qinghao), a plant used for centuries in traditional Chinese herbal remedies for the treatment of febrile illness.”

Ref: Page 495, Bennett: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed.

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Tu Youyou is a Chinese medical scientist, pharmaceutical chemist, and educator. She won the 2011 Lasker Award in Clinical Medicine for discovering artemisinin (also known as Qinghaosu) and dihydroartemisinin, used to treat malaria, which saved millions of lives

- wikipedia

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• Black water fever due to hemoglobinuria seen in P. falciparum malaria.

• This is a rare manifestation involving a complement-mediated immune reaction found in patients who have been treated with inadequate doses of antimalarial medication.

• The treatment includes appropriate antimalarials together with supportive medical care

Ref : Wein: Campbell-Walsh Urology, 10th. ed.Page 491

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• Question 3

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Courtesy : sauparnika author (pseudonym)

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• Answer: Progressive Supra Nuclear Palsy (PSP)

• PSP was first described in 1964 by Steele, Richardson, and Olszewski

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• 1. Image in background: Toronto General hospital where from the first cases in the paper of Richardson et al described

• 2. The PET Imaging in PSP which would help to distinguish from other dementias and Parkinsonism.(dynamic regional localization of tau fibrillar aggregates in PSP.)

• 3. Humming bird: MRI imaging in sagittal view will have the characteristic humming bird appearance of midbrain.

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• 4. The Board walk scene from Atlantic City, NJ where the first report / case series of PSP was presented at the American Neurological Association meeting

• 5. Last image: Dudley Moore, the British actor comedian who was one of the notable celebrities suffered from PSP.

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• Question 4

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Courtesy : Dr. Unnikrishnan, Clinical Lecturer in Cardiology at University of Cambridge

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• Answer : Aspirin

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• building 1- is Halmstad castle in the province of Halland Sweden. Bengt Samuelsson hails from here.

• Building 2 - is the Casina Pio IV home to the Pontifical Academy of Sciences where the second chap Sune Bergstrom was a member - this of course was after he gained prominence

• Building 3 - is the William Harvey Research Institute founded by John Vane

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THANK YOU

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