By- Dr.

Santosh Patil
 Gastroenterology

Peptic ulcer ->

·
IstMK -
H. Pylori
NSAIDs
· 2nd M1c-

· Mc complication ofPUD ->

Bleeding
peptic ulcer

R.
H. Pyloxi
·
Recommended regimen:Bismuth
containing
quadruple regimen

-Clarithromycin
Drug
posted X
·

resistence
Metronidazole
 Components <
BMT->
Tetracycline

Omeprazole)inMetronidazole
subsalicylate
·Duration of R- 10-14 days

Liver:

·
MICK Cirrhosis (CLD -> NAFLD

foracute lives failure E

hepatitis.
India:Viral

World:Drugs -
MI Paraceta
- mol
 Question ·2nd Mick for acule

Type question here

-
Liver

In
failure) 18s
India

⑰k
Defn
↳
Acute lives
ATT
·

failure
Developmentof hepatic encephalopathy
onset of
Ein dys/wke of
AASLD.
Acc. to
jaundice.
-

-
ACC INASL
-> ↳4
s,
 disorder:
· Autoimmune hepatobiliary

Autoimmune hepatitis
Lupoid
1)
= -
patitis
ass. SLE

-
Anti-LKM1 antibody -

R ->

Oral corticosteroids
1st line agents -
 ii) Primary Biliary Cholangitis:
Prim. biliary
cirrhosis

~
Autoimmune disorder
affecting small & medium
bile ducts.
sized

,oproo
Antimiton
-ANTB dria
Intrahepatic cholestasis

Fatigue
-
Mc symptom
~

2nd Mk symptom ->

Itching/pruvitis
choice:Ursodeoxycholic
Drug of
~

acid.
 -and line
Obeticholic
:

agent
acid
(add on) -
Farsenoid
Mech. of action:
X R
-

iii) Primaxy Sclerosin

I agonist

cholangitis:

·PY
·

small/medium ↳
Autoimmune disordel
tra
affecting
-
ANTB
Al ~
CF a large
-
Entire
bile ducts hepalic
biliarTree Cholestasis
P
· On
imaging? dilated intrahepatic
radicles.
biliary
 association
strong citis.
ulcerative

R Doc- Ursodeoxycholic acid.

Respiratory System:
·
Asthma-

10c ->
Spirometry IPFT

Y
IOC in the
PEFR
absence of orCII for
spirometry

Diagnostic criteria:
FEV1
is - bsed

ratio
10.7
ii) FEX, IFV
<0:7
iii) Bronchodilator

revessibility test

⑭test-
to
Done
If
-

FEV, increases

diff blu
by > 12% or

Asthma

>200m
by
ED

S/0 astuma.
 COPD
Asthma

↓sed ↓, sed
FEX,
<0.7
<0.7
FEX, II
No use in FEN,
FEV1 ↑ses by

I
BDR if
increase,
>127 or

* 12-1

DLCO
Normal/Ased. ↓sed
·

Phenotypical classification:

Non Type R
Type 2

- ·
Th1 GT1z
·
The cell mediated
inflammation
Eosinophils Neutrophils
Eftes y
·

11
111
·
Inflammatory-
3 125
111t

cytokines
IgE
 - 183
Hing
targe
·

Dupilimumab
-

Anti-ILR
Reslizumab Antil 15
·

Bensalizumab-115R
Anti-

Mepolimumab
·
-

Anti-IL5

Omalizumab
·

Anti-IGE
-
COPD: Persistent
- -

disorder
· Chronic obstructive lung
small, medium
Enlarge
affecting Cirwar
I also Lung parenchyma

·
Mick -

smoke
smoking

for
Mick
cops in non-smoking
q) Burning of
biomass feed

<Chora)
Asist
·

FEX 1
used
PFT:

FEV, /FVC 50.7

DDB test) FEx, 4x [12%

DLCO-lised

CXR-
i) Flattened diaphragm
ii) Widened rib spaces

iii) Tubular
heart
DS -

Berlin Criteria
Diagnostic criteria
-

Hypoxia ->
-
ak,
rato (300
PaOzIFiO2
x > 400
200
Mild

⑰00
not
was
.

be
alveolar moderate

opacities
⑩
I
severe
·
Cardiac r
2D Echo 1
=

cause
ruled
orinvasive
out
monitoring
vell
Temporal
·

onset) <7days.
bIn trigger & ARDS
 Classification of causes for ARDS

---
C
Extrinsic
Intrinsic
-
M/ sepsis
MIC Pneumonia

Management:
choice:Mechanical Ventilation
12 of
Ventilatorysettings
recommended:

·
Ty-low tidal vol=GmL/kg body not.
·
PEEP- High PEEP
strategy
[30cmU2O
·Plateau pressure

· Prone position ventil for ARDS

moderate

ARDS
·

ECMO -for severe

 in male,
MK -

11DS smokers

11D Idiopathic
of
->

1 type chronic
pulmonary fibrosis
related
smoking Desquamative
·

ILDS interstitial
(DIP)
Pneumonia

bronchiolitis
"Respiratory
associated ILD

(RB-11D)
 it) ishcodeater
·

Most common

genelic abnormality
in pts =

CIPE)

·
Mostcommon ILD in
Idiopathic
->

non-smoking females non-specific

interstitial

pneumonia
CIdiopathic
NS1P)
 IPF NS1P

40-50 yrs
> 60
ce yrs

Males
Females
Gender

Strong Occurs in
Smokin
g "isk non-smokers

Usual Interstitial NSIP

HRCT
Pneumonia pattern
CUIPY pattern
Ground glass
·
Honey-comb apacities
appearance
Prognosis Poor Good
Ansculta
findings
in IOF ↳ fine, end
crepitation
inspiratory

"Velcro like"

&
of ICD

[Nintedanib I
Pirfenidone Anti
1st line
IPF -

agents
fibrotic
agents

3
and line
Immunosuppressants
agents

Definitive Lung transplantation

 NSIP->
1stline
agents steroids
2nd
agents ↳
line
Immuno

suppressants.

isofsmoking
y
·

smoking
IQuit
related ILDS

(D1P (RB-11-D) steroids

·Which is mimicks ARDS: Diffuse alvelar

hemorrhage (DAH)
·
Sarcoidosis

inflamma
-

Multisystems autoimmune
toty
disorder.

~
MIC
affected system:Respiratory system.
Hilar lymphadeno

E
Granulomas path
t

Non-caseating Parenchymal involvement

>
Erythema
~and modosum
M1c affected -> Skin

organ Lupus
pernio
~
MIC CNS
-> th neuve
palsy
manifesto
-
MIC venal
- Interstitial
manifests nephritis.

Staying of
Savcoidosis:
Scadding
staging
Lagnosis:
i) S. ACE I sed

ii) Rest.
Negative CBNAAT or IGRA
 iii)
Biopsy slo non-ascating
granulomas
Ov

Typical imaging
finding
aging modalityof 10
· per t

② Gallium scan

is"Panda sign"
ii)" Lambda sign"
X
 R -

DOC -
Corticosteroids

2
ine 4 Immunosuppressants. -

Neurology
2nd MIC
-

einer's disease ->

Parkinson's
dis
disorder
·
Mc neurodegenerative

Gemelic:
i) Presenilin-1 muth
 ii) ApoE variants

(Apo E (En)

iii) Down's syndrome

>
Earliest
·

sile to Entorhinal
get
affected contex

itsn
pot
rise Earliest loss
symptom Memory
->

is
Messed a e
>
ent memory
>Renole
memory

e -
pP ·
Metal
I
toxicity
Y sed AD risk b Aluminium
 Clinical
ggnosis
-

--

for Dementia
Reversible Causes

Biz
Niacin
I deficience
Hypothyroidism
Normal pressure

hydrocephalus
CNS
infections
NAME OF TEST ON APP DATE
FMGE TEST- 1 16.7.23
FMGE TEST- 2 23.7.23
FMGE TEST- 3 25.7.23
FMGE TEST- 4 26.7.23
FMGE TEST- 5 27.7.23