Saturday, 7 February 2015

HIGH YIELD POINT FOR (Preventive and Social Medicine) PSM 2015


Preventive and Social Medicine important topics for DNB-CET, AIPGMEE, FMGE, DNB-PDCET, UPSC-CMS online medical examination .

Peumoconiosis(usually takes 10-12 yrs to develop): 0.5-3 micron dust cause pneumoconiosis. No treatment so prevention

is the only option. Initial stages--> Disease is arrested with stoppage of exposure(not reversed)

 Silicosis: Shortest incubation period(few mth - 6yrs); involves *upper lobe, Intense nodular fibrosis--> hence

snow storm appearance on CXR, crazy paving appearence on HRCT

Asbestosis: Referred to as fibre of death; *Diffuse peribronchial fibrosis, CXR-Ground glass appearance,affects

lower 2/3;calcification of diaphragmatic pleura is characteristic;Associated cancers-Bron.Ca., GIT Cancers, Mesothelioma(M/C with crocidolite variety)--> types: pleural(more common)/peritoneum; Crysolite is safest variety

 Cotton--> Byssinosis; 1st stage called Monday fever

Latest guidelines in RNTCP:

History of 2 wk duration--> TB suspect--> Do sputum microscopy--> 2 samples required

Sputum positivity:

 1 or 2 positive--> sputum smear positive TB--> start ATT

 2 negative--> Antibiotics(FQ or Aminoglycosides:7-10 days) Improves--> Non TB

No improvement--> CXR

 Suggestive of TB--> Sputum smear negative TB--> Give ATT

 Not suggestive of TB--> HIV testing--> positive

 >200 CD4+ --> Give ATT then ART

 <200 --="" cd4=""> Give ART first
Q Thioacetazone is C/I as second line drug of ATT with ART