FCPS Part1 exam Bangladseh

FCPS Part1 exam Bangladseh FCPS part 1 exam..Bangladesh....

25/02/2023

Patients with epilepsy should be advised to avoid activities where they might
place themselves or others at risk if they have a seizure. This
applies at work, at home and at leisure. At home, only shallow
baths (or showers) should be taken. Prolonged cycle journeys
should be discouraged until reasonable freedom from seizures
has been achieved. Activities involving prolonged proximity to
water (swimming, fishing or boating) should always be carried
out in the company of someone who is aware of the risks and
the potential need for rescue measures. Driving regulations
vary between countries and the patient should be made aware
of these

25/02/2023

Absence seizures Absence seizures (previously ‘petit mal’) always
start in childhood. The attacks are rarely mistaken for focal
seizures because of their brevity. They can occur so frequently
(20–30 times a day) that they are mistaken for daydreaming or
poor concentration in school.

25/02/2023

To function normally, the brain must maintain a continual balance
between excitation and inhibition, remaining responsive to the
environment while avoiding continued unrestrained spontaneous
activity. The inhibitory transmitter gamma-aminobutyric acid
(GABA) is particularly important, acting on ion channels to enhance
chloride inflow and reducing the chances of action potential
formation. Excitatory amino acids (glutamate and aspartate)
allow influx of sodium and calcium, producing the opposite
effect

25/02/2023

A number of rare headache syndromes produce pains about
the eye similar to cluster headaches . These include
chronic paroxysmal hemicrania and SUNCT (short-lasting
unilateral neuralgiform headaches with conjunctival injection
and tearing). The recognition of these syndromes is useful
because they often respond to specific treatments such as
indometacin.

25/02/2023

In this rare condition, the gastric pits are elongated and tortuous,
with replacement of the parietal and chief cells by mucus-secreting
cells. The cause is unknown but there is excessive production
of transforming growth factor alpha (TGF-α).

25/02/2023

Diffuse oesophageal spasm presents in late middle age with
episodic chest pain that may mimic angina but is sometimes
accompanied by transient dysphagia. Some cases occur in
response to gastro-oesophageal reflux. Treatment is based on
the use of PPI drugs when gastro-oesophageal reflux is present.
Oral or sublingual nitrates or nifedipine may relieve attacks of
pain.

25/02/2023

For most, trigeminal neuralgia remains an idiopathic condition
but there is a suggestion that it may be due to an irritative
lesion involving the trigeminal root zone, in some cases an
aberrant loop of artery. Other compressive lesions, usually
benign, are occasionally found. Trigeminal neuralgia associated
with multiple sclerosis may result from a plaque of demyelination
in the brainstem.

25/02/2023

The
most frequent culprits are compound analgesics (particularly
codeine and other opiate-containing preparations) and triptans,
and MOH is usually associated with use on more than 10–15 days
per month.
Management is by withdrawal of the responsible analgesics.

25/02/2023

Achalasia is characterised by:
• a hypertonic lower oesophageal sphincter, which fails to
relax in response to the swallowing wave
• failure of propagated oesophageal contraction, leading to
progressive dilatation of the gullet.
The cause is unknown. Defective release of nitric oxide by
inhibitory neurons in the lower oesophageal sphincter has been
reported, and there is degeneration of ganglion cells

25/02/2023

Potassium supplements and NSAIDs may cause oesophageal
ulcers when the tablets are trapped above an oesophageal
stricture. Liquid preparations of these drugs should be used in
such patients. Bisphosphonates cause oesophageal ulceration and
should be used with caution in patients with known oesophageal
disorders.

25/02/2023

Cluster headaches (also known as migrainous neuralgia) are
much less common than migraine. Unusually for headache
syndromes, there is a significant male predominance and onset
is usually in the third decade

25/02/2023

Migraine usually appears before middle age, or occasionally in
later life; it affects about 20% of females and 6% of males at
some point in life. Migraine is usually readily identifiable from
the history, although unusual variants can cause uncertainty.

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