NBE CME programme for DNB consultants - National Board Of ...

NBE CME programme for DNB consultantslevels and copper levels ; Serum ElectrolyteDifferential Diagnosis (Few Of them) - Haemolytic Disease; Hepatitis/ Cirrhosis of Liver; G.I .Malignancy with Metastastasis; Primary biliary cirohosis; Wilson’s disease; Obstructive Jaundice;Hemolysis due to infectionNon Surgical Management-Depends on the diagnosis made-Diuretics; Salt restriction;Removal ofprecipitating causes; Treatment of infections;Treatment of Haemolysis;Treatment of chronic Hepatocellular failure; Treatment of G.I. Bleeding;Steroids in specific auto immune hepatitis;i/v Octreoatide,Beta BlockersSurgical Treatment -Sclerotherapy; Esophageal banding (Superior to Sclerotherapy); Peritonealshunts; Various specific surgical procedures for obstructive jaundice; Splenectomy.Diabetes MellitusDefinition-The national diabetes data group &WHO have issued diagnostic Criteria for D.M.Symptoms of Diabetes plus random blood glucose concentration > 126mg/dL during on oralglucose tolerance test.History-Polyuria, Polydipsia, Polyphagia, weight loss; Blurred vision, lower extremity paresthesias,yeast infection, particularly Voluovaginitis in women, balanitis in men; Obese patients; Patientfirst degree relative with type 2 diabetes mellitus; Patients with hypertension; Patients with hightriglyceride or HDL- Cholesterol men. Place- endemic area for goiter. Any history ofswelling in neck - When was the swelling 1 st sighted?, Has the size of swelling remained same/gradually increasing?, Any pain at the sight of swelling?(In Hasimoto’s thyroiditis there will besome discomfort in the neck) ; Any history of painful enlargement of thyroid gland with fever?Thyroiditis)- Initially there will be thyrotoxic state-> Hypothyroid state ;History of symptoms S/oHypothyroidism - History of tiredness, weakness, History of loss of appetite with weight gain,History of cold intolerance, Recent excessive loss of hair, History of any change in voice(hoarsenessof voice), History of parasthesia suggested by tingling numbness in limb, any loss of sensationssuggested by inability to feel foot wear (this complication/symptom is very rare/late), Any history ofdysponea on exertion and effort angina, History s/o constipationPersonal History - Decrease in appetite, History of constipation, History of loss of libidoMenstrual history/ Obstetric history-Complete obstetric history- GPL status, Ask specifically forhistory of any congenital Hypothyroidism in baby. Suggested by - Prolonged jaundice, Feedingproblem, Flaccidity, Macroglossia, Delayed bone maturation, Umbilical hernia, Permanentneurological deficits in the child.Menstrual history - History of increase flow (menorrhagia) followed by decrease flow,(oligomenorrhea) and then amenorrhoea; History of recurrent abortions.Drug/ Treatment history - H/o recent thyroid surgery or treatment with radio iodine in recent past. B]135