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Inflammatory Bowel Disease (IBD): Causes, Symptoms, Diagnosis & Treatment Inflammatory Bowel Disease (IBD) is a term used to describe chronic inflammatory conditions that affect the gastrointestinal (GI) tract. The two main types of IBD are Crohn’s disease and ulcerative colitis , both of which can significantly impact quality of life if left untreated. This article explores the causes, symptoms, diagnosis, and treatment options for IBD. What is Inflammatory Bowel Disease (IBD)? IBD is a group of autoimmune conditions where the immune system mistakenly attacks the digestive tract, leading to inflammation. Unlike irritable bowel syndrome (IBS), IBD causes visible damage and inflammation in the intestines, which can be confirmed through diagnostic imaging and biopsies. Types of IBD 1. Crohn’s Disease Can affect any part of the GI tract from the mouth to the anus. Often involves the ileum (the last part of the small intestine). Inflammation can occur in patches and pe...

Scenarios of Cerebral Palsy Patients Scenario 1: Spastic Diplegia in a Child A 6-year-old boy is brought to the clinic by his mother due to walking difficulty. He was born prematurely at 30 weeks and stayed in the NICU for one month. He started walking at age 3 and walks on tiptoes with scissoring of the legs. On examination, he has increased tone and brisk reflexes in both lower limbs, but normal upper limb function. His intelligence is average. ➡️ Likely Diagnosis : Spastic Diplegic Cerebral Palsy ➡️ Management Focus : Physiotherapy, orthotics, botulinum toxin, gait training Scenario 2: Quadriplegic CP with Feeding Issues A 4-year-old female with a known history of hypoxic birth injury presents with severe motor delays. She cannot sit without support and has poor head control. She also has difficulty swallowing and frequent episodes of choking while feeding. Her limbs are stiff, and her fists remain tightly closed. She is nonverbal. ➡️ Likely Diagnosis : Spastic Quadriplegic Cerebra...

Myocardial Infarction—50 MCQs with Answers Section 1: Basic Concepts (1–10) Which of the following arteries is most commonly occluded in myocardial infarction? A. Left circumflex artery B. Right coronary artery C. Left anterior descending artery D. Posterior descending artery ✅ Answer: C Myocardial infarction is most commonly caused by: A. Coronary artery spasm B. Embolism C. Atherosclerotic plaque rupture with thrombus D. Vasculitis ✅ Answer: C Which enzyme rises earliest after MI? A. Troponin I B. CK-MB C. Myoglobin D. LDH ✅ Answer: C Which cardiac marker remains elevated the longest after an MI? A. Myoglobin B. Troponin I C. CK-MB D. AST ✅ Answer: B Which of the following ECG changes is seen in the early stage of MI? A. ST depression B. T-wave inversion C. ST elevation D. U waves ✅ Answer: C The term “silent MI” refers to: A. MI without ECG changes B. MI without elevated enzymes C. MI without chest pain D. MI with heart murmurs only ✅ A...

Question 1: Classic MI Presentation A 58-year-old male smoker presents with severe chest pain radiating to the left arm, sweating, and nausea. ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis? A. Anterior wall MI B. Inferior wall MI C. Lateral wall MI D. Non-ST elevation MI (NSTEMI) ✅ Correct Answer: B. Inferior wall MI Question 2: Silent MI in a Diabetic A 65-year-old diabetic female complains of fatigue and shortness of breath for 2 days without chest pain. ECG shows Q waves in anterior leads. Troponin is elevated. What is the most likely diagnosis? A. Stable angina B. Silent myocardial infarction C. Panic attack D. Congestive heart failure ✅ Correct Answer: B. Silent myocardial infarction Question 3: Drug-Induced MI A 29-year-old man with a history of cocaine use presents with chest pain and palpitations. ECG shows ST elevation. Which of the following drugs should be avoided in his treatment? A. Nitroglycerin B. Aspirin ...

 Tuberculosis Scenario Questions & Answers 1. Secondary TB with Apical Cavitary Lesions Question: A 55-year-old man with a history of smoking presents with a 3-month history of chronic cough, night sweats, weight loss, and occasional blood-streaked sputum. Chest X-ray shows cavitary lesions in the upper lobes of the lungs. Sputum smear is positive for acid-fast bacilli (AFB). 👉 What is the likely diagnosis, and why are the lesions located in the upper lobes? Answer: The patient most likely has secondary (reactivation) tuberculosis . Secondary TB occurs due to reactivation of dormant Mycobacterium tuberculosis bacilli in a previously infected individual, often when immunity is weakened. The lesions are typically located in the upper lobes because these areas have higher oxygen tension , which favors the aerobic growth of M. tuberculosis . Cavitary lesions result from caseous necrosis and tissue destruction, allowing the bacilli to multiply and be expectorated, making the p...

Secondary Tuberculosis (Reactivation or Post-primary TB) Secondary tuberculosis is the form of TB that occurs in a person who has previously been infected with Mycobacterium tuberculosis . It may result from reactivation of latent TB or reinfection with a new strain, usually in the lungs . Causes Reactivation of dormant bacilli from a previous primary infection (common) Reinfection from external sources (less common, but possible) Occurs when: Immunity weakens (e.g., HIV, malnutrition, old age, diabetes, immunosuppressive therapy) Common Sites Apex of the lungs (upper lobes) Higher oxygen tension here favors mycobacterial growth Pathological Features Feature Details Lesion type Caseating granulomas, cavitary lesions Cavity formation Due to caseous necrosis and tissue destruction Fibrosis and scarring Seen in chronic cases Possible spread Local (to other lung areas) or systemic (via blood or lymph) Clinical Features Symp...

Primary Tuberculosis (Primary TB) Primary tuberculosis is the initial infection caused by Mycobacterium tuberculosis in a person who has never been previously exposed to the bacterium. It typically occurs in children or young adults  but can also affect people of any age. Key Features of Primary TB Aspect Details Cause First exposure to M. tuberculosis Immunity Host has no pre-existing immunity Common Site Mid/lower zones of the lungs (usually subpleural) Characteristic Lesion Ghon focus (initial lesion in lung parenchyma) Lymph Node Involvement Ghon complex = Ghon focus + involved hilar lymph nodes Immune Response Cell-mediated immunity develops over 2–3 weeks Outcome Usually heals with fibrosis and calcification; may become latent Pathogenesis of Primary TB Inhalation of bacilli → reaches alveoli Bacilli are engulfed by alveolar macrophages Initiates granulomatous inflammation Formation of Ghon focus (small area of caseatio...