Causes of recurrent spontaneous pneumothorax are:

Cystic fibrosis
Lung cysts
Emphysematous bulla / apical subpleural bleb
Rupture of bronchogenic carcinoma / esophageal carcinoma
Honeycomb lung
Catamenial pneumothorax (associated with menstruation)
AIDS

Differential diagnosis for blisters presenting at birth are:

Impetigo
Herpes simplex
Epidermolysis bullosa
Bullous icthyosis
Incontinentia pigmenti

Upper motor neuron type

Vascular (Multi infarct dementia)
Motor neuron disease

Lower motor neuron type

Guillain Barre syndrome
Sarcoidosis – uveoparotid fever
Leprosy
Lymphoma / leukemia

Chest infections can cause atrial fibrillation in 3 ways:

By inducing a stress response which increases the sympathetic tone

Increased sympathetic tone can precipitate atrial fibrillation (AF)

Hypoxia leading to increased pulmonary resistance

This results in pulmonary hypertension and atrial dilatation
Atrial dilatation can lead to AF

Direct involvement of the atria

Factors that predispose to development of pneumonia are:

Smoking
Alcohol
Upper respiratory tract infections
Recent influenza infection
Corticosteroid therapy
Old age
Pre existing lung disease

Cerebral angiography can be done through various routes

Transfemoral – most common
trans axillary – rarely used
trans carotid – rarely used

Why direct puncture of carotid artery is not used?

Any local complications like hematoma and pseudoaneurysm may be life threatening
Atherosclerotic plaques in the cartoid may dislodge during wall puncture and cause stroke\

Why is the axillary artery not used?

Difficult to approach
Difficult to manouvre the catheter into the carotid artery

Why is transfemoral route preferred?

Easy and fast access
Even if local complication arise, they are not life threatening

Ophthalmoplegic migraine was previously considered as a subtype of migraine.
Now it is classified as a cranial neuralgia.
It is characterised by recurrent attacks of migranous type headache associated with paresis of one or more ocular cranial nerves.
Oculomotor palsy is the most common.
But abducent and trochlear nerves can also be involved.
There is no visual loss.
It usually occurs in children less than 10 years old.
An inflammatory etiology is proposed.
The prognosis is generally good.
The headache is usually relieved within 1 week.
But the ophthalmologic abnormalities may take days or weeks to resolve.

Ref : Pediatric neurology: a …

Mnemonic for Day of appearance of rash in a febrile patient is : Very Sick Person Must Take Double Tablets
Very – Varicella (day 1)
Sick – Scarlet fever (day 2)
Person – Pox – small pox (day 3)
Must – Measles (day 4)
Take – Typhus (day 5)
Double – Dengue (day 6)
Tablets – Typhoid (day 7)

Clinical features of Factor XIII deficiency

History of prolonged bleeding from umbilical stump
Delayed bleeding
Recurrent abortions

Diagnosis (Investigations)

Prothrombin time and Activated partial thromboplastin time are normal

Factor XIII is needed for stabilization of fibrin clot
Intrinsic and extrinsic pathways are not affected

Clot stability in 5M urea – qualitative test

Normal clot remains stable in 5M urea
But in cases of Factor XIII deficiency, the clot dissolves
But it becomes positive only in very severe deficiency

Quantitative factor XIII assay – using photometry

It starts in early adolescence
Bilateral myoclonic jerks are seen
Mostly in the morning
Precipitated by sleep deprivation
The patient usually remains conscious during the episode
Associated with absence seizures and generalised tonic clonic seizures
Benign condition
Complete remission is uncommon
Positive family history may be present
Responds well to anticonvulsants
Drug of choice – Valproate