Common terms of degenarative spinal disease

Common terms of degenarative spinal disease

1.Desiccation ---loss of disc water

2.Disk bulge---circumferential enlargement of the disc contour in symmetric fashion

3.protrusion---a bulging disc that is eccentric to one side but <3mm beyond vertebral margin

4.large protrusion---disk protrusion that extends more than 3mm beyond the vertebral margin

5.extruded disk ---extention of nucleus pulposus through the annulus into the epidural space

6.free fragment(sequestration) ---epidural fragment of disk no longer attached to the parent disk


Disk herniation can occur with an intact but thinned annulus (similar to protrusion) or with frank rupture of the annulus and extrusion of the nucleus through the defect .The term disk prolapse has been used to describe  a herniated disk covered by  a few remainning annular fibres.

MCQ FRCR--- INTERVERTEBRAL DISC

Q.True regarding  intervertebral disk 
a.the nucleus pulposus contain relatively more proteoglycans than annulus pulposus
b.Sharpey fibres attaches inner  anuulus with adjacent vertebral bodies
c.the nucleus pulposus  contain less water than nucleus pulposus
d.increase in water content of disk in evening

ANS ---a.The nucleus pulposus contain relatively more proteoglycans than annulus pulposus,WHILE more collagen is found in annulus pulposus.
Sharpey fibres attaches outer  anuulus with adjacent vertebral bodies
The nucleus pulposus(80-85%)  contain more water than annulus pulposus(80%)
There is decrease  in water content of disk in evening



Q2.All are changes seen in the intervertebral disc with age except

a.increase in ratio of keraton sulphate to chondroitin sulphate
b.the proteoglycans lose close association with the disc collagen
c.water content decreases to 40%
d.gas formation
e.calcification

ANS --C.  Water content decreases to 70 % with age.

MCQ---MRI imaging of spine

Q.True regarding the MRI imaging of spine 

a.T2W image mandatory in lumbar region
b.thin sections are required in cervical and thoracic regions
c.fewer  artefact from CSF pusation in thoracic and cervical region
d.GRE images better in contrast and spatial resolutiong
e.Gradient momment nulling is routinely applied with FSE.

ANS---b.Thin sections are required in cervical and thoracic regions for visualisation of neural foramina.

T2W image is  mandatory in cervical and thoracic region to assess the spinal cord region

More artefact from CSF pusation is noted in  thoracic and cervical region

FSE images are  better in contrast and spatial resolution than GRE.

Gradient momment nulling is routinely applied with GRE and conventional T2w spin-echo sequences.

CHOLEDOCHAL CYST

CHOLEDOCHAL CYST

Choledochal cyst is a congenital dilataion of bile ducts.

Different types of choledochal cyst occurs (type I-V) 

Complications ---ascending cholangitis,bleeding ,cirrhosis,stone formation,portal hypertention,carcinoma of biliary tree.

USG is the initial imaging technique of choice.

TALK ABOUT THEM ,NOT ABOUT YOURSELVES .

TALK ABOUT THEM ,NOT ABOUT YOURSELVES .

Whom you want to address ? 
Whom you want to talk ?
Whom you want to influence ?
Whom you want to take on your side ?
Whom you want to respect you?
Whom you want to get atttention?
Whom you want to ---?
Whom you want to---?
Whom you want to---?

WHAT IS THE WAY OUT ----------

PEOPLE 'S FAVOURITE SUBJECT IS ALWAYS THEMSELVES

(DALE CARNEGIE)

----SO TALK ABOUT THEM ,NOT ABOUT YOURSELVES .

MCQ FOR PG EXAM /FRCR

Q1. Which radionuclide is used in Sialoscintigraphy 
a.Tc pertechnetate
b.gallium citrate
c.I-iodide 
d.I-MIBG

Q2.Albunex is
a.USG contrast agent
b.synthetic albumin
c.lipid reducing agent
d.new MRI  contrast agent

ANS  Q1.a
          Q2.a

Screening method for chest tuberculosis (x ray vs CT)

According to Notohamiprodjo and colleagues,chest x-ray is  probably still a valuable screening method for tuberculosis , and justify the use of low-dose CT in case of doubt, especially for patients with negative findings of pleural scars but with positive medical history, positive interferon-gamma release assays, or other postspecific changes.

Low-dose CT could evolve into a screening method in the future thanks to dose reduction technologies such as automated tube current modulation and model-based iterative reconstruction.

"Reach the 3 million"

World Tuberculosis Day - 24 March 2014

The "missed" 3 million

In 2014, the slogan for World Tuberculosis Day is "Reach the 3 million".

TB is curable, but current efforts to find, treat and cure everyone who gets ill with the disease are not sufficient. Of the 9 million people a year who get sick with TB, a third of them are "missed" by health systems.

The burden of tuberculosis

Progress towards global targets for reductions in TB cases and deaths in recent years has been impressive: TB mortality has fallen over 45% worldwide since 1990, and incidence is declining.

• In 2012, there were an estimated 8.6 million new cases of TB and 1.3 million people died from TB.
• Over 95% of TB deaths occur in low- and middle-income countries. Poor communities and vulnerable groups are most affected, but this airborne disease is a risk to all.
• TB is among the top 3 causes of death for women aged 15 to 44.
• There were an estimated 500 000 cases and 74 000 deaths among children in 2012.

Challenges

• Around 3 million people (equal to 1 in 3 people falling ill with TB) are currently being ‘missed’ by health systems.
• There is slow progress in tackling multi-drug resistant TB (MDR-TB): 3 out of 4 MDR-TB cases still remain without a diagnosis, and around 16 000 MDR-TB cases reported to WHO in 2012 were not put on treatment.
• Provision of antiretroviral therapy (ART) for TB patients known to be living with HIV needs to increase to meet WHO’s recommendation that all TB patients living with HIV promptly receive ART.

REF--

http://www.who.int/campaigns/tb-day/2014/event/en/