I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
2. Number of cranial nerves at a particular level - Remember 2244.(For the exam)
CN 1,2 Cerebrum. (First 2)
CN 3,4 Midbrain. (Next 2)
CN 5,6,7,8 Pons. (Next 4)
CN 9,10,11,12 Medulla. (Next 4)

#PLAB #Neurology
3. Dementia clinchers
-Vascular dementia:STEPWISE progression
-Frontotemporal dementia(Pick's disease):disinhibition,difficulty 'PICK'ing right words
-Lewy Body dementia:LBD LSD (Visual hallucinations)/(Lewy sees bodies)+mild Parkinsonism+FLUCTUATING levels of attention&awareness
4A- True dementia including Alzheimer's disease: patient is BROUGHT TO THE HOSPITAL/DOCTOR BY SOMEONE ELSE (family member/neighbour/police) .. this denotes that they DO NOT HAVE INSIGHT about their problem and unaware of their condition.

#PLAB #Neurology
4B - Pseudodementia (depressive dementia) : as depression patients they also HAVE INSIGHT about their problem and they PRESENT ON THEIR OWN and usually they have a past history of depression.

#PLAB #Neurology
5. #Radiology clinchers #PLAB

Air fluid level in -
*UPPER MEDIASTINUM - pharyngeal pouch (Zenker's diverticulum).

*BEHIND THE HEART - Hiatus hernia
6. Diffuse esophageal spasm - CCCC

Symptoms - Chest pain.
Cause - Cold ingestion.
Dx - Corkscrew appearance on barium studies.
Rx - Calcium channel blockers.

#PLAB
7. #PLAB clinchers

-Post ERCP : RUQ pain = ascending cholangitis.
-Post ERCP : epigastric pain = acute pancreatitis.
8. #PLAB #Pharmacology

Advise patients to NOT TO LIE DOWN FOR 30 MINS AFTER TAKING ALENDRONATE so that it rapidly reaches the stomach.

Otherwise it can cause OESOPHAGEAL STRICTURES.
9A. #Gastroenterology clinchers for #PLAB

-severe sudden RUQ pain - BILIARY COLIC.
-RUQ pain + Fever with chills - ACUTE CHOLECYSTITIS.
-RUQ pain+ Fever+ Jaundice - ASCENDING CHOLANGITIS.
-Post partum RUQ+ Pruritis - CHOLESTASIS.
9B.
-Pruritis in Middle age women+AMA+ Associated SJOGREN Syndrome - PRIMARY BILIARY CIRRHOSIS.
-Pruritis+Ulcerative colitis/Chron's+ Dx by ERCP -PRIMARY SCLEROSING CHOLANGITIS.
-Abnormal LFTS + Sec Amenorrhea/ any Auto immune disorder - Autoimmune Hepatitis

#PLAB #GIMED
10. Cushing's
#PLAB #Endocrinology
Apologies for the handwriting 😂 Image
11. Diabetes insipidus (DI in image)
#PLAB #Endocrinology Image
12. CAH - Congenital Adrenal Hyperplasia
A=Aldosterone
T=Testosterone
Whichever position is taken up by '1' in 21,17,11, is increased

The clincher for CAH is ''she reached pubarache at age 11 -Early pubarache does not occur in PCOS // Cushing's syndrome

#PLAB #Endocrinology Image
13. G6PD deficiency

G6PD deficiency -- fava beans -- Heinz body inclusions(Bite cells) -- drug induced(primaquine).

"I LOVE EATING BEAN SANDWICH WITH HIENZ KETCHUP.. TAKE A BITE " :P

#PLAB #Haematology
14. Neuropathic Pain Rx -
Away (Amitriptyline)
Goes ( Gabapentin)
D ( Duloxetine)
Pain (Pregabalin).

#PLAB #Neurology
15. #PLAB #Endocrinology

- Whipple's triad + ↓ insulin + ↓ c-peptide = Alcohol, Chronic illnesses or hypopituitarism.
- Whipple's triad + ↑ Insulin + ↑ c-peptide = Sulfonylurea or Insulinoma.
- Whipple's triad + ↑ Insulin + ↓ c-peptide = Exogenous Insulin.
16. #PLAB #Haematology

-1 word 1 abnormality : Hemophilia : prolonged aPTT
-2 words 2 abnormalities: Von Willebrand : Prolonged aPTT and bleeding time
-3 Words 3 abnormalities : Disseminated Intravascular Coagulation : Prolonged PT, aPTT and Bleeding time
17. #PLAB #Pharmacology
Adverse effects of combinations with Clarithromycin
- clarithro + statin - rhabdomyolysis
- clarithro + salbutamol - hypokalemia
18. #PLAB #InfectiousDiseases
DR. Bruce works in a farm
(Doxycycline + Rifampicin - brucella - history of working in farm)
19. #PLAB #InfectiousDiseases

Children can safely go to school without the fear of spread of the disease in -

Mnemonic -Children Can Meet at School with Rashes.
Coxsackie virus ( Hand,foot and mouth)
Cold sores (HSV)
Molluscum
Slapped cheeck(Parvovirus)
Roseola
20. #PLAB #InfectiousDiseases

Roseola-

Rule of 3

Below age 3
Fever for 3 days
Rash for 3 days after fever
3+3 = HHV6 (causative organism)
21. Diseases involving multiple organ systems

LIVER + BRAIN= WILSON
LIVER + LUNGS (COUGH)= ALPHA 1 ANTI TRYP.
GIT + LUNGS (COUGH) = Cystic Fibrosis
BRAIN+KIDNEY = Autosomal Dominant Polycystic Kidney Disease
LUNGS +KIDNEY = Goodpasture

#PLAB
22. #PLAB #Paediatrics
Bedwetting/Nocturnal Enuresis management Image
23. No need to memorize the entire APGAR score table.
If the baby is -
a)VERY LIVELY/GOOD : 2 Points b)DEAD: 0 points
c) ANYTHING IN BETWEEN: 1 point.

Then start counting whatever info is given.
You will understand it better once you solve the questions

#PLAB #Paediatrics
24. #PLAB #Pharmacology
*zero order kinetics - remove fixed drug amount - clearance is variable

*1st order kinetics - remove fixed drug percentage - clearance is constant

Zero order-Watt Power
W- Warfarin
A- Aspirin, Alcohol
T- Theophylline
T- Tolbutamide
Power- Phenytoin
26. #PLAB #obgyntwitter

Sometimes it's difficult to differentiate between Acute Fatty Liver of Pregnancy(AFLP) and HELLP syndrome.

The clinchers for AFLP are -
1. Hypoglycaemia
2. Raised serum ammonia
3. Association with Pre-eclampsia
27. #PLAB #GI

-Asymptomatic cholelithiasis=Reassure
-Symptomatic cholelithiasis ie. with cholecystitis but stable pt=Laparoscopic cholecystectomy
-Unstable pt=ER cholecystectomy
-CholeDOcholithiasis - DO SOMETHING! (no matter whether symptomatic or not)= TREAT THE PT (ERCP)
28.
*Addison’s(⬇️cortisol)-Hyperkalemia, Hypotension, hypoglycemia and Metabolic Acidosis
*Conn’s(⬆️Aldosterone)-Hypokalemia, Hypertension and Metabolic Alkalosis
*PHEochromocytoma (⬆️catecholamines)-
(PHE) Palpitations, Headache, Hypertension,(ph)Flushing (sweating),EPISODIC
29. #PLAB #Endocrinology #obgyntwitter

-Premature ovarian failure: FSH>25 (2 values ,4wks apart)
-Post pill amenorrhea - normal FSH, LH, mildly raised prolactin
- Prolactinoma : prolactin>1000 or persistently raised >400
30. #PLAB

-Polycythemia rubra Vera = JAK2 mutation
(Jack and Ruby are in love)

Rx -
-Venesection
-Chemotherapy — <40yrs— interferon, >40yrs — hydroxyurea,
-Aspirin 75mg OD
31. #PLAB #Dermatology

-Bullous pemphigoi(D)=(D)eep Tense bullae + Old age+blisters (nikolsky signs negative)+itching, no oral lesions

-Pemphigu(S) vulgaris =(S)uperficial Flaccid Bullae+Adults+blisters (nikolsky sign positive) +painful (not pruritic) +extensive oral lesions
32. #PLAB

Dermatomyositis = Anti-Jo antibody

(DERMATOmiley cyrus is ANTI-JOnas brothers)
33. #PLAB #Psychiatry

a. FLUOxetine stops FLOw of sperm ... ie. it causes inability to ejaculate.

b. HALoperidone HALts erection...that's erectile dysfunction.

c. Risperidone (RESperidone) causes RETrograde ejaculation.
34. #PLAB #Pharmacology

In addition to this tweet,


clarithromycin+methadone=QT prolongation
clarithromycin+warfarin=increased INR
35A. #PLAB #RespiratoryMedicine
#Asthma:
NICE guidelines
Step 1. SABA (salbutamol)
Step 2. SABA + ICS (beclomethasone)
Step 3. SABA + ICS + LRA (leukotriene receptor antagonist)
Step 4. SABA + ICS + LABA
35B. BTS guidelines
1: SABA(Salbutamol)
2: SABA+ICS(beclomethasone)
3: SABA+ICS+LABA(Salmeterol, formeterol)
4: SABA+ICS+LABA+LRA(Leukotriene Receptor Antagonists e.g Montelukast, Zafirlukast) OR Theophyline.
5:SABA+ICS+LABA+LRA/Theophylline+ Oral prednisolone.
36A. #PLAB #Psychiatry Syndromes

-Ganser = Gangester seeking gain
-CAPgras= an imposter wearing the CAP of someone he knows
-Cotard = I am dead, bury me in the COURTYARD
-SOMATization = SYMpTOMS
-HypoCHONdriasis = CONDITION = disease
-MUNCHausen = MUCH attention
36B. #PLAB #Psychiatry Syndromes

-Othello,, she can't handle her partners saying hello to others
-EkBOM's syndrome: incorrect belief that you're -BOMbarded with parasites/insects.
-Folie a deux - Madness of 2 - 2 closely related ppl believe the same thing
Haloperidol* 🤦🏻‍♂️
37.When to give NAC in Paracetamol poisoning?

-4 hours post ingestion and plasma conc. above the line
-8 hours post ingestion and 150mg/kg or unknown dose
-unknown time of ingestion
-staggered dose of ingestion

If ingestion > 8HR - GIVE NAC & then measure paracetamol level
38. BEFORE STARTING LITHIUM do:
*TFT-may mimic/precipitate mania&depression
*RFT-its excreted by kidneys
*S.calcium-toxicity causes Hypercalcaemia
AFTER STARTING LITHIUM
-S.lithium level after 1wk&den 3monthly
6MONTHLY-
*LFT,RFT
*Electrolytes&Urea
*TFT-for hypothyroidism
39.Reminder during Sodium correction:
"High to low your brain will blow" (Cerebral Edema).
"Low to high your pons will die" (central pontine myelinolysis).

#PLAB
40. Remembering a common side effect :

ASPIRIN TOXICITY - TINNITUS!!!

(AspiRINGING in ears)

#PLAB #Pharmac
41. #PLAB #Palliative

How to remember that Midazolam is used in catastrophic bleed in palliative patients ?

Midas touch gone horribly wrong and caused catastrophic bleeding
42. Nausea Rx #PLAB
RadiOH (O = Ondansetron H = Haloperidol)
CheMO (M = Metoclopramide O = Ondansetron)
Delayed Motility (gastric emptying)(D = Domperidone M = Metoclopramide)
PregnanC (Hyperemesis gravidarium) (P = Promethazine, Prochlorperazine C = Cyclizine, Chlorpromazine)
43A. #PLAB #Palliative
Dose adjustments of analgesics-

*If Oral not tolerated, switch to S/C form.

*Switching routes/opoids needs to be analgesic equivalent and multiply or divide by conversion factor:

(refer next tweet)
43B. #PLAB #palliativecare
-PO Morphine to SC Morphine>Divide by 2
-PO Morphine to PO Oxycodoen>Divide by 2
-PO Oxycodone to SC Oxycodone>Divide by 2
-PO Morphine to SC Diamorphine>Divide by 3
-PO Codeine to PO Morphine>Divide by 10
-PO Tramadol to PO Morphine>Divide by 10
44A. #PLAB #Ethics
Regarding informing the DVLA

Group 1 = car and motorcycle.
Group 2 = bus and lorry

•Single TIA in group 1 drivers : stop driving ((1 month)) (3 months if post-MI)
•Multiple TIA in group 1 driver : advise to inform DVL ,if refused, inform by yourself.
44B.
•Single TIA in group 2 drivers : stop driving ((1 year)) AND advise to inform DVLA , if refused, inform by yourself.
•Alzheimer, Stroke, Seizures Fit, Blackout, Obstructive sleep apnea --------> Advice to Inform DVLA , if refused, inform by yourself.
45. #Tonsillectomy-
Indications: "753,123"
- >7 episodes in 1yr
- >5 episodes in a year for 2 years
- >3 episodes in a year for 3 years
Complications:
*Primary haemorrhage - within 24hrs - Return to theatre
*Secondary haemorrhage - after 24hrs - Admit, antibiotics and observe
46A. Tympanic Membrane findings in #ENT
#PLAB

*Teachers (T=Tympanosclerosis) use chalk -Chalky white plaque
*Dull grey or yellow retracted or bulging - OME (remember effusion will give a dull percussion note)
*Pink flamingo (Schwartz) - Otosclerosis
46B. #PLAB #ENT
*Red, yellow or cloudy bulging-AOM
*Cartwheel appearance-ASOM
*White pearly mass behind TM-Cholesteatoma
*Attic-Ruptured TM
47. #PLAB #ENT
Weber test: "We Create Best Students"
Weber lateralized to Worst (We) ear in Conductive hearing loss (Create).
Weber lateralized to Better (Best) ear in Sensorineural hearing loss (Students).
48. #PLAB #Ophthalmology

-GC---CG
(Glares in Cataract--- Coloured haloes in Glaucoma)

-Cells and flares - Iritis (Ant uveitis)

-Floaters in CURD
CMV retinitis
Uveitis
Retinal Detachment
Diabetic Retinopathy (proliferative)
49. #PLAB #Ophthalmology
4 S in Cataract
1- Sunlight (UV light exposure)
2- Steroids (oral corticosteroids)
3- shortsighted (high myopia)
4-strike/smack (trauma)

glare at night > cataract
absent red reflex > cataract
dense opacities in fundus > cataract
steroid > cataract
50. #PLAB #Anatomy

BALLS (Testis and Ovaries) drain into PALS (Para-aortic Lymph nodes)

while

SKINS (Scrotum and Vulva) drains into SINs (Superficial Inguinal Nodes)

😛

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