STENCILDENT

                                       CANCRUM ORIS(NOMA) INTRODUCTION: Cancrum oris is a Special type of gangrene Extensive ulcerative disease of cheek mucosa occurring in malnourished children Sign of gangrene :loss of pulsation, colour, temperature ,sensation, function As disease progress, whole thickness of the cheek may be lost PRECIPITATIG FACTORS: Malnourishment Major disease like diphtheria ,whooping cough, typhoid, measles, kala azar  As a result of these factors opportunistic -borrelia vincentii and fusiform multiply and cause ulcer, erosion, fibrosis CLINICAL FEATURE : Lip-induration , edema -ischemia -necrotic -large area of lip ,cheek ja may be destroyed  Painful condition Patient ill ,anorexic High temperature  COMPLICATION: Fibrosis causing restriction of the movement of jaw septicemia, toxemia and death TREATMENT : Ryle tube feeding Improve the nutrition App...

                        ACTINOMYCOSIS INTRODUCTION: It is caused by actinomycosis Israeli Gram positive fungal like bacteria ,anaerobic Its also known as RAY FUNGUS -sun ray appearance Present in :oral floral Invade tissue in case of carious teeth ,trauma, poor oral hygiene  CLINICAL TYPES: A)CERVICOFACIAL Commonest type Lower jaw -commonly involved  Site :Tonsil, trauma from infected tooth  Gums (induration) Nodules from with involvement of face and neck  Softens ,burst through skin forming multiple tortuous sinuses Discharge pus ,containing sulfur granules Cervical lymph node not enlarged  Differential diagnosis : Carcinoma in floor of mouth  Jaw tumor Osteomyelitis of mandible B)THORACIC : Aspiration -lung and pleura gets infected later emphysema develop chest wall nodule -discharging sinuses C)ABDOMINAL: In Intestine the organism cross bowel wall -pericecal region causing inflammatory reaction ...

  PAPILLARY CARCINOMA THYROID  Thyroid gland is the only endocrine gland where in malignant tumor spread by all possible routes: Local  Lymphatic  Blood Thyroid gland is the only endocrine gland where in malignant tumors are usually non -functional ETIOLOGY: Accidental radiation to neck /Hodgkin lymphoma result in papillary carcinoma of thyroid It can be complication of hashimoto thyroiditis Occur often in gardner syndrome ,Cowden syndrome patient associated with mutation :chromosomal translocation involving RET PROTO ONCOGENE ,Chromosome (10q11) PATHOLOGY: Its made up of colloid like filled follicles  calcific lesion are found which are called PSAMOMA BODIES Follicular variant of papillary cancer : LINDSAY TUMOUR Mixed lesion Tall cell papillary cancer :Aggressive, rapidly growing tumor  Calcification  Cystic changes Cuboidal pale cells Crowded nuclei Cytoplasmic inclusion -intranuclear Cartoon character -ORPHANANNIE  Calcified deposits: PSAMMOMA...

                                ANEURYSM  INTRODUCTION: It is a dilatation of localized segment of arterial system . true aneurysm -contains all three layers of artery  false aneurysm -contains single layer of fibrous tissue wall of sac and it usually occurs after trauma Sites:  Aorta Femoral Popliteal Subclavian Berry aneurysm -multiple aneurysm occurring in circle of Willis Abdominal aneurysm commonest aortic aneurysm Peripheral aneurysm less common compared to cavity aneurysm  Types: Fusiform Saccular Dissecting  Etiology : Atherosclerosis (to learn   Etiology of atherosclerosis  )  Syphillis Traumatic  Collagen disease like Marfan syndrome Dissecting aneurysm -hypertension  Trauma Cystic medial necrosis  CLINICAL FEATURES: Swelling -pulsatile, Smooth, Soft, Warm ,  Palpitation-thrill, Auscultation -bruit  Altered sensation due to compr...

                        LUDWIG ANGINA STUDENTS CORNER : HI !my dear stencildent family ,today we will be discussing about a very important topic ,yes its about Ludwig angina here we given a sample as to how you can present this answer when asked first of all do start by listing out table of content ,then move on to describing the surgical anatomy ,reason for Ludwig angina existence and how it gets precipitated ,pathology ,clinical features ,management -surgery point of view and conclude with complications.                         TABLE OF CONTENT : INTRODUCTION SURGICAL ANATOMY ETIOLOGY PRECIPITATAING FACTOR PATHOLOGY CLINICAL FEATURES MANAGEMENT  SURGERY COMPLICATION INTRODUCTIO N: Ludwig angina refers to serious ,potentially life threatening polymicrobial cellulitis of submental ,submandibular region combined with inflammatory edema of mouth Organism commonly i...

      REACTIONARY HEMORRHAGE  INTRODUCTION: The term hemorrhage refers to excess loss of blood due to rupture of blood vessel STUDENTS CORNER : Start your answer by giving a short introduction to the topic followed by table of contents ,it can be visa versa to ,under the table of content mention etiology ,precipitating factors, pathophysiology ,clinical features and end it with treatment plan . Now let me give you a mnemonic that I used while preparing in order to remember etiology remember HTC MTC where: H-HYDROCELE SURGERY   T-THYROID SURGERY   C-CHOLECYSTECTOMY  M-MAJOR ABDOMINAL SURGERIES T-TONSILLECTOMY  C-CIRCUMSICION .  To remember precipitating factors the mnemonic as:   PBS ,CVS P(SILENT )  B- BLOOD PRESSURE  S-STRAING   C-CLOT DISLODGEMENT   V- VOMITING  S - SLIPPING OF LIGATURE . Clinical feature CDC TROPHY   C-CYANOSIS  D-DRY FACE,DRY MOUTH   C-COLD CLAMMY SKI...

  CLAUDICATION PAIN IN LEG WHILE WALKING  INTRODUCTION: Claudio means to limp (Latin word) Crampy pain in muscle seen in limbs  Site of pain depends on site of arterial occlusion Due to arterial occlusion Metabolites -lactic acid Substance p accumulate in muscle and cause pain common site -calf muscle Pain in foot - block in lower tibial and plantar vessel Pain in calf-block in femoropopliteal site Pain in thigh - block in superficial femoral artery  Pain in buttocks'-block in common iliac - LERICHE SYNDROME Pain commonly develops when muscles are exercising  During exercise: increase perfusion and increased opening of collateral wash the metabolites away BOYD CLASSIFICATION: GRADE 1: Pain after walking distance which pain develop CLAUDICATION DISTANCE  If patient continues to walk pain subsides -metabolites causing pain are washed away in the circulation due to increased blood flow in muscle and also opening of collateral GRADE2: Pain still persist on cont...

                   RAYNAUD DISEASE  INTRODUCTION: Raynaud phenomenon:  Vascular disease characterized by intermittent arteriolar vasospasm of the digits Etiology :Cold temperature /stress Features: Exaggerated vasoconstriction of digital arteries and arterioles Pain Pallor Cyanosis Hyperemia Symptoms present with characteristic changing of hands from white to blue to red PRIMARY RAYNAUD PHENOMENON: Also known as RAYMAUD DISEASE Less severe than secondary  Its seen in females Usually bilateral Occur :upper limb and normal peripheral pulses Etiology :abnormal sensitivity to cold that result in upper limb (hand ) arteriolar spasm Symptoms can be precipitated Observed by placing hands in cold water DIFFERENCE BETWEEN RAYNAUD PHENOMENON AND SECONDARY RAYNAUD PHENOMENON PRIMARY RAYNAUD PHENOMENON: Also known as Raynaud disease Less severe than secondary  Vasospasm is not associated with ischemic injury or an underlying asso...

                       NECROTISING FASCITIS  INTRODUCTION: It is a spreading ,destructive ,invasive infection of skin and soft tissue including deep fascia with relative sparing of muscle Common sites:  Lower extremities Genitalia Groin Lower abdomen  Similar to melaneys gangrene CAUSATIVE ORGANISM : MONOMICROBIAL : Group A BETA hemolytic streptococci Type 2 necrotizing fasciitis  POLYMICROBIAL : Synergistic combination anaerobe +coliform /non-group A streptococci  Type 1 necrotizing fasciitis  No history of injury when it occurs in lower limbs RISK FACTORS FOR TYPE 1 NECROTISING FASCITIS : Diabetic mellitus Malnutrition Obesity Corticosteroid Immune deficiency  CLINICAL FEATURES: Affected area: sudden pain, gross swelling of the limbs part: swollen red, erythematous ,edematous skip lesion of necrosis ,ulceration skin changes : Bronze hue Brawney induration Blebs /crepitus High degree fever ,j...