Triad and Pentads

• Exposure to heat stress
• CNS dysfunction
• Temperature >40.5°C
• [Not RF]

• Elevated TG >250 mg/dl (250-1000)
• Normal or Mildly elevated total Cholesterol <250 mg/dl
• Reduce HDL

• Abdominal pain
• History of amenorrhea
• Vaginal bleeding

• Low serum zinc level
• Mutation of SLC39A4 gene
• Reverse with zinc supplement
• AR
• Defect in intestinal zinc transport
• Alopecia, diarrhoea, lethargy, acute eczematous and erosive dermatitis favouring perioral , periocular , anogenital and acral areas.

• Hepatic artery
• Bile duct
• Portal vein

• Bleeding into biliary tract from an abnormal ethernal source to intrahepatic biliary fistula.
• ▪GI bleeding (melena)
• ▪Jaundice (obstructive)
• ▪Pain (Biliary colic)
• [NOT fever]

☆ Quincke's triad / Sandbloom triad : GI haemorrhage + Biliary colic + Jaundice

Portal triad

If manual compression of the liver fails control hemorrhage, pringle maneuver is required to control bleeding.

Placing on crossing vascular clamp across the sutures in the porta hepatis to control bleeding.

A. Thalium

Seen in Multiple sclerosis

• Triad :
• ▪Nystagmus
• ▪Intentional tremor
• ▪Scanning speech
• [NOT Rigidity]

• Dermatitis
• Glossitis
• Alpoecia

• Symptoms of Biotin deficiency :
• ▪Dermatitis "Spectacle eyed" appearance d/t circumocular alopecia.
• ▪Pallor of skin and membrane
• ▪Depression, lassitude, somnolence
• ▪Anaemia
• ▪Hypercholesterolemia

Acute Glomerulonephritis

• Ataxia
• Ophthalmoplegia
• Areflexia

• It is a variant of GBS described by Fischer.
• In MFS, first affected is head, resulting in difficulty controlling eye muscles and balance.
• Anti GQ1b antibodies, activated by certain students of campylobacter jejuni have a relatively high specificity and sensitivity for MFS.

• Experience the world as demanding
• Perceive self as negative
• Expectation of future
• [Not Ambivalance about future]

• Tinnitus
• Progressive deafness
• Vertigo along with facial weakness

• Triad of
• ▪Saturnine gout
• ▪Hypertension
• ▪Renal Insufficiency

• Asthma
• Aspirin sensitivity
• Nasal/Ethmoidal polyposis

First symptoms is Rhinitis.

• Optic Ataxia
• Simultagnosia
• Ocular apraxia
• [Not Opsoclonus]

• It is a classical human dorsal pathway syndrome.
• It is a/w lesion in B/L angular gyrus located in inferior parietal lobule.

• Hypertension
• Bradycardia
• Irregular respiration

Indicates Gallstone ileus.

• Ectopic gall stone
• Gas in bile duct
• Intestinal Obstruction

• Lower Abdominal pain
• Cervical motion tenderness
• Bilateral adnexal tenderness

• Note :
• Cervicitis is not included in PID.

B. Ophthalmoplegia

Improves within hours. However horizontal nystagmus may persist.

Then ataxia > Encephalopathy

• Thrombocytopenia
• PaO2 <60
• Rashes
• [NOT Fat globules in urine]

• Bronchiectasis
• Cystic fibrosis
• Vitamin A deficiency

• M/c site : duodenum (50-70%)
• Pancreas (20-40%)
• Most common hormone to be secreted beside gastrin is ACTH
• most common site of peptic ulcer produced is first part of duodenum
• Basal acid output is greater than 60% of output induced by maximal Stimulation.

• Loin mass
• Hematuria
• Loin pain

• Polyuria
• Polydipsia
• Wt loss
• [Not Polyphagia , it is a feature of DM but not a triad]

Gall stones

Wall-echo-shadow or double arch shadow sign (WES) may be seen as two echogenic curvilinear Parallel lines separated by sonolucent line.

• Edema (d/t hypoalbuminemia)
• Markedly retarded growth
• Psychomotor (mental) changes
• (Not hypoglycemia)

• Heterochromia
• Posterior subcapsular Cataract
• Keratic precipitates

• Skin lesion
• Mononeuritis Multiplex
• Eosinophilia

• Infertility
• Dysmenorrhea
• Dyspareunia
• [NOT cyclical hematuria]

• M/C site in order of frequency :
• Ovaries > POD > Uterosacral ligaments.

• Abnormal movement
• Hypotonia
• Emotional liability

• Elevated TG >250 mg/dl (250-1000)
• Mildly elevated total cholesterol <250 mg/dl
• Reduced HDL
• [Not elevated LDL >300 mg/dl]

B. Increased protein C

• Impaired social development
• Disturbed communication and language
• Presence of stereotypes

• Peptic ulceration
• Gastric hypersecretion
• Non beta cell tumour

• M/C site of Gastrinoma : Duodenum (50-70%) , Pancreas (20-40%)
• M/C hormone to be secreted besides gastrin : ACTH
• M/C site of peptic ulcer produced : 1st part of Duodenum
• Basal acid output is greater than 60% of output induced by maximal stimulation (BAO>MAO)

• Triad of
• Multiple bony defects (Predominantly calvarial)
• DI
• Exopthalmos

C. Increased protein C

• Polyuria
• Polyphasia
• Polydipsia
• [Not weight loss]

• Rash
• Fever
• Internal organ involvement

• Depressed mood
• Slowed thinking
• Psychomotor retardation
• [Not Distractibility] Q

• Episodic peripheral neuropathy
• Angiokeratomas
• Hypohidrosis

• Late :
• Progressive renal failure
• Cardiovascular disease

• Deficient enzyme : α-galactosidase A
• XR

• Excessive day time somnolence
• Cataplexy
• Hypnagogic hallucination
• Muscle paralysis upon awakening

• Seen in acute appendicitis
• Hypersensitiveness of skin
• Reflex muscular contraction
• Tenderness at mcburney's point

• Seen in Gastric volvulus
• Epigastric pain
• Inability to vomit
• Inability to pass NG tube

• Seen in Mesenteric cyst
• Soft fluctuant swelling in umbilical region
• Freely mobile perpendicular to mesentery
• Zone of resonance all around

• Seen in Boerhaave's syndrome
• Thoracic pain
• Vomiting
• Cervical subcutaneous emphysema

• Seen in Gall stone ileus
• Small bowel obstruction
• Pneumobilia
• Ectopic gall stone

• Hemoptysis
• IDA
• Multiple alveolar infiltrates on chest radiograph