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INICET, Medical, Medicine, Medicine classes, NExT, NExT Exam

FDA Approves First Oral Drug for Dermatomyositis

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Brepocitinib (Lisraya) Explained: Mechanism, VALOR Trial, Dose, Safety & Exam Pearls By Dr Deepak Marwah  |  Marwah Medicine A major change has arrived in dermatomyositis treatment. On August 27, 2026, the US FDA approved brepocitinib (Lisraya) tablets for adults with dermatomyositis, making it the first FDA-approved oral treatment specifically indicated for adult dermatomyositis. HIGH-YIELD ONE-LINER Brepocitinib = oral selective TYK2-JAK1 inhibitor → adult dermatomyositis. For medical students, that one line may be enough to answer a future NEET-PG, INI-CET or FMGE update question. For clinicians, however, the story is more interesting: the Phase 3 VALOR trial showed meaningful improvement in overall dermatomyositis activity, skin disease, physical function and glucocorticoid tapering with the 30-mg dose. Why this approval matters Dermatomyositis is a systemic autoimmune inflammatory myopathy. The classic teaching focuses on proximal muscle weakness, heliotrope rash and Gottron papules, but clinically the disease may involve skin, muscle, joints, lungs and other organs. Treatment has traditionally relied heavily on glucocorticoids and other immunomodulatory therapies, many used off-label. A specifically approved oral targeted therapy therefore represents an important change in the treatment landscape. What exactly is brepocitinib? Brepocitinib is an oral selective inhibitor of TYK2 and JAK1. These kinases participate in intracellular cytokine signaling pathways involved in immune activation and inflammation. Think of the pathway as: Cytokine signal → JAK/TYK signaling → inflammatory gene signaling → immune-mediated tissue injury. By inhibiting TYK2 and JAK1, brepocitinib modifies several inflammatory signaling pathways implicated in dermatomyositis. The study behind the approval: VALOR The pivotal evidence came from the Phase 3 VALOR trial, a double-blind randomized placebo-controlled study involving 241 adults with dermatomyositis. Participants received brepocitinib 30 mg once daily, brepocitinib 15 mg once daily, or placebo for 52 weeks. Background standard therapies were continued and glucocorticoids were tapered. What did the trial show? Group Mean Total Improvement Score at Week 52 Brepocitinib 30 mg 46.5 Brepocitinib 15 mg 37.5 Placebo 31.2 The 30-mg dose was significantly superior to placebo for the primary endpoint. Importantly, brepocitinib 30 mg was also superior across all nine key secondary endpoints, including skin disease activity, systemic glucocorticoid tapering and functional disability. Improvements in some outcomes were observed as early as week 4. It was not just about muscle enzymes One of the clinically attractive aspects of the VALOR results is that benefit was not restricted to a laboratory value. Dermatomyositis can produce persistent and troublesome cutaneous disease even when muscle manifestations are less dramatic. The 30-mg dose demonstrated improvement across clinically relevant domains including skin activity and physical function. The steroid-sparing angle Long-term glucocorticoid exposure carries substantial toxicity, including diabetes, osteoporosis, infection risk, cataracts, hypertension and weight gain. In VALOR, improvement with brepocitinib 30 mg was accompanied by greater glucocorticoid tapering. This makes the result clinically more meaningful than a change in a single disease marker. Does this replace steroids? No. The approval should not be interpreted as meaning that every newly diagnosed patient can simply replace conventional therapy with one tablet. Dermatomyositis is heterogeneous. Treatment decisions still depend on the severity and pattern of muscle disease, dysphagia, respiratory involvement, interstitial lung disease, skin disease, autoantibody profile, malignancy evaluation, previous treatment response and patient-specific risks. Also remember an important trial detail: standard therapies were continued while glucocorticoids were tapered. Brepocitinib adds a new targeted option; it does not erase the need for individualized specialist management. Dose: the number worth remembering The FDA-approved Lisraya tablet contains brepocitinib 30 mg, administered orally once daily for adults with dermatomyositis. Safety: oral does not mean casual Brepocitinib is a potent immunomodulatory therapy. In VALOR, serious infections occurred more frequently with brepocitinib 30 mg than with placebo (10% versus 1%). The FDA prescribing information contains important warnings and precautions, including serious infections, malignancy, major adverse cardiovascular events and thrombosis. Common adverse reactions reported in the FDA medication information include upper respiratory tract infections, headache, fatigue, urinary tract infection, nausea, bronchitis, arthralgia, diarrhea, back pain, falls, influenza and acne. Clinical message: “Oral” should never be confused with “low-risk.” Appropriate patient selection, screening and monitoring remain essential. What should medical students remember? Drug: Brepocitinib Trade name: Lisraya Route: Oral, once daily Dose: 30 mg once daily Mechanism: Selective TYK2-JAK1 inhibitor Indication: Dermatomyositis in adults FDA approval: August 27, 2026 Key trial: VALOR Potential exam question A patient with dermatomyositis is started on a newly FDA-approved oral therapy that selectively inhibits TYK2 and JAK1. Which drug is most likely being prescribed? Answer: Brepocitinib (Lisraya). The bigger lesson: targeted therapy is entering myositis For years, dermatomyositis was taught through its memorable clinical signs: heliotrope rash, Gottron papules and proximal muscle weakness. Those remain fundamental. But modern medicine increasingly asks a second question: which molecular pathways are driving the disease, and can those pathways be targeted? Brepocitinib represents that transition from broad immunosuppression toward more targeted immune modulation. Its ultimate place in treatment algorithms will continue to evolve with real-world experience, longer-term safety data, accessibility and cost. But the 2026 approval itself is already an important milestone in dermatomyositis therapy. Frequently Asked Questions What is the new oral drug for dermatomyositis? Brepocitinib, marketed as Lisraya, was FDA-approved in August 2026 for the treatment of dermatomyositis in adults. What is the mechanism of brepocitinib? Brepocitinib is an oral selective inhibitor of TYK2 and JAK1, modifying cytokine signaling involved in inflammatory and autoimmune pathways. What is the dose of brepocitinib for dermatomyositis? The FDA-approved Lisraya dose is 30 mg orally once daily. Is brepocitinib a JAK inhibitor? Yes. Brepocitinib selectively inhibits TYK2 and JAK1. Is brepocitinib better than steroids for dermatomyositis? The treatments should not be reduced to a simple either-or comparison. In VALOR, background standard therapies were continued while glucocorticoids were tapered. The 30-mg brepocitinib group showed clinical benefit and greater glucocorticoid tapering. What is the most important safety concern? Serious infection risk is important. The FDA label also contains warnings and precautions regarding malignancy, major adverse cardiovascular events and thrombosis. What should NEET-PG and INI-CET students remember? Brepocitinib → oral TYK2-JAK1 inhibitor → adult dermatomyositis. Remember the 30-mg once-daily dose […]

Medicine, NEET PG, NExT, NExT Exam

The Future of Anti-Hypertensive Therapy Explained

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Once in 6 Months Blood Pressure Injection: The Future of Anti-Hypertensive Therapy Explained High blood pressure affects millions of people in India — and nearly 1 in 4 adults lives with hypertension, many without knowing it. The real challenge is not just treatment, but taking medicines regularly. Now imagine controlling blood pressure with just two injections per year. A new investigational therapy called zilebesiran may make this possible. Let’s understand it in simple language — clinically relevant, exam-focused, and easy to remember.   Featured Snippet: What Is the Once-in-6-Months Blood Pressure Injection? The once-in-6-months blood pressure injection refers to zilebesiran, an investigational RNA-interference therapy that lowers blood pressure by reducing liver production of angiotensinogen, a key component of the RAAS pathway. A single subcutaneous injection may provide blood pressure control for up to 6 months. 🇮🇳 Why This Matters: Hypertension in India Around 25–30% of Indian adults have hypertension. Many remain undiagnosed or irregular with treatment. Poor medication adherence leads to stroke, heart failure, and kidney disease. This makes long-acting therapies extremely interesting for the future of cardiovascular care. Related reading: [Hypertension management guide] (internal link)   Really? A Once-in-6-Months Anti-Hypertensive Drug? Yes — and this is what makes zilebesiran unique. Unlike conventional drugs that block hormones after formation, this drug works at the gene expression level. Daily pills block RAAS… RNAi stops RAAS from being born.   Mechanism of Action of Zilebesiran Target Liver-produced angiotensinogen (AGT) Method RNA interference (gene silencing) Effect ↓ Angiotensinogen ↓ Angiotensin II formation ↓ Vasoconstriction ↓ Blood pressure This means the drug acts upstream in the RAAS pathway, creating prolonged suppression. Related reading: [RAAS system explained simply] (internal link) Why Only Twice a Year? RNA-interference molecules remain active inside cells for a long time. Because of prolonged intracellular action: One subcutaneous injection suppresses AGT production for ~6 months. Dosing becomes biannual instead of daily. This mirrors what happened in diabetes care when therapy shifted from daily insulin to weekly injections. Clinical Trial Evidence — KARDIA Trials Phase II Study Highlights Double-blind, placebo-controlled trial 672 patients with hypertension Average baseline SBP: 143 mm Hg Key Findings Significant reduction in systolic BP vs placebo Additional benefit on top of standard medications BP lowering sustained for up to 6 months after one dose In some studies, the effect was similar to adding another oral antihypertensive drug. Why Is This a Big Deal? Solves adherence problems: Many patients forget daily pills. Twice-yearly injections could transform compliance. Continuous blood pressure control: No missed doses means more stable BP. Potential use in high-risk patients: Especially those uncontrolled despite multiple medications.   Limitations (Important Clinical Perspective) Still investigational (not routine therapy yet) Long duration means limited dose adjustment Side effects, if any, may persist longer Expected to be costlier initially So no — this does NOT replace current BP medicines yet.   Frequently Asked Questions (FAQ) ❓ What is the once-in-6-months BP injection? It is zilebesiran, an investigational RNA-interference drug that lowers blood pressure by reducing angiotensinogen production in the liver. Is zilebesiran available in India? No. It is currently under clinical trials and not yet approved for routine use. How does it differ from ACE inhibitors or ARBs? ACE inhibitors block hormone action, whereas zilebesiran prevents hormone production upstream. Who may benefit in the future? Patients with poor medication compliance or resistant hypertension may benefit if approved. Is it better than regular tablets? Not necessarily — current drugs remain effective and affordable.   Quick Summary Box Feature Zilebesiran Type RNA interference therapy Target Hepatic angiotensinogen Route Subcutaneous injection Frequency Every 6 months Status Investigational (Phase III underway) Major Advantage Improved adherence   Conclusion Will this replace daily BP tablets? Not yet. But it may represent the next evolution of hypertension treatment — where technology helps solve the biggest real-world problem: patients forgetting medicines. The future of cardiovascular pharmacology is moving toward long-acting, precision-based therapies — and zilebesiran may be one of the first steps in that direction.   References World Health Organization (WHO) ICMR Hypertension Data American College of Cardiology (ACC) trial presentations  

FMGE, INICET, Medical, Medicine, NEET PG, NExT Exam

Must Read Topics in General Medicine for INICET Examination

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The INICET tends to blend image-based questions with clinical vignettes, emphasizing practical application over rote learning. Clinical reasoning, such as interpreting lab values or recognizing syndromes from case scenarios, is prioritized. Also, several questions in the last few papers have integrated basic sciences like pathology and microbiology into clinical contexts, so revisiting integrated concepts may give you an edge. For the November INI-CET (Institute of National Importance Combined Entrance Test), General Medicine is a key subject. The exam tends to emphasize clinical knowledge, diagnostics, management protocols, and recent updates. Here’s a structured list of must-know topics for General Medicine preparation: Cardiology – ECG interpretation– MI, arrhythmias, heart blocks, electrolyte disturbances Horizontal ST depression with upright T waves + R/S > 1 in lead V2 HTN patient with SOB and palpitations. On examination, HR= 120 min, irregular with BP= 90/60 mm Hg. Bilateral crackles in both lung fields is seen. Which is not correct? a. Rate control with esmolol b. Warfarin is not used non -valvular atrial fibrillation c. Rhythm control with Amiodarone d. DC shock is not given in persistent AF a a,b b,c b,d – Brugada syndrome vs TTCM -Acute Coronary Syndrome (STEMI/NSTEMI management) – Congestive Heart Failure (CHF) and NYHA Classification – Infective Endocarditis (update ISCVD 2023 update modified Duke’s criteria) – Hypertension – Aortic dissection management based on type A and type B Neurology – Stroke – Types, NIHSS score, thrombolysis, secondary prevention Would you perform thrombolysis a patient with weakness of face and arm weakness for last 1 hour with normal CT scan – Epilepsy – types and GCSE management – Parkinson’s disease vs HD vs PSP – Multiple Sclerosis and Guillain-Barré Syndrome – Meningitis/Encephalitis – Empirical antibiotics, CSF findings – Headache – Migraine, cluster headache, tension headache vs SAH vs GCA Endocrinology – Diabetes Mellitus – Diagnostic criteria of DKA/HHS management – Thyroid Disorders – Hypo- and hyperthyroidism, nodules, malignancy markers – Adrenal Disorders – Addison’s disease, Cushing’s syndrome   – Pituitary Disorders – Acromegaly, SIADH, DI (diabetes insipidus) – MEN Syndrome Pulmonology – Sleep Apnea Syndrome and obesity hypoventilation syndrome – Pulmonary Embolism and DVT – Risk factors, anticoagulation therapy Biker had polytrauma and develops breathing difficulty after 12 hours of injury. Sp02= 85%CT chest is shown. Echo shows Normal cardiac parameters. a. Fat embolism b. Pulmonary embolism c. ARDS d. Pneumothorax – COPD and Asthma – Harrison based guidelines, stepwise management – Interstitial Lung Diseases (ILDs) and Sarcoidosis – Tuberculosis (including MDR-TB management) Gastroenterology and Hepatology – Chronic Liver Disease and Cirrhosis – Child-Pugh score, MELD – Hepatitis – B graphs of Acute and chronic hepatitis B – GI bleed – Upper vs. lower, endoscopic management – Boerrhave vs Stomach volvulus vs Mallory Weiss vs Acute variceal bleeding Nephrology – Acute interstitial nephritis: Eosinophiluria — CIN vs Athero-embolic kidney disease -Fluid and Electrolyte Disorders – Sodium, potassium, calcium disturbances – Acute Kidney Injury (AKI) vs Chronic Kidney Disease (CKD) identification – Glomerulonephritis – RPGN, nephrotic vs nephritic syndrome – Renal replacement therapy – Hemodialysis, CRRT, peritoneal dialysis Rheumatology – Overlap syndrome – Anti synthetase syndrome vs Dermatomyositis vs Polymyositis Systemic Lupus Erythematosus (SLE) – Diagnostic criteria and antibodies – Rheumatoid Arthritis – Treatment protocols (DMARDs, biologics) – Vasculitis syndromes – ANCA-associated vasculitis, Takayasu’s arteritis – Gout and Pseudogout Infectious Diseases – Scrub typhus – Tropical Infections – Dengue, Malaria – HIV/AIDS – ART guidelines, opportunistic infections – COVID-19 and Post-COVID Syndromes -Sepsis and Septic Shock – Management protocols Hematology and Oncology – Leukemia and Lymphoma – Acute vs chronic, Hodgkin’s vs non-Hodgkin’s – Multiple Myeloma and Plasma Cell Disorders – Coagulation Disorders – DIC, hemophilia, thrombophilia – Paraneoplastic Syndromes General Topics & Miscellaneous – Acid-Base Disorders (ABG interpretation) – Shock – Types and management Study Tips  – Solve MCQs from previous INI-CET papers and clinical vignettes. – Focus on latest guidelines and protocols– These are frequently tested. – Give time to integrated questions involving multi-system involvement (e.g., heart and kidney-related disorders). This plan covers high-yield topics that are essential for the exam. Practice application-based questions regularly and ensure you revise the core topics thoroughly.

FMGE, INICET, Medicine, NEET PG, NEETPG2024, NExT, NExT Exam

Contraindications to thrombolysis in Myocardial infarction

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Fibrinolytic agents should be given with 30 minutes of arrival to non-PCI capable hospital where transport to PCI capable hospital is not possible or has delay beyond 120 minutes Current recommended regimen is tPA 15 mg bolus followed by 50 mg Intravenously over 30 minutes and 35 mg over the next 30 minutes. In contrast tenecteplase can be given as weight based intravenous bolus over 10 seconds. Clear Contraindications are remembered by mnemonic: HAS-BLEED 1.       Hypertension marked elevation of BP > 180/110 mm Hg at any time during presentation 2.       Aortic dissection suspected 3.       Stroke: Hemorrhagic at any time 4.       Stroke: Non-hemorrhagic in last 1 year 5.       Bleeding (active internal bleed excluding menses) Relative contraindications to fibrinolytic therapy Mnemonic: RIP – AB AB implies has allergy or Bleed in eye/GIT or bleed risk due to hypertension Recent invasive surgical procedure in last 2 weeks INR> 2 due to current use of OAC Prolonged CPR (> 10 minutes) Pregnancy Risk of Allergic reaction with received STK within preceding 5 days to 2 years Hemorrhagic diabetic retinopathy Active Peptic ulcer disease Severe Hypertension   Hemorrhage is the most serious and most frequent complication of thrombolysis. Hemorrhagic stroke can occur in 0.5 to 0.9% of patients treated with fibrinolytic agents

Medicine classes, NEET PG, NEETSS, NExT, NExT Exam

MULTIFOCAL ATRIAL TACHYCARDIA

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#NEETPG #NEETSS #USMLE 2 min read Multifocal Atrial Tachycardia: A Diagnostic and Therapeutic Challenge Multifocal atrial tachycardia (MAT) presents a unique challenge for clinicians. Its variable presentation, non-specific symptoms, and potential for mimicking other arrhythmias necessitate a high index of suspicion and a nuanced approach to diagnosis and management. Clinical Presentation: While some patients with MAT may be asymptomatic, common presentations include: Palpitations Dyspnea Lightheadedness Fatigue The hallmark ECG finding in MAT is multiple P wave morphologies preceding each QRS complex, often with a short P-R interval. However, differentiating MAT from sinus tachycardia with varying P wave morphology or atrial flutter with conduction block requires careful analysis. Unveiling the Underlying Cause: Identifying the underlying condition driving MAT is crucial for optimal management. Here are some key areas to consider: Pulmonary Disease: Chronic obstructive pulmonary disease (COPD), acute respiratory failure, and pulmonary embolism can all trigger MAT. Cardiac Insults: Myocarditis, pericarditis, and coronary artery disease can create a substrate for MAT. Electrolyte Imbalances: Derangements in potassium, magnesium, or calcium can disrupt electrical conduction. Other: Stimulant use, upper GI bleed, and even thyrotoxicosis can be associated with MAT.   Therapeutic Strategies: Treatment for MAT revolves around addressing the underlying cause: Pulmonary Optimization: Managing COPD, treating respiratory failure, and anticoagulation for pulmonary embolism are crucial. Electrolyte Correction: Restoring electrolyte balance is essential for normal cardiac conduction. Medications: Calcium channel blockers, beta-blockers, or amiodarone can help control heart rate and rhythm. Catheter Ablation: When medications fail or the arrhythmia is highly symptomatic, catheter ablation targeting the ectopic foci in the atria can be curative.

Medicine, Medicine classes, NEET PG, NExT, NExT Exam

Revised Mayo Criteria for TTCM

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#NEETSS #CARDIOLOGY #MEDICINELECTURES 2 min read The revised Mayo Clinic criteria for Takotsubo cardiomyopathy were developed to improve the accuracy of diagnosing this condition. These criteria were proposed by Mayo Clinic researchers and have been widely adopted in clinical practice. The revised Mayo Clinic criteria for TTCM include:   Transient Hypokinesis, Akinesis, or Dyskinesis of the Left Ventricular Mid-Segments with or without Apical Involvement: Echocardiography or other imaging modalities should demonstrate transient wall motion abnormalities in the left ventricle, typically involving the mid-segments with or without apical involvement. The characteristic appearance is akin to a Japanese octopus trap (Takotsubo). Absence of Obstructive Coronary Artery Disease or Angiographic Evidence of Acute Plaque Rupture: Coronary angiography should reveal no significant obstructive coronary artery disease or evidence of acute plaque rupture that would explain the extent of myocardial dysfunction observed. New ECG Changes (ST-Segment Elevation and/or T-Wave Inversion) or Troponin Elevation: ECG findings may mimic those of acute coronary syndrome, such as ST-segment elevation or T-wave inversion, but without corresponding coronary artery occlusion. Elevated levels of cardiac biomarkers, such as troponin, may also be present, indicating myocardial injury. Absence of Pheochromocytoma and Myocarditis: Other potential causes of acute myocardial dysfunction, such as pheochromocytoma or myocarditis, should be considered and excluded based on clinical assessment and diagnostic tests. Recovery of Left Ventricular Dysfunction Within a Short Time Frame: The characteristic feature of TTCM is the transient nature of left ventricular dysfunction, with recovery typically occurring within weeks to months.

Medicine, Medicine classes, NEET PG, NExT, NExT Exam

Allergic bronchopulmonary Aspergilloma

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#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE 2 min read Telegram link: https://t.me/realmarwahmedicine  Mnemonic to remember the key features of Allergic Bronchopulmonary Aspergillosis (ABPA): “SPADE.” S: Serum Ig E elevation > 1000 IU/ml  is a  hallmark feature of ABPA due to allergic sensitization to Aspergillus. Alternatively Skin test reactivity can be used for diagnosis confirmation. P: Pulmonary findings like infiltrates on CXR and CT scan shows Central Bronchiectasis and Positive Precipitins to aspergillus A: Asthma association though in some cases patient may has cystic fibrosis. Aspergillus colonization of airways is responsible for this presentation. D: Dyspnea: Dyspnea, or shortness of breath, is a common symptom of ABPA, often accompanied by coughing, wheezing, and sputum production. E: Eosinophilia For management of ABPA, itraconazole and systemic steroids are used. Alternatively, Omalizumab is used. The rationale for using itraconazole is to reduce antigenic stimulation.   Comparison of ABPA versus Acute eosinophilic pneumonia   ABPA Allergic interstitial pneumonitis Etiology Allergic reaction to the fungus Aspergillus Unknown, smoking initiation, Vaping Clinical Presentation Brown sputum plugs in an asthmatic or cystic fibrosis Acute respiratory distress, fever, cough, and shortness of breath. The onset is rapid, often within a few days. Chest X-rays may show diffuse infiltrates.   Labs Elevated serum IgE levels, eosinophilia, and positive Aspergillus-specific IgE and IgG antibodies Eosinophilia and BAL showing eosinophils Treatment Steroids plus antifungals Steroids  

Medicine, Medicine classes, NEET PG, NExT, NExT Exam

Churg-Strauss syndrome or Eosinophilic Granulomatosis with Polyangiitis

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#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis (EGPA), has peripheral eosinophilia and pulmonary eosinophilia with infiltrates on CXR. The characteristic feature of this disease is Eosinophilic vasculitis which is not seen in other diseases of lungs which have eosinophilia. A mnemonic to remember Churg-Strauss syndrome is: “CHARM”: C –Cardiac manifestation of myocarditis H –High eosinophil count with as much 75% of TLC being eosinophils A – Asthma and Allergic rhinitis history R – Renal involvement with Glomerulonephritis and Rashes with Purpura M – Mononeuritis multiplex (peripheral neuropathy) Usually, the patient will start having features of asthma and allergic rhinitis by 20-30 years of age. Lateral Peripheral eosinophilia is seen with as much as 75% of TLC being eosinophils. Eosinophils then infiltrate tissues producing neuropathy, myocarditis, eosinophilic gastroenteritis. In late forties or fifties these patients will develop fever, weight loss and malaise with myalgia.   Laboratory Findings Eosinophilia: Elevated eosinophil count in peripheral blood. Elevated Acute Phase Reactants: Such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Positive ANCA (Antineutrophil Cytoplasmic Antibodies): Although not always present, ANCA positivity, particularly perinuclear ANCA (p-ANCA), can be seen in a subset of patients. Chest X-ray: May reveal pulmonary infiltrates, nodules, or cavities CT Scan: High-resolution CT may show ground-glass opacities, interstitial fibrosis, or other pulmonary abnormalities. Biopsy Findings: Histopathological examination of affected tissues may reveal eosinophilic infiltration, vasculitis, and granulomatous inflammation. Telegram link: https://t.me/realmarwahmedicine

Medicine, Medicine classes, NEET PG, NExT, NExT Exam

HYPERSENSITIVITY PNEUMONITIS

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#NEETPG #INICET #FMG #MCISCREENING #MARWAHMEDICINE #PREPLADDERMEDICINE Here is a Quick mnemonic to remember the features of Hypersensitivity pneumonitis is: FARMER’S LUNG 4 F – Fever and Breathing problems A – Acute onset on exposure to grain, Moldy hay and Silage which harbor Thermophilic Actinomycetes R – Respiratory symptoms (cough, dyspnea and Clubbing is seen too M – Malaise starting within 4 to 8 hours of antigenic exposure E – Elevated erythrocyte sedimentation rate and BAL shows lymphocytosis R – Radiographic findings (ground-glass opacities, reticulonodular infiltrates) S – Symptoms improve with removal from exposure L – Lymphocytic alveolitis U – Uncommon but can progress to chronic disease N – Noncaseating granulomas G – Granulomatous inflammation and Diagnosis is based on Clinical prediction rule 4- Type 4 hypersensitivity reaction This mnemonic can help you recall the key features associated with Hypersensitivity pneumonitis.

NEET PG, NExT Exam

Dangal Actor Suhani Bhatnagar 19 years expired due to possible complications of Dermatomyositis on 17 Feb 2024 as per NDTV

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2min read #NEETPG #INICET #NEXTEXAM #FMGEXAM Unfortunately, it could be diagnosed very late and caused this irreparable trauma to the Bhatnagar family.  Our condolences to the family. The young actress played role of young Babita Phogat in movie Dangal. Here is a quick revision of Contributors of mortality in Dermatomyositis for medical professionals. Some of the key contributors to mortality in dermatomyositis include: Aspiration Pneumonia: Dysphagia is common in dermatomyositis due to involvement of the muscles involved in swallowing. This can lead to aspiration pneumonia, a serious complication where food, liquids, or saliva are inhaled into the lungs, causing infection and respiratory compromise. Interstitial Lung Disease is a common complication of dermatomyositis, characterized by inflammation and scarring of the lung tissue. Severe ILD can lead to progressive respiratory failure and respiratory complications, which can be fatal. Malignancy: Patients with dermatomyositis have an increased risk of developing certain cancers, particularly ovarian, lung, pancreatic, and gastrointestinal cancers. The presence of malignancy can significantly impact prognosis and contribute to mortality. Cardiac Involvement: While less common than lung involvement, cardiac manifestations such as myocarditis and arrhythmias can occur in dermatomyositis, contributing to mortality, particularly in cases of severe cardiac dysfunction. Infections: Immunosuppressive therapy used to treat dermatomyositis can increase the risk of infections. Patients may be more susceptible to opportunistic infections, which can become serious or life-threatening, especially if not promptly recognized and treated. Complications of Corticosteroid Therapy: Long-term use of high-dose corticosteroids, which are often necessary to control inflammation in dermatomyositis, can lead to complications such as osteoporosis, diabetes, hypertension, and susceptibility to infections, contributing to mortality over time.  

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