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MBBS study, Srinagar (2026)

27/12/2025

🩺 AVH Rashes – Treatment (According to Nelson Textbook of Pediatrics)
Rashes in Acute Viral Hepatitis (AVH) are usually immune-mediated and self-limiting, most commonly seen in the prodromal phase before jaundice, especially with Hepatitis B.
🔹 Key points you should remember:
✔ Rash is due to immune complex deposition
✔ Usually resolves with onset of jaundice
✔ No specific treatment for the rash itself
🟢 Management is mainly supportive
• Adequate rest
• Normal age-appropriate diet
• Avoid hepatotoxic drugs
🟡 For itching / urticaria
• Antihistamines (Cetirizine, Loratadine)
• Calamine lotion / emollients
🔴 Steroids are NOT routinely indicated
➡ Used only rarely in severe serum sickness–like reactions under specialist care
📘 Reference: Nelson Textbook of Pediatrics (21st & 22nd Edition)
⚠️ Disclaimer:
This content is for educational purposes only and not a substitute for clinical judgment or specialist consultation.

👉 If any misprint, please comment below.

17/12/2025

Alemtuzumab (CD52) – Explained Simply 🧬

Alemtuzumab is a humanized monoclonal antibody that targets CD52, a surface antigen present on both B and T lymphocytes. By binding to CD52, it causes antibody-dependent cellular cytotoxicity (ADCC) and complement-mediated cell lysis, leading to profound and long-lasting lymphocyte depletion.

🔹 Key Uses
✔️ B-cell Chronic Lymphocytic Leukemia (CLL)
✔️ Highly active Relapsing-Remitting Multiple Sclerosis (RRMS)

🔹 Why it’s important?
Alemtuzumab is highly effective but requires strict monitoring due to risks of serious infections and autoimmune complications, especially thyroid disorders and ITP. In MS patients, monitoring is required for up to 48 months after treatment.

📌 Exam Pearl:
CD52 is expressed on both B and T cells (unlike CD20 which is only on B cells).

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⚠️ Disclaimer:
This post is for educational purposes only. It is not a substitute for professional medical advice. Treatment decisions should always be made by a qualified healthcare provider.

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📝 Note:
If any misprint, please comment below.

13/12/2025

Cetuximab is a targeted anticancer monoclonal antibody that acts against the Epidermal Growth Factor Receptor (EGFR). It is mainly used in KRAS/NRAS wild-type metastatic colorectal cancer and head & neck squamous cell carcinoma.
By blocking EGFR signaling, cetuximab inhibits tumor cell proliferation, angiogenesis, and metastasis, while also promoting apoptosis. A characteristic acneiform rash often correlates with treatment response.
⚠️ KRAS/NRAS mutation testing is mandatory before use, as mutated tumors do not benefit from this therapy.

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Disclaimer

This content is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult an oncologist before initiating or modifying therapy.

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If any misprint, please comment below.

13/12/2025

Panitumumab is a fully human monoclonal antibody targeting the Epidermal Growth Factor Receptor (EGFR), used in the management of metastatic colorectal cancer (mCRC).
It works by blocking EGFR-mediated signaling pathways responsible for tumor cell proliferation and survival.

🔬 Key clinical point:
Panitumumab is effective only in KRAS/NRAS wild-type tumors. Patients with RAS mutations do not benefit from this therapy, making molecular testing mandatory before initiation.

💉 Dose: 6 mg/kg IV every 14 days
⚠️ Important adverse effects: acneiform rash, hypomagnesemia, diarrhea, and rare pulmonary toxicity.

A classic example of precision oncology, where treatment is guided by tumor genetics rather than tumor site alone.

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⚠️ Disclaimer:
This post is for educational purposes only and not a substitute for professional medical advice. Treatment decisions should always be made by a qualified oncologist based on individual patient factors.

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📝 Note:
If any misprint, please comment below.

11/12/2025

Letrozole is a non-steroidal aromatase inhibitor commonly used in postmenopausal hormone-positive breast cancer. It works by reducing estrogen levels in the body, slowing down the growth of ER+ tumors.
It is also used off-label for ovulation induction in women with PCOS.

🔹 Class

Aromatase inhibitor (Hormonal antineoplastic)

🔹 Mechanism of Action

Blocks aromatase enzyme → prevents conversion of androgens to estrogens → ↓ estrogen levels → slows cancer cell growth.

🔹 Indications
• Early-stage adjuvant therapy
• Extended adjuvant therapy
• Metastatic breast cancer
• Ovulation induction (off-label, clinician-guided)

🔹 Dosage

Adults:
• Breast cancer: 2.5 mg once daily
• Ovulation induction: 2.5–7.5 mg daily for 5 days (cycle day 3–7)

Pediatrics: Not routinely used; only specialist-supervised off-label cases.

🔹 Common Side Effects
• Hot flashes
• Fatigue
• Bone loss / osteoporosis
• Arthralgia, joint pain
• Nausea
• Headache

🔹 Contraindications
• Pregnancy & lactation
• Premenopausal women (unless supervised for ovulation induction)
• Severe liver disease

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⚠️ Disclaimer

This educational post is for learning purposes only. Not a substitute for professional medical advice. Always consult a qualified doctor before starting or changing any medication.

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If any misprint, please comment below.

11/12/2025

📘 EXEMESTANE – A Complete Drug Overview (Simple & High-Yield)

Exemestane is a steroidal aromatase inhibitor used mainly in postmenopausal women for hormone-positive breast cancer. It works by irreversibly inactivating the aromatase enzyme, leading to a significant reduction in estrogen levels, which slows the growth of estrogen-dependent tumors.

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🔹 What is Exemestane?

A potent aromatase inactivator (su***de inhibitor) used after tamoxifen or in metastatic disease. It is especially useful in long-term endocrine therapy for breast cancer.

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🔹 How Does It Work? (MOA)

✔ Irreversibly binds to aromatase
✔ Prevents estrogen production
✔ Reduces tumor growth dependent on estrogen
✔ More effective in postmenopausal women

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🔹 Indications

➡ Hormone receptor–positive breast cancer
➡ Adjuvant therapy after tamoxifen
➡ Metastatic breast cancer
➡ (Off-label) Ovulation induction in infertility

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🔹 Dosage

💊 25 mg once daily after meals
❌ Not recommended in pediatrics

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🔹 Common Side Effects
• Hot flashes
• Fatigue
• Arthralgia / myalgia
• Osteoporosis
• Nausea
• Headache
• High cholesterol
• Sweating, insomnia

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🔹 Contraindications

❌ Pregnancy & breastfeeding
❌ Premenopausal women (except infertility therapy)
❌ Hypersensitivity
⚠ Caution in osteoporosis & liver disease

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🔹 Clinical Pearl

Exemestane is often switched after 2–3 years of tamoxifen as part of the standard 5-year endocrine therapy plan. This improves disease-free survival in postmenopausal women.

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📌 Disclaimer

This post is for educational purposes only. Consult a medical professional before taking any medication.

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If any misprint, please comment below.

08/12/2025

ANASTROZOLE is a non-steroidal aromatase inhibitor widely used in the management of hormone-receptor–positive breast cancer in postmenopausal women.
It works by blocking the aromatase enzyme, which reduces the conversion of androgens to estrogens, leading to significant estrogen suppression — an essential step in slowing or stopping estrogen-driven tumor growth.

🔹 Uses / Indications
• ER/PR-positive breast cancer
• Adjuvant therapy after surgery
• Metastatic breast cancer
• Prevention of recurrence
• Off-label: Gynecomastia, ovulation induction (specialist-guided)

🔹 Dosage
• Adults: 1 mg orally once daily
• Pediatrics: Not routinely used (specialist situations only)

🔹 Common Side Effects
• Hot flashes
• Joint pain
• Bone loss / osteoporosis
• Fatigue
• Vaginal dryness
• Mood changes
• Increased cholesterol

🔹 Contraindications
• Premenopausal women (unless ovarian suppression)
• Pregnancy & breastfeeding
• Severe hypersensitivity
• Concurrent estrogen therapy

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⚠️ Disclaimer

This post is for educational purposes only.
Not a substitute for professional medical advice, diagnosis, or treatment.
Consult a qualified healthcare provider for personalized guidance.

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If any misprint, please comment below.

04/12/2025

Raloxifene is a Selective Estrogen Receptor Modulator (SERM) used mainly in postmenopausal women for improving bone health and reducing the risk of certain breast cancers.

It works as an estrogen agonist on bone, helping increase bone mineral density, and as an estrogen antagonist on breast and uterus, thereby lowering the risk of estrogen-dependent cancers.

✨ Key Uses
• Treatment and prevention of postmenopausal osteoporosis
• Reduction of invasive breast cancer risk in high-risk postmenopausal women
• Preferred when osteoporosis treatment and breast cancer risk reduction are both desired

💊 Dose
• 60 mg orally once daily
• Can be taken with or without food

⚠ Side Effects
• Hot flashes
• Leg cramps
• Peripheral edema
• Flu-like symptoms
• Increased risk of DVT/PE
• Stroke risk in women with cardiovascular disease

🚫 Contraindications
• Pregnancy and lactation
• Active/past DVT or PE
• Retinal vein thrombosis
• Prolonged immobilization

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📌 Disclaimer

This post is for educational purposes only and not a substitute for professional medical advice. Always consult your doctor before starting or changing medications.

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If any misprint, please comment below.

03/12/2025

📌 Fulvestrant (SERD) – Complete Clinical Overview |

Fulvestrant is a Selective Estrogen Receptor Downregulator (SERD) used in the management of hormone receptor–positive metastatic breast cancer, especially in postmenopausal women.
Unlike Tamoxifen, it has no agonist activity, making it a pure anti-estrogen agent.

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🔬 Mechanism of Action
• Competitively binds to estrogen receptors
• Causes ER degradation + downregulation
• Completely blocks estrogen signaling
• Slows progression of estrogen-dependent tumors

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🩺 Indications
• HR+ metastatic breast cancer
• Disease progression after anti-estrogen therapy
• First-line or second-line treatment
• Commonly used with CDK4/6 inhibitors (Palbociclib, Ribociclib, Abemaciclib)

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💉 Dosage

Adults:
• 500 mg IM (2 × 250 mg injections)
• Day 1, Day 15, Day 29
• Then monthly

Pediatrics:
• Not recommended

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⚠️ Side Effects
• Injection-site pain
• Hot flashes
• Nausea
• Fatigue
• Arthralgia
• Elevated LFTs
• Rare: hypersensitivity

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🚫 Contraindications
• Pregnancy
• Lactation
• Known hypersensitivity
• Caution: severe hepatic impairment

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Disclaimer:

This post is for medical education only. Not a substitute for professional diagnosis or treatment.

If any misprint, please comment below.

03/12/2025

Tamoxifen is a Selective Estrogen Receptor Modulator (SERM) widely used in the management of estrogen-receptor–positive breast cancer.
It works by blocking estrogen receptors in breast tissue while acting as a partial agonist in bone and endometrium. This dual action helps prevent cancer recurrence, improves overall survival, and is also used for male breast cancer, gynecomastia, and some off-label hormone-related conditions.

🔹 Mechanism of Action (MOA)
• Antagonist on estrogen receptors in breast
• Partial agonist in endometrium, bone, liver
• Reduces estrogen-driven cell proliferation

🔹 Indications
• ER-positive breast cancer (treatment + prevention)
• Post-surgery adjuvant therapy
• Metastatic breast cancer
• Male breast cancer
• Gynecomastia (off-label)
• Ovulation induction (rare, off-label)

🔹 Dosage
• Adults: 20 mg once daily (or 10 mg BD)
• Pediatrics: Not routine; specialist-guided only

🔹 Side Effects
• Hot flashes
• Vaginal discharge / menstrual irregularities
• Nausea
• Increased endometrial cancer risk
• DVT/PE risk
• Visual disturbances
• Liver enzyme elevation

🔹 Contraindications
• Pregnancy, breastfeeding
• History of DVT/PE
• Hypersensitivity
• Caution with warfarin

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⚠️ Disclaimer

This content is for medical education only and not a substitute for professional clinical judgment. Consult guidelines and specialists when making treatment decisions.

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If any misprint, please comment below.

03/12/2025

Mitomycin-C: Complete Overview (Easy Explanation)

Mitomycin-C is an antitumor antibiotic with powerful DNA-crosslinking effects used in several cancers, especially those with hypoxic areas. It works by bioreductive alkylation, forming inter- and intra-strand DNA cross-links, ultimately stopping cell division and inducing apoptosis.

🧪 Mechanism of Action (MOA)
• Creates irreversible DNA cross-links
• Inhibits DNA synthesis
• Works best in hypoxic tumor cells
• Non–cell cycle specific (alkylating-like action)

🎯 Indications
• Gastric & pancreatic cancers
• Breast cancer
• A**l cancer (Nigro regimen with 5-FU + radiotherapy)
• Superficial bladder cancer (intravesical therapy)

💉 Dosage

Adults:
• IV: 10–20 mg/m² every 6–8 weeks
• Intravesical: 20–40 mg weekly × 8 weeks → then monthly

Pediatrics:
• Rarely used; when required: 5–10 mg/m², interval 6–8 weeks

⚠️ Side Effects
• Severe delayed myelosuppression
• Hemolytic-uremic syndrome (HUS)
• Pulmonary toxicity (pneumonitis, fibrosis)
• Nephrotoxicity
• Nausea, vomiting, mucositis
• Blue-green urine discoloration

🚫 Contraindications
• Bone marrow suppression
• Renal failure
• Pregnancy & breastfeeding
• Hypersensitivity
• High cumulative dose history

Mitomycin-C must be used with extreme caution due to delayed bone marrow suppression and risk of HUS, especially at higher cumulative doses.

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📘 Disclaimer

This post is for medical education only. Not a substitute for professional clinical judgment.

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If any misprint, please comment below.

02/12/2025

Actinomycin-D (Dactinomycin) is a powerful antitumor antibiotic used widely in pediatric and adult oncology.
It works by intercalating into DNA and blocking RNA polymerase, which stops transcription and prevents cancer cells from making essential proteins. Because of this strong mechanism, it is a key part of treatment protocols for Wilms tumor, rhabdomyosarcoma, Ewing sarcoma, and gestational trophoblastic neoplasia (GTN).

It must be used with caution due to significant toxicities such as myelosuppression, mucositis, hepatotoxicity, and the risk of veno-occlusive disease (VOD) in children.
As it is a vesicant, extravasation can cause severe tissue necrosis, so central-line administration is preferred.

Disclaimer: This post is for medical education only and not a substitute for professional medical advice.

If any misprint, please comment below.

MBBS study

27/12/2025

17/12/2025

13/12/2025

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11/12/2025

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