PART 1

DURING EXERCISE:

☆ Inadequate blood supply:

Kidneys

☆ Inadequate O2 delivery:

Skeletal muscles

☆ Minimum change in blood flow:

Brain

☆ Estrogen in Reproductive years (when a woman is like a doll)

ESTRADIOL --- Doll (di - girl n boy)

☆ Estrogen in pregnancy:

ESTRIOL --- (tri - mom, dad, child)

☆ Estrogen in menopause:

ESTRIONE --- (one - woman becums single again)

Estrogen containing OCPs:

☆ Inc risk of Thromboembolism > Breast CA

High Estrogen containing OCPs:

☆ Inc risk of endometrial CA

Low Estrogen containing OCPs:

☆ Inc risk of Hepatic Adenoma

1)Best way to measure gfr =inulin Clearance

2) best way to estimate gfr = creatinine clearance

3) best way to measure renal plasma / blood flow = PAH

4 ) clinically by creatinine

5) highest renal clearance = pah

ECG

☻P Wave → Atrial Depolarization

☻ Q → Septal Depolarization

☻ R → Early Vent. depolarization (potential travelling to apex of vents)

☻ S → Late Vent. depolarization (Potential travelling to base of vents)

☻ T → Vent. repolarization

☻ U → Delayed repolarization of Purkinje system or papillary muscles

☆ Premalignant change in mouth:

Chronic ulcer

☆ Premalignant Condition:

Lichen planus

☆ Premalignant Lesion (Most common):

Leukoplakia

☆ Premalignant Lesion (Most lethal):

Erythroplakia

☆ Bettlenut chewing:.

Submucosal fibrosis

GEOMED pneumonic

☆ Giant cell --- Epiphysis

☆ Osteosarcoma --- Metaphysis

☆ Ewing sarcoma --- Diaphysis

☆ Osteoblastoma --- Vertebral bodies

Epiphyseal Lesions:

☆ Giant cell tumor

☆ Chondroblastoma
☆ Chondrosarcoma

can occur Rarely in...

☆ Osteosarcoma

☆ Osteoblastoma

TYPHOID FEVER INVESTIGATIONS:

MNEMONIC BASU to memorize ie

B=Blood, A=Antibody, S=Stool, U=Urine

-1stweek = blood culture

-2ndweek = antibody/widal

-3rdweek = stool

-4thweek = urine culture

🌟Barbodies diagnostic for........Turner

🌟Barbodies absent in............Turner

🌟Scanty Barbodies present in.....Turnere(because of mosaic pattern)

🌟Presence of single barbodies diagonstic for......Klinefelter's(as klinefilter ve one barbody...xxy)

🌟Total x chromosome minus one is the number of bar bodies for example in xxx there are 2 bar bodies

benign tumor - warthin

hamartoma - tumor LIKE benign overgrowth...(brs)

LYSOSOMES:

• Arise from Golgi apparatus

• Contain hydrolases

• Cause degradation of unfolded proteins

• Uterus and breast regress after pregnancy by lysosomes

• On H & E stain: hollow structure around nuclei\

PEROXISOMES
• Originate from SER

• Contain OXIDASE, H2O2 AND CATALASE

• Single membrane

CENTRIOLE

• Microtubules

RER

• Protein synthesis

• Continuous with nuclear membrane

• =Nissle bodies

• Basophilia of cell

• Absent in axon hillock

SER

• Detoxification of drugs

• Giver peroxisomes

• Contain Calcium

MITOCHONDRIA

• DNA

• Energy house

GOLGI COMPLEX

• Binds carbohydrate with protein, enclose them in vesicles and release

• Secretary vesicles

• Lysosomes arise here

NUCLEOLUS

• No limiting membrane

• Site of RNA synthesis and assembly

DOUBLE MEMBRANE ORGANELLES

• Nucleus…>Mitochondria…..>Golgi complex

CYTOSKELETON

1. Cytoskeleton which connects ECM to ICM = Intermediate filament

2. Cytoskeleton connected to ECM = Proteoglycan

3. ECM connected to ICM through = Integrin

REGARDING THIRST...!!

Thirst Is Is Increased By. .

increase in Angi0tensin 2

decrease in blood v0lume

incerease in osmolarity

drynes of m0uth.

Increase in ADH.. .

THIRST is decreasd by. .

Gastric distensi0n.

Decrease in ADH,

Angi0tensin2,

Increase in BP.

Increase in blood volume.

(Reference Guyton)

Important Point Regarding Dialysis Fluid Wala question..

DIALYSING FLIUD ME SIRF

GLUCOSE AND BICARBONATES INCREASE HUN GAY PLASMA FLUID K MUQABILAY ME ...

BAQI SUB KUCH DECREASE HOGA...

Ref Guyton..
creatinine clearance

>> 90 ....NORMAL

60-89. .....mild

45-59. ...moderate

30-44. ...damage

15-29. ....severe

< < 15. ....ESTABLISHED renal failure

radiosensitivity

seminoma > glial glioma > craniopharyngioma

♧highest

☆ TG = chylomic > VLDL

☆ cholesterol = LDL

☆ protiens = HDL

■Granuloma===Characteristic cells===Epitheloid cells

■Tuberculosis granulomas ===Caseating granulomas/necrosis characteristic.

Also occur in histoplasmosis

●To differentiate ===AFB.

●Cervical lymph nodes biopsy done

Now characteristic ===Caseating granuloma

●Cervical lymph nodes biopsy done and biopsy shows Caseating granulomas now further

===AFB detection === definitive Dx.

■Non - caseating granulomas===SARCOIDOSIS, Crohns disease etc.

STAGES OF MITOSIS

INTERPHASE

- Chromosomes are copied (doubles)

- Chromosomes appear as thread like coils (chromatin) at the start but each chromosome and its copy
(sister chromosome) changes to sister chromatids at end of this phase

PROPHASE

- Mitosis begins (cell begins to divide)

- Centrioles (or poles) appear and begin to move to opposite ends of cell

- Spindle fibers form between the poles

METAPHASE

- Chromatids (or pair of chromosomes) attach to the spindle fiber

ANAPHASE

- Chromatids (or pair of chromosomes) seperate and begin to move to opposite ends of the cell

TELOPHASE

- Two new nuclei form

- Chromosome appear as chromatin (threads rather than rods)

- Mitosis ends

1)Most effectve antiTb drug=Rifampicin

2)Most bactericidal antiTb drug=Rifapicin

3)Most toxic antiTB drug=IsoNiaxid

4)AntiTb DruG causing rapid sputum conversion=Isoniaxid

5)Orange urine=Rifampicin

6)ist to develop resiatnce=ISONIAXID

7)Drug contraindicated in all categories of dots=INH+Rifampicin

8)injectble antiTb drug=Rifampicin

9)OPTIC neuritis by=Ethambutol

10)Vestibular damge=Streptomycin

11) Drug with only bacteriostatc=Ethambutol

1.inferior thyroid artery ligation...damage recurrent laryngeal nerves

2. Superior thyroid artery ligation...damage external larngeal

3. Thyroidectomy...damage external laryngeal

4. Thyroidectomy with vocal cord damage....damage recurrent laryngeal

5. Tracheostomy...recurrent laryngeal

☆Pus = penile urethra superfascial pouch/scrotum ✔🌟

☆Bus = bulbar urethra = sup pouch

☆Mud = membranous urethra deep pouch

1 REST

Max blood flow at rest=

1.liver(1500ml)

2.kidneys(1260 ml)

Max bld flow/ 100gm at rest

1st.carotid bodies

2nd.kidney

EXERCISE=

Max bld supply =Skeletal muscle

least bld supply(not according to demand)=kidneys

Least oxyegen supply(not according to demand)=skeletal muscles

cystinuria b6

cystinemia b12

Implant removed,fluid leaking,type of cells.....Giant cells

Implant removed,,no leaking,type of cells.....Giant cells

Implant not removed,,leaking of fluid present,type of cells........Giant cells

Implant removed,,leaking of fluid plus signs of inflammation,type of cells.....Neutrophils

Implant not removed,,no leaking but there is tenderness r other signs of inflammation,type of
cells........Neutrophills
Only these two type of cells we ll find,,there is no roll of immunity so no plasma cells...

Points to remember....

In breast implant type of cells.....giant cells

But when inflammation mentioned then neutrophils......simple

basal cell carcinoma is Boss present on upper lip

squamous cell carcinoma is secretary so present on lower lip

TOP🌟🌟🌟ANATOMICAL LEVELS TO RELATED STRUCTURES🌟🌟🌟BOTTOM

JUST REMEMBER THE IMP ONES LIKE ISTHMUS OF THYROID GLAND N AORTA BIFURCATION ETC ETC

🌟C1-C2 VERTEBRA: vocal cords

🌟C2-oropharynx and soft palate with mouth open

🌟C3-hyoid bone

🌟level of larynx in infants-C2-C3

🌟levwl of larynx in adults-C3-C6

🌟C3-C4:bifurcation of common carotid artery

🌟C4 &C5-thyroid cartilage

🌟C6-cricoid cartilage

🌟C6-begining of trachea

🌟C6-begining of oesophagus

🌟C7-vertebra prominence

🌟thyroid lobe superior extent-oblique line of thyroid cartilage

🌟isthmus of thyroid gland-2nd through 4th tracheal rings

🌟thyroid lobe inferior extent-sixth tracheal ring

🌟spine at root of scapula-opposite third thorasic spine

🌟thoracic inlet-T1

🌟superior angle of scapula-overlies part of 2nd rib-1st intercoastal space superior to angle/T2
🌟jugular notch-T2&T3 vertebral junction

🌟carnia-T3-4 or T4

🌟manubrium Sterni-T3&T4

🌟sternal angle-T4&T5

🌟body of sternum-T5to T9 vertebra

🌟greater splanchnic nerve-T5-T9 sym ganglia

🌟apex of heart/mitral value-5th intercoastal space

🌟base of heart/supine position-T5 to T8 vertebra

🌟base of heart/erect position-T6 to T9

🌟oblique fissure of lung-T6

🌟inferior angle of scapula-T7

🌟vena caval foramen-T8

🌟xiphoid process-T9

🌟xiphisternal joint-T9 vertebra typicaly

🌟esophageal hiatus-T10

🌟termination of oesophagus-T11

🌟lesser splanchnic nerve-T10-T11 sym ganglia

🌟least splanchnic nerve- T12 sym ganglian

🌟aortic hiatus-T12

🌟coeliac trunk branch of abdominal aorta-T12

🌟median arcuate logament of respiratory diaphragm- T12 &L1 junction

🌟pulmonary valve-left 2nd intercoastal space medial

🌟aortic valve-right 2nd intercoastal space

🌟tricuspid valve-right lower sternum

🌟nipple in male-4th intercoastal space in midclavicular line

🌟transpyloric plane-L1

🌟celiac trunk-L1 superior border

🌟superior mesentric artery-L1 inferior border

🌟pylorus of stomach-L1

🌟1st part of duodenum-L1

🌟left renal vein-L2

🌟2nd part of duodenum-L1,L2,L3right side

🌟3rd part of duodenum-L3

🌟left crus of diagphram-L2

🌟right crus of diagphram-L3 vertebra

🌟inferior mesentric artery-L3

🌟subcoastal plane-L3

🌟spinal cord termination

L1 in adults

L3 in New borns

🌟spleen-obliquely along axis of 10th rib

🌟right kidney-

Superior pole-T12

Inferior pole-L3

Hilum-L1

🌟left kidney-

Superior pole-T12

inferior pole-L3

Hilum-L1

🌟pancrease head-L2&L3
🌟umbilicus(in supine/recumbent position)-disc between L3-L4

🌟bifurcation of abdominal aorta-L4

🌟supracristal plane/higheat point on illiac crest-L4

🌟transtubercular plane-L5

🌟origin of inferior vena cava-L5by by

🌟anterior superior illiac spine-S1/sacral promontary

🌟posterior auperior illiac spine-S2

🌟pubic symphysis-tip of coccyx

PART 2

✅Hypertension..JG cells affected

✅Dopamine BBB not crossed

✅Floor of 4th ventrical suprolateral scp

✅Protooncogen overexpresdion most common cause of neoplasm

✅Dorsal rami supply extensors of trunk

✅Cortisol extrahepatic catabolism

Hepatic anabolism of proteins

✅Lens never regenerate

✅Heart contractility depends upon calcium ions

✅BPS airated by tertiary brochus

✅Gram staining quick way to check gonococcus

✅Olfactory cells biopolar neurons

✅Adh via v1 causes sm consriction in arterioles Gq

✅Infraorbital artery branch of maxillary artery

✅Xx+pseudohermaphrodism androgenitql syndrome

✅Rt main bronchus lenghth 2.5

✅Platlets infusion contraindicated in spleenomegaly

✅In venous blood rbcs have more hco3

✅Shortening of chromosome > transcriptase

✅Normal resp cycle

2sec ins 3 sec exp

✅Pressure is dissipated at arteriolar arterioles

✅6th post mi day pericardial temponade common

✅Highest Mg stores in bones

✅Angiopathy neuropathy cause of ulcers in diabetics

✅Edema of kidney origin albuminuria and na retension

✅Tubercle of bacili cells comes from monocytes

✅Cristmas factor b> factor ix

✅Primordial germ cells derived from endoderm

✅Kidney derived from intermediate mesoderm

✅ureteric bud derived from caudal end of mesonephric duct

✅fisherman with ecchymosis on lips caused by vit c def

✅Trisomy 21 robertsonion translocation

✅premalignant lesion of vulva is condyloma

✅chlamydia most common cause of PID

✅uv prolapsed complication > chronic discharge and metaplasia

✅sorbitol is an alcohal sugar

✅HLA compatability for BMT

✅in deep inspiration dead space does not change

✅graft versus host disease is an example of apoptosis

✅serotonin and epinephrine are mainly metabolized by MAO

✅proteinuria leads to russel bodies formation

✅dead space is not changed in deep inspiration

✅metaplasia is functional change in size

✅virulence of bacteria depends upon type of toxin

✅inc in stroma and dec in glands is atrophy

✅patent lumen of allantois>urachal fistula

✅nociceptive afferents terminate in post gray column

✅dorsal colum enter in dorsal gray horn

✅only protein diet > inc glucagon

✅gaba mediates anxiolytic effect

✅parasympathetic 75% by vagus

✅sphingomyelin does nit contain glycerol

✅volume of distribution:dose upon concentration

✅sjogren > sialogram test assessry

✅thioridazone has strongest antimiscarinic effect

✅inc resp in pregnancy> progesterone

✅bradykinin > polypeptide > vasodilation

✅cervical spine lateral horn is missing

✅peroxisomes long chain fattay acids oxidation

✅whole wheat source of thiamine

✅1litre urine contains NACL =2-6 gm/litre

✅miscele carry products of TAG digestion to small intestine epithelium

✅surfactant forms macromolecular layer between water molecules

✅endogenous muscle relaxant is endorphin

✅restlessness is effect of atropine on cns

✅swallowing of bronchial secretions is parasympathetic action

✅slow pain substance p

✅fast pain glutamate

✅stimulatory neurotransmitter in cerebellum is glutamate

✅granular layer is the only stimulatory layer of cerebellum

✅clostridium does not produce endotoxin

✅HLA gene on chromosome 6

✅calcitonin congo stained

✅aortic notch is due to aortic valve

➡️tubuloglomerular feedback supported by dec peritubular NA conc

✅submandibular surgery

Injures marginal branch of mandibular branch of facial nerve

✅renal artery >segmental >interlobar>arcuate

✅upper origin of external oblique forms digitation with serratous anterior

✅sarcoidosis>granuloma with asteroid bodies

✅mumps rna

✅IM dna

✅Endopeptidases are more imp than exopeptidases for protein digestion

✅deep sea divers > emboli in arteries

✅albino>dec melanin in choroid layer of retina

✅iga neohropathy mesangial deposits in gbm

✅igm and c3 deposits in FSGS

✅tracheostomy level 2-3rd tracheal ring

✅germinal follicles cortex of LN

✅IAPP endocrine type

✅systemic AL

✅secondary AA

✅heridity TTR

✅ant triangle c2,c3

✅Folia seen in cerebellum

✅acetylcholine not released at postganglionic nerves to vasoconstricting muscles

✅histones have arginine and lysine

✅nucleus is continuous with rough endoplasmic reticulumn

✅distributiok curve :mean and standard deviation

✅antidepressants:seizures

✅fetal cortisol major role in parturation

✅CPN related to biceps femoris laterall

✅standard deviation in normal distribution mean median mide coincide

✅neural tube forms cns

✅listeria only gram positive organism producing LpS

➡️Thermogenesis

✅Earliest response inc catecholamine

✅Potent. Shivering

✅Anterior hyoothalmus main controling center

✅Thermogenesis via sympathetic b1 to fats

And motorneurons

➡️

✅Dissipation mainly via parasympathetic

✅IL-1 increses prostaglandin in brain to inc set point

✅Cogwheel or lead pipe in parkinson

✅Clasp knife in upper motor neyron leision

✅exogenous steroids> dec IL-2 release

✅Sturge weber >choroid hemangioma

✅afibrogenemia ➡️pt➡️ptt➡️bt

Normal playlets

✅no granuloma in anaerobes

✅muscles supply

40% sens 60% motor

✅basiphillia to cells is bt RER

✅diencephalon does not include superior colliculus

✅b-endorphins mist abundantly in hypothalamus

✅most common genetic pathology is by nucleotides

✅lichen simplex chronicus is a/w sq neoplasia

✅polyclonal huperplasia > IM

✅insula is deep to lateral sulcus

✅diazepam relaxes sk muscle by inhibitory interneurons

✅diphenoxylate DOC for travellers diarrhea

✅synapses absent in dorsal root ganglion

✅cerebral aqueduct forms cavity of midbrain

✅griseofulvin not used in candid

✅isotonic exercise TPR remains same

✅chromophobes smallest cells in ant pituitary

✅subclavian artery arches over 1st rib

✅transduction genome from bacteria to virus

✅tip of nose ophthalmic division

✅release of histamine is by morphine

✅microaneurysm of HIv don't include hard exudates

✅adenoid cystic CA invades the periphral nerves sheath

✅forced respiration sternocleidomastoid and scalnes

✅spleenomegaly in hodgkins is stage 3

✅nuclear bag fibers carry dynamic response

✅pseudihypoparathyroidism is associated with hupocal dmi

✅birbeck granules are associated with histocytosis

✅conc urine is function of vasa recta

✅collagen amorphous abundant substance

✅adamstroke. High degree heart block stroke with FND

✅cruciate intracapsular

✅Lesion at l1 conus medularis

✅denticulate ligament extension of pia meter

PART 3 ...PEARLS

☆¤Haemorrhages

¤Extradural haemorrhge=middle minengeal artery

¤subdural haemorrhage =diploic vein

¤subarchnoid haemorrahge=rupture on berry aneursm

☆tennis ball injury to eye=circulis iridis major

☆epistaxis=sphenopalatine artery

☆during tonsilectomy= para tonsillar vein,tonsillar and ascending palatine artery

☆tracheostomy=isthmus and inferior thyroid vein

☆heamoptysis=bronchial artey

☆gastric ulcer=left gastrc and splenic artery

☆dudenal ulcer=gastrodudenal artery

☆hemmorhoids=submucosal rectal venous plexuses formed by superior rectal vein and inferior rectal
vein

☆retropubic proastatectomy=drsal venous plexuses

¤¤

☆Turner = 45XO

☆KF= 47XXY

☆True hermaphrodite =XXy

☆peudohermaphrodite =46Xy or 45X

¤¤Mole

☆complete hydatidfm mole -46XX

☆partial mole -69XXy

¤¤¤Chromosomes n Dna both replicate in interphase

¤Studied in Metaphase

¤¤¤¤Trisomy

21 > Down syndrome

13 > Ptau

18 > edvert

16 > spontaneous abortion

¤¤¤ Lumber Pucture

☆Most common loccation ==L4L5

☆LP Best Site ====above L4

☆IF pt e miningitis LP site ===below L3

¤¤¤Epidural anesthesia ==L3-4

☆widest epidural space > L2

☆Cauda Equina (CHILDren) === L3

☆Conus medullaris (Adult) = L1

☆Subarchnoid space == S2

☆Chorea > caudate

☆Athetosis > putamen

☆Pco2 rises upto 12mmhg in first minute of apnea

☆ Increased alpha feto protein plus increased albumin = Anencephaly.

☆Vitamin A prevents squamous cell carcinoma.

☆Right border of heart is made by right atrium.

☆Right border of heart on XRAY made by SVc +Rt Atrium

☆ Trephine biopsy Indicates = aplastic anemia > ALL.

☆In anesthesia halothane is always given with Nitric oxide.

☆Most diagnostic test for TB = PCR > AFB > Caseous.

☆Down syndrome occurs 1/100.

☆Common genital vesicle is herpes simplex virus.

☆Inferior orbital fissure contents are maxillary nerve and its zygomatic branch, inferior ophthalmic vein
and sympathetic nerves and this fissure communicates with pterygo palatine fossa.

☆Superior orbital fissure communicates with middle cranial fossa and it transmits lacrimal nerve, frontal
nerve, trochlear nerve, oculomotor nerve, abducent nerve, nasociliary nerve and superior ophthalmic
vein.

☆Thyroid is the only endocrine gland that stores its secretions outside the cell.

☆Sensations from the tip of nose are carried by ophthalmic division of trigeminal nerve.

☆Tensor tympani is supplied by mandibular division of trigeminal nerve.

☆Stapedius is supplied by facial nerve.

¤¤Nucleus raphe synthesize serotonin.

¤¤ Locus Ceruleus = Nor epinephrine.

☆At term CRL = 36 cm and CHL = 50 cm.

¤¤CRL used b/w 7 - 14 weeks.

☆☆BPD is used 16 - 30 weeks.

☆Sperm life in genital tract is 24 to 72hours.

¤¤¤Active ===24- 48hrs

¤2nd most common cause of osteoporosis in old age is Cushing syndrome.

¤Prenatal chromosome is detected at 14 -18 weeks.

¤Bronchial asthma plus hypertensive patient > Best drug Verapamil.

¤Aphasia and facial nerve palsy > damage to middle meningeal artery.

☆Diabetic plus hypertensive patient > Best drug Captopril.

☆Inferior wall MI > Right marginal artery block.

☆ Epidermis of partoid gland is derived from ectoderm.

☆To kill spores of surgical instrument > moist heat at 160 C for 1 hr.

☆Food poisoning caused by Staph. Aureus is through entertoxin.

☆Least positive value for Widal is 1:120.

☆Trigeminal ganglion is completely covered by dura.

☆ Tactile sensation is carried by dorsal white column to medial leminiscus.

☆ Anti HBcAg = positive window period.

☆MAP = diastolic +1/3 pulse pressure.

☆ Insulin secretion is inhibited by beta blocker.

☆Increased By Glucagon

☆Highest triglyceride =Chylomicrons >VLDL > Chylomicrons remanents

☆Highest cholesterol = LDL.

☆ Highest lipoprotein = HDL.

☆ Which is not a phospholipid = Plasmalogen.

☆ Best way to check bone density is the scan of spine.

☆End break down of glucose is pyruvate.

☆☆In pre eclamptic patient hydralazine is the drug of choice before surgery.

☆In down syndrome: Triple test (alpha feto protein is decreased, b-HCG is increased and estriol is
decreased) and if we add up inhibin which is increased then it will be called as .

☆Bar body diagnostic for Tuners syndrome

☆scant bodies in KF

☆PLAP (Placental Alkaline Phosphatase) is a tumor marker in seminoma and ovarian carcinoma.

☆Tubo ovarian abscess by IUCD - most causative agent is Actinomycosis.

☆Major intracellular buffer is Hb.

☆ DVT more common in popliteal vein but pulmonary embolism is through femoral veins.

☆Investigation of DIC D-dimers, FDPs, Platelet count and PT (except clotting time).

☆Referred pain:

¤¤Cervix S2-S3

¤ Ovary -T10-T11

¤Testis -T10

¤ Umbilicus -T10

¤Kidney T12-L2.

☆Trimethoprim (co-trimoxazole ) side effect > megaloblastic anemia plus leukopenia.

☆ Sacrospinous ligament does NOT contribute in wall of perineum.

☆ Lesser omentum connects with duodenum.

"☆Sphincteric urethra is known as external urethral sphincter and is supplied by pudendal nerves where
as internal os is supplied by inferior hypo gastric plexus.

☆Nerve supply of rectum is hypogastric plexus.

☆Uterine tube is 10 cm long.

"☆Urachal cyst is the remanant of allantois.

☆Thyroid gland is derived from endoderm.

☆Thymus and inferior parathyroid develops from 3rd branchial pouch.

☆Superior para thyroid is developed from 4th brachial pouch.

☆ Diaphragmatic hernia occurs due to absence of pleuro peritoneal membrane.

☆Superior thyroid artery is related to external laryngeal nerve which supplies posterior cricothyroid
muscle of larynx. Injured during Thyroidectomy

☆Inferior thyroid artery is also related to recurrent laryngeal nerve which runs b/w trachea and
esophagus and its most common injury is in Traceostomy.

☆ In papillary carcinoma of thyroid > it occurs in young age and involves cervical lymph nodes.

☆ Tracheostomy is done at 2nd tracheal ring by pulling the isthmus inferiorly.

☆ Nonfunctional nodule or cold nodule has high chances of malignant transformation.

☆Erythropoiesis in middle trimester is in the liver.

☆ Levator ani muscle is supplied by L2, L3 & L4.

☆Defect in Bulbus Cordis results in VSD, hypertrophy of Right ventricle, congenital cyanosis,
transposition of great vessels (but not ASD)

☆Endocardial cushion is important for the formation of four chambers of heart.

☆Thirst is least stimulated by blood pressure.

☆Important hormone involved in gluconeogenesis is Cortisol.

☆Apoptosis is inhibited by bcl-2 inhibition.

☆Apoptosis ~ Actuvation of caspases

☆Low serum complement in SLE.

☆C3b & IgG are Opsonins

☆C5a is chemotactic protein.

☆ Urea is an important indicator for muscle protein loss.

☆ESR is decreased when albumin is increased.

☆ESR increased during Infection

" Drug which does not cause gynecomastia is Androgen & drugs which cause gynecomastia are Digoxin,
Girsoefulvin, Cimetidine, Androgens, Spironolactone and Ketoconazole.

☆Tx of hirstuism is Cyproterone Acetate.

☆Pyruvic acid is intermediate from glucose to acetyl coA.

☆Epinephrine .nor epinephrine & dopamine are derived from tyrosine.

☆End product of Purine is Uric acid.

☆RBCs have glycolytic enzyme activity.

☆End product of glucose gives 2 Pyruvate.

Alanine should be taken in diet.

☆Cisplatin is more notorious to cause renal toxicity.

☆Dysplasia is seen in epithelia.

☆MRNA has a codon.

☆HSV is associated with vulvar papules.

☆Wart on the lateral wall of introitus it is caused by HPV.

☆Plaque like lesion on posterior superior wall of vagina is squamous cell carcinoma.

☆ German Measles causes Congenital Cataract.

Anterior abdominal wall swelling with umbilical cord attached to it in a new born baby is known as
Omphalocele.

☆Beta-lactam acts on the Cell Wall.

¤¤¤ ATT Drugs

☆Streptomycin=== ototoxity.

☆Isoniazid ==Hepatotoxicity.

☆Pyrazinamide == Gout

☆Rifampacin=Orange red color urine

☆ Opportunistic organism ~E. Coli Kleibeslla

☆Pseudomembranous colitis is caused by C. difficile.

☆Most common organism involved in gynecological & abdominal procedures is Bacteriods .

☆Vulvular itching = Chlamydia

☆ fish like smell; Bacterial Vaginosis.

☆ Vitamin K dependent: Factors 2, 7,9,10, Protein C, Protein S, Fibrinogen and Prothrombin.

☆Intrinsic and Extrinsic pathways of coagulation converge at factor 10.

☆Threonine does not contain Sulfa group.

☆Autosomal dominant is hereditary Spherocytosis & Poly cystic kidney disease.

☆Lens opacity causing drugs >Chlorpromazine, Amidarone, Tamoxifen, Gold & Iron toxicity.

☆Drugs causing corneal opacity > Amiodarone, Chloroquine, Mepacrine & Copper.

☆ Ribosome have purple color on Eosin & Methylene blue staining

☆High energy content > Starch.

☆High energy compound > ATP

☆Antidote of warfarin is vitamin K but if action is more quickly required then FFP.

☆Olfactory cells are the only neurons in the body that regenerates.

☆Projectile vomiting greenish in color means bilious vomiting so it is due to duodenal atresia but if
projectile vomiting non bilious then it is hypertrophic pyloric stenosis.

☆ Pulmonary trunk relation with the bronchus at the hilum of the lung-mnemonic is RALSR- Right
Anterior & Left Superior.

☆Rhino sinusitis is caused by Strep Pneumonia, H. Influenza, M Catarrahalis.

☆ Homan’s sign is present in DVT in which if you dorsiflex the foot there will be pain in calf muscles.

☆ Classic triad of Pulmonary Embolism: -

☆☆Neurological manifestations.

-Petechial rash.

-Hypoxemia.

☆Nitrogen bubbled precipitator in ascending divers and can be treated with hyperbaric oxygen.

☆CT pulmonary angiography is the best test to detect Pulmonary Embolism.

☆The most common infectious agent transmitted by blood transfusion is cytomegalovirus (CMV), which
is present in donor lymphocytes.
☆Before blood is transfused into newborns or patients with T-cell deficiencies, it must be irradiated to
kill donor lymphocytes. This prevents the patient from developing a graft-versus-host reaction or a CMV
infection.

☆Yersinia enterocolitica, a pathogen that thrives on iron, is the most common contaminant of stored
blood.

☆ Iron is stored in bone macrophages.

☆ Structures passing thru superior orbital fissure....

NOT-FAL

¤NASOCILLIARY¤OPTHALIMIC VEIN¤TROCHLEAR¤FRONTAL

☆☆Suture Removal:

¤Head 5-7days

¤Face 3-5days

¤Eyelid & eyebrow 3-5days

¤Trunk 5-7days

¤Extremities 7-10days

¤Surface of joint 10-14days

¤Hand ==7days

☆☆Absorption

☆iron nd divalents absorb in duodenum.

☆Folic acid, maximum water, max electrolytes, long chain fatty acids in jejunum.

☆Bile nd B12 absorb in ileum.

☆water nd electrolytes absorb in colon but less than jejunum. Short chain fatty acids absorb in colon.

¤¤Buffers

☆Major intracellular buffer is protein.

☆Major extracellular buffer is bicarb.

☆If only major buffer asked then Bicarb.

☆Major renal buffer is still bicarbonate if depleted theb

¤Phosphate ==Qualitative

¤Ammonia == Quantitative

☆Buffer in blood is H2co3 > Hb

¤¤Uterus

☆Uterosacral felt on PR

☆Main support is cardinal(also named transverse cervical ligament )

☆Round ligament of uterus keeps it anteverted anteflexed

☆broad ligament has very lessor role in support

☆Best way to "measure" gfr is inulin clearance.

☆best way to "estimate" gfr is creatinine clearance.

☆best way to "clincally" measure gfr is creatinine clearance.

☆best way to measure renal plasma / blood flow is PAH .

☆best test for renal falilure is creatinine clearance.

☆☆☆☆ blood transfusion

↪multiple===hemochromatosis

↪massive===hyperkalemia

↪repeated ===hypocalcemia

PART 4 MICROBIOLOGY

Ascetic tap - E.coli

Peritonitis - E.coli.

Pyogenic peritonitis - Bacteroids.

Puerperal sepsis - Bacteroids.

P.O abdominal and gynaecological infection - Bacteroids.

Abscess - S.Aureus.

Acute osteomyelitis - S.Aureus.

Toxic shock syndrome - S.Aureus.

Wound infection - S.Aureus > Pseudomona.

Hospital acquired pneumonia - S.Aureus.

Septic meningitis - Streptococcus.

Initiation of dental caries - Streptococcus.

Pyogenic lung abscess + Meningitis - Staphylococcus.

Subacute bacterial endocarditis - S.viridians.

Prosthetic valve endocarditis - S.epidermidis.

Cellulitis - S.pyogenes.

Multiple draining sinuses - Actinomyces.

IUCD infection - Actinomycosis.

Trachoma - Chlamydia.

Pelvic inflammatory disease - Chlamydia.

Lymphogranuloma venereum - Chlamydia.

Pseudomembranous colitis - C.Difficile.

Gas gangrene - C.Perfringes / C.Welchii.

Fatal diarrhea - V.Cholrea.

Tubulo ovarian cyst - Gonococcus.

Abscess - S.Aureus.

Acute osteomyelitis - S.Aureus.

Toxic shock syndrome - S.Aureus.

Wound infection - S.A

Valvular itching + Pink purulent discharge - Trichomanas vaginilis.

Infection in post liver transplant patient - CMV.

Chorioretinitis in AIDS - CMV.

Bronchogenic carcinoma - CMV.

Herpangia - Coxsakie virus.

Hand foot and mouth disease - Coxsakie virus

Lymphoma in AIDS - EBV.

Burkitt lymphoma - EBV.

Non hodgkin lymphoma - EBV.

Hairy tongue - EBV.

Nasopharyngeal carcinoma - EBV.

Infectious mononucleosis - EBV.

Kaposi sarcoma - HHV8.

Cervical cancer - HPV 16.

Vulval papules - HSV.

Meningo-encephalitis - Echovirus.

Meningitis in AIDS - Cryptococcus neoformans.

Black water fever - Plasmodium falciparum.

Cysticercosis - Taenia solium.

Cyst in liver - Teania echinococcus.

SCC of bladder - Schistosomiasis.

Cholangio carcinoma - Clonorchis Sinensis.

Migratory lesion of foot - Cutaneous larva migrans.

Toxoplasmosis - Cat