Excellent Important Points

[Medicoman]

Excellent Important Points from
Collection of different important points…!!!
Post is a bit long but it will refresh hundreds of things…the first part is having answers of controversial mcqs so its compulsory…the other parts are those which were previously posted in this group but now i have compiled them all in this one single post…!!!
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​:octopus:ANATOMICAL LEVELS TO RELATED STRUCTURES​:octopus: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​:arrow_up:ptt​:arrow_up: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