High yield points of Medicine

For
Final year , NLE , FCPS1 Exam
By
Dr.Masoom qasim (IMC FSD)
Edited by
Dr.Hammad ramay (IMC FSD)

CVS 🫀
Murmur radiation to neck= aortic stenosis

Murmur radiate to axilla=Mitral regurgitation

Pulsus paradoxus=PDA,,,aortic regurgitation

Absent P wave = Atrial fibrillation

Saw tooth ECG= atrial flutter

U wave on ECG= hypokalemia

DOC for vasospastic angina = Ca.channel blocker

DOC for stable angina= nitroglycerin

Most common artery involve in aneurysm= Aorta then popliteal,,

Most common origin of pulmonary embolism= femoral vein

Wedge shape area on Xray in lung =Pulmonary infarction

Most common vein involved in DVT =popliteal

Peri-friction Rub =Acute pericarditis

Pain relief in acute pericarditis by = NSAIDS

Globular heart in = pericardial effusion

Radiofemoral delay= Coarctation of aorta

Drug for closure of PDA = indomethacin

Drug maintain opening of PDA = misoprostol

S1Q3T3 pattern on ECG= pulmonary embolism

Clubbing and Splenomegaly with murmur in =infective endocarditis

Most common cause of infection endocarditis in IV drug user = Stap.aurus

Cardiac defect in Rubella= PDA

.
Cardiac defect in Turner = Coarctation of aorta

Figure of 3 = Coarctation of aorta

Figure of 8 in = TAPVR

Pain in abdomen after eating with history of coronary heart Disease is called = acute mesenteric
ischemia

Artery involve in acute mesenteric ischemia = SMA

Most common defect in Down Syndrome = ASD

Boxer shape heart = ebstein anomaly

.
Most common problem in infective endocarditis is = tricuspid regurgitation

Most common valve involved in RHD = mitral

Mid.Diastolic murmur=Mitral stenosis

Pan systolic M=Mitral regurgitation+VSD

Early diastolic =Aortic regurgitation

.
Ejection systolic= Aortic stenosis
.
Raised 1st sound=Mitral stenosis
.
Irregular QRS complex + Irregularly Irregular pulse = Atrial fibrillation
.
Cause of Atrial fibrillation = Mitral stenosis +Thyrotoxicosis

Cause of stroke in Atrial fibrillation = Emboli

3rd heart Sound= Heart failure

Cause of sudden death in athlete= Hypertrophic cardiomyopathy

rapid y descent= Chronic pericarditis

DOC for ventricular tachycardia = Lidocaine

DOC for Supraventricular tachycardia = Adenosine

Cause of Torsades"d point= decrease Ca,Mg,K

Delta wave on ECG occur in = Wolff"parkinson-white syndrome

DOC for Pulmonary edema in Left heart failure is = Furosemide

DOC for edema in cirrhosis= Spironolactone

Hepatosplenomegaly + Ascites + pitting edema + orthopnea occur in = Right heart failure

Pulmonary edema is feature of left heart failure

DOC for heart failure is = Digoxin

Opening snap is feature of = mitral stenosis

S3 sound present in = Heart failure + mitral regurgitation

S4 sound present in = Aortic regurgitation

ST elevation in Lead V1 and V2 = septal wall Mi

ST elevation in lead v3 and v4 = anterior wall Mi

ST elevation in lead v5 + v6 + AVL = Lateral wall Mi

ST elevation in Lead ll+lll + AVF = inferior wall Mi

ST depression in V1 to V6 = posterior wall Mi

Common artery involve in Mi= LADA

Sudden cause of death in Mi= ventricular tachycardia

Earliest raised Mi marker is = myoglobin

Marker remain for long time = Troponin

Marker for previous Mi= CK MB

Smoker have absent distal pulses and present Proximal pulse = Burger disease

Spherical swelling in centre of abdomen with Thrill and bruit = Aortic aneurysm

Most common cause of thoracic Aortic aneurysm is = HTN,,,and for abdominal is =

atherosclerosis

Most common cause of Aortic Dissection is = HTN

Investigation of choice for aortic aneurysm is = USG

Investigation of choice for aortic dissection is = CT/MRI

DOC for HTN in OLd= Ca channel blockers

DOC for Diabetics= ACE/ARB

DOC for pregnancy= methyldopa

B.blocker are contraindicated in HTN in COPD patients

Most common valve involved in RHD is = Mitral,,

And least common is = Pulmonary

Most common disorder in infective endocarditis = tricuspid regurgitation

Most common cause of infective endocarditis in Colon cancer patients is = S.bovis,,,if damage
valve then = S.viridans

Soft s1 sound= mitral regurgitation

Austin flint murmur= Aortic regurgitation

Boot shape heart = TOF

Boxer shape heart= ebstein anomaly

Jerky pulse with "Double impulse at Apex and S4 occuer in = Hypertrophy cardiomyopathy

Most common heart tumor= atrial MyXoma

Pain of Acute pericarditis relief by Leaning forward and Dom Shape ECG occur in it and Aspirin
give

Kusmual breathing occur in = Chronic pericarditis + metabolic acidosis

Calcification occur in Chronic constrictive pericarditis

GIT ⏳
Achalasia cause = SCC of esophagus

GERD cause = Adenocarcinoma of esophagus

SCC at = upper and middle end

Adenocarcinoma at =lower end of esophagus

Chagas disease cause = achalasia

Bird beak deformity occur in = achalasia

Most common site of Peptic ulcer on the Stomach = antrum/lesser Curvature

Ulcer on duodenum= 1st part

Most common site of PUD ulcer disease perforation= Anterior wall of duodenum 1st part

Speicific test of PUD= specific urease test

Sensitive test of PUD= urea breath test

Investigation of choice in CA of stomach= Endoscopy

Lymph node of Left supraclavicular fossa called= Virchow node

Enlargement of Virchow node called= Trouser"s sign

Blumber shelf + Thrombophlebitis occur in = gastric adenocarcinoma

If CA of stomach metastasis to Ovary called = Krukenberg tumor

If above is opposite =Pseudomyxoma peritonea

Succision splash occur in = gastric outlet Obstruction

Vomiting can cause = Hypokalemia + Metabolic Alkalosis

Vomiting contain food particles occur in = gastric outlet Obstruction

Most common site of Carcinoid tumor = Appendix

Wheezing + FLUSHING + Diarrhea typical feature of = CARcinoid tumor

Gluten free diet give in = celiac disease

Celiac disease cause = T.cell LYMPHOMA

Anti.gildan +anti.TTG in = Celiac disease

Skin manifestation in celiac = Dermatitis herpetiformis (give Dapsone)

Fissure + Fistula occur in = Crohn's

Aphotus ulcer occur in = Crohn's + behcet disease

Urethritis + Conjunctivitis + arthritis = Riter"s syndrome (vv imp)

Urethritis +arthritis + aphthous ulcer = BEHCET disease

Most common site of TB+typhoid Crohn's= Ileum

Cobblestone + Transmural ulcer = Crohn's

Submucosal ulcer + crypts abscess in = Ulcerative Colitis

Megacolon in = Ulcerative Colitis + Hirschsprung

Renal stone occur in = Crohn's

Gall stone occur in = Ulcerative Colitis

Primary sclerosis cholangitis occur in = Ulcerative Colitis

Investigation of choice for colon cancer = colonoscopy

Most common site of colorectal cancer= Rectosigmoid

Most common cause of appendicitis = Fecolith

Most common tumor of appendix = carcinoid

Treatment of Hirschsprung disease= Resection of Non.ganglionic segment (imp)

Pain in LUQ radiation to back = acute pancreatitis

Most specific test for pancreatitis = Lipase

Most common cause of acute Pancreatitis =Gall stone

Most common cause of chronic Pancreatitis= Alcohol

Trousser"s syndrome occur in= pancreatic Carcinoma

Most common site of Pancreatic cancer= head

Sausage shape mass= Intussusception

Double bubble sign= duodenal atresia

Non.bilious vomiting in 1 year old boy = Pyloric Stenosis

Bilious vomiting in 1 year old boy= duodenal atresia

Multiple polyp in colon with family history is called= Familial adenomatous polyposis

Pigmentation of lips + polyps in jejunum= peutz jeghr syndrome

Retrosternal chest pain on supine but relief on tilt head upward= GERD

Retrosternal chest pain increase on leaning forward = acute pericarditis

Dome shape ECG = acute pericarditis

Pain in chest at rest relief by nitrate= unstable angina

Pain in chest at rest not relief by nitrate= prinzmetal angina

Pain in chest on stress relief on rest and nitrates= stable angina

Pain in abdomen after taking food with history of Mi= acute mesenteric ischemia

Pain radiation to back with widening of mediastinum = Aortic Dissection

S4 sound in = aortic regurgitation

S3 occur in = heart failure

Double impulse at apex occur in = Hypertrophic cardiomyopathy

Liver 🌡
Gilbert syndrome due to = UDP glucuronosyl"transferase enzyme deficiency

Unconjugated Bilirubin more then conjugated in = Gilbert + crigler najjar syndrome

Conjugated Bilirubin more in = Dubin johnson syndrome

Hepatic VEIN thrombosis occur in = Budd chiari syndrome

If Unconjugated Bilirubin more then conjugated then it will = Pre-hepatic jaundice

If both conjugated and Unconjugated Bilirubin increase = Hepatic jaundice

If conjugated Bilirubin more then unconjugated = post-hepatic(cholestasis) jaundice/obstructive

jaundice

Most common cause of obstructive jaundice = stone in Bile duct

Most common cause of acute pancreatitis is = stone in bile duct

Most common cause of chronic Pancreatitis= Alcohol

Dupuytren's contracture occur in = alcoholic cirrhosis

Fibrous nodules separated by septa = cirrhosis

Liver enlarged in Acute cirrhosis while shrink in chronic cirrhosis due to fibrosis

ALT and AST in thousands then it will = acute viral hepatitis

If problem.in then biliary ducts then = Alkaline phosphatase increase

In Alcoholic Patient there will = AST more then ALT

Non.Alcoholic Liver disease association with = Diabetes + obesity

Which is associated with Primary sclerosing cholangitis = Ulcerative colitis

Which skin lesion occur in Ulcerative Colitis = erythema marginatum

Which skin lesion occur in Crohn's = erythema nodosum

Which is raised in Primary biliary cholangitis(PBC) = AMA

PBC is associated with = Grave's disease/scleroderma

Which is raised in Primary sclerosing cholangitis = ANCA

Which enzyme raise in the PBC and PSC = ALP

Severe itching .with scratch mark on abdomen occur in which liver disease = PBC + PSC

Type-2 Diabetes + Skin pigmentation (bronze skin) + cirrhosis,,,this is triad of =

hemochromatosis

Drug of choice for hemochromatosis = Deferoxamine

Keyser fleischer ring with extra pyramidal.effects occur in children = wilson disease

How will diagnose wilson = 24"hr urinary copper excreation

Drug.of.choice for Wilson = Penicillamine

Charcot's triad.= Fever + jaundice + RUQ pain

Reynold pentad = charcot triad + shock + altered mental status

Charcot's triad + Reynold's pentad is feature of = Acute cholangitis

If RUQ pain and vomiting without fever,,, without Jaundice and without raised WBCs it will=
GALL STONES

If RUQ pain with Fever and raised WBCs without Jaundice = Acute cholecystitis

If RUQ pain with jaundice,,,, without fever and raised wBCs = Choledocholithiasis

If RUQ pain + jaundice + fever = acute cholangitis

Most common benign tumor of liver is = cavernous Hemangioma

Most common tumor of liver in OCP using female = hepatic adenoma

Which protein raise in the HCC = AFP

Type.of.ascites in Nephrotic syndrome + Pancreatitis +peritonitis TB = Exudative(vvvimp)

Type.of.ascites in Heart failure + Acute.pericarditis +liver failure is = Transduative(vvvvimp)

Most common tumor of Gall bladder is = Adenocarcinoma

Most common.site.of pancreas tumor in = head(Adenocarcinoma)

Most common tumor of appendix = Carcinoid(wheezing in flushing + diarrhea)

Confusion.+ flapping.tremor.in = Hepatic encephalopathy

Hepatic Encephalopathy.due to = raised Ammonia

Drug.for encephalopathy= rifaximin + lactulose

Risk factor of encephalopathy= constipation raised protein

Durg to decrease Ascites = furosemide

Respiratory system 🫁
Hyperesonant percussion note + Shifting of mediastinum towards normal side = Pneumothorax

Stony dull percussion note shift of mediastinum towards normal side= Pleural effusion

Shift of mediastinum towards disease side = fibrosis+collapse

Transudative pleural fluid = heart failure

Exudative pleural fluid = TB pancreatitis

Treatment for emergency pneumothorax= needle decompression (in 2nd IC space midclavicular
line)

Specific treatment of pneumothorax= Thoracostomy(5th IC space midaxillary line)

Late inspirational crackles occur in = idiopathic pulmonary fibrosis

End inspiratory crackles with squeaks History of pigeon = Hypersensitivity pneumonia

Pneumonia in AIDS cause by = pneumocystis jiroveci

Non.matted LN + non.caseating granuloma= Sarcoidosis

Investigation of choice for Sarcoidosis= Transbronchial biopsy

Treatment of choice for Sarcoidosis = Corticosteroids

History of femur fracture + Sudden SOB = pulmonary embolism

Finding on ECG in pulmonary embolism= S1Q3T3 pattern

Drug for DVT in pregnancy = low molecular weight Heparin

Leading cause of Bronchiectasis in eastern countries = TB(if western then Cystic fibrosis)

Greenish Foul smelly Copious Sputum = Bronchiectasis

Investigation of choice for Bronchiectasis= HR-CT

Most common cause of Typical Pneumonia= Streptococcal pneumonia

Cause of Atypical pneumonia= Mycoplasma pneumonia

Ventilator association pneumonia= Pseudomonas

Pneumonia in Alcoholic= Klebsiella

Drug of tB cause peripheral neuropathy= isoniazid

Casue vision problem= ethambutol

Old age + Chain smoker+ SOB = COPD

Investigation of choice for COPD= spirometry

Drug of choice for acute asthma = SALBUTAMOl

Cough in spring season related to allergies= asthma

Clubbing in Respiratory disease = Bronchiectasis fibrosis or cancer

Tumor cause horner syndrome= pancoast tumor

Small cell CA cause the = Cushing syndrome

SCC of lung cause = hypercalcemia

sCC is central location while adenocarcinoma on peripheral,,,,SCC in smoker and

adenocarcinoma in non.smoker

Asbestos cause = Bronchogenic CA >Mesothelioma

Sudden SOB = pneumothorax or Pulmonary Embolism

Wedge shape area on Lungs = pulmonary infarction

Rhumatology 🦿
Early morning stiffness less then 30mints = Osteoarthritis

Heberden + bouchard nodules in = osteoarthritis

1st joint involved in osteoarthritis = DIC

Osteophytes present in = osteoarthritis

Early morning stiffness more then 30 mints = RA

1st joint involved in RA = Proximal interphalangeal joint

Drug of choice for RA = methotrexate

Caplan syndrome occur in = RA

Specific test of RA = ACPA

Seronegative disease are = Psoriasis + Ankylosing spondylitis

Diuretics can cause the = GOUT

DOC for acute Gout = NSAIDS (2nd line is colchicine)

DOC for chronic gout = Allopurinol

Crystal in Gout = Monosodium urate crystals

Negative Birefringent Crystal present in = GOUT

Crystals in Pseudogout = Calcium pyrophosphate positive Birefringent

Chronic backache + Uveitis occur in = Ankylosing spondylitis

Valuver disease in Ankylosing spondylitis= Aortic regurgitation

Bamboo spine occur in= ankylosing spondylitis

Nail + hair involved + joints involved = Psoriasis

Skin shine and Tight + inability to wash clothes in = systemic sclerosis

Which antibody positive in Systemic Sclerosis= anti-topoisomerase

Paralysis of proximal muscle of Body = polymyositis

Inability to hanging clothes and stand from chair = polymyositis

Which enzyme positive in polymyositis = CK

Butterfly rashes + Malar rash + photosensitivity = SLE

Specific test of SLE is = anti.DNA

Anti.Smith positive in = SLE

Dry eyes dry mouth enlarged lacrimal glands =sjogren's syndrome

Ant.Ro + anti.La positive in = Sjogren's syndrome

Antiphospholipid antibody positive in = RA

Drug for Sjogren's syndrome = Pilocarpine

Pulselessness disease is = Takayaso arteritis

Strawberry tounge + coronary artery involve in = Kawasaki disease

History of Hep.B and C + Arthritis = Polyarteritis Nodosa

Temporal artery involve in = Giant cell arteritis

Uveitis + arthritis + Conjunctivitis = Riter disease

Aphthous ulcer + arthritis + urethritis = Behcet disease

Recurrent fracture of bone on fall = osteoporosis

Investigation of choice for osteoporosis = bone mineral density

Drug of choice for osteoporosis = bisphosphonates

Investigation of choice to check spine = MRI

Involved by TB = Spine

Blood 🩸
Drug of choice for CML = Imatinib
.

Smudge cell present in = CLL

Aur rods presen in = AML

IF lymph node rubbery = Lymphoma

If lymph node matted = TB

If lymph node not matted = Sarcoidosis

Pancytopenia + Hepatosplenomegaly = ALL

Lytic lesion of bone + Panda eye + HYPERCALCEMIA = multiple myeloma

Reed"Sternberg cells = Lymphoma

Anemia in cow milk boy = iron deficiency anemia

Most common anemia in Female = iron deficiency anemia ( bcz ofmenstrual period)

MCV less then 80 = Iron deficiency + Thalassemia

Hair on end pattern on skull = Thalassemia

Investigation of choice for Thalassemia = HB electrophoresis (vvvimp)

In iron deficiency anemia = dec.Ferritin + inc Transferrin + inc.iron binding capacity (vvvimp)

In Thalassemia = inc. ferritin + dec.transferrin

If MCV 80 to 100 = Hereditary spherocytosis SCD

Anemia + jaundice + Splenomegaly +spherocyte = Hereditary spherocytosis

Gall"stone + dactylitis = SCD

If splenectomy occur then most common infection is = Pneumococcus

In SCD = valine for glutamate

In SCD which will increase = HbS

In Thalassemia = inc.Hb A2+ increase/normal HbF+ dec.HbA

If history of radiation and pancytopenia = aplastic anemia

Anemia in malaria drug using = G6PD deficiency anemia

Bite cell + heinz bodies = G6pD deficiency

In Hemophilia A = APTT + CT raise

In VWD = APTT + BT increase

In ITP = BT increase + Platelets decrease

Investigation of choice for DIC = raised D.dimer

In VWD mucous membrane involved but in hemophilia there is joint and soft tissue involved

Raised RBC + Splenomegaly = polycythemia rubra vera

CNS 🧠
.
Drug of choice for migraines = Sumatriptan
.
DOC for cluster headache = Sumatriptan

Drug for prophylaxis of migraine = valproic acid/ Beta blockers

.
Drug of choice for Trigeminal neuralgia = Carbamazepine
.
Drug of choice for partial seizure = Carbamazepine

Drug of choice for grand mall epilepsy = Valproic acid

Drug of choice for absence seizure = ethosuximide

.
Drug of choice for parkinson = dopamine

Lead pipe + cogwheel rigidity = Parkinson

Clasp Knife rigidity = UMN lesion

Atrophy and Hyperreflexia in = LMN lesion

Spastic paralysis occuer in = tetnaus

Symmetrical ascending paralysis occur in = GBS(vvivmp)

.
Drug of choice for Acute GBS = Ig,,and for choric GBS is = steroid

If ptosis or meiosis + respiratory muscle paralysis = Myasthenia(vvvimp)

If paralysis of Pharyngeal and palate muscle = bulbar palsy(vvvimp)

If UMN lesion sign in lower limb and LMN lesion in Upper limb = Motor neuron disease (vvvim)

Drug of choice for Myasthenia = neostigmine

.
Drug use for diagnose of Myasthenia = edrophonium

Most common cause of meningitis in Neonates = E coli

.
Hypoglycemia occur in = Bacterial meningitis
.
Lymphocytosis occur in = tuberculosis meningitis

Lhermitte sign + 6th nerve palsy = Multiple Sclerosis

Investigation of choice for MS = MRI

STROKE (CNS) 🧠
Most common cause of hemorrhagic stroke is = Hypertension

Most common cause of ischemic stroke is = Embolism

Hyper"Dense(WHITISH) area on CT is = hemorrhagic stroke

Hypodense(Black) area on CT = Ischemic stroke

Ischemic stroke take 6 to 24hr time to appear on CT,while hemorrhagic stroke appear on that
time

If Ischemic stroke recovery in 12 hr then = TIA

Investigation of choice for Stroke = CT scan

Aphasia + hemiparesis + Hemisensory loss + homonymous Hemianopia = middle cerebral

artery occlusion

Aphasia + isolated paralysis of Arm/leg = branch of MCA occlusion

Nystagmus And ataxia vison problem = PCA occlusion

Pure sensory/pure motor loss = Lacunar artery occlusion

DOC for Ischemic stroke = TPA

Lucid interval in = Extradural hematoma

Artery involved in Extradural hematoma = Middle meningeal artery

Artery involved in subdural hematoma = bridging veins

Mannitol is Contraindicated in = Subdural hematoma

Atrial fibrillation cause = ischemic stroke,

.
Thunderclap headache = Subarachnoid hemorrhage

Most common cause of Subarachnoid hemorrhage= rupture of berry aneurysm

Medicine-2

Kidney

Proteinuria more then 3.5g/24hrs + PERIORBITAL edema(puffiness) = Nephrotic syndrome

Nephrotic syndrome in children called = minimal change disease

Disease best response to Steroids is = Minimal change disease (MCD)

Glomerulus look normal in MCD,, effacement of foot process occur

Nephrotic in adult = Membranous nephropathy

Nephrotic syndrome in "COCAINE"" intake person = focal segmental glomerulosclerosis (FSG)

Proteinuria less then 3.5g/24hr + hematuria = Nephritic syndrome.

History of pharyngitis less then 1 week and sign of Nephritic syndrome,,it will = IgA nephropathy

If above condition more thej 1 week then = Post streptococcal glomerulonephritis (PSGN)

Complement level normal in IgA nephropathy but decrease in PSGN

Drug to control BP in Nephritic syndrome= ACE inhibitors/ARB

Drug of choice to control BP for Diabetics nephropathy= ACE inhibitors/ARBs

Best diagnose finding in Diabetic nephropathy is = Microalbuminuria (vvvvimp)

Feature of Nephritic + RASHES on buttock = Henoch scholein Purpura (vvvimp)

Complication of HSP= Intussusception

WEDGE shape area in kidney = Renal INFARCTION

bilateral lumber swelling + Hematuria = PCKD

Investigation of choice for PCKD = USG

Fluid and protein restrictions in PCKD

Unilateral mass in Lumber region + Hematuria = RCC

RCC occur in = VHL disease

Paraneoplastic syndrome occur in RCC = SIADH + polycythemia

Unilateral mass in Lumbar region in CHILDREN + Hematuria = WILMS tumor

Dull pain in Lumber region + hematuria = Renal stone

Colicky pain in lumbar radiation to groin/loin = Ureteric stone

Investigation of choice for kidney stone = non.contrast CT scan

1st line of investigation of Renal stone = USG(if this not available then X.ray)

Investigation of choice for RCC = Contrast CT scan

BPH occur in = Traditional zone

Prostate cancer occur in = Peripheral zone

Which protein raised in Prostate cancer = PSA

Most common cause of UTI = E.coli

Most common cause of Prostatitis = S.aureus

Drug of choice for UTI = Ciprofloxacin

Pain in COSTOVERTEBRAL angle + FEVER = acute
pyelonephritis

Bilateral lower abdominal pain + fevr = UTI

If Hematuria + Cataract + Sensorineural deafness = ALPORT syndrome (vvvimp)

If Pulmonary Hemorrhage (hemoptysis) + Nephritic syndrome = Good pastur syndrome(vvvimp)

Anti.GBM ab positive in = GPS

In nephrotic syndrome fluid collect in Lung,,but in Good pasture there will pulmonary
Hemorrhage....

Sudden OLIGURIA = Acute kidney injury (vvvimp)

Most common cause of AKI = mostly drug induced

Most common cause of CKd = Hypertension/Diabetes

.

In CKD there will history in months and Years, urea

Creatinine level will rise

Best diagnostic test for CKD is = creatinine

Complication of CKD))vvvimp
A) Hyperkalemia
B) Hyponatremia
C)Hyperphosphatemia
D) Hypocalcemia
E) Pericarditis
D) Anemia
E) osteodystrophy

Cause of anemia in CKd= decrease erythropoietin

Indication of dialysis will same complications of CKD

Cause of renal rejection after transplant = CMV

Dialysis should started when GFR less then = 15

Most common feature of bladder cancer = painless hematuria

Most common bladder cancer= Transitional cell CA

Cause of bladder cancer = schistosomiasis + Dye + Rubber + cyclophosphamide

Investigation of choice for nephrotic= Renal BIOPSY

Investigation of choice for UTI = Urine culture

Acid base and Electrolytes

Tall / Peak T.wave + Wider QRS complex = Hyperkalemia

Ectopic U wave + Prolong PR interval = Hypokalemia

Cause of Hypokalemia = Cushing + CONN syndrome + loop diuretics

Cause of hyperkalemia = Addison + Spironolactone

Treatment of hyperkalemia = Ca"gluconate + Loop diuretics insulin and dextrose

Normal Osmolarity of plasma is 300mOsmol

Any fluid which have osmolarity more then 300 it will hyperosmolr

If Plasma osmolarity more and urine osmolarity is less then it will = Diabetes insipidus,,,
If above vise versa then it will """SIADH""(vvvvvvvvvvvvimmmp MCQS + SEQs)

Drug of choice for SIADH = demeclocycline

DOC for diabetes insipidus = Desmopressin

Test for Diabetes insipidus is = Water deprivation test

If Bone pain + Peptic ulcer + polyuria = Hypercalcemia

If Tetany + Chvostek sign + Carpopedal spasm = Hypocalcemia

Prolonged QT interval occur in = Hypocalcemia

Cause of Metabolic acidosis in which normal anion gap = Diarrhea..

Type of breathing in metabolic acidosis = Kushmual breathing

Compensatory response of respiratory system in metabolic acidosis is = Hyperventilation

Metabolic acidosis#
PH <7.3
HCO-3< 25
PCO-2 = 40
If compensation by Respiratory then
PCO2 less then 40

Metabolic Alkalosis
PH >7.3
HCO-3> 25
PCO2 = 40
If compensation by Respiratory then
PCO2 more then 40

Cause of Metabolic alkalosis is = Hyperaldosteronism + Vomiting (vvvimp)

Diarrhea cause metabolic acidosis and vomiting cause metabolic alkalosis (vvimp)

Hyperventilation occur in metabolic acidosis and hypoventilation occurs in Metabolic alkalosis

Respiratory Acidosis#
PH <7.3
PCO2 > 40
HCO-3 = 25
If compensation by kidney then
HCO-3 more then 25

Cause of respiratory acidosis is= COPD + Asthma + Opoid

Respiratory Alkalosis#
PH >7.3
PCO2 < 40
HCO-3 = 25
If compensation by kidney then HCO-3 less then 25

Cause of Respiratory Alkalosis is = Anxiety + pulmonary embolism (vvvimp)

Endocrinology
Type of tremor in Thyrotoxicosis = Fine tremor

Whenever there is Weight loss + Hot and sweaty hand + increase appetite = hyperthyroidism
(Thyrotoxicosis)

Heart Problem in Thyrotoxicosis= Atrial fibrillation + Sinus tachycardia (vvvimp)

While Sinus bradycardia occur in hypothyroidism

Anxiety occur in Hyperthyroidism and Depression occur in hypothyroidism

Exophthalmos lid lag + lid retraction occuer.in = Thyrotoxicosis

Gynecomastia occur in Hyperthyroidism but Galactorrhea occur in hypothyroidism

Loss of lateral side of eye 👁️ brows occur in Hypothyroidism

Whenever Dry skin + Cold intolerance + Weight gain + loss of appetite = Hypothyroidism

finding in Thyrotoxicosis =
Raised T4 + T3
Decrease TSH(vvvimp)

Finding in Hypothyroidism=
Decrease T4 + T3
Raised TSH(vvvvimp)

Treatment of Hyperthyroidism in Pregnancy = PTU in 1st trimester + carbimazole in 2nd and 3rd
trimester

Radio"iodine contraindications in Pregnancy (vvvvimp)

Durg to control tremor in Thyrotoxicosis= beta blocker(imp)

Anti.Thyroglobulin + Anti.thyroid peroxidase positive in = Hashimoto Thyroiditis (vvvimp)

Type of cancer in Hashimoto Thyroiditis= Lymphoma (vvvimp)

Radiation will cause = papillary Carcinoma of thyroid (vvvimp)

Which thyroid tumor occur in MEN-2 syndrome = Medullary Carcinoma (have Amyloid deposits
raised calcitonin (vvim)

Short stature + Web NECK + Streak ovary = Turner syndrome(45XO)

Investigation of choice for turner syndrome = Karyotyping (vvimp)

Oligomenorrhea Acne + Hirsutism occur in = polycystic ovarian disease (PCOS)

Finding in PCOS = Raised LH + Prolactin(vvimp)

Large height + small testis = Klinefelter syndrome(47XXY)

Most common cause of Hypercalcemia = parathyroid Adenoma

Cause of Primary hyperparathyroidism= Parathyroid adenoma + hyperplasia

Cause of secondary Hyperparathyroidism= CKD

Most common cause of Cushing syndrome = Exogenous intake of steroids (vvimp)

TUMOR causing Cushing syndrome = Small cell carcinoma of lungs (vvimp)

Whenever Central obesity + Moon face + buffalo 🦬 hump = Cushing syndrome

Metabolic disorder in Cushing syndrome = Hypokalemia alkalosis (imp)

Metabolic disorder in Addison disease = Hyperkalemia + acidosis

Gold standard test for Cushing syndrome = 24hr urinary cortisol measure (imp)

Blackish Pigmentation over the KNUCKLES + hypotensive + Hyperkalemia = Addison disease

Test for Addison disease = ACTH stimulation test

If emergency conditions feature of Addison disease it will = Addison crisis

If emergency conditions feature of hypothyroidism ,it will = myxedema coma

DOC for pheochromocytoma =a.blocker (Phenoxybenzamine) vvvimp(it also give before

surgery)

Finding in pheochromocytoma = raised VMA + chromogranin

Ambiguous genitalia occur in = congenital adrenal hyperplasia due to deficiency of

11.b"hydroxylase (vvvimp)

Wheezing + FLUSHING + diarrhea = Carcinoid tumor(give octreotide)

Amenorrhea + galactorrhea + loss of libido = Prolactinoma ( Give bromocriptine)vvvimp

Large hands large feet + increase size of clothes = Acromegaly,, treatment is transsphenoidal
surgery and investigation is ""serum insulin growth factor"""(vvvimp)

Carpel tunnel syndrome occur in = hypothyroidism + acromegaly + multiple myeloma

MEN-1 syndrome example = 3P"s,,, parathyroid + pancreatic + pituitary cancer

MEN- 2 syndrome = parathyroid + medullary CA of thyroid + Pheochromocytoma

Polyuria + polydipsia + Raised plasma osmolarity and decrease urine osmolarity = Diabetes
insipidus (test is ""water deprivation test and treat is Desmopressin""")imp

Cardiac problem in turner = Coarctation of Aorta + bicuspid aortic valve

Diabetes milletus

Best test for Diabetes = OGT(imp)

Prediabetic#
If RBS is = 140-200
FBS = 110-126

Diabetic#
RBS>200
FBS>126

Type 1 diabetes is Autoimmune and associates with ""HLA-DR3 and DR4""

Polyuria +polydipsia + polyphagia = Diabetes sign

Dangerous complication of Diabetes is = Hypoglycemia (imp)

Type 2 diabetes associate with Metabolic syndromes

DKA#
RBS>200
Ketone bodies positive
PH less then 7.3
pHCO3 less then 15

DKA is most common in = type.1 diabetes

Dose of insulin in DKA is = 0.1 U/Kg

When Glucose give in DKA = when Glucose is less then 252mg/dl

Type of fluid use in DKA= N/S

When will half saline give in DKA = when Na is >155mmol/L

Most common risk factor of DKA in female = UTI(infection)

Investigation of choice for DKA =urinary Ketone bodies (imp)

Diabetic patient is Trembling + sweating + Drowsiness,,,it will = Hypoglycemia

Value of hypoglycemia= less then 70 RBS

Which disease can cause hypoglycemia = Addison disease

DOC for DIABETIC type 2 in OBESE patient is = Metformin (vvvimp)

Complication of metformin is = Lactic acidosis

What are insulin secretagogues= Sulfonylureas(cause weight gain)

Citagliptin and saxagliptin are = DPP-4 inhibitors

Exenatide is = GLP-1 receptor agonist

Drug of Diabetes cause ""Osteoporosis and cardiac abnormality= Thiazolidinediones

Treatment of choice for type 1 diabetes = insulin

Rapid acting insulin is = lispro + aspart

Intermediate acting insulin is = lente NPH

Long acting insulin is = Glargine

Drug of Diabetes use in CVS patient = Empagliflozin exenatide

Microvascular complications of Diabetes is = Retinopathy nephropathy neuropathy

Macrovascular complications= MI + TIA +! Diabetic foot

If patient of diabetic have """Tingling sensation in LIMBS it will =peripheral neuropathy (imp)

If diabetec patient have Dribbling of urine.it will= Autonomic neuropathy (imp)

DOC for diabetic neuropathy= Pregabalin

DOC diabetic nephropathy= ACE/ARB

Typical finding in Diabetic nephropathy = Microalbuminuria (imp)

1st finding in Retinopathy is = Microaneurysm (imp)

Psychiatry

False but firm belief = Delusion

Perception without stimulus= hallucinations

Perception with stimulus= Illusion ( ‫سمجھنا‬ 🐍 ‫)رسی کو سانپ‬

If patient belief someone will harm him it will = Persecutory delusion

If patient conviction that he has cancer = Hypochondriacal

If patient belief he have some special status = Grandiose

If patient belief """his head is missing/some body part Missing= Nihilistic

If hallucinations occur when falling asleep = Hypnagogic

If hallucinations occur on waking = hypnopompic

Auditory hallucinations occur in = Schizophrenia (vvvvimp)

Visual hallucinations occur in = Delirium (vvvimp)

Anxiety occur in Hyperthyroidism while Depression occur in Hypothyroidism

Dementia in Old Age + Tau protein = Alzheimer"s disease(give anticholinesterases,,)

Area defective in Alzheimer = Hippocampus (plaques and tangles formation)

Medical disorder in which dementia occur = Hypothyroidism

Psychological symptoms after alcohol withdrawal = Alcohol withdrawal syndrome ( Give ABCD=
acamprosate + benzodiazepine + chlorpromazine Disulfiram)

Ataxia + Nystagmus + delirium = Wernicke encephalopathy (Give Thiamine Vit.B1)vvvimp

Which vitamin deficiencies occur in Alcoholic= vit.B1 thiamine)

Street drug = cocaine

Person is suspicious + Auditory hallucinations = Schizophrenia

Person were using schizophrenia drugs but now he have Fever and Tremors = Neuroleptic
malignant syndrome (NMS)vimpppp

Treatment of NMS = Dantrolene + Diazepam

Which toxicity is common in all Schizophrenia drugs = weight Gain

Effect of Clozapine is = Agranulocytosis

Suicidal Thoughts occur in = depression

Loss of interest + loss of joy due to breakup/divorce/ job loss,,it will = Depression (vimp)

Amitriptyline is = TCA

Fluoxetine is = SSRI

Venlafaxine is = Nor-epinephrine reuptake inhibitors and SSRI

Stage of happy mood alternative with depress mood =Bipolar disorder (vvimp)

Child was performing good in School but now he feeling lonely for some days= bipolar disorder

DOC for prophylaxis of Bipolar disorder = Lithium/Sodium Valproate (immmp)

Toxicity of lithium= diabetes insipidus + Hypothyroidism+ ebstein anomaly

Bipolar disorder + schizophrenia = Schizoaffective disorder

Fear of going to Crowd for example fear to go bazaar = Agoraphobia (vvimp)

Chest pain with palpitations but ECG and respiratory investigation normal it will = Anxiety (panic
disorder)vimp

Which disorder occur in Anxiety = Respiratory Alkalosis (imp)

Therapy for anxiety is = desensitization (vvvimp)

DRugs for anxiety = SSRI/TCA(vvvimp)

Repeatedly Washing hand bcz of fear of disease,,it is = obsessive compulsive disorder ( OCD)
(imp)

DOC for OCD= SSRI

Nightmare after war/accident/death it will = post"traumatic stress disorder(imp)

Patient Multiple medical symptoms such as Headache,,, abdominal pain but on investigation no
disease it will = SOMATiSATION(vvvimp)

If Multiple visit in Hospital in single day with multiple complain and it is DRAMATICALLY and
convinced Dr to do investigation = Munchausen syndrome (vvvvvimp)

If Munchausen syndrome associated with benefits for example leave from court appearance =
Malingering (vvimp)

If patient say """loss of function in limbs + Aphonia it will = Dissociative conversion disorder
(DCD)vvimp

If patient felt he have irregular shape of his BODY it will = Agoraphobia

Young girl not Take food and do exercise ,,she have weight loss and emaciation occur it will =
Anorexia nervosa

Young girl Recurrent bouts of eating but herself vomiting it will = Bulimia Nervosa

Russel sign + Mallory weiss tears + Parotid gland enlarged occur in = Bulimia Nervosa

Metabolic disorder in Bulimia Nervosa = Hypokalemia

ECG changes in eating disorder = ST depression T wave inversion prolong QT interval

DOC for eating disorder = SSRI

Mother have Tearfulness , irritated and low mood after delivery of baby within 2 week and it
requires no treatment it will = Post-partum blues

If mother delivery a bady and,,,now she have loss of self esteem + suicidal thought + Self harm
it will occuer after 2 week of delivery it will = Postpartum depression

DOC for Postpartum depression = TCA then SSRI

If mother is suspicious that someone will harm her baby and have auditory hallucinations it will
= Postpartum psychosis

Drug for prophylaxis of Postpartum psychosis= lithium

Infectious Disease 🪰
RICE water stool is feature of = CHOLERA and DOC for this = Tetracycline

Bloody diarrhea with Tokic look occur in = Shigellosis (dysentery) and DOC is Ceftrioxne

Bloody/non.bloody diarrhea with Liver Mass = Amebiasis and DOC for this = Metronidazole
(vvimp)

Foul smelly greasy stool with TROPHOzoites in Stool= Giardiasis and DOC for this =
Metronidazole

Chronic diarrhea= diarrhea more then 14 days (imp)

Specific investigation in above infectious disease is= Stool culture

STEP"LADDER fever + Green Rose spots On abdomen = Typhoid fever

Tachycardia occur in fever but in Typhoid fever there will bradycardia

Leucopenia occur in = COVID-19 + Typhoid

Investigation of choice in 1st week of Typhoid is = Blood culture,,,,in 2nd week = blood culture +
Widal test

DOC for Typhoid fever= Ciprofloxacin

Most common site of GIT for Typhoid is = Terminal ileum

3 disease effect Terminal ileum = Typhoid + TB + Crohns

Diagnostic test for Polio is = Stool culture

Irregular weakness/paralysis of muscle occur in = POLIO

If ascending Symmetrical weakness/paralysis it will = GBS

Polio effect on = anterior horn Cells of spinal cord (imp)

Whitish membrane formation occur in pharyngeal wall larynx + Pericardium in = Diphtheria

BULL neck in = diphtheria

Dose of Diphtheria antitoxin = if duration is 2 day(20k to 40k),,,if duration is 3 day(80k to 100k)

Cough follow by Vomiting = Pertussis and DOC is Erythromycin

Lock jaw + Opisthotonos occur in = Tetanus

Seizure in Light and on touch after trauma = tetanus

Tetanus toxin dose= ATS is (50k to 100k) and TIG(3k to 6k)

Antibiotic for tetanus is = penicillin

MACULOPAPULAR Rash with Conjunctivitis and Koplik's spots = Measles

Which vitamin give in measles = vit.A

Most common complication of Mumps = Orchitis

MMR vaccine give in = 12 to 15 month

Rain"drops like rashes = Chicken pox

Strawberry tounge occur in = Kawasaki disease

Vesicle in Tympanic membrane + 7th Nerve palsy = Ramsy hunt syndrome (vvvimp) cause by
HZV

Fever + chills + Rigors typical triad of = malaria

Most virulent malarial parasite is = Falciparum

Most common malaria parasite is = vivax

Investigation of choice for malaria = Blood smear (thick and thin giemsa stain)

Types of seizure in cerebral malaria is = Generalized tonic clonic fits

Black water Fever occur in = malaria

DOC for Malaria in Pregnancy = Chloroquine (imp)

Large incubation period of malaria parasite = p.malariae

Less incubation period= p.falciparum

Periorbital pain + Joint pain + gum bleed = DENGUE

Dengue is cause by = Aedes"egypti

If patient of dengue fever have Hypotension,, tachycardia with cold Peripheries it will = Dengue
shock syndrome

CBC disorder in Dengue = Thrombocytopenia

Maculopapular rash and enlarged tonsil after intake of AMPICILLIN = infectious mononucleosis
cause by EBV(vvvimp)

PAUL"bunnel test for = EBV

Leishmaniasis is cause by = SAND"fly

Rabies vaccine#
Pre-exposure prophylaxis= 0,7,21,28 days

Post.Exposure=
If previous vacicnated then 2 doses of 0,3 days

Which Parasite cause. anemia = Ancylostoma dudenale(vvimp)

Peri-anal itching = Entroboious vermicullaris (vvimp)

Rectal prolapse cause by = Trichuris trichiura

Drug of choice for Ascaris is = MEBENDAZOLE (imp)

Cataract + PDA + hearing loss = RUBELLA (imp)

Chorioretinitis + Cerebral calcification occur in = Toxoplasmosis
And DOC is (Sulphadiazine and Pyrimethamine)

Microcephaly + PEri-ventriculer Calcification occur in = CMV

Temporal lobe is effect by = HSV

Type of hepatitis by blood transfusion = Hep.B

Type of hepatitis in Pregnancy = Hep.E

Disease in sewerage worker = Leptospirosis (vvimp)DOC for this is Doxycycline

SWINGING Fever is feature of = Brucellosis (imp)

LION 🦁 like face + THICK nerve and skin in = LEPROSY and DOC for this is = Dapsone (imp)
AIDS#
If CD4<100 = CMV + Toxoplasmosis occur
If CD4 <200= Pneumocystis jiroveci
If CD4 200 to 500 = T.B + lymphoma

CHANCRE + Condylomata acuminata in = SYPHILIS

AND DOC is Penicillin(imp)

Curdy white discharge through vagina = Candidiasis(Clotrimazole give)imp

Yellow green discharge= Trichomonas vaginallis(DOC is metronidazole

Fishy odour discharge and CLUE cells =Gardinella vaginalis (DOC is metronidazole

DOC for gonorrhea= Ceftriaxone

DOC for chlamydia =azithromycin

Screening test for AIDS = p24 antigen

Viral load of HIV by = PCR

Whitish membrane in Mouth in AIDS = Candidiasis

Hydatid cyst occur in liver by = Echinococcus granulosus and DOC is Albendazole

RoMana"s sign + Achalasia occurred in = Chagas disease cause by trypanosoma (Reduviid
BUg) ,DOc is ""nifurtimox""

Sleeping sickness cause by ""Tsetse fly"

Malaria and Yellow fever caused by = anopheles mosquito 🦟

Maculopapular Rash On cheek's= Scarlet fever (imp)

Skin

Vesicle around Angle of mouth = HSV(DOC is acyclovir)

Painful vesicle on side of chest and abdomen = Shingles cause by HZV

Photosensitivity with malar Rash= SLE

Maculopapular rash on face with Tonsil enlarged is feature of = Scarlet fever

Multiple sinus wound on back of neck and shoulder in DIABETIC = Carbuncle caus by S.aureus

DOC for tenia capitis is = Griseofulvin

DOC for Dermatophyte= Terbinafine (vvvimp)

DOC for Pityriasis versicolor= Selenium sulphide

Rash in Finger WEB space= Scabies give permethrin

Greasy face with papule and comedones = Acne Vulgaris

Patient having papule with FLUSHING and Telangiectasia = Rosacea

Whenever history of ASTHMA and RASH with SCRATCH MARKS = Eczema(vvvimp)

Feature of Chronic Eczema is = LICHENIFICATION + Fissures(vvvimp)

SALMON patches occur in = Psoriasis

Auspitz sign occur in = PSORIASIS

PLAQUE and PUSTULES feature of = Psoriasis

VIOLACEOUS papules is feature of = LICHEN planus (vvvimp)

LACE like pattern + Wickham"s striae + KOBNER phenomena occur in = Lichen planus

WEALS formation occur in = URTICARIA

Sudden Eruption of Blisters All over the body,,,person was taking SULPHONAMIDES + NSAIDS
= Toxic Epidermal Necrolysis (vv imp)

BULLA + Millia formation in OLD age = Bullous pemphigoid (vv imp)

Which antibodies positive in Bullous pemphigoid = antibodies against BPAg-1 and 2 ,

Blister With CHICKEN wire appearance in YOUNG = Bullous pemphigus (vvimp)

Which antibodies positive in Bullous pemphigus= Antibody against Desmoglein 1 and 3

NIKOLSKY sign positive in = Toxic epidermal Necrolysis + Bullous pemphigus Staphylococcal

scalded skin syndrome (vvimp)

Skin manifestation in CELIAC disease = Dermatitis herpetiformis

DOC for Dermatitis herpetiformis is = DApSone

Round spherical nodule on SHIN = Erythema nodosum and occur in Sarcoidosis and Crohn's
disease

Target lesion with Bull"eye in = Erythema Multiforme

Keratosis in NECK in OBESE and DIABETIC = Acanthosis negricans (vvvimp)

Irregular Crust formation on shin = Erythema marginatum(vv imp)

Transverse ridging of Nail occur in = Eczema

Longitudinal Ridging of nail + Pitting of nail occur in = PSORIASIS

Sandpaper texture nail occur in = Lichen planus

Separation of nail from nail bed = Psoriasis

Half and half nail = CKD

White nail = Hypoalbuminemia

Spoon shape nail = iron deficiency anemia