Important one-liners (Recalls)

Contraindication of thrombolysis in ischemic CVA?  Seizures at the time

of presentation. Refrence: OHCM

Frontal lobes lesions:

Most common organism isolated in patients with bronchiectasis 
Expressive (Broca's) aphasia:
Haemophilous influenza. Refrence: Pass medicine
located on the posterior aspect
Most common type of VSD is  Membranous VSD. (most common
of the frontal lobe, in the
location is membranous interventricular septum).
inferior frontal gyrus. Speech is
Antivirals are given in hepatitis B because the reduce the risk of  HCC
non fluent, laboured, and
What is the first line management in acute hyperkalemia  calcium
halting. Anosmia ,Changes in
gluconate
personality ,Disinhibition
Most common organism involved in post ERCP sepsis is Ecoli
Primitive reflexes (positive
Hemineglect syndrome is caused by the lesion in  Right parietal lobe.
grasp, pout and palmomental
Parietal lobe lesions:Sensory inattention.Neglect.Apraxias (loss of the reflexes).Urinary and faecal
ability to execute learned purposeful movements).Astereognosis (tactile incontinence,Perseveration
agnosia) (inability to recognize object by feeling).Inferior homonymous (repeatedly asking same
quadrantanopias. question or doing same
task).Inability to generate a list
Gerstmann's syndrome (lesion of dominant parietal): Alexia (inability rapidly (For example name
to read).Acalculia (inability to perform mental arithmetic calculation), animals in 60 seconds or words
Agraphia (difficulty in writing),Dyslexia (inability to recognise letters or beginning with the letter F,
words) Finger agnosia (difficulty in identifying fingers and naming etc.). Difficulties with executive
them)Right-left disorientation skills.

Note: 50% of patients

presenting with status
Temporal lobe lesion: Wernicke's (recepTive) aphasia.Superior homonymous
quadrantanopias.Auditory agnosia.Prosopagnosia (difficulty recognising
faces).Memory impairment.

Occipital lobe lesions: Homonymous hemianopia (with macula sparing).

Cortical blindness (blindness due to damage to the visual cortex, may
present as Anton syndrome: there is blindness but the patient is unaware or
denies blindness). Visual agnosia (seeing but not perceiving objects- it is
different to neglect since in agnosia the objects are seen and followed but
cannot be named). Unilateral occipital lobe lesions (left or right) cause
contralateral hemianopia or quadrantanopsia, visual illusions and

Black colored hepatocytes ae seen in  Dubin jhonson syndrome

Anemia is SLE is  comb s’ positive
Auer rods are seen in  AML
What is the investigation of choice to diagnose sarcoidosis  Trans
bronchial biopsy.
Most common antibody positive in SLE is  ANA.
Patient presented with signs and symptoms of porphyria what othe
findings may be present Psychiatric.
What is the management option to treat torsades pointes  IV
magnesium sulphate
Hypertensive patient presented with sign and symptoms of left sided
hemiplegia (pure motor stroke) what is the cause  Lacunar infarct.
What investigation is done to diagnose pernicious anemia  intrinsic factor
antibody,
Head injury can lead to  SIADH.
Painless ulcer with discharging sinus in the genital area, what is your
diagnosis?  Lymphogranuoma venerum (Chlamydia)
If dirrohea improves with fasting,what is the type of dirrohea  Osmotic
dirrohea.
Multiple duodenal ulcers at unusual sites  ZES
Recurrent duodenal ulcers at the usual sites  H-pylori.
How to differentiate between Barrter and Gittlemen syndrome  In
barter syndrome there is no hypomagnesemia.
Other differences are:
What type of skin lesion is seen in rheumatic fever  Erythema
Marginatum.
Asthmatic patient presented with atrial fibrillation how will you controle the
heart rate  Verapamil.
Patient presented with atrial flutter, his BP is 80/60, how will you manage
this case  DC cardioversion.
Remember: In
Male patient presented with bullous disorder involvind skin and mucous Pemphigous foliacious there is
membrance( oral mucosa) that is painful but non itchy what is your
no ORAL MUCOSA.
diagnosis  Pemphigous vulgaris.
Characteristic rash seen in Lichen plannus? polygonal pruritic paplues and involvement and the lesions
plaques. (Association with hepatitis C). are characteristically itchy
Wickham s’ striae are whitish lines visible on the papules of Lichen plannus
Homonymous hemianopia with macular sparing  Seen in the lesion of PCA
(occipital lobe)
Shistosoma mansoni is associated with portal hypertention and jaundice
and is endemic to Africa and west indies.
For the staging of colorectal cancer what investigation is to be performed?
CT scan
What is the best treatment option for hepatopulmonary syndrome  Liver
transplant.
Post ileal resection what is the cause of dirrohea  Bile acid.
Budd chiari syndrome  HEPATIC vein occlusion
Patient presented with SVT and low BP what is the management option 
DC cardioversion
8th week Post delivery patient is hyperthyroid what drug to be given? PTU
(PTU is most suitable among antithyroid drugs during lactation (Refrence:
Davidson)
30 year old male is going to the gym, he is taking anabolic steroids, he is
complaining of on/off severe abdominal pain and psychiatric symptoms
what is the most likely diagnosis  Acute intermittent porphyria .
In acute porphyrias symptoms are mostly triggered by:
a. Alcohol
b. Smoking
c. Use of certain medication and hormones (OCPs) and anabolic steroids.
d. Stress
e. Dieting and
f. Fasting. ( high carbohydrate diet is recommended in porphyria so these
patients can not do fasting)

Patient presented with torsades pointes and unrecordable BP what is the

best management option  DC cardioversion.
Obese female presented with headache, papilledema and signs and
symptoms of 6th nerve palsy, what is the most likely diagnosis  Benign
intracranial hypertention.
Hypertensive patient presents with infarcts in the brain, what type of
infarcts are common in hypertensive patient  Lacunar infarcts.
What of of sign is seen in barium study in case of Ulcerative colitis  Lead
pipe appearance.
Carotid artery aneurysm can lead to  Hornor syndrome.
Patient was admitted in ICU suddenly developed SOB. CT scan of the lungs
shows ground glass appearace what is the cause ARDS.
What is the best management option for diabetic gastroparesis 
metochlorpromide.

Asthmatic patkient was admitted to the hospital what PEFR will suggest to
discharge the patient? 75% Refrence: OHCM
Indication of pace maker following acute inferior wall MI is  Trifascicular
block.
Indiction for pace makers:

Pencil in a cup deformity on Xray hand is seen in  Psoriatic arthropathy.

Patient is having history of flu, fever and rash( dew drop appearance) from
several days now developed severe epigastric pain, nausea and vomiting,
serum amylse,xray and U/S abdomen is awaited, what is the most likely
diagnosis  Pancreatitis.
Patient presented with HTN emergency and was diagnosed as a case of
pheochromocytoma. What is the best drug for this condition 
Phentolamine.

Patient with HIV got painfull genital ulcers that are resistant to acyclovir
what can be done next  Foscarnet.
Pregnant female was diagnosed as a case of hyperthyroidism, what drug to
be given  PTU.
Managemment of warfarin toxicity with bleeding is  FFPS and VItamin K.
 Female patient was taking treatment for pruritis from dermatologist,was
examined by physician and noted hepatomegaly and raised ALP on
biochemical investigation, what is the most likely diagnosis  PBC.
Patient resented with chronic dirrohea, D-xylose test was performed,which
is normal what is the most likely diagnosis :
a. Pancreatic insufficiency (Maldigestion)
b. Malabsorption (Mucosal abnormality )
ANS: A D-xylose test is performed to differentiate between maldigestiona
and malabsoption.
Asymptomatic hypercalcemia is seen is  Parathyroid ademoma or primary
hyperparathyroidism.
Symptomatic hypercalcemia is seen is  Malignant hypercalcemia.
Known epileptic patient, well controlled on phenytion, develops fits again,
what to do next  Check serum phenytoin level.
Preproliferative diabetic retinopathy is characterized by Retinal
neovascularization.
Types of diabetic retinopathy

Background retinopathy:

1) Microaneurysms (MA) (dots) 2) Blot haemorrhages (less than 3) 3) Hard exudates (HE): collections of

exudated lipid and protein 4) Seen in both type 1 & 2 DM

Pre-proliferative retinopathy: 1) Cotton wool spots (CWS): (soft exudates; ischaemic infarcts of the

nerve fibre layer of the retina) 2) > 3 blot haemorrhages 3) Venous beading/looping, 4) Deep/dark cluster haemorrhages
5) More common in Type I DM, treat with laser photocoagulation.

Proliferative retinopathy: 1. Retinal neovascularisation - may lead to vitrous haemorrhage

2. Fibrous tissue forming anterior to retinal disc. 3. More common in Type I DM, 50% blind in 5 years

4. Normal visual acuity is seen in proliferative retinopathy. 5. Urgent referral to ophthalmologist for panretinal
photocoagulation.

Maculopathy: 1. Based on location rather than severity, anything is potentially serious 2. Hard exudates and
other 'background' changes on macula. 3. Check visual acuity. 3. More common in Type II DM
Tall male patient suddenly beeome SOB, on the right side breath sounds are
absent, what is your diagnosis  Pneumothorax.
Anti-hypertensive
hypertensive contraindicated in pregnancy is  Captopril.
Middle age female presented with wide pulse pressure, hyperdynamic
circulation and early diastolic mumur what is your diagnosis  AR.
Patient was having angioedema 2 weeks back, now recovered, now
recently he has been diagnosed as Hypertensive, What antih antihypertensive
will you advise him?
a. Losartan
b. Captopril
c. Phentolamnine
d. Beta blocker
ANS: A
Patient is diagnosed case of aortic aneurysm, now presented with chest pain
and unequal pulse in both the arms, he is vitally stable, what is the most
appropriate investigation  Trans esophageal echo.

Following MCQ is taken from Master the boards Usmle

step 2 Ck
Patient is hypertensive, with raised cretinine and pulpable mass in the
lumbar region, his father was having some kidney disease, what
investigation will you perform  U/S abdomen and pelvis.

Ultrasound diagnostic criteria (in patients with positive family history):

1. Two cysts, unilateral or bilateral, if aged < 30 years
2. Two cysts in both kidneys if aged 30-59 years
3. Four cysts in both kidneys if aged > 60 years

CT is more sensitive than USS and may aid in diagnosis in younger patients.

MRA angiography: In patients with a family history of intracranial aneurysm - to

screen for cerebral aneurysms.

Screening is recommended after 20 years age (if < 20 yrs. age >>>>
Ultrasound

gives false –ve result and CT is not needed as it will involve unnecessary high

radiation dose to this young boy or girl, so just follow up US at the age of 20 years

old age).Cysts usually develop during teenage years, so one cannot be confident a child has not
been affected until they are at least 20 years.

Patient presented with psychiatric symptoms, hallucination and tachycardia,

what poison he has taken  Amphetamines.
Early diastolic murmur followed by the mid-diastolic murmur,ECHO shows
AR, what is that mid-diastolic murmur called in this case  Austin-Flint
murmur.
Most reliable sign of Mitral stenosis is called  Presystolic accentuation.
Yound boy developed fever and sore-throat amd jint pains for which he was
treated , now he is developed unable to grip things properly and abnormal
movements (cerebellar signs were negative) what is the most like diagnosis
 Rheumatic chorea (Sydenham chorea).
ECG findings in pericarditis is  ST elevation with upward concavity.
Most specific for pericarditis is  PR depression.

In case of TIA  Give aspirin

immediately then Clopidogril life
long as a treatment.
A-Fib leading to TIA 
Anticoagulation (warfarin. With
heparin cover).
A-Fib leading to stroke  CT if
ischemic start Aspirin and
anticoagulation is started after
14 days in case of ischemic CVA