⑱

TOPNOTCH MEDICAL BOARD PREP BIOCHEMISTRY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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Be
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DERIVATIVE OF AMINO ACIDS
IMPORTANT LEGAL INFORMATION
Pare True Love Does Not Exist

⑤
The handouts, videos and other review materials, provided by Topnotch Medical Board
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I-

syn No ?
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Hi t
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DISCLOSURE Guy for Excitatory CNS

The handouts/review materials must be treated with utmost confidentiality. It shall Him
be the CNS
responsibility of the person, whose name appears therein, that the handouts/review
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-I
disposed in any manner. Any handout/review material found in the possession of another
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THIS HANDOUT IS NOT FOR SALE! Noxius
o
Attitude
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This will be rendered obsolete for the next batch • Tryp Mo Siya No?
since we update our handouts regularly.
Lysine • Carnitine
BIOCHEMISTRY – BUZZWORDS Methionine
• Homocysteine
• Cysteine
By Frinz Moey C. Rubio, MD
Amino acid that can be
GENERAL CHEMISTRY synthesized by the body but
-
Arginine
during puberty it becomes
Breakdown of substances to cat the -

-
Catabolism breaker essential to the diet
simpler forms -

-
I

Synthesis of larger molecules And the

-

Anabolism builder ESSENTIAL AND NONESSENTIAL AMINO ACIDS

from simpler ones -

Essential Semiessential Nonessential

-

• Losing electrons and

hydrogen Amino Acids Amino Acid Amino Acids
• Gaining oxygen Oxidation
PVT TIM HaLL
• Increase in oxygenation
Always ARGues Et al
number
Never TYRes
-

Phenylalanine
OXIDATION & REDUCTION
Valine
Oxidation Reduction Tryptophan
Threonine
• Losing electrons
• Losing hydrogen
• Gaining electrons
• Gaining hydrogen
Isoleucine
Methionine
Arginine
- All other amino
acids
• Gaining oxygen • Losing oxygen Histidine
Increase in oxidation number Decrease in oxidation number Leucine
(e.g., Fe2+ → Fe3+) (e.g., Fe3+ → Fe2+) Lysine

Reaction Reaction MNEMONIC TYPES OF COLLAGEN

RELEASES ENERGY STORES ENERGY • Type 1 collagen – B-ONE, Tend-ONE
• Type 2 collagen – Car-TWO-lage
Oxidized agent = Reducing Reduced agent = Oxidizing • Type 3 collagen – Re-THREE-cular fibers
agent agent • Type 4 collagen – FOUR on the FLOOR
LEORA • CATABOLISM – Breakdown of substances to its simpler forms
- • Type 7 collagen – “7” looks like a hook

GEROA • ANABOLISM
- ~

substances
– Synthesis of larger molecules from simpler
Gross hematuria, bilateral -

sensorineural loss, ocular

-
Type↳
4 Collagen
MNEMONIC -
LEORA X
AND GEROA problems. What is the
-
(Al-FOUR-th syndrome)
• Loses Electron • Gains Electron defective type of collagen?
• Oxidized • Reduced Thin Gross hematuria, gross Gard Esture syndrome
> i -
Type84 Collagen
• Reducing Agent • Oxidizing Agent membrane hemoptysis. What is the
>

(Goodpasture syndrome)
disease defective type of collagen?
Most common type of Ehlers-
MACROMOLECULES
-

Hypermobile EDS

JType I
Danlos syndrome
-

Maple syrup urine odor. Most serious type of Ehlers-

" T h

Vascular EDS
What are the amino acids that Leucine, Isoleucine, Valine Danlos syndrome
-

accumulate in this condition? (nonpar) Defective collagen fiber in

Mousy or musty urine odor. dystrophic epidermolysis
-
Type&
7 collagen fiber
What is the amino acid that Phenylalanine bullosa -

accumulate in this condition?

Creatinine is directly derived byproduct : I 4- classical
by muscle Creatine
from:
uses

What is the parent amino acid

Arginine
of creatine?

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 Anabolic (WE Leysch Nyhan =

HGPRT
(insulin) SCID =

Adenosine Deaminase
Glycogenesis
-

Lipo genesis
-

- kin
y
synthase
=

B5
Amino B6
muscle

- liver
=

Acety((0A =

B7
carboxylase
prop hious BA &BR
malamig
cirgente mainit

As -

Metone
Smooth
HR -

col.esteol

I
&

Neuropsychiatric
B
-

>

- symptoms
-

-
3 skin symptoms

Bi B2 B B5
, , , ,

maarte

maarte
 TOPNOTCH MEDICAL BOARD PREP BIOCHEMISTRY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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NUTRITION Saturated fat and trans fat <10% of total kcal

Protein – 4 kcal/gram Polyunsaturated fatty acids
5-10% of total kcal
③
(PUFA)
-

Carbohydrates – 4
Amount of kilocalories per -

Monounsaturated fatty acids

kcal/gram 10-20% of total kcal
gram of macronutrients
Fats – 9 kcal/gram ->
(MUFA)
B
-

Alcohol – 7 kcal/gram
-

-
Simple sugars <10% of total kcal
Amount of kilojoules in 1
4.2 kilojoules
kilocalorie (kcal) Major issue in marasmus Caloric deprivation
I

1) Age, 2) Physiologic state

Ea n e e
Major issue in kwashiorkor Protein deprivation
-

In determining dietary (weight/height), 3) Sex

reference intakes for Dietary Reference intake
MNEMONIC KWASHIORKOR AND MARASMUS
specific nutrients, what (DRIs are only meant for Kwashiorkor results from Marasmus
factors are considered? ->
HEALTHY people – never Protein-deficient MEALS
SICK people) • M – alnutrition • M-uscle wasting!
Daily intake of a specific • E – dema
Estimated average
nutrient estimated to meet •-A – nemia
requirement
the requirement of - 50% of • L – iver is fatty
(EAR)
the healthy individuals -

• S – kin lesions with

Daily intake of a specific dyspigmentation
nutrient estimated to meet Recommended dietary
the requirement of nearly⑤ all allowance (RDA)
of the healthy individuals
-

If there is insufficient
evidence to calculate for
the EAR or RDA of a specific -
Adequate intake (AI)
nutrient, this may be used
-

instead
Beyond this level of nutrient Tolerable upper intake
intake, adverse effects may
-
level
occur (UL)

DIETARY REFERENCE INTAKES

Nutrient Intake Interpretation
Need to be improved because Food items with biological
Intakes
the probability of adequacy is values close to 1 -
Eggs > Milks, Soybean
below EAR
≤50%
Intakes Likely need to be improved DIETARY PROTEIN QUALITY MEASUREMENT
between EAR because the probability of
and RDA adequacy is <98%
- i
Tran
Intakes
Considered adequate
at or above-
-
-
RDA
Bunyanga
Intakes
-

Considered adequate
above the&AI Parameter Feature Value
Intakes Based on
Can be considered to have no Protein Digestibility-
between RDA profile of 0 to 1
risk for adverse effects Corrected Amino Acid
and UL essential 0: lowest
Score (PDCAAS) value
amino acids
00 Biological Value (BV) See above
1:
highest
value
Net Protein Utilization (NPU) See above

≥2.7:
Acceptable macronutrient Excellent
Determined
distribution range (AMDR) of 45-65% Carbohydrates protein
by the
carbohydrates Protein Efficiency Ratio source
efficiency of
AMDR of saturated and trans (PER) <2.7:
animal
I

fat
-

&
<10% of total kcal
growth (rats)
Poor
protein
-

source
ACCEPTABLE MACRONUTRIENT DISTRIBUTION RANGES

Production of colostrum 12th – 16th week of

-
D occurs in this period pregnancy

-
VITAMINS AND MINERALS
Vitamin involved in fatty acid
-

Vitamin B5
synthesis
Pantothenic acid
-
(fatty acid synthase)
Vitamin involved in majority
Vitamin B6 >

of amino acid metabolic

Pyridoxine -

pathways
Vitamin involved in
Vitamin B6
glycogenolysis
Pyridoxine
-
(glycogen phosphorylase)
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 TOPNOTCH MEDICAL BOARD PREP BIOCHEMISTRY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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Vitamin B2 (Riboflavin) Posterior column defects
FAD, FMN (loss of position sense,
Vitamins involved in redox
proprioception defect),
reactions
Vitamin B3 (Niacin) hemolytic anemia (pale, Vitamin 8
E
NAD, NADPH jaundice, tea-colored
- -

Earliest-sign of Vitamin A Loss of sensitivity urine). What is the deficient

D deficiency to green light
-

vitamin?
>

-of Vitamin
EarliestI
symptom Night blindness Posterior column defects
A
I

A deficiency (nyctalopia) (loss of position sense,

Xerosis – Conjunctiva proprioception defect), Vitamin B12
Locations of xerophthalmia -

macrocytic anemia (pale).

Bitot spots – Sclera
lesions -

What is the deficient vitamin?

Keratomalacia – Cornea
Fish-
-

Type of stone formed in Calcium oxalate Helminth associated with

-
tapeworm
Vitamin C toxicity (especially among males) Vitamin B12 deficiency Diphyllobothrium latum
-

Vitamin⑦
"

B6 toxicity Sensory neuropathy Child presenting with

Podagra diarrhea. Besides hydration,
- i

Vitamin↳ what micronutrient may be

- i

B3 toxicity (Hepatotoxicity,

Dermatitis, dementia,
Facial flushing) provided?
(but take note that this does
-
Zinc
Vitamin B3 (3Ds) not reduce mortality in this
diarrhea (pellagra). What is
(Niacin) population)
the deficient vitamin?
Cheilosis, corneal Vitamin 3B12
Vitamin B2 (2Cs) What vitamin is deficient
vascularization. What is the (may occur after 3-4 years
(Riboflavin) among vegans?
deficient vitamin? -
of veganism)
Confusion,
-
ophthalmoplegia, ataxia, METABOLISM AND GENETICS
dementia, confabulation Vitamin B1
What electron transport
(Wernicke-Korsakoff (Thiamine)
Dryberizx chain complex produces Complex IV
syndrome). What is the -
Wet 48K
-

deficient vitamin?
-water?

ELECTRON TRANSPORT CHAIN

B9 ↳
↳ Bry I

unecupling

-
-

What metabolic pathway -

Marathon runner. What is
depends on a product of the
-

citric acid cycle?

-
Gluconeogenesis the major mechanism being
utilized by his or her leg
Oxidative metabolism
muscles?
CITRIC ACID CYCLE What is the first energy
system being utilized by Phosphocreatine
-

- -
-
muscles when initiating
-
(Phosphagen system)
exercise?

SKELETAL MUSCLE FIBER METABOLISM

Type I Type II
Size Smaller Larger
* Contraction
Slow Fast
velocity
Fiber color Red White
Anaerobic
Oxidative
glycolysis →
Predominant metabolism →
bursts of
metabolism sustained
maximal
contraction
contraction
Mitochondria,
↑ ↓
Myoglobin
Endurance
Increased in this S Weightlifting,
training
Type of Training Sprinting
Marathon
-

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 TOPNOTCH MEDICAL BOARD PREP BIOCHEMISTRY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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cat NAD A
Pentose phosphate
-

What pathway produces

pathway
ribose and NADPH (used
(Hexose monophosphate
for anabolism)?
shunt)
What hormone is increased
well fad during the fed state?
-
Insulin
First increased:-
Glucagon
pasting What hormone is increased S

Second increased:
during the fasting state? -

Epinephrine
-
What happens to the activity
of
fructose bisphosphatase-2 Increase in FBPase-2
fasting (FBPase-2) and activity
phosphofructokinase-2 Decrease in PFK-2 activity
(PFK-2) during the fasting
state?

REGULATION BY FRUCTOSE-2,6-BISPHOSPHATE

Increase in glucagon à activation of protein kinase A à

Fasting state
INCREASE FBPase-2 activity, DECREASE PFK-2 activity à- Gluconeogenesis
Increase in insulin à in-activation of protein kinase A à
Fed state
DECREASE FBPase-2 activity, INCREASE PFK-2 activity à- Glycolysis

Glucose (becomes ketone Adult hemoglobin

Major fuel of the brain bodies during states of Hemoglobin A1 α2 - β 2 (most common)
starvation)
Hemoglobin A2 α2 -δ2
Major fuel of the
Glucose Hemoglobin F α2 - γ 2
skeletal muscles
Major fuel of the
A Free fatty acids This form of hemoglobin has 8
R form
-cardiac muscles
This salient feature of the high oxygen affinity (Relaxed form)
-
-

genetic code states that any This form of hemoglobin has T form
specific codon can Unambiguous low
-
oxygen affinity (Taut form)
represent only one amino
acid
-

MYOGLOBIN VS. HEMOGLOBIN

Wine Myoglobin Hemoglobin

-

This salient feature of the

genetic code states that 1 polypeptide + 4 polypeptides +
reading of genetic does not Nonoverlapping Structure
-
1 heme 4 heme
involve overlapping of
> O2 Bound 1 O2 only 4 O2
sequence

-
This salient feature of the O2 SIGMOIDAL
HYPERBOLIC
genetic code states that more Dissociation Shows
than 1 codon represent a
-
Degenerate (Redundant) Curve --
Shows saturation
cooperativity
single amino acid Main Purpose For O2 storage For O2 transport
This salient feature of the
- i

Universal
genetic code states that a
(exception to the rule are
specific codon represent a
codons of mitochondrial
specific amino acid in all
I
DNA)
species of known life -

MEDICAL BIOCHEMISTRY
Composition of fetal - >
2 alpha globins
hemoglobin
-
2 gamma globins

TYPES OF HEMOGLOBIN
Hemoglobin Components
Embryonic hemoglobin
Gower I ζ2 - ε2
Gower II α2 - ε2
Portland I ζ2 - γ2 CABET do the RIGHT thing, LET GO!
Portland II ζ2 - β2
Fetal hemoglobin Form of hemoglobin bound to
Carboxy-hemoglobin
Hemoglobin F α2 - γ 2 carbon monoxide "

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 TOPNOTCH MEDICAL BOARD PREP BIOCHEMISTRY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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Form of hemoglobin bound to GLYCATION VS. GLYCOSYLATION
ferric iron or oxidized form
-
Methemoglobin -
Glycation Glycosylation
-
of iron
- • Non-enzymatic chemical Enzymatic (covalent)
Most common defect in reaction between sugars à chemical reaction between
* hereditary spherocytosis
Ankyrin
proteins/lipids sugars à proteins/lipids
Missense point mutation at (hemoglobin)
A Mutationdisease the ·
-

in sickle cell 6th position for the

beta-chain: Glutamate à Substance secreted by
Valine
-

vasoconstrict
- platelets that contributes to
Missense point mutation at -platelet aggregation (also Serotonin
Mutation in hemoglobin C
8 the 6th position for the -
implicated in pulmonary
disease beta-chain: Glutamate à
I

- hypertension)
Ly-C-ine
-

- X A 1) Drug and toxin

What is the predominant metabolism, detoxification
Hemoglobin -Barts What are the key functions of
hemoglobin if A 2) Steroid hormone
* - 4 alleles encoding alpha
(contains 4 gamma
globulins)
- the CYP450 enzyme
system?
synthesis
chains are deleted? A 3) Vitamin D and

cholesterol metabolism
ALPHA THALASSEMIA (CHROMOSOME·
16)
-

This type of bilirubin is in- -

1 missing Silent carrier soluble in water (bound to

Un-conjugated bilirubin
allele (Alpha thalassemia silent) albumin for transport), and -

(in-direct bilirubin)
2 missing usually increased in states -

Alpha thalassemia trait of hemolysis

alleles
Hemoglobin H disease
3 missing TYPES OF BILIRUBIN
• Hemoglobin Barts (4 gamma chains)
alleles
• Hemoglobin H (4 beta chains)
Un-conjugated bilirubin Conjugated bilirubin
4 missing -
Alpha thalassemia major In-direct bilirubin Direct bilirubin
alleles • Hemoglobin Barts (4 gamma chains)
In-soluble in water Soluble in water
Hemolytic diseases Obstructive biliary tract
Gilbert syndrome disorders
- UDPGT activity)
(10-35% Rotor syndrome
Crigler-Najjar syndrome I (defective OATP1B1,
⑤
(0% UDPGT activity) -
OATP1B3)
-

Crigler-Najjar syndrome II (1- Dubin-Johnson syndrome

&
10% UDPGT activity) (defective MRP2)
-

Hypertension, virilization.
-
What is the type of congenital
adrenal hyperplasia of the -
11-beta-hydroxylase
deficiency
Chromosome involved in patient?
beta chain production of
hemoglobin
Chromosome 11 y
CONGENITAL ADRENAL HYPERPLASIA
What is the secondary
structure of prion proteins Virilization or
seen in patients with Hypertension Precocious
Beta-pleated sheet Deficient
transmissible spongiform (increased puberty
enzyme
encephalopathies aldosterone) (increased
(prion diseases)? testosterone)
-

What is the secondary 17-alpha-

structure of the amyloid Present None
Beta-pleated sheet hydroxylase
plaques of patients with
Alzheimer disease? 21-hydroxylase
-

This process is involved in None Present

-
(most common)
the formation of Glycation
hemoglobin A1c. 11-beta-
-
Present Present
hydroxylase
• Starts in 1 – hypertensive patient
• End in 1 – virilized patient

END OF BIOCHEMISTRY – BUZZWORDS `

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s.
...
.
i
⑰te
Anatomy
-
TOPNOTCH MEDICAL BOARD PREP ANATOMY AND HISTOLOGY HANDOUT BY DR. OICO BRILLANTE
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IMPORTANT LEGAL INFORMATION

The handouts, videos and other review materials, provided by Topnotch Medical Board
Preparation Incorporated are duly protected by RA 8293 otherwise known as the
Intellectual Property Code of the Philippines, and shall only be for the sole use of the person:
a) whose name appear on the handout or review material, b) person subscribed to Topnotch

E
Medical Board Preparation Incorporated Program or c) is the recipient of this electronic
communication. No part of the handout, video or other review material may be reproduced,
shared, sold and distributed through any printed form, audio or video recording, electronic

hislo
medium or machine-readable form, in whole or in part without the written consent of
Topnotch Medical Board Preparation Incorporated. Any violation and or infringement,
whether intended or otherwise shall be subject to legal action and prosecution to the full

⑮
extent guaranteed by law.

DISCLOSURE
The handouts/review materials must be treated with utmost confidentiality. It shall be the
P
responsibility of the person, whose name appears therein, that the handouts/review
( )
⑲ ②38
materials are not photocopied or in any way reproduced, shared or lent to any person or

Hindi
disposed in any manner. Any handout/review material found in the possession of another
person whose name does not appear therein shall be prima facie evidence of violation of RA
Nic -
8293. Topnotch review materials are updated every six (6) months based on the current
trends and feedback. Please buy all recommended review books and other materials listed Kasama
below.
THIS HANDOUT IS NOT FOR SALE!

**
C
*

This handout is only valid for the October 2023 PLE batch.
This will be rendered obsolete for the next batch
since we update our handouts regularly.
-
ANATOMY AND HISTOLOGY
BUZZWORDS -
superior
By Edroico Mari B. Brillante, MD
oblique -
torsion -
NEUROANATOMY
OCULOMOTOR NERVE
PALSY

D Midbrain lesion. Describe the

-

eye manifestations.
• “Down and out eyeballs”
• Ptosis
⑰ Lenticulostriate artery origin
Middle Cerebral Artery
• Mydriasis :
Basal Ganglia

W
CN# NAME FUNCTION CNS ENTRY/EXIT
I Olfactory Sensory Telencephalon S

II Optic Sensory Diencephalon

III Oculomotor Motor -

Midbrain >

IV Trochlear Motor
V Trigeminal Mixed Pons
VI Abducens Motor
Junction between
VII Facial Mixed
pons and medulla
VIII
IX
Vestibulocochlear
Glossopharyngeal
Sensory
Mixed
n
Medulla Cerebral hemorrhage
X Vagus Mixed
XI Accessory Motor Spinal cord -
XII Hypoglossal Motor Medulla Contralateral leg weakness. ANTERIOR CEREBRAL
1975-mixed * Infarction of what artery: ARTERY

1973
parasymp AFFECTED
-
.

AREA SUPPLIED PRESENTATION

ARTERY
oculo
-

Trochlear Anterior Motor & sensory Contralateral paralysis

cerebral cortices of the and sensory loss of
artery - lower limb lower limb
I Contralateral paralysis
and sensory loss of face
Motor & sensory and upper limb
Middle cortices of the
cerebral upper limb and If stroke in dominant
artery face, temporal hemisphere = aphasia; if
lobe & frontal lobe stroke in nondominant
S
hemisphere =
hemineglect
Posterior Contralateral
A patient hit on the back of his
-X
-

cerebral Occipital lobe hemianopia with

head. What vessel is VERTEBRAL ARTERY artery
-

macular sparing
ruptured? -

"
19
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 TOPNOTCH MEDICAL BOARD PREP ANATOMY AND HISTOLOGY HANDOUT BY DR. OICO BRILLANTE
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ORGAN ↳
2/3 1/3
External Acoustic
Bone Cartilage
↳ Meatus
Youtube Eustachian Tube Cartilage Bone
add
cart Tongue
CN VII CN IX
↳ innervation

Frontal sinus drainage: -X

Middle Meatus
⑧ -

STRUCTURES (SUPERIOR
STRUCTURES DRAINED
TO INFERIOR)
Spheno-ethmoidal recess ASphenoidal sinus
Superior nasal concha
Pupil constriction and lens accommodation -
Superior meatus A Posterior ethmoidal sinus
* Edinger-Westphal nucleus OCULOMOTOR NERVE Middle nasal concha
Anterior ethmoidal sinus
Middle ethmoidal sinus
Middle meatus
Maxillary sinus
Frontal sinus
Inferior nasal concha
-
Inferior meatus ANasolacrimal duct
sensory motor
AFFERENT EFFERENT
REFLEXES
NERVE NERVE
Pupillary Light
Optic Nerve Oculomotor Nerve
Reflex
Trigeminal Nerve
Corneal Reflex Facial Nerve
- (V1)
Trigeminal Nerve
Sneeze Reflex Vagus nerve
-
(V2)
Trigeminal Nerve
Jaw Jerk Reflex Trigeminal Nerve
- i
(V3)
Glossopharyngeal
Gag Reflex Vagus Nerve

-
Nerve
Carotid Sinus & Glossopharyngeal
Vagus Nerve
Body Reflexes Nerve
Vestibulo-ocular Vestibulocochlear
EOM nerves
reflex Nerve

MUSCULOSKELETAL
->
Most distal supply of the
Branches
CN Nucleus Ganglion Distribution brachial plexus
Edinger Ciliary muscle and
III Ciliary BUZZWORD NERVE AFFECTED
Westphal sphincter pupillae
Lacrimal gland and -
Scapular winging Long thoracic nerve

l
-

VII Lacrimal Pterygopalatine glands in palate and Upper trunk of brachial

Burner or stinger
nose plexus
VII
Superior
salivatory
Submandibular
Submandibular and
Sublingual glands
=>
Erb-Duchenne palsy
Upper trunk of brachial
-

plexus
Lower trunk of brachial
IX
Inferior
salivatory
Otic Parotid gland
Glossaryngea
-
Klumpke palsy "

plexus
Lower trunk of brachial
Anterior pituitary is derived
-I
Pancoast tumor
plexus
RATHKE’S POUCH Tunnel of Guyon Ulnar nerve
X from: Tunnel of
I
IX Ligament of Struthers Ulnar nerve
Medial intermuscular septum
↳
ANTERIOR POSTERIOR
VII Ulnar nerve
(Adenohypophysis) (Neurohypophysis) or arcade of Struthers
Hypophysial pouch Neurohypophysial Cubital tunnel Ulnar nerve
(Rathke’s pouch): bud: downgrowth Radial tunnel syndrome Deep branch, radial nerve
Origin -

upgrowth from roof of

-

primitive mouth
from the forebrain
(diencephalon)
- a i

=>
Arcade of Frohse Radial nerve
Tendinous origin of extensor
-- Pars nervosa carpi radialis brevis
Radial nerve
Pars distalis o ADH
Distal edge of supinator Radial nerve

E C 3
-

Acidophils Basophils o Oxytocin

GH FSH Releases ADH and
-

Vascular leash of Henry Radial nerve extensor

PRL LH oxytocin which are -
Ill-fitting axillary crutches Radial nerve
Secretions
TSH produced in the Fractures of proximal
Radial nerve
problem
ACTH supraoptic and -
-
humerus and humeral shaft
Pars intermedia: paraventricular Prolonged application of
-
-

Radial nerve
o MSH nuclei of the tourniquet
=
hypothalamus Pressure of the back of the
arm on the edge of operating Radial nerve
Brain sands / Corpora table
Pineal Gland
arenacea -
Wrist-drop Radial nerve
2/3 Anterior: CN VII Kiloh-Nevin syndrome Anterior interosseus nerve
Tongue innervation:
1/3 Posterior: CN IX Dog handler’s syndrome Superficial radial nerve
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 Latterall to mediall
Positactory i
POSTERDOR

YinNunabikasy
D
FrnDo iBao
-hum
pa
R I
D c B
'C5 M
-
>Se
↑
it
ICA
⑪ i
*
·
optic CA
III N A
nerie

i
/

%
We
8

(Fire
⑲
e
[7
·
NAVEL ⑧ ⑧
⑧
↑
downgrowth

- y
(8 Femoral
#
T
inter 0 #
sheath
,

n
8
⑨
#
m
U
y
⑧
⑧ a

Internal Spermatic Fascia =

Transversalis fascia

YYY MIX
Cremasteric Internal
fascia -

oblique apo
CNSEXT/ENTRY BUNNY
.

->
External spermatic Fascia =

External oblique apo .

-
mydriasis
-
malaki 7 Midbrain
0

HORNER SYNDRONE
liit
miosis -

8
-

R TD
anterior

8B
-

digastric

pon's
-

posterior

N
-

digastric
Horner syndrome includes constriction of the pupil (miosis), 3
St 8D

M
drooping of the upper eyelid (ptosis), and lack of sweating plus vasodilation
-
(anhidrosis), depression of the eyeball into the orbital cavity (enophthalmos)
H
N

Marmy
Mnemonic:SAMPLE 05

⑭
o S – Sympathetic chain injury
⑳°
⑳
. . .
.
⑧
°
↳ Medulla
N
o A – Anhidrosis
o M – Miosis
1975 -

mixed
12
o P – Ptosis
o L – Loss of ciliospinal reflex
1975 -

parasympathetic
o E – Enophthalmos (illusion due to ptosis)
spinothalamic -

somatosensory
cortico
spinal -
motor

Willis Allien !

-
*
ES
C ↳
.
-
⑧ . 8

y
③
8.

C
is
"Standing Room Only"
Maso cillary nerve

V, Superior Orbital
fissure L Frontal
2

St A
arding prM shortviscarinich
Is
nerve
.

PLA SMA
-Rotondum Lacrimal nerve
superioroblique
a

tealeasie pelvic splanchnic sympathetic -

sacralsplanchnic parasympathetic-

Vg-Ovale
 naTaLUS siMed Cisbes later
Cuncing Trans

Reed-Sternberg cells are the hallmark tumor cells of Hodgkin lymphoma. Characteristic of these
cells are two mirror image nuclei or nuclear lobes, each containing a large (inclusion-like)
acidophilic nucleolus surrounded by a clear zone, features that impart an owl-eye appearance.

Inner hair cells =

transform sound vibration

Outer hair cells-amplify sounds

Stereocilia= mechanoreceptos found deep within the cochlea and labyrinth

continuous above with the antrum and are lined with mucous
mastoid air cells- membrane that is continuous with that of the antrum and the rest of
the middle ear apparatus.

pneumothorax
& 1 antitrypsin COPB
"heavy smoker"
-
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BUZZWORD NERVE AFFECTED
Cheiralgia paresthetica Superficial radial nerve
Handcuff palsy Superficial radial nerve
Wartenberg’s disease Superficial radial nerve

-
Saturday night palsy Radial nerve
Pronator teres syndrome Median nerve
Carpal tunnel syndrome Median nerve
Supracondylar fracture of
Median nerve
humerus
Lunate dislocation Median nerve

-Hand of benediction
Ape hand deformity
Median nerve
Median nerve

Lateral part of the antecubital Radial Nerve

-
fossa

ARRANGEMENT OF Fracture of the medial

AREA DIRECTION
A STRUCTURES
Radial Nerve
epicondyle involves what Ulnar Nerve

-
Antecubital -
nerve?

3
Lateral to Biceps Tendon
Fossa
Medial Brachial Artery
(RN TAN)
Median Nerve
Inferior Portion

I
V – Intercostal Vein
of Ribs Superior to
A – Intercostal Artery
(COSTAL = Inferior
N – Intercostal Nerve

-triangley
VAN)
N – Femoral Nerve
Femoral
A – Femoral Artery
stath

y
Triangle
A ↳
Lateral to V – Femoral Vein
(FEMales
Medial E – Empty space
showing
L – Inguinal Lymph
NAVEL)
Nodes
N – Common Fibular /

j
Hernia MEDIAL to the inferior
Popliteal Area Peroneal Nerve DIRECT Inguinal Hernia
Lateral to epigastric vessels
B (POPS like to
watch NNVA)
Medial
N – Tibial Nerve
V – Popliteal Vein Quadriceps Femoris Femoral Nerve
A – Popliteal Artery

RYN -

sin
:

Foot drop: Common Peroneal Nerve

BUZZWORD AFFECTED NERVE

Wrist drop Radial nerve
Claw hand Ulnar nerve
Paresthesia (ring + little
Ulnar nerve
finger)
Paresthesia (middle + index +
Median nerve
thumb)
Humeral neck fracture Axillary nerve
Humeral shaft fracture Radial nerve
Median nerve (Anterior
Supracondylar fracture
interosseous nerve branch)
Saturday night palsy/ Crutch
Radial nerve
palsy
Winging of scapula Long thoracic nerve
Dropped scapula Accessory nerve
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 TOPNOTCH MEDICAL BOARD PREP ANATOMY AND HISTOLOGY HANDOUT BY DR. OICO BRILLANTE
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BUZZWORD AFFECTED NERVE REMEMBER the variations in venous drainage:
Femoral neck fracture Sciatic nerve -Ovarian vein Right Directly to0 IVC
Testicular vein
Acetabular fracture Sciatic nerve - i

Adrenal / Suprarenal vein

Left -
Left renal vein → IVC
Sciatic/ Common & Deep
-
-
-

Foot drop -

Peroneal nerve Nodes affected in pathologies

Superficial Inguinal LN
Loss of sensation (medial side
-

Saphenous nerve
-
of the vulva:
foot)
Loss of sensation (lateral side BUZZWORD LYMPHATIC DRAINAGE
Sural nerve
foot) -
Ovary & Testis -
Para-aortic lymph nodes
Paresthesia (Glove and - Superficial inguinal lymph
Diabetes mellitus Scrotum & Vulva -

stocking pattern) nodes

Deep cervical à Jugular
Posterior oropharynx
Extensor Pollicis Brevis lymph nodes
EPoBre (EPB) -
Medial malleolus directly Inguinal lymph nodes
DeQuervain’s tenosynovitis:
Abductor Pollicis Longus Popliteal à Inguinal lymph
-
Lateral malleolus
"Finkelstein test"
-

Apolo (APL) nodes

BUZZWORD UPPER LIMB INJURY Gland located below the

-
Skene’s gland
Tennis Elbow Lateral Epicondylitis -
urethra: -

Golfers Elbow Medial epicondylitis

Dupuytren’s contracture Thickened palmar fascia

⑧
- h > h

Muscles transected in median Skim

Perineal body
episiotomy
-

birtholi
-
I
sertoli -blood-testis
"Toll" barrier

MALE REPRODUCTIVE

More
Leyte
n

Produces testosterone: Leydig cells

• 3 Arteries
• 2 Nerves
Contents of the spermatic
mchios transval
cord
• 2 Others

.
• 1 Vein
• 1 Lymphatic Vessel
It’s easier to remember the contents of the spermatic cord this way:

"
ex 3 Arteries → testicular artery, cremasteric artery, artery of vas deferens
2 Nerves → autonomic nerves,- genital branch of genitofemoral nerve
2 Others → vas deferens, processus vaginalis
1 Vein → testicular veins
1 Lymphatic vessel → testicular lymph vessels
Location of adult breast: 2nd to 6th rib
y
Make sure your total content is always 9 in number.
Drainage of the right ovarian
Inferior Vena Cava Internal spermatic fascia Transversalis Fascia
vein:

N
8 -

-
i
-
-

>

-
0 -

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 TOPNOTCH MEDICAL BOARD PREP ANATOMY AND HISTOLOGY HANDOUT BY DR. OICO BRILLANTE
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GASTROINTESTINAL
Aortic opening in the
T12
diaphragm:

88 -

105
Dam I &

-
Superior – Gastroduodenal
-

Pancreaticoduodenal artery
> )
Inferior -
- – Superior
Mesenteric
-

Crypts of Lieberkuhn: Intestines

-
-

HEAD AND NECK

Socket for the eyeball --
Tenon’s fascia
Brunner's gland-duodenum
Peyer’s patches -
Ileum
Gall bladder fundus is at what
9th
rib level:
vertebral
LEVEL STRUCTURE ASSOCIATED
C3 Hyoid Bone
Criboid Cricoid Cartilage
I
C6
Start of Trachea and Esophagus

y
- " i

C6 – T4 Trachea
C6 – T10 Esophagus
T3 – T4 Manubrium
T5 – T8 Heart
5th ICS MCL Apex of Heart
5th ICS MAL Pleural tap

6
↳9th Costal
Cartilage
T9 –2 T10 3
Gallbladder fundus
Xiphoid process
6 1/3 Cartilage, 2/3 bone * Eustachian
ousticTube
Meatus

T10 – L3 Stomach
ORGAN 2/3 1/3
①L1 -Transpyloric plane
External Acoustic Meatus Bone Cartilage
L1– L3 Duodenum
Eustachian Tube Cartilage Bone
T12 – L3 Kidneys
Tongue innervation CN VII CN IX
DL1 End of Spinal Cord in Adults
-

L2 Ureteropelvic Junction
Maxillary Alveolar Process
Iliac Crest Le Fort I
L4 bit
I Fracture
-
Bifurcation of Abdominal Aorta
L5 Trans/ Intertubercular Plane
0
S2 ASIS, PSIS
---

Most mobile part of the

Superior
duodenum:

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CARDIOVASCULAR AND HEMATOLOGY Moderator band is found in: Right Ventricle

Accompanying vein of
posterior interventricular Middle cardiac vein
artery:

VEIN ARTERY
Great Cardiac vein Anterior Interventricular artery
Middle Cardiac vein Posterior Interventricular artery
Small Cardiac vein Right Marginal artery

Auscultatory location of Left lower end of

tricuspid valve: parasternal border

Frosted-glass cytoplasm Monocytes

Distribution & Main Functions of the Cells of the

Mononuclear Phagocyte System
Cell Type Major Location Main Function
Precursor of
Monocyte Blood
macrophages

-
CT, Lymphoid
organs, lungs, bone
Production of
Macrophage marrow, pleural
cytokines, chemotactic
and peritoneal
factors, & several
cavities
other molecules
Liver participating in
Kupffer Cell
(perisinusoidal) inflammation, antigen
Azygos vein drains to: Superior Vena Cava processing, and
Microglial Central nervous presentation
Cell system

Langerhans
Epidermis of skin
Cell Antigen processing
Dendritic Lymph nodes, and presentation
Cell spleen
Localized digestion of
Osteoclast Bone
bone matrix
In CT under various Segregation and
Multinuclear
pathological digestion of foreign
Giant Cell
conditions bodies

RESPIRATORY
Inferior border of the
Oblique fissure
superior lobe of the left lung:
-
-

f 8 18
1
-

ENDOCRINE
Calcitonin is produced by: Parafollicular cells
one down calciums
Active hormonal gland found

grape
Pancreas
in retroperitoneal space:

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LYMPHATICS

posterior
& supplies perincom

anterior

(
Part of the bladder near the
Apex
symphysis pubis:

-
-
Lymph nodes harvested from
Bronchopulmonary / Hilar
the thorax just after entering
-

Lymph Nodes 0
the pulmonary hilum:

Og -
Ureter constrictions
• Ureteropelvic Junction
>

• Over pelvic brim

-

• Ureterovesical junction
#

Accompanied by Uterine
Female Ureter
water Artery
Bridge over

INTEGUMENTARY
Sudoriferous glands Sweat glands

Cords of Billroth are located in Scalp layer. Wound gaping: Aponeurosis

A
what organ?
Reed pulp, spleen
- "

Lymph node level, thyroid

Cervical Lymph Node0
V --
cancer -
drains first:

J
BUZZWORD LYMPHATIC DRAINAGE
Oral Cavity and Lips Levels I, II, III
Oropharynx, Hypopharynx,
- -
Levels II, III, and IV -
Larynx
-

Nasopharynx and Thyroid Level V

Ovary & Testis Para-aortic lymph nodes
Scrotum & Vulva
Superficial inguinal lymph I
nodes
Deep cervical à Jugular
Posterior oropharynx
lymph nodes
Medial malleolus Inguinal lymph nodes
Popliteal à Inguinal lymph
Lateral malleolus
nodes

UROGENITAL
END OF ANATOMY AND HISTOLOGY BUZZWORDS
Blood supply of the perineum Internal pudendal artery
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)
Microbis
TOPNOTCH MEDICAL BOARD PREP MICROBIOLOGY AND PARASITOLOGY BUZZWORDS HANDOUT BY DR. FRINZ MOEY C. RUBIO
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IMPORTANT LEGAL INFORMATION ORGANISMS ASSOCIATED WITH OSTEOMYELITIS

Condition Bacteria
The handouts, videos and other review materials, provided by Topnotch Medical Board
Preparation Incorporated are duly protected by RA 8293 otherwise known as the

E
Intellectual Property Code of the Philippines, and shall only be for the sole use of the person: Most common Staphylococcus aureus
a) whose name appear on the handout or review material, b) person subscribed to Topnotch
Medical Board Preparation Incorporated Program or c) is the recipient of this electronic Sickle cell anemia Salmonella choleraesuis
communication. No part of the handout, video or other review material may be reproduced,
shared, sold and distributed through any printed form, audio or video recording, electronic
medium or machine-readable form, in whole or in part without the written consent of
Burns Pseudomonas aeruginosa
Topnotch Medical Board Preparation Incorporated. Any violation and or infringement,
whether intended or otherwise shall be subject to legal action and prosecution to the full Staphylococcus aureus
extent guaranteed by law. IV drug users
Pseudomonas aeruginosa

Para
DISCLOSURE Prosthetic joints Staphylococcus epidermidis
-

The handouts/review materials must be treated with utmost confidentiality. It shall be the
responsibility of the person, whose name appears therein, that the handouts/review
materials are not photocopied or in any way reproduced, shared or lent to any person or Refers to the fragmented,
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Sequestrum
8293. Topnotch review materials are updated every six (6) months based on the current osteomyelitis
trends and feedback. Please buy all recommended review books and other materials listed
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Refers to the complication of
THIS HANDOUT IS NOT FOR SALE! osteomyelitis arising in the
- metaphysis of long bone
-
Brodie abscess
This handout is only valid for the October 2023 PLE batch. (usually in Staphylococcus
This will be rendered obsolete for the next batch aureus infection)
since we update our handouts regularly. Superantigen associated with
Exfoliatin toxins0
A and B
Ritter disease

MICROBIOLOGY AND STAPHYLOCOCCUS AUREUS TOXINS

PARASITOLOGY – BUZZWORDS TOXINS

superantigen causing
By Frinz Moey C. Rubio, MD Exfoliatin A and B
-epidermal separation
Enterotoxins superantigen causing
CLINICAL SYNDROMES (heat-stable) -food poisoning
Fever, headache, focal Toxic shock syndrome superantigen leading to
neurologic deficits (usually
Brain abscess
toxin (TSST-1) -
toxic shock syndrome
cerebellar lesion). What is the causes marked necrosis of the
condition? Alpha toxin
-
-skin and hemolysis
Fever, headache, meningeal
signs,-photophobia. What is Meningitis
Second most common cause of UTI,
the condition? -
Staphylococcus
especially among sexually active
Fever, headache, altered -

young women, nitrite-negative -

saprophyticus
mental sensation. What is the
-
Encephalitis -

condition?
ORGANISMS ASSOCIATED WITH URINARY TRACT INFECTION
Fever, cough, tachypnea,
crackles, egophony (E à A), Condition Bacteria
whispered pectoriloquy
Pneumonia Most common cause of UTI Escherichia coli
(increased loudness with
-whispering). What is the
condition? Second most common cause of UTI, Staphylococcus
nitrite-negative saprophyticus
Fever, cough, tachypnea, air-
fluid levels on chest
-

Lung abscess Klebsiella

Third most common cause of UTI
-

radiograph. What is the -

pneumoniae
condition?

E
Well-defined borders of skin Formation of staghorn calculi, Proteus
Erysipelas
lesion. What is the condition? urease-positive, swarming motility
- mirabilis
Less defined borders of skin forms ammenad
Cellulitis
lesion. What is the condition?
Elevated parameter seen in those
Skin necrosis, crepitations,
- h

hemorrhagic bullae. What is Necrotizing fasciitis

with antecedent Streptococcus
" i =
Anti-streptolysin O
- pyogenes pharyngitis
the condition? - i

Dysuria, gross hematuria,

EVIDENCES OF STREPTOCOCCAL PYOGENES INFECTION
suprapubic pain, NO fever. Cystitis
What is the condition? Diagnostic Tool
Dysuria, gross hematuria, Elevated titers suggest antecedent
Anti-streptolysin O

Mean
-
flank pain, nausea or
(ASO)
pharyngitis à rheumatic heart
Pyelonephritis
vomiting, WITH->
fever. What is
the condition?
O
disease (type II hypersensitivity)
Elevated titers suggest antecedent
skin infection à poststreptococcal
Anti-DNAse B
MEDICAL BACTERIOLOGY glomerulonephritis (typeI
- III
hypersensitivity)
Pneumatoceles, abscess
-

formation in the lungs,

necrotizing pneumonia, Staphylococcus aureus Toxin implicated in
had prior influenza. What is necrotizing fasciitis caused
- Exotoxin B
-

the etiologic agent? by Streptococcus pyogenes

Tricuspid valve Toxin implicated in a patient
vegetations, IV drug use. Staphylococcus aureus with strawberry tongue,
Erythrogenic toxin
-
What is the etiologic agent? sandpaper-like rash,
--
Pastia’s line (scarlet fever)
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TOXINS AND VIRULENCE FACTORS OF Streptococcus pneumoniae
STREPTOCOCCUS PYOGENES Splenectomy increases the Haemophilus influenzae
Toxins or Virulence Factor risk for these organisms Neisseria meningitidis
Neisseria gonorrhoea
M protein Rheumatic fever
Hyaluronidase Cellulitis SHIN (OR NHS) ORGANISMS

13
Exotoxin B Necrotizing fasciitis SHiN organisms
o S. pneumoniae
Erythrogenic toxin Scarlet fever
o H. influenzae
o Neisseria spp.
Test used to determine the •-(+) IgA protease
A susceptibility of a patient to Dick test • Has vaccine (except N. gonorrhoeae)
scarlet fever • Increased risk of infection after splenectomy
TESTS USED FOR TOXINS Organisms implicated in
Test gastroenteritis occurring Bacillus cereus (emetic form)
<4-6 hours from intake of Staphylococcus aureus
*
Dick test Susceptibility to scarlet fever
Schick test Susceptibility to diphteria infected food
Encapsulated bacteria whose
To detect toxigenicity of
Elek test capsule is made up of protein Bacillus anthracis
diphtheria toxin -
(poly-D-glutamate)
Risus sardonicus,
mediastinal widening
Most common cause of Streptococcus agalactiae
neonatal sepsis (Group B Streptococcus)
Streptococcus bovis I
opisthotonos, trismus -
tetanus. What is the
treatment of choice?
- Metronidazole +
debridement of wound
Bacteria associated with
(presently known as Flaccid paralysis, intake of
colorectal cancer
Streptococcus-gallolyticus)

A
-

bulging cans, honey -

Lancet-shaped diplococci, botulism. What is the 18 – 24 hours
- positive in Quellung
reaction, seen in the sputum
Streptococcus pneumoniae incubation period of this -

condition?
of a patient with pneumonia Food poisoning may occur
with Clostridium
ORGANISMS ASSOCIATED WITH PNUEMONIA perfringens, and this Bacillus cereus
Condition Organism presentation is similar with
this pathogen
Most common cause of pneumonia Streptococcus Pseudomembranes, toxic
acrossI --
-
·

all ages pneumoniae -

megacolon, prior antibiotic
use (clindamycin, 2nd and
Most common cause of pneumonia in Streptococcus -Oral vancomycin
3rd generation
neonates-
<3 weeks agalactiae (never IV vancomycin)
- cephalosporins,
ampicillin). What is the
Most common cause of pneumonia Respiratory
treatment of choice?
from ages-
3 weeks to <5 years syncytial virus
Chinese characters,
Most common cause of pneumonia Mycoplasma metachromatic granules,
from 5 years to 18-20 pneumoniae bull neck,
- i
Corynebacterium diphtheriae
pseudomembranes in the
-
-
-

throat. What is the etiologic

Most common cause of agent?
A Streptococcus Leading bacterial cause of
pneumonia in the adult Corynebacterium diphtheriae
pneumoniae

--
population myocarditis?

Af Klebsiella pneumoniae MOST COMMON CAUSES OF MYOCARDITIS

Alcoholism (red currant jelly);
A Anaerobic organism Type Organism

Pseudomonas Viral etiology

A Coxsackievirus B
Bronchiectasis aeruginosa (and most common cause
A Burkholderia cepacia overall) ↳
(pusong B-ato)

Burkholderia
- Helminthic etiology Trichinella spiralis
Southeast Asia travel pseudomallei
AAvian influenza virus
Corynebacterium
Bacterial etiology
diphtheriae
Stay in hotel or cruise ship in A Legionella Protozoan etiology Trypanosoma cruzi
past 2 weeks
smoker my
comorbiditis

a
,

Cold enhancement, has

Exposure to birds Chlamydia↳
psittaci actin polymers, tumbling
Exposure to rabbits >
Francisella tularensis
motility, granulomatosis
infantiseptica. What is the -
Listeria monocytogenes
(ampicillin)
Exposure to sheep, goats, etiologic agent and drug of
- -
Coxiella burnetii choice?
parturient cats -
&
fewer -Orange colonies, aerobic, -

weakly acid fast. What is the Nocardia asteroids

etiologic agent?

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GRAM POSITIVE BACTERIA WITH BRANCHING FILAMENTS GENITAL ULCERS

D Nocardia asteroides

Aerobic
Actinomyces israelii

Anaerobic
Etiologic
Agent

Treponema
Lesion

Chancre (primary
*
Clinical Feature

PAINLESS, solitary, raised

Weakly acid fast Not acid fast pallidum syphilis) ulcer

-I
Orange colonies 3
Yellow ‘sulfur’ granules Herpes
simplex Herpes
PAINFUL, multiple ulcers,
erythematous edges
Sulfonamides Penicillin virus

Orofacial abscess PAINFUL, multiple

TB mimicker Haemophilus ->

PIDs among IUD users Chancroid excavated ulcers,

ducreyi -

ragged, irregular edges

• Orange asteroid hitting the Yellow sands of Israel
- -

• SNAP: Sulfonamide – Nocardia; Actinomyces - Penicillin PAINLESS, solitary ulcer

Chlamydia Lymphogranuloma
PAINFUL
trachomatis venereum (LGV)

⑧
LYMPHADENOPATHY
No polysaccharide capsule,
no maltose oxidation, Granuloma
gram-negative diplococci.
Neisseria gonorrhoeae
A Klebsiella
granulomatis
inguinale
PAINLESS ulcer
Red and beefy base
What is the etiologic agent? (donovanosis)

MENINGOCOCCI VS. GONOCOCCI

Meningococci
Gram-negative diplococci
Oxidizes glucose
(+) lipooligosaccharides (LOS)
Cherry red epiglottis,
Go-NO-cocci thumb sign on neck lateral
Haemophilus influenzae
Xray. What is the etiologic
agent?
This strain of Escherichia coli EAEC-iyak
⑰ is associated with HIV/AIDS
-
Enteroaggregative E. coli
AIV/AIDS
-

patients jyak kasi

8
(+) polysaccharide NO polysaccharide capsule may
capsule
STRAINS OF ESCHERICHIA COLI
(+) maltose oxidation NO maltose oxidation Strain Syndrome Unique
Enterotoxigenic Cholera-like
(+) vaccine is available NO vaccine due to antigenic Watery diarrhea
E. coli (ETEC) manifestation
variation of pilus proteins
No toxin
Enteropathogenic
Infants produced. Flattens
E. coli (EPEC)
High fever, widespread villi.
Neisseria meningitidis
purpura, DIC, adrenal Hemorrhagic
>
(Waterhouse-Friderichsen
insufficiency. What is the Enterohemorrhagic colitis and Has shiga-like
-
syndrome)
etiologic agent? E. coli (EHEC) hemolytic uremic toxin
Late complement (5b syndrome (HUS)
deficiency. Patient is
-19
Neisseria infections Enteroinvasive Shigella-like
predisposed to these Bloody diarrhea
E. coli (EIEC) manifestation
infections.
Enteroaggregative HIV/AIDS
Nucleic acid amplification
E. coli (EAEC) patients
tests (NAATs) as gold S Neisseria gonorrhoeae
standard tools for Chlamydia trachomatis
diagnosis of these organisms Facultative gram-negative
rods, non-lactose-
Gram-negative coccobacilli
fermenting,C H2S
in ‘school of fish’ pattern, Salmonella spp.
utilized --Factor X (hemin) Haemophilus ducreyi I motile,
production,
-
oxidase-negative. What is
only, painful ulcers. What is
the etiologic agent?
the etiologic agent?
NON-LACTOSE FERMENTERS (SSPP)
GROWTH REQUIREMENTS OF HAEMOPHILUS SPP.
Bacteria Features
A Salmonella H2S production, motile,
oxidase-negative
A No H2S production, non-motile,
A Shigella
oxidase-negative
Oxidase-positive, blue-green colonies,

S
Pseudomonas corn tortilla odor
Multiple antibiotic resistance
8 Proteus Swarming motility, urease-positive

-Stepwise fever pattern,

constipation à diarrhea,
Salmonella typhi
rose spots. What is the likely
species of Salmonella?

• H. ducreyi (an agent causing STD) loves the XXX factor!

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SALMONELLA MEDICAL VIROLOGY
Clinical Syndrome Positivity in Slapped cheek appearance –
Features erythema infectiosum,
(Species) culture -
Adenovirus
Blood culture – aplastic crisis. What is the
-

Stepwise fever 1st – 2nd week of etiologic agent?

Enteric fever pattern disease Most common sexually
-
(Salmonella typhi) Rose spots Stool culture – transmitted disease
GI symptoms 2nd week worldwide; most common viral Human papillomavirus
onwards sexually transmitted disease
worldwide
Septicemia Fever only Blood culture Most common cause of
(Salmonella (sepsis signs) only during anogenital cancers and head
choleraesuis)
Enterocolitis
No GI symptoms high fever and neck cancers (except
nasopharyngeal cancer)
⑧
HPV-16 > HPV-18

(Salmonella GI symptoms Most common cause of

Stool culture
typhimurium, only nasopharyngeal caner,
only after onset Epstein-Barr virus
Salmonella No fever lymphomas, Burkitt
enteritidis) lymphoma (kissing disease)
PATTERNS OF FEVER INFECTIONS AND CARCINOGENESIS
Fever Pattern Condition Infectious Agents Associated Cancer
Stepwise pattern Enteric fever (typhoid fever)
Gastric adenocarcinoma
I

Picket-fence pattern Acute pyelonephritis H pylori

Gastric MALT lymphoma
-

Undulating pattern
-
Brucellosis
Relapsing pattern Borrelia recurrentis Hepatitis C virus >
Hepatocellular carcinoma (HCC)
* Pel-Ebstein pattern Lymphomas Hepatitis B virus

Dysuria, red eye, joint pains –
A Reiter syndrome/Reactive
arthritis. What is the etiologic
agent-mostly associated with
- Hodgkin/Non-Hodgkin
this condition?
MNEMONIC
• ShY ChiCS
• Sh – igella
• Y – ersinia
• Ch – lamydia
• C – amplyobacter (most associated)
• S – almonella
What is the etiologic agent
causing -
swimmer’s ear and
ecthyma gangrenosum?
- and neck
Vector of Yersinia pestis
Bacterial infection associated
with animal bites
Adult T-cell
HTLV-1 (not HTLV-2)
leukemia/lymphoma
-
Campylobacter jejuni
(Others – think of ShY
ChiCS)
Burkitt lymphoma
Epstein-Barr virus
lymphomas
(EBV)
Nasopharyngeal carcinoma
Reiter syndrome Etiologic Agents (NPCA)
Squamous cell carcinoma of the
S haematobium
bladder
Liver flukes
Opistorchis sp., Cholangiocarcinoma
Clonorchis sp.
Pseudomonas aeruginosa Squamous cell carcinoma of the
Human papilloma
female genital tract, and head
virus (HPV)
Xenopsylla cheopis
(oriental rat2
flea) – rats are
not the vectors! Associated with progressive
Pasteurella multocida
multifocal JC virus O
leukoencephalopathy (PML) -

Associated with hemorrhagic

ORGANISMS ASSOCIATED WITH ANIMALS cystitis and nephropathy,
post-transplant
BK virus 8
Animal or Condition Bacteria
Most common cause of
Animal bites Pasteurella multocida
sporadic encephalitis
-I Herpes simplex virus 1
Human bites Eikenella corrodens - h

(usually affects temporal Iis more associated

(HSV-2
with viral meningitis)
* Rat bites -
Streptobacillus moniliformis lobe) -

Associated with cows, goats Brucella Most common cause of

Francisella congenital abnormalities -Cytomegalovirus
Associated with rabbits worldwide
(causes tularemia)
Cat scratch Bartonella henselae
ORGANISMS ASSOCIATED WITH CONGENITAL ANOMALIES
Jaundice, renal failure, Infection Feature
bleeding (pulmonary CMV Periventricular calcifications
-

hemorrhage) – Weil -
Pasteurella multocida Toxoplasma gondii Intracerebral calcifications
syndrome. What is the
-

-
I (eye) LOVE RUBY EAR-rings
treatment of choice?
Cataracts (eye)
Rubella virus
Heart anomaly (PDA)
NON-LACTOSE FERMENTERS (SSPP) Sensorineural hearing loss (ear)
Jaundice, renal failure, ->
Penicillin G (since this is
bleeding (pulmonary severe leptospirosis); Heterophile-positive, atypical

-
hemorrhage) – Weil Doxycycline is the drug of lymphocytes; fever, sore
syndrome. What is the choice for mild
-
Epstein-Barr virus
throat, splenomegaly. What is
treatment of choice? leptospirosis
-

the etiologic agent?

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EPSTEIN-BARR VIRUS VS. CYTOMEGALOVIRUS
Rabies Nicotinic Ach receptor
EBV CMV /most common
Fever, pharyngitis, posterior neck lymphadenopathy, Rhinovirus ICAM-1
splenomegaly
Infectious mononucleosis-
Infectious mononucleosis
like syndrome
MEDICAL PARASITOLOGY
Most important
Atypical lymphocytes NO atypical lymphocytes Plasmodium spp.
parasite of man
Heterophile-positive Heterophile-NEGATIVE Intermediate host
Has both nuclear AND Homo sapiens sapiens
of Plasmodium spp.
Has nuclear inclusion bodies cytoplasmic inclusions (owl’s Flask-shaped ulcers (narrow-

E
-
eye appearance) necked ulcers), dysentery. Entamoeba histolytica
• Measles virus and CMV have BOTH nuclear and cytoplasmic What is the etiologic agent?
inclusions Balantidium coli
Wide-necked ulcers, (only medically important
Acute severe hepatitis among dysentery. What is the ciliate of man, largest
8
A
expectants, endemic in etiologic agent? medically important
- -

Hepatitis E virus
equatorial regions. What is
- protozoan)
the etiologic agent? Reservoir host of
Pigs
Balantidium coli?
HEPATITIS VIRUSES
Parameter Features RESERVOIR HOSTS
Reservoir Hosts Parasite
Causes of-
AcutE Vowels – A and E
hepatitis Orofecal – T-AE Pigs Balantidium coli
Causes of-
Chronic Brugia malayi
Consonants – B, C and D Cats
hepatitis
-

-
Toxoplasma gondii
Transmitted by Blood, Birthing Rodents Paragonimus westermani
Hepatitis B
and Bonking (sex)

Single virus that is more often to Falling-leaf motility,

Hepatitis C cause Chronic hepatitis, steatorrhea, hikers, traveler’s Giardia lamblia or
Cirrhosis, Cancer diarrhea. What is the etiologic Giardia duodenalis
agent?
Hepatitis D Defective virus Strawberry cervix, greenish,
- -
Trichomonas vaginalis
foul-smelling, discharge, pH
Endemic in Equatorial regions (only known sexually
>4.5. What is the etiologic
Hepatitis E May cause acute, severe infection transmitted protozoan)
agent?
to Expectants (pregnants)
VAGINITIS
Most common cause of
-
Rhinoviruses Bacterial
common colds Parameter
vaginosis
Candidiasis Trichomoniasis
Second most common cause of
-
Coronaviruses
common colds Consistency
Thin,
RNA virus with the of Thick, curdy Frothy
Coronaviruses homogenous
-largest genome discharge - -

Influenza virus associated with Influenza virus A

[
Color of Clear to Clear to
pandemics (due to antigenic shifts) discharge white white -
Yellow
Influenza viruses associated Influenza virus A and B
with epidemics (due to antigenic drifts) pH of vaginal
>4.5 <4.5 >4.5
Etiologic agent causing discharge
subacute sclerosing Measles virus
i

Clue cells
panencephalitis
-

-
(>20%)
Etiologic agent causing Wet mount Amine odor (+) hyphae, (+) motile
Respiratory syncytial virus
bronchiolitis obliterans features after spores trichomonads
-
(RSV)
among neonates addition of

-
Receptor used by SARS-COV2 KOH
ACE-2 receptors
for viral tropism in the body
> Other Strawberry
- -
-

features cervix
VIRAL TROPISM
Receptor(s) for Viral What is the culture for
Virus
Tropism
-
Trichomonas vaginalis? ↳
Diamond’s medium
Primary amebic encephalitis.
SARS-CoV-1 Angiotensin-converting
What is the etiologic agent? -
Naegleria fowleri
SARS-CoV-2 enzyme 2

A MERS-CoV

EBV
-

&
CD21
-
Dipeptyl peptidase 4 (CD26)

CMV Integrins -
(heparan sulfate)

CXCR4 (T cells), CCR5

HIV
(macrophages)

Parvovirus B19 P antigen (RBCs)

FREE-LIVING AMEBAS
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Etiologic Agent
Acanthamoeba
Naegleria fowleri
What is the culture for
Leishmania?
Unilateral palpebral swelling
(Romaña sign), Chagoma,
arrhythmias,
megaesophagus, megacolon.
What is the etiologic agent?
Leading cause of heart failure
in the Latin Americas
Enlargement of the posterior
cervical lymph nodes
(Winterbottom sign), Deep
-
hyperesthesia (Kerandel
sign), Somnolence. What is the
etiologic agent?
-
Members of the Unholy Trinity
-
⑧
Members of soil-transmitted
-
helminths
Only soil-transmitted
helminth with no heart-lung
migration à hence no
Loeffler pneumonitis
Prominent nematodes of the
-small intestines
Prominent nematodes of the
large intestines
Pruritus ani, increased risk
-
for UTI, D-shaped eggs can be
-
inhaled and cause infection.
What is the etiologic agent?
Erratic migration. What is the
- All mycoses are dead-end
etiologic agent?
Iron deficiency anemia. What
is the etiologic agent?
Wakana syndrome. What is
the etiologic agent?
Creeping eruptions
(cutaneous larva migrans).
What is the etiologic agent?
Running eruptions
(cutaneous larva recurrens),
immunocompromised state,
Cochin-China diarrhea. What
is the etiologic agent?
Rectal prolapse. What is the
etiologic agent?
Protein-losing enteropathy,
borborygmus, migratory
- Capillaria philippinensis
birds are part of life cycle.
What is the etiologic agent?
Vector of Brugia malayi
- >
Vectors of Wuchereria
-
bancrofti
-
Megaloblastic, macrocytic
-
anemia. What is the etiologic
agent?
-
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Disease Presentation Space-occupying lesion in the
Taenia solium
brain, intake of raw pork.
(neurocysticercosis)
Granulomatous amebic What is the etiologic agent?
-
encephalitis (GAE)
-
What is theA natural
Acanthamoeba keratitis intermediate host of Sheep
Echinococcus granulosus?
Primary amebic
-
What is the -
accidental
meningoencephalitis
-
intermediate host of Homo sapiens sapiens
(vs secondary amebic Echinococcus granulosus?
meningoencephalitis caused by All trematodes have
E histolytica) Fasciola
praziquantel as the drug of
(Triclabendazole)
choice &except for: =
Novy-MacNeal-Nicolle
(NNN) medium GENERALITIES OF TREMATODES
-AT8DES
Mycosis Diagnostic Features
Trypanosoma cruzi All human parasitic Schistosoma spp.
america eeping trematodes are (have female and male adult
hermaphrodites EXCEPT worms in copula)
All human parasitic
Trypanosoma cruzi Schistosoma spp.
trematodes have
(cercariae is the infective
metacercariae as their
stage)
infective stage EXCEPT
Trypanosoma brucei All human parasitic
-
complex trematodes eggs are Schistosoma spp. eggs
operculated EXCEPT
All human parasitic
Ascaris lumbricoides trematodes have 2
Trichuris trichiura Schistosoma spp.
intermediate hosts
Hookworms EXCEPT
Ascaris lumbricoides
Trichuris trichiura Swimmer’s itch, Katayama
->
Hookworms
-
fever. What is the etiologic Schistosoma japonicum
Strongyloides stercoralis agent?
What is the⑧ intermediate
vector of
host
Oncomelania hupensis
Trichuris trichiura Schistosoma japonicum in the
quadrasi
Philippines?
1st intermediate host:
Gardiasis What are the intermediate
(CASH)
G
hosts of Paragonimus
->
Antemelania (snail)
Capillaria philippinensis 2nd intermediate host:
-
westermani in the
Ascaris lumbricoides -
Sundathelphusa philippina
-
Strongyloides Philippines?
(crab)
Hookworms Largest trematode infecting
(TaE) man; Largest liver trematode -
Fasciola gigantica
seectumTrichuris trichiura
Enterobius vermicularis
infecting man
-
Largest intestinal trematode
-
infecting man 0
Fasciolopsis buski
Enterobius vermicularis
MEDICAL MYCOLOGY
-
Cutaneous mycoses
Ascaris lumbricoides -
hosts-
except: (Dermatophytoses)
·
Ancylostoma duodenale > Most prevalent mycosis Cutaneous mycoses
Necator americanus worldwide (Dermatophytoses)
Most common type of
Hookworms Tinea-
pedis
cutaneous mycoses
Animal hookworms:
Ancylostoma braziliense A Cutaneous mycosis that is
hardest to treat inga
Tinea unguium
(onychomycosis)
(cat hookworm) Dermatophytes with the
Ancylostoma caninum (dog greatest number of
Anthro-philic
hookworm) infections; Difficult to
>
=
⑤
dermatophytes
-
eradicate, more chronic in
presentation
Strongyloides stercoralis 8
Microsporum
Genera that causes ⑤
Trichophyton
dermatophytoses or
-
⑧ Epidermophyton
cutaneous mycoses (Trichosporon causes white
Trichuris trichiura -
piedra, a superficial mycosis)
- S i
Rose gardener, cigar-shaped
>
-
yeasts, asteroid bodies. What Sporothrix schenckii
-
is the etiologic agent?
-
-
Mansonia
Aedes, Anopheles, Culex
SUBCUTANEOUS MYCOSES
-
Diphyllobothrium latum Mycosis Diagnostic Features
Page 6 of 7
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Cigar-shaped yeasts;
Sporotrichosis Presence of TH17 deficiency Chronic mucocutaneous
Asteroid bodies
increases the risk for: candidiasis
Sclerotic bodies or copper Asthmatic patient,
Chromoblastomycosis presenting with fleeting
penny bodies Aspergillus-
fumi-gatus
infiltrates over chest
(think of fumes causing
Mycetoma
(Madura foot)
-
-
Sulfur granules radiograph - allergic
bronchopulmonary
asthma attack)
aspergillosis. What is the
Darkly pigmented septate etiologic agent?
Phaeohyphomycosis
hyphae in tissue Diarrhea in an
-

immunocompromised
Broad-based budding of
-
patient. Probable etiologic &
Cryptosporidium parvum
yeasts. What is the etiologic Blastomyces dermatitidis
- -
agent?
agent? Meningitis in an
-
>
immunocompromised host. Cryptococcus neoformans
ENDEMIC OR SYSTEMIC MYCOSES Probable etiologic agent?
Pneumonia, HIV patient,
Mycosis Diagnostic Features bilateral ground-glass
Pneumocystis jiroveci
Macrophage filled with opacities. Probable etiologic >

Histoplasmosis Histoplasma (ovoid agent?

ralles
structures) Aseptate hyphae, wide-

-
river - -

angled branching, diabetic Mucormycosis

ketoacidosis. Probable (Rhizopus, Mucor)
-

Broad-based budding of
D
Blastomycosis "

yeasts etiologic agent?

Coccidioidomycosis Spherules MNEMONIC Aspergillosis VS. Mucormycosis

# ilipine • Acute angle branching, septate hyphae - Aspergillosis
Captain’s wheel formation
-

• Wide angle branching, aseptate hyphae - Mucormycosis

Paracoccidioidomycosis
of budding yeasts
->

Latin americas
"Pirates" 1

southwestern/ desserts

↳ Filipino race High risk :

END OF MICROBIOLOGY AND PARASITOLOGY – BUZZWORDS `

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