MOST IMPORTANT

ENTRANCE
POINTS
 Father/ Contributors
• Father of medicine/ First true epidemiologist- Hippocrates
• Father of Indian surgery- Susrutha
• Chinese medicine- barefoot doctors.
• Yin & Yang- pioneers of immunization & acupuncture.
• Father of public health- Cholera
• Father of microbiology- Louis Pasteur
• Father of medical microbiology- Robert Koch
• Father of epidemiology- John Snow
• Multifactorial causation- Petenkoffer
• Web of causation – Mc Mohan & Pugh
• Social medicine- term-Jules Guerin
• Father of social medicine- Rudolf Virschow
• Greek God of Medicine- Aesculapius
• Father of psychiatry- Asclepiads
• Egyptian medicine- Imhotep
• Greek medicine- Hippocrates
• Frocastoro- Founder of epidemiology
• Anton Von Leeuwenhoek-First microscope
• Ruska- first electron microscope
• Father of obstetric ultrasound- Ian Donald
• Father of modern toxicology-Mahieu Orfila
• Father of physiology – Claude Bernard
• Growth chart-David Morley
• First polio vaccine- Jonas Salk
• Life cycle of malarial Parasite-Ronald Ross
• Plasmodium- CA Laveran
• Term “Vaccination”- Edward Jenner
• Term “Vaccine”-Louis Pasteur
 Diseases and other name
• Barometer of social welfare, Pott’s disease, Koch
disease, white plague
• Father of public health, Blue death
• Black death, black fever, black water fever
• Slims disease/GRID
• Break borne fever
• 100 day cough
• Monkey fever
• Hansen’s disease
• Father of anatomy-Andreas Vesalius
• Father of modern surgery- Ambroise Pare
• Father of psychoanalysis- Sigmund Freud
 Vaccines &
Immunity
Active immunity
a.Natural – natural exposure to disease
b.Artificial- Immunization, vaccination
Passive immunity
a.Immunoglobulins
b.Antisera
 Live attenuated
• Mumps
vaccines
• Yellow fever
• Rubella
• Oral Polio; Oral typhoid
• Measles
• Endemic Typhus
• TB vaccine(BCG)
• Rubella
• Influenza
• Plague

MY ROME TRIP (Mnemonic)

5
 Inactivated / killed
• Typhoid
vaccine
• Cholera
• Pertussis
• CS meningitis
• Plague
• Rabies
• Salk (Polio
vaccine)
• Influenza
• Hepatitis A
• Hepatitis B
• JE
6
• Vaccines stored in freezer compartment – Polio &
measles
• Vaccines stored in COLD part and never allowed to
freeze– BCG, DPT, Tetatus, DT.
• Polio vaccine is the most sensitive to heat (-20
C)
• Temperature range of refrigerator is +2 to +8
(except polio)
 Scoring
1. systems
Downe’ s score: RDS/HMD
Cyanosis, retractions, grunting, resp. rate, air entry
2. Braden scale: Risk of pressure sore; Barbara Braden &
Nancy Bergstrom
Activity, mobility, nutrition, sensory perception, shear or
friction, moisture; 9 or less- severe risk, 15-18- at risk
3. VIP scale: Visual Infusion Phlebitis(0-5)- assessing early
signs of phlebitis

4. Apgar score: For newborn assessment; Max: 10; Min: 0

Heart rate, respiratory effort, muscle tone, reflex,
colour
5. GCS: Glasgow Coma Scale; Max: 15; Min: 3; level of
consciousness
Eye opening(4), Verbal response(5), Motor response(6) First
described by Jennett and Bond.
6. Westley score: Croup (0-17)
7. Ballard score:
Assessment of gestational age 5-50 score
Physical maturity – Skin, eye/ear, lanugo, plantar surface,
breast bud, genitals
Neuromuscular maturity – Posture, Square window, arm
recoil, popliteal angle, scarf sign, heel to ear.
8. Kramers criteria:
Dermal staining and bilirubin level; seen in neonatal jaundice
9. Nada’s criteria: Congenital heart disease
10.Jone’s criteria: Rheumatic heart disease
11.Modified Duke criteria: Infective Endocarditis
12.Bishop score: Maternal readiness for labor
dilatation of cervix, effecement,consistency, position, station of presenting
part. Score 6 or more- readiness for labor
13.Child Turcot Pugh score: assessing prognosis of CLD Total bilirubin,
Serum Albumin, PT, ascites, hepatic
encephalopathy
 15. Gomez Classification:
PEM
Grade I - 75-90 % of expected weight
Grade II - 60-75% ,,
Grade III- <60% ,,
16. Bell’s criteria- Necrotizing
enterocollitis
17. Killip classification- CCF
18.Norton scale: assess risk for pressure ulcer in adult
patients.
19.Waterlow scale: predictive information about the risk
of developing pressure sore
20.BOAS: Beck Oral Assessment Scale- assess oral cavity
21.NIHSS: NIH Stroke Scale- to quantify impairment
caused by stroke
22. FLACC scale: Face, Legs, Activity, Cry, Consolability
scale-assess pain for children (2 months- 7 years)
23.CDR: Clinical Dementia Rating- assess severity of
symptoms of dementia.
24.RASS: Richmond Agitation & Sedation Scale- assess
patient’s level of sedation in ICU
25.MMSE: Mini Mental Status Examination – assess
cognitive function. 30 point scale; 24 or more- normal
cognition.
 Names of surgery &
Conditions
• Blalock-Taussing shunt: TOF Anastomosing
subclavian artery with pulmonary artery
• Pott’s Operation: TOF Anastomosing
descending aorta to Pulmonary artery
• Water Stan Surgery: TOF Anastomosing
ascending aorta with right pulmonary artery.
• Beffe’s operation: TGA (Vena caval
anastomosis to LA & Pulm. Vein to RA
• Modified Fontan- Tricuspid atresia- creating
an outlet from right atrium
• Ventriculoperitoneal(VP) shunt, Ventriculoatrial
shunt- Hydrocephalus
• Ramstedt’s Procedure- Fredet-Ramstedt extra-
mucosal Pyloromyotomy- Pyloric stenosis
• Hydrostatic Reduction- Saline reduction in
Intussusception
• Swenson’s procedure, Duhamel’s procedure [ Pulling
down bowel behind the lower aganglionic
Segment],Soave’s procedure-
Hirschsprung’s disease
 X ray signs and
X ray signs/conditions
diagnostic signs Disease condition
Boot shaped heart TOF
Egg on side appearance Transposition of Great arteries

Ground glass appearance RDS/HMD

Cottage- loaf sign/‘snow man’ or ‘ Total Anomalous Pulmonary Venous

figure of 8’ sign Connection

Box Shaped Heart Ebstein’s anomaly

Steeple sign Croup

Cherry red epiglottis on laryngoscopy Croup

Honey comb appearance Bronchiectasis

Flask shaped/pear shaped/money bag/leather Pericardial effusion
bottle shaped heart

Jug handle appearance Primary pulmonary artery hypertension

3 like appearance Coarctation of aorta

Egg in cup appearance Constrictive pericarditis

Pericardial calcification Constrictive pericarditis

Bat’s wing appearance Pulmonary edema

Pruned tree appearance(of pulmonary Pulmonary artery hypertension

circulation)

Step ladder or stair case pattern in X ray Intussusception

 Inde
x Development Index(HDI)
1. Human
•It is an index of QOL
•Life expectancy at birth, Knowledge, Income
•India ranks 131 in HDI category (0.624)
2. Physical Quality of Life Index(PQLI)
•Infant mortality, life expectancy at age 1 year, literacy
•PQLI of India is 65
3. Human Poverty Index(HPI)
•Measures average deprivation in basic dimensions of human
development.
•Vulnerability to death at early age, adult literacy rate, lack of
access to decent standard of living
4. Sullivan’s index: Subtracting duration of bed
disability from expectation of life at birth. eg: If
expectation of life is 70 years for an Indian and
the disability days is 7 years, Sullivan’s index is
70-7=63 years.
5. Brito index(MALARIA)
No. of positive containers

Total houses examined

6. Container index(malaria)
No. of positive containers X 100

No. of containers examined

7. Quetelet’s index: Weight in Kg

Height in M2
8. Broca’s index: Height in cm-100
9. Ponderal index: Height in cm

Cube root of body weight

10.Pearl Index:
 SCI- and motor
Level of SCI
loss Motor loss

C1-C4 Quadriplegia & loss of respiratory function

C6-C7 Quadriplegia; diaphragmatic breathing

remains intact

T1 and L1-L2 Paraplegia

Cauda equina Mixed loss of motor, sensory, bowel,

bladder and sexual function

Sacral spinal nerves Loss of bowel, bladder and sexual function

Nerve Injuries
1. Erb-Duchenne Palsy
C5, C6 injury
Shoulder and elbow paralyzed and turned inwards (waiter’s
tip)
2. Klumpke’s Palsy
C7, C8 injury
3. Wrist drop- Radial nerve injury
4. Claw hand- Ulnar nerve injury
5. Ape thumb- Median nerve injury
6. Winging of scapula- Long thoracic nerve injury
7. Foot drop- Common peroneal nerve injury
Theories:
Psychosexual development theory - Sigmund Freud
Psychosocial development theory - Erik Erikson
Cognitive Development theory - Jean Piaget
Moral Development theory -Lawrence Kohlberg
Spiritual development theory -Thompson & Randall
Autosomal Dominant
Huntington’s, Marfan Syndrome, achondroplasia,
Osteogenesis imperfecta, Neurofibromatosis, Tuberous
sclerosis
Autosomal Recessive
Cystic fibrosis, sickle cell, PKU, Thalassemia, Hurler’s,
Galactosemia, CAH
X Linked Dominant Hypophosphatemia
X Linked Recessive
Hemophilia A, color blindness, G 6 PD deficiency
 Miscellaneous entrance
tips
• Continuous “machine-like” (also described as
“rolling-thunder” and “to and-fro”) heart murmur-
PDA
• Radiofemoral delay, weak femoral pulse-
Coarctation of aorta
• Splinter hemorrhage,Retinal hemorrhage (Roth
spots),Osler’s node,Janeway lesions-painless
hemorrhagic lesions on palms and soles seen in
Infective Endocarditis
• Strawberry tongue is seen in Kawasaki disease
• 3C- Coughing, Choking, Cyanosis is seen in TEF
• 3 Ps- Projectile Vomiting,Palpable mass, Olive like
mass,Visible gastric peristalsis, propagating from
left to right- seen in Pyloric stenosis
• Red current jelly like stools,Sausage shaped mass
on right upper quadrant,Bilious vomiting seen in
Intussusception
• Ribbon like stools, pellet like stools- Hirschsprung’s
disease
• Brush field’s spot (iris lesion) – gray, light yellow spot at the
periphery of iris, Single crease on the palm (simian crease)- Down
syndrome
• Horse shoe kidney is seen in Edwards syndrome
• Low fat food- Hirsch sprung disease
• restricted protein, salt and fluid intake-
Glomerulonephritis
Type of stool Condition
Rice water diarrhea Cholera
Pea soup stools Typhoid
Ribbon shaped stool Hirschsprung disease
Currant jelly stool Intussusception
Diarrhea with mucus and blood Dysentery
Steatorrhea (oil droplets on toilet water) Pancreatic insufficiency/ liver disease
Watery diarrhea Celiac disease
 Vector Disease
Anopheles mosquito Malaria
Culex mosquito JE, West Nile fever, Bancroftian filariasis
Aedes mosquito Yellow fever, Dengue, DHF, Chikungunya
Sand fly Kala azar
Tsetse fly Sleeping sickness
Soft tick Q fever
Itch mite Scabies
Cyclops Guinea form disease
 Pediatric Chromosomal
Disorders
Trisomy 21 - Down syndrome
Trisomy 18 - Edwards syndrome (common)
Trisomy 13 - Patau Syndrome
Trisomy 8 - Warkany syndrome XXX - Triple X
Syndrome
XO - Turner syndrome
XXY – Klinefelter’s Syndrome.
 IMR is highest in Madhya Pradesh (47) and lowest in Goa
(8)
 CDR- 6.4
 CBR-20.4
 Life expectancy at birth: 67.5 years
 Day
diseases
• First disease: Measles/ Rubeola
• Second disease: Scarlet fever
• Third disease: Rubella
• Fourth disease: Ritter’s disease/SSS
• Fifth disease: Erythema infectiosum
• Sixth disease: Roseola infantum
Public health institutes

Institute Location
Industrial toxicology research centre Lucknow
NIOH Ahmedabad
Central Labor institute Mumbai
National institute of nutrition Hyderabad
ICMR New Delhi
All India institute of hygiene and public Kolkata
health
National tuberculosis institute Bengaluru
National institute of virology Pune
Vector Control Research centre Puducherry
Health programmes
 National Malaria Control Programme- 1953
 National Water Supply and Sanitation Programme- 1954
 National Filaria Control Programme- 1955
 National Leprosy Eradication Programme- 1955
 NTP-1962, RNTCP-1992
 Urban Malaria Scheme- 1971
 National Cancer Control Programme- 1975-76
 NMHP-1982
 National AIDS Control Programme- 1987
 PPI Programme- 1995
 NRHM- 2005 April
 1952: NFPP
 1977: NFWP
 1985: UIP
 1992: CSSM
 1997: RCH- I
 2005: RCH-II
Community Nutrition Program
 Vitamin A prophylaxis program- 1970
 Prophylaxis against nutritional anemia-1970
 Balwadi nutrition Progamme- 1970
 Mid day meal program- 1961
 ICDS-1975- supplementary nutrition, vitamin A
prophylaxis, iron and folic acid supply.
 Mid day meal scheme 1995. universalization of
primary education by increasing enrolment, retention
impacting on nutrition of students.
 Annapoorna scheme- 2001
 Color coding of all gas
cylinders
Oxygen – white shoulder, black
body Nitrous oxide- Light blue
Medical air- Black and white
Suction- Yellow
Nitrogen- Black Carbondioxide-
Grey Helium- Brown
 Disease condition and primary
Disease signs
Important signs

Addison’s disease Bronze like skin pigmentation

Appendicitis Mc Burney’s point, Rovsing’s sign, Psoas sign- pain

from flexing the thigh to the hip
Basilar skull fracture Raccoon eyes(Periorbital ecchymosis), Battle’s sign

Buerger’s disease Intermittent claudication. Inflammation &

thrombosis in small and medium sized blood
vessels
Bulimia Chipmunk facies(parotid swelling)

Chickenpox Pleomorphism – all stages of the rash are seen

Chlamydia Milky discharge and painful urination

Cushing’s triad Bradypnea, Bradycardia, Systolic hypertension

CMV infection Owl’s eye appearance of cells

Down syndrome Protruding tongue, single crease on palm, flat nasal bridge,
epicanthal fold, flat facial profile
Glaucoma Tunnel vision

Gonorrhea Green, creamy discharges and painful urination

GBS Ascending muscle weakness

Herpes Simplex Type II Painful vesicles on genitalia

Hyperpituitarism Carotenemia (discolouration of skin) Xanthemia (excess

carotene in blood stream)
Kawasaki disease Strawberry tongue

Leprosy(Hansen’s disease) Leonine faces(faces that resemble that of lion)

Malaria Step ladder like fever with chills
Multiple sclerosis Charcot’s triad: nystagmus, intention tremor,
dysarthria
Myasthenia gravis Descending muscle weakness, ptosis
MI Levine’s sign- clutching of chest
Pernicious anemia Beefy red tongue(Schilling’s test)
Pneumonia Rust coloured sputum or Greenish rusty sputum
Trichomoniasis Yellow, itchy, frothy, foul smelling vaginal discharges
Typhoid Rose spots in abdomen
 Fetal
• Coronal sutures unites frontal bone with parietal bone
skull
• Sagittal suture unites 2 parietal bones
• Lambdoid suture unites parietal with occipital
• Squamosal suture unites temporal with parietal bone
• Metopic suture unites 2 frontal bones
• Largest foramen of skeleton is Obturator foramen in
ishium
• Anterior fontanel(bregma) is diamond in shape,
formed at junction of coronal, frontal and sagittal
sutures, closed at age of 18 months.
• Posterior fontanel(lambda) is triangular in shape,
formed at junction of sagittal and lambdoid suture,
closed at 6 weeks.
• Lichtenberg figures is an external lesion seen
in lightning strike.
• Superficial, thin, tortuous markings are seen on the
skin.
• When the pattern resembles a fern leaf, it is called
Lichtenberg figures or filigree burns.