Step 1 Uworld

Question
Main Division
Id
Sub Division
Notes
174
Pharmacology
Allergy & Immunology
Loratidine is 2nd gen antihistamine and safe in elderly coz no fall problems
375
Pathophysiology Allergy & Immunology
Hep B itself is not hepatotoxic but CD8+ repsonse to HBsAg and HBcAg will cause
damage
723
Microbiology
Protein M is the main virulence of strep pyogenous as it inactivates phagocytosis,

complement activation and permit bacterial adherence. It is also the target of
humoral response to the infection Streptolysin O will lyse RBCs amd PMNs
1155
Immunology
Calcineurin activate IL2 which permit T cell proliferation. Hence the use of
Calcineurin inhibitors in transplants
1388
Microbiology
If a child has diphteria give antitoxin (passive immunization; most efficient), penicilin
or erythromycin and vaccine. Otherwise prevent with vaccine (active immunization)
1389
Microbiology
Not all diphteria will cause pseudomembranous pharyngitis but need Tox gene to
produce its exptoxin AB
2068
Immunology
Tryptase is a specific marker for mast cells amd is useful in anaphylaxis
2069
Immunology
After IgE bind to receptors on Basophils and Mast cells these aggregate and cause
degranulation of substances.
1175
Biostatistics
Biostatistics & Epidemiology Absolute Risk Reduction= Event Rate % (A) - Event Rate % (B)
1183
Biostatistics
Biostatistics & Epidemiology Mode is the most frequent value on statistics, it the least affected by outliers
1189
Biostatistics
When choosing two groups of same age and sex and race you are reducing the
Biostatistics & Epidemiology chance of confounding bias. While selection bias occurs when you don't choose a
representative sample of the population
1204
Biostatistics
P value is called type I error: Probability that the difference ovserve is due to chance
alone. Type II error is measured with the power: Beta (probabiity of concluding that
Biostatistics & Epidemiology
there is no difference when there is actually one) The power is 1 - Beta; meaning
that is the pobability of concluding that there is a difference when there is actually one
1274
Biostatistics
Biostatistics & Epidemiology A result is considered legit if the 95% CI does not cross 0, so p value is less than 0.05
1278
Biostatistics
Validity (accuracy) is when a test gives very similar results than gold standard
Reliability refers to reproducibility of test (similar values all the time)
1279
Biostatistics
Effect modification is when smoking increases HRT risks of DVT compared to just
smoker, while HRT alone do not increase the risk of DVT
1282
Biostatistics
Biostatistics & Epidemiology In skewed graphs the hill is the Mean, then the Median and uphill is the Mode
1286
Biostatistics
Biostatistics & Epidemiology Lung cancer has been increasing a lot recently in women
1299
Biostatistics
95% CI that value is between X+/- Y Y is 1.96 (SD/rootsquare N) aka (SE) if it is as

99% CI it becomes 2.58 SE
1302
Biostatistics
Berkson's bias: The bias of choosing hospitalized patient in the study Hathorne effect
(observer effect): The tendency of subject to change their behavior as a result of
awareness that they are being studied Pygmalion effect: the effect of researcher's
belief on outcome
10570
Biostatistics
Ecological study are like cross sectional study, but in ecological study you want to
Biostatistics & Epidemiology measure a certain geographical population habits or whatever. Used to make
hypotheses about populations
35
Embryology
Cardiovascular System
Transposition of Great Arteries is failite of Aorticoopulmonary spiral septum to

undergo septation.
40
Pathology
0-4 hr post mi the myocardium is normal on histology. 4-12: coagulation necrosis,

edema hemorrhage, wavy fibers 1-5 days neutrophils 5-10 macrophae 10-14
granulation tissue then scar with collagen
42
Pathophysiology Cardiovascular System
Myocyte will stop contracting 1 min after total ischemia but it reversible until 30 mins
43
Pathology
Hibernating myocardium refers to the presence of ledt ventricular systolic dysfunction

due to reduced coronary blood flow at rest that is partially or completely reversible by
coronary revascularisation
92
Pathology
In dilated Myopathy (also in ischemic myopathy): Contractile function is decrease but

normal diastolic funciton (normal compliance) it is the opposite in HTN and
hypertrophic cardiomyopathy
96
Constrictive pericarditis is chronic
136
Pharmacology
NO will induce high cGMP which put myosin light chain in their inactive conformation
141
Pharmacology
In HOCM we use bb ccb disopyramide and diuretics or dilators
142
Pharmacology
Patients taking nitrates shld have a nitrate free period daily to avoid tolerance
144
Physiology
Both cardiac and smooth muscles are activated starting with extracellular Ca2+,
therefore CCB's work on them, unlike in skeletal muscles
155
Pharmacology
Digoxin: AV block (parasympathetik) so helpful in Afib while in CAD its effect is helful
coz of increase co tractolity ( DI goxi. So two functions)
160
Pharmacology
Prevent NIACIN FLushing BY NSAIDS
198
LHF will cause RHF by congestion pulmonary veins leading to vasoconstriction of

pulmonary artey and intimal thickening with media hypertrophy
200
S3 is caused by increased preload and it can lead to functional mitral regurg that is
eliminted by preload reduction
201
Pulmonary HTN cause irreversible damage to pulmonary arteries while RV

hypertrophy can be reversible with correcting the HTN
202
Embryology
PFO (failure of septum primum and secundum to fuse) and ASD (aplasia of either
septum secundum most commonly or septum primum) can both cause stroke from
venous clot but the difference is that PFO does not cause murmur.
232
Pathology
IE: vegetations on valve cups along with degeneration Rhemuatic fever: fibrous
thickening and distortion of mitral valve with commissural fusion at leaflet edges
240
Histology
Aschoff bodies are seen in heart rheumatic fever
245
Physiology
In tubes velocities: V1A1=V2A2=Cte (considering incompressible tubes, assuming

vessels are not compressible we can apply this rule)
296
Metastatic calcification occurs in cell necrosis (like in old aortic valve)
446
Atheros plaques involve platelets (PDGF) macrophages that will promote migration
of smooth muscels
449
Pathology
In mild HTN u get hyaline arteriosclerosis ( deposition in intima and media of vessels)
In severe HTN u get onion like concentric thickening of the wall
474
Pathology
In Varicose vein we morry most about skin ulceratio not DVT and stuff
551
Physiology
Permissive effect of cortisol: (it permits others to work at their best) On its own it
doesnt do anything But increase sensitivity of vessels and bronchial tissues to
catecholamines and increase glucose response to Glucagon
679
Microbiology
only Aureus is coagulase + among the Staphes
693
Pharmacology
ACE inhibitor can cause hypotension in first doses therefore started gradually
(dosage)
778
Pharmacology
Statins and fibrates have fucked up effects on muscles
898
Pharmacology
In PSVT adenosine will cause chest burning and flushing
899
Pharmacology
Amiodarone (class III K+ channel blocker of cardiac pacemaker cells so decrease

repolarization and increase AP so imcrease depo and repo time hence increase QT
but less associated with Torsades maybe coz of more homogeneous repolarization.
So eventhough Amiodarone is BAD it has a GOod Side of the Force. Adenosine
increase K+ conductance in AV and cause delay
900
Pharmacology
Lidocine (IB) bind rapidly depolarizing cells (like cocaine is rapid). Ischemic heart is
depolarized, so Lidocaine likes it. SO LIDOCAINE IS GOOD IN MI
944
MR is severed with volume overload so when have S3 u know MR is at its max
951
Physiology
In exercise, tachycardia will reduce Diastolic time, so this is the limiting factor in Heart
perfusion
1003
Microbiology
Viridans are acquired after dental procedure if have cardiac structural

abdnormaloties, and take glucose from out of cells and transform it into dextran to
integrate it into its polysaccharide cell wall, and also permits it to adhere to fibrin. So
Viridans adhere to fibrin and platelets that are deposited at site of endothelial trauma
in the valves and cause infection there.
1014
Pharmacology
Doxorubicin cause dose related dilated cardiomyopathy by creating free radicals..

Radiation cause myopathies by perocardial fibrosis (viral and surgery.)
1080
Pharmacology
Cilostazol is used in PAD, reduce,atelt activation and cause vasodilation
1094
Microbiology
Diphteria toxin (AB exotoxin) ribosylate and therefore inhibit EF-2, so will inhibit
protein synthesis causing cell death
1118
Pharmacology
ANP, BNP, NO --> increase cGMP --> relaxation of smooth muscle
1166
Pharmacology
if have cough with ACE go for ARBs
1174
Biostatistics
When comparing the efficiency of a new drug mortality benifit over another standard
drug, the NNT (number to treat), represents the ammount of people needed to be
treated to prevent on event compared to standard drug: 1/ARR(2.5%(risk of deaths
of old drug)-1% (risk of death of new drug))
1252
Pharmacology
Arteriolar vasodilator like hydralazine and minoxidil will cause reflex tachycardia and
fluid retention
1344
Pharmacology
Dobutamine affects B1 and lesser B2 and A1. So increase HR and Contractility

hence increase Demand of O2
1444
Pharmacology
FLAT CHAMP INCREASE cAMP
In fluid loss even if BP is low TPR is high due to Sympathetic activation. But Fluid
infusion will increase preload and increase End-Diastolic sarcomere length and will
increase Volume status decreasing Sympathetik stimulation and decrease TPR
Remember SBP= CO.TPR, so in Hypovolemia CO is super low and even with
sympathtic compensation to increase TPR, SBP stays LOW
1512
Physiology
1513
Physiology
Cardiac electrical transmission speed: PAVA: Fastest --> Slowest: Purkinje fibers -->
Atrial muscles --> Ventricular muscles --> AV node
1515
Physiology
PSVT: Do Carotid massage (XI -> X), Valsalva or Adenosine and this will prolong AV
node refractory period
1517
Physiology
In mitral valve stenosis we have a snap (indicating that the stenosed valve is trying to
open but is finding difficulties) then a dyastolic rumbling murmur because of turbulent
flow across this damaged valve.
1528
Physiology
At rest or exercise both systemic and pulmonary circulations have similar blood flows
since both systems are continuous and same amount of blood going from the LV is
going from the RV ( both systems differ in r and l of the equation but end up equal in
Q since they are continuous)
1529
Physiology
CO= O2 consumption/ AV O2 difference
1557
Physiology
S3 sounds in people >40 is abnormal and indicate LV enlargement (MR, AR, Dilated
or Ischemic Cardiomyopathy). It is Increased in End of Expiration (LV fills more), Left
lateral Decubitus (Higher Flow in LV), and Heard with the Bell of Steth in Cardiac
Apex in Early Diastole. Amyl Nitrite (Vasodilation, Decrease Bp, Decrease Venous
return), Furosemide (Diuresis, lower LV Volume),Valsalva or Standing (lower V
return) all Decrease S3
1589
Physiology
In exercise PaO2 and PaCO2 do not change but CO and HR increase to

accomodate for tissue's demand PE --> Hyperventilation = Lower PaCO2
1621
Physiology
Flow (Q)= dP/R Remember U=R.I R= v.L/r4 Q=r4.(dP/v.L) So if flow decrease by X in

a medium of same property this means that the radius is decreased by X root 4 But
Velocity relation is A1V1=A2V2 and has a r2 relatioship change with velocity
1624
Physiology
In the Cardiac output, Venous return curve its easy. If an event decreases venous
return like anaphylaxis for example lower the venous return curve. MI will lower the
Cardiac output curve maximum and slope. Anemia would higher it since we will have
tachycardia
In Heart PV curve, the lowest horizontal curve where heart receives blood, the slight
increase in P is preload whereas in the upper horizontal line which demonstrates
heart emptying, the slight increase in P is Afterload. Nitroprosside will decrease both
Preload and Afterload by Vasodilating Both Veins And Arteries.
1652
Physiology
1782
Physiology
Pulsus Paradoxus usually happens in Tamponade but can also happen in

Constrictive Pericarditis, Asthma COPD, or Hypovolemic Shock. In Tamponade,
increased pericardial fluid will compress LV, and during Inspiration increased venous
return in RV will move InterVentricular Septum towards LV, making it even smaller,
thus a >10% decrease in SBP.
1871
Anatomy
The Inferior wall of left Ventricle lies on the Diaphragm and is supplied by the
Posterior descending artery (from RCA)
1931
Physiology
Prior to myochte relaxation Ca2+ leave cells through Ca2+ ATPases and Na+/Ca2+
exchange (3 to 1, and does not require ATP) Besides its action in Smooth Muscle
contraction, Calmodulin plays a role in Cardiac Ca2+ efflux, by binding Ca2+
ATPases and activating it.
1947
Pharmacology
Phentolamine is competetive alha blocker wheras phenoxybenzamine is a non

competitive irreversible antagonist
1973
Physiology
CCB's slow Diastolic depolarization of Pacemaker cells. (phase 0) they also decrease
intracellular Ca2+, affecting excitation-contraction of these cells, therefore
decreasing Contractility. But when question is about antiarrythmitic studies choose
the Antiarrythmic action of CCB's.
1975
Physiology
ACh and Adenosine reduce phase 4 of spontaneous depolarisation, in cardiac

pacemaker cells.
Desynchronization between P and QRS means 3rd degree AV Block. This means
Atria contract from SA node but the impulse does not make it to AV node on time
most probably due to circuit abnormality, so AV node will take over to contract
ventricles and will get narrow QRS (since it supraventricular firing, so AV node will
filter the impulse sent)
1976
Physiology
1983
Physiology
Holosystolic murmur, that increase during inspiration is only tricuspid regurgitation

since the right heart will fill on inspiration. Left sided holosystolic murmurs and VSD
are not affected by inspiration since it does not increase left V load. Tricuspid
murmur: left sternal border, 3rd and 4th intercostal space Mitral murmur: Apex of
heart Aortic stenosis: Diamond shape (since aorta is most important and every old
person has diamonds)
2002
Pharmacology
Thiazide increase GLUC Glucose, LDL, Uric Acid, Ca
The heart has the highest oxygen extraction rate. (6075%) During exercise only
increasing coronary flow by Vasodilation which is mediated by Adenosine and NO will
accommodate for the increase oxygen demand since extraction is already almost
maximal. A
2009
Physiology
2055
Physiology
Afib can be induce systemic illness (HTN, Geart failure, Hyperthyroid), Increased
Sympathetic tone and Excessive alcohol consumption. Get irregularly irregular fast
rythm with absent P waves and often Narrow QRS. on EKG. High QRS amplitude is
due to ventricular hypertrophy often due to HTN. Prolonged QT can be congenital
and associated with Torsades De Pointes and can also be dure to chronic alcohol
use (not one episode of bunge drinking, which can cause Afib)
2130
Anatomy
Most common cause of aortic rupture in MVC is at the Aortic Isthmus; the site of
ligamentum arteriosum just dital to right subclavian
7640
Pharmacology
Class III will increase QT, while digoxin will cause AV block
8711
Histology
Thpe I Collagen is the most abundant overall and is the one we find in scars.
11745
Physiology
BNP (natriuretic peptide) is released in response to atrial and ventricular stretching

--> Natriuresis, Diuresis, Vasodilatory (antagonize vasoconstriction action of RAAS)
effect and protects against heart remodeling. BNP then inhibits RAAS system and
renin levels. Neprisylin metalloproteases, degrades BNP, bradykinins, oxytocin and
bradykinin. Neprisylin inhibitors are then good in Heart failure --> increase BNP and
in turn decrease Renin
11764
Anatomy
In cardiac cath, when trying to reach the femoral artery, if cannulation is done above
the inguinal ligament you can induce RETROPERITONEAL HEMORRHAGE
(CARDIOLOGIST ARE SCARED OF THIS)
11833
In right MI have stiffness of RV so increase CVP (backup of blood) but low RV output
so Low PCWP
11842
Anatomy
In Afib clots form in left atrial appendage its a motionless part of the atria (ma ela
3aze)
876
Pathology
Dermatology
Dermatitis herpetiform usually appear at 40-50 Eczema can occur after some food
1061
Biochemistry
Dermatology
Zinc deficiency causes acrodermatitis enteropathica, infertility and Growth retardation
1106
Anatomy
Dermatology
Apocrine glands secrete by cel lysis and content exretion like pimple glands
(sebacious and meibomian) Apocrine secrete membrane bound vesicles (breast)
while Merocrine secrete via exocytosis like salivry, eccrine and apocrine sweat
glands (named this way coz thought to be apocrine in nature ) DA FUCK bass CV u
wont be confused
1110
Pathology
Dermatology
Vitiligo: loss of melanocyte (autoimmune pooly understood) in albinism have

melanocyte but cannot produce melanin (unlike vitiligo where melanocytes are
fucked up)
1314
Pathology
Dermatology
Leprosy is attacked by CD4+ Th1 cell mediated response (like other Mycobacterium)
so skin lesions are due to IL2 and IFN Gamma
1334
Biochemistry
Dermatology
In Hartnup disease you have decrease Tryptophan absorption in guts and

reabsorption in kidneys. So you will eventually have decreased niacin and pallegra
1613
Immunology
Dermatology
GVHD occur also with liver transplant because it is rich in lymphocytes and occurs a
week later (around), Acute and chronic rejection are usually Host vs Graft (also T cell
mediated)
1641
Pharmacology
Dermatology
Acyclovir valcyclovir gancyclovir and those are nucleoside analogues that require
both cellular and herpes kinases for conversion to their active nucleotide
triphosphate form Cidofovir is a nucleoside monophosphate only require host cellular
kinase
1669
Microbiology
Dermatology
Post auricular lymphadenopathy makes us more suspicious towards rubella rather

than measle
1725
Genetics
Dermatology
Androgenic alopecia have Polygenic Inheritance patterns
1937
Pathology
Dermatology
Lymhedema (like post mastectomy) increase risk of Angiosarcoma
2037
Biochemistry
Dermatology
In tRNA we have a CCA site where amino acids bind
8569
Pharmacology
Dermatology
Psoriasis is often treated with with topical vit D analogs; calcipotrieme that bind
vitamin D recptor, inhibits keratinocytes proliferation and stimulate their differentiation
8904
Pathophysiology Dermatology
Accessory nipples are the most common congenital anomaly and fluctuate with
menstrual cycle, unlike nevi. On the other hand Neurofibroma are composed of
Shwann cells and neural fibroblasts and can sometimes retract to subcutaneous
tissue when pushed down.
11738
Pathology
Dermatology
TGF beta is responsible for fibroblast migration proliferation and CT synthesis
11852
Pathology
Dermatology
opioids, contrast, and vanco.. can trigger mast cell degranulation
Ear, Nose & Throat (ENT)
Cleft lip: maxillary prominence fail to fuse with intermaxillary segment(below nasal
septum) Cleft palate: Failure of palatine shelves to fuse with one another or with
primary palate Occur in 5-6 week of embryo development. Cam occur together or in
isolation.
1740
Embryology
11628
Pathophysiology Ear, Nose & Throat (ENT)
Cholesteatoas are collection of squamous cell debris that form behind tempanic
membrane, can be congenital or acquired following infection, trauma.. cause hearing
loss due to ossicle erosion
11783
Anatomy
Ear, Nose & Throat (ENT)
Psterior bleeding with sphenopalatine bleed is usually uncontrollable with bleed and
occur with HTN
163
Pharmacology
Endocrine, Diabetes &

Metabolism
Fibric acids (gemfibrozil..) decrease triglyceride production while Cholestyramine

(bile acid sequestrant) cause hypertriglyceride and gallstones ( cause decrease bile
acid reuptake so new cholesterol is put in bile u know..)
166
Pharmacology

Metabolism
Gemfibrozil are the most efficient for triglyceride so the best in pancreatitis induced
by triglycerides
167
Pharmacology

Metabolism
In addition to DERMATITIS of NIACIN Add GOUT (hyperuricemia; part of dermatitis

;) )
209
Pharmacology

Metabolism
GnRH agonist: at first act as GnRH but then in contrary coz not pulsatile
216
Physiology

Metabolism
Sertoli cells secrete Inhibin B to feedback inhibit FSH. Leydig cells secrete Testos
that feedback inhibit LH. Sertoli cells also secrete Androgen binding proteins to bind
Testosterone and trap it there since it needs it for spermatogenesis. This is different
from Sex binding protein which let testosterone circulate in the blood and is produced
by liver
225
Pathology

Metabolism
Acute hemorrhage into the pituitary (pituitary apoplexy) is usually aassociated with
Pituitary Adenoma Severe Headache, Cranial Nerve Involvement (bitemporal
hemianospia, ophtalmoplegia) and meningeal irritation. Cardiac Collapse is due to
adrenal insuficiency
342
Embryology

Metabolism
Increase AFP (Dating error most commonly) Patau Gastroschisis, Omphalocele,

Neural tube defect, and Multiple gestation. Decreased levels in Trisomy 21, 18.
599
Pharmacology

Metabolism
Pioglitazone and stuff work on PPAR gamma in fat so make u FAT not only by fat but
also by increasing Na absorption in Collecting Tubules
602
Biochemistry

Metabolism
Cortisol produced in the cortex will pass through the veins that will go the medulla
and enhance the PNMT (phenylethanolamine N methytransferase) enzyme that
converts Norepi to Epi (Makes sense right)
603
Pharmacology

Metabolism
Pioglitazone affect transcription factor and gene involvement so takes time
604
Pharmacology

Metabolism
Gliflozin are SGLT2 inhibitors (sodium glucose cotransporter in PCT) cause

glucosuria so possible UTI and genital mycotic infection. Also cause osmotic diuresis.
In Pple with renal impairement, the meds will not work well and can have increase
adverse effects
605
Pharmacology

Metabolism
PPAR gamma is a nuclear receptor affected by Pioglitazone and Rioglitazone ..
631
Pathophysiology

Metabolism
hyperPTH leads to Osteitis Fibrosa Cystica where we have subperiosteal eiosions

affecting phallanges of hand, "salt and pepper" skull, and brown tumor bone cysts.
767
Pathophysiology

Metabolism
High dose of Iodine will inhibit iodine uptake by follicular cells (used if have
radioactive iodine intoxication, T4 is not efficient coz it takes days to work)
769
Pathology

Metabolism
du quervain: mixed cellular infiltrate with occasional multinuclear giant cells (post
URI) Hashimoto: lymphocytic infilitrate with germinal centers and Hurthle cells
surrounding residual follicles (large oxyphilic cells filled with granular cytoplasm)
770
Physiology

Metabolism
TSH stimulate I-(Iodide) absorption (Na+I- symporter) in Follicular cells and is

competitively inhibited by Perchlorate and Pertechnetate, then goes in the colloid. Iis converted to I2 (Iodine) in the colloid (catalysed by Peroxidase). Thyroglobulin is
synthesized in Follicules then go to colloid too, where its tyrosine residues bind to I2
(Peroxidase). MIT and DIT are phagocytosed in follicular cells then those who are
not deiodinated join and T3, T4 form and are released
771
Embryology

Metabolism
Neural crest: PNS, Adrenal Medulla and Parafollicular pf thyroids (both are
chromaffin cells)
920
Pharmacology

Metabolism
Glitazones PPAR GAMMA STUFF reduce insulin resistance
980
Biochemistry

Metabolism
Remember Thiazide and HyperGLUC
990
Physiology

Metabolism
7-dehydrocholesterol -(UV)-> CholeCalciferol (D3) (1st step) then 25-OH in Liver

then 1-OH in Kidney
992
Physiology

Metabolism
Steroid, Thyroid hormones, VitD: Intrareceptor with DNA domain (to alter DNA
expression when go in nucleus) Ligand-gated ion channels (Na+,K+,Ca2+,Cl-)
across membrane for membrane potential etc. Intrinsic Phosphorylation: Insulin and
Insulin like GF JAK STAT: GH, Prolactin, EPO Hypercalcemia Hypocalciuria (AD
since all family has it): Defective Ca2+ sensing G (THINK C, G LOOK ALIKE) proteins
coupled receptors in PT gland and kidney that regulate circulating Ca2+ levels.
994
Biochemistry

Metabolism
Glucagon, beta adrenergic, PTH and TSH receptors work through Protein Kinase A
responsible for the G protein/ Adenylate cyclase secondary messenger system
1009
Physiology

Metabolism
Beta cells: Glucose enters pancreas through GLUT 2 transporter undergoes

glycolysis and produces ATP which will bind ATP-sensitive K+ channels (opened at
rest and maintains K+ efflux keeping cell hyperpolarized) and close them. This will
depolarize cell, which will open Voltage-dependent Ca2+ channels, increasing Ca2+
intracellularly and inducing insulin release. If KATP channels do not respond to ATP
we will have DM. Sulfonylurea bind KATP, close them irrespectively of ATP
1010
Biochemistry

Metabolism
Glucokinase will control glucose entry in Glycolysis in pancreas and liver and hence
stimulate insulin release. If non functional you can have DM predisposition
1012
Pathology

Metabolism
DM I : Islet leukocytic infiltration DM II: Islet amyloid deposition
1013
Biostatistics

Metabolism
Smoking cessation is by far the most effective preventive intervention to avoid

Cardiac events
1022
Biochemistry

Metabolism
gluconeogenesis requiring conversion of oxaloacetate to PEP uses GTP as a source

of energy and this GTP comes from the conversion of Succinyl CoA to Succinate in
the Krab Cycle. COOL Hein
1031
Biochemistry

Metabolism
Fructose 2,6 biphosphate favors Insulin effect and decreasing conversion of

pyruvate to Glucose ( decrease cAMP) in contrary to Glucagon
1034
Biochemistry

Metabolism
High Acetyl CoA level is the main Allosteric Actiator of Gluconeogenesis Increasing
the activity of Pyruvate Carboxylase, Converting Pyruvate into Oxaloacetate
1044
Biochemistry

Metabolism
Panthothenic acid is B5 and is used to synthesize CoA used in TCA cycle especialy
in first step reaction
1119
Biochemistry

Metabolism
Pentose phosphate reactions are all in Cytoplasm (coz only 5 carbona WTF) First
step of Gluconeogenesis consisting of Puruvate to Pxaloacetate requires B1 and is in
Mitochondria
1163
Pathophysiology

Metabolism
In Cushing we HyperPlasia of Zona Fasciculata (Not Hypertrophy) ... think that ure
producing an adenoma NON SENSE BUT STILL
1324
Pharmacology

Metabolism
Alpha stimulation is dominant over beta thats why epinephrine decrease insulin
1325
Physiology

Metabolism
In DM, Infection, Pain and Sleep Deprivation can cause Hyperglycemia, while
Exercise can induce Hypoglycemia.
1326
Pathophysiology

Metabolism
Serine and threonine phosphorylation of insulin receptor lead to insulin resistanec

(mediated by TNF alpha, catechols, steroids and glucagon)
1328
Pathophysiology

Metabolism
Elevated free fatty acid levels contribute to insuline resistance (impair insulin
dependant glucose uptake and increase hepatic gluconeogenesis and insulin
secretion) and DM II
Physiology

Metabolism
Glucose is transported in the D-Glucose form. Glut 4 is insulin mediated and

transports it into fat and muscle tissues whereas Glut 2 tranports Glucose from Liver,
SI and Kidneys into blood circulation and helps regulates insulin secretion from
pancreas. Glut transport Glucose via Carrier-mediated transport (Active transport)
1540
Physiology

Metabolism
Insulin has no effect in Glucose reabsorption in kidneys, but Increase Na+ Renal
Absorption increasing blood volume and BP. Insulin also inhibits glucose release
from liver, and Inhibits Glucagon secretion by directly acting on Alpha cells. It is
Anabolic (Glycogen, Protein Synthesis) and inhibits Glycogenolysis, Lipolysis and
other Catabolic reactions.
1615
Physiology

Metabolism
Thyroid produce mainly T4, which is converted to T3 (active hormone) rT3 (inactive)
1660
Pathology

Metabolism
RAT (activating mutation) in Men RAS is follicular thyroid
1355
1768
Physiology

Metabolism
Insulin synthesis: Insulin translation starts in ribosomes to yield PreProInsulin. Then

translation continues in RER Ribosomes (the same ribosome translocates). In the
RER first the N terminal is cleaved giving Proinsulin then 3 disulfides bonds in the
Insulin parts form. The ProInsulin is sent to the Golgi Apparatus and is cleaved by
endopeptidases, but both Insulin and C peptides are stored in granules and secreted
from Beta cells. But C peptide's half life is only 35 mins
1979
Pathophysiology

Metabolism
In metabolic acidosis (E.g DKA) u hyperventilat but in DKA u have lung edema so u
go in respiratory failure not only because of exhaustion
1984
Pharmacology

Metabolism
Severe hypoglycemia (patient not conscious so cannot swallow) so give Glucagon (if
outsode hospital) and Sugar per IV (in Hospital)
2066
Biochemistry

Metabolism
Orotic acid converts to UMP, UDP --> TMP, CTP (pyrimidine). If the enzyme Orotate
phosphorybosyl transferase is missing, you won't be able to convert orotic acid. But if
you supplement patient with Uridine you negatively feedback the reaction
2081
Pathology

Metabolism
In CAH give Steroids to supress ACTH
8531
Pathology

Metabolism
Sulfonylurea can cause Severe Hypoglycemia
11565
Pharmacology

Metabolism
Sulfonylurea can cause Hypoglycemia
11634
Pharmacology

Metabolism
Ezetemibe is like fenofibrate but decrease absorption of cholesterol, not bile acids
207
Physiology
Female Reproductive
System & Breast
For ovulation induction you can use Menotropin (mimics FSH) then HCG (mimics LH,
same alpha subunit. Similar subunit with FSH too but not that much, and not the
point here)
258
Pathology
Female Reproductive
System & Breast
PCOS have increased risk of endometrial ca and DM II
299
Physiology
Female Reproductive
System & Breast
Upon withdrawal of Progesterone, Endometrial cells undergo Apoptosis around 5

days later, causing Menses
1015
Histology
Female Reproductive
System & Breast
Koilocyte seen in HPV are cells with dense nucleus (pyknotic: dense DNA, as part of
apoptosis first step) and perinuclear halo clearing
1057
Pathology
Female Reproductive
System & Breast
Comedocarcinoma (DCIS): solid sheet of pleomorphic, high grade cells with central
necrosis
1158
Pathology
Female Reproductive
System & Breast
Granuloas cell tumor of ovary: Call Exner (cuboidal cells in rosette pattern with bean
nuclei) and yellow theca cells with lipids Large unilateral adnexal mass with increase
Estrogen and inhibin
1549
Pathophysiology
Female Reproductive
System & Breast
Herpes facial palsy is HSV 1 (oral not genital) HSV 2 resides in dorsal root ganglia in
sacral ganglia and be reactivated and give recurrent genital ulcer VZV also goes in
dosal root but in trigerminal ganglia
1560
Physiology
Female Reproductive
System & Breast
Theca interna: Cholesterol -(LH)-> progesterone + Androgen --> Granulosa

(Aromatase): Androgen -(FSH)-> Estrogen. This actually explains why LH and
Progesterone are not null during Follicular phase. Theca externa serve as supportive
connective structure.
1632
Anatomy
Female Reproductive
System & Breast
Ovary is innervated by Ovarian artery, vein, lymphatic and nerves which are
contained in suspensory ligament as the suspensory ligament hold the ovaries in
suspension in the abdomen
1739
Anatomy
Female Reproductive
System & Breast
Pudendal block is sometimes use if epidural was not used. It is intravaginal medial to
ischial spine and will num the perineum the genitals, and motor og urthra sphincter
and external anal sphincter (S2-S4)
1809
Embryology
Female Reproductive
System & Breast
In contrast to Androgen insensitive patient those with Vagina agenesis (upper vagina
and sometimes uterus, it's Mullerian defect) ave Pubic hair etc.
1831
Embryology
Female Reproductive
System & Breast
Bicornuate nucleus: Incomplete lateral fusion of paramesonephroc duct
1899
Physiology
Female Reproductive
System & Breast
Anovulation is common in first years of menarche (Immature axis, so follicle does not
become corpus luteum) and last years before menopause, it manifests with
menstrual variability, spots Complex atypical endometrial hyperplasia occurs with
prolonged unopposed estrogen, it can happen with chronic anovulatory cycles
(where you only have estrogen without progesterone), HRT without progesterone or
Obese old women. Atrophic endometrium occurs in menopause (also get spotting
2056
Pathology
Female Reproductive
System & Breast
Ovary is cuboidal cells
8556
Genetics
Female Reproductive
System & Breast
Turner's have abnormal ovary but normal Uterus so can get pregnant with donation
etc.
11781
Anatomy
Female Reproductive
System & Breast
Ureter injury will cause leakage of urine irritating the bowel causing ileus, flank pain
and fever but no urinary incontinence
11802
Microbiology
Female Reproductive
System & Breast
KOH is used to diagnose gardenella While trichonoma protozoa with flagella are
seen on wet mount
11820
Anatomy
Female Reproductive
System & Breast
Internal urinary sphincter are parasympathetic innervation while external one ( distal)
is pudendal voluntary Kegel exercice target levator ani ( think of how u contract ur
perineum)
47
Microbiology
Gastrointestinal & Nutrition
hep B give hep D a capsule giving it its virulence and ability to invade hepatocyte
57
Pathology
Aflatoxin G->T mutation in p53, increasing risk of HCC. Found in grains corns
soybeans peanuts where fungi are grown
62
Microbiology
Liver abscess can be caused by Staph throgh hematogenous route MESH GHALAT
70
Biochemistry
In infections Beta glucoronidase are released by hepatocytes and unconjugate

conjugated bilirubin causing it to precipitate and causing brown stones
78
Pathophysiology Gastrointestinal & Nutrition
cholesterol makes bile less soluble while bile salts and phosphatidylcholine makes it
more soluble
Physiology
Acid secretion: 3 phases Cephalic: Vagal and cholinergic: stimulated by thought,

sight, smell and taste of food Gastric phase: Chemicals in food and gastric distention;
Gastrin-->Histamine (Enterochromafin like cells; ECL) --> Acid secretion Intestinal
phase: proteins in Ileum and Colon will produce Peptide YY which will bind to ECL
and inhibit gastrin stimulated histamine release from these cells When acid is
secreted Bicarb and Cl- decrease in circulation (predictable)
126
133
Can diagnose Lactase deficiency by decreased pH of stool
165
Pharmacology
Statins decrese cholesterol formation SURE, BUT BUTTT cholestyramine will bind
bile acids and cause increase excretion so liver will produce more cholesterol to
throw in bile
280
Pathology
Esophageal spasm is due to imparied neural inhibition within the myenteric plexus
290
Pathology
Erosion does not cross Muscularis Mucosa While Ulcer Do Cross it
306
Mastocytosis will increase Histamine and cause Gastric Hypersecretion (EZ)

(Associated with KIT receptor Tyrosine Kinase Mutation)
319
Embryology
Duodenal atresia is due to recanalization failure while Jejunal/Ileal atresia is due to

vascular injuries
320
Embryology
Imperforate anus, is most commonly associated with urogenital abnormalities

(fistulas and stuff). Then you think of VACTREL Vertebral, Anus, Cardiac, TE,
Eosophageal atresia, Renal, Limbs
322
Embryology
Meckels diverticulum is part of vitelline (omphalocele) duct remnant (in embryo

connects midgut to yolk sac but obliterated in 7th week) If not obliterate it can cause
vitelline diverticulum where meconium passe through it into the umilibcal cord, or we
can just have a band or a cyst.
328
Embryology
Meckels diverticulum is a true one and is composed of all layers; mucosa,

submucosa and muscular layers
369
Inhaled halothane can cause fulminant hepatitis (looks like viral hep) and will have
high ALT AST, and decrease hepatic function so failure so prolonged PT and stuff
but no hepatic HTN
370
Pathology
Alcohol inhibits Free FA Oxidation and Gluconeogenesis coz have INCREASED

NADH
373
Immunology
Children <6 yrs usually get asymptomatic Hep A. They don't get anti IgM antibody
since no disease
374
Microbiology
Hel B is a ds DNA but replicate via reverse transcription (+RNA template)
406
Pathology
Crohn Th1 (terminal ileum) UC Th2
407
Pathology
in UC the rectum is always involved
410
Pathology
Toxic megacolon is UC is diagnosed by Xray
412
Crohn, ileum involvement, bile acid will not be reabsorbed so bile will have less bile
acids and will be more cholesterolous hence gallstones
415
Pathology
Traction Diverticula is True Diverticula and due to inflammation and stuff While
pulsion Diverticula is False (like sigmoidal Diverticula) Outpouching of the mucosa
and submucosa through the muscularis
431
Pathology
Polyp were shown to be involved with COX2, thats why we give aspirin for colon CA
432
Pathology
Tenesmus is seen in rectal adenoCA not colon righ colon: occult bleed iron
deficiency Left colon: obstruction and often hematochezia
435
Pathology
Pancreatic pseudocyst wall is not lined by epithelium but by granulation and fibrous
tissues Serous cyst have glycogen rich cuboidal cells epithelium Mucinous cysts
habe columnar mucinous epithelium Atypical papillary projections are seen in
AdenoCa
437
Embryology
Pancreas Embryology: Dorsal bud Tail, Neck most of Body, Accessory Duct Ventral
bud: Uncinate, Inferior Posterior Moreover, Inferoposterior aspect of Head and Major
Duct In Pancreatic Divisum (5% of population) the two buds fail to fuse fiving two
seperate ducts with independant drainage. Ventral duct (will be smaller) drain into
major papillae, Dorsal duct (major) drain into smaller papillae. Cery rarely this can
cause chronic Pancreatitis
539
Immunology
Ig's attach Phagocytic cells through Fc portions and attach Complements through
hinge portion
589
Immunology
Secretory IgA come in a dimer form where both Fc portions are attached by a J chain
745
Immunology
Cells with decreased MHC1 expression like virus infected cells and tumor cells, are
targeted by NK cells to kills them
755
Biochemistry
1g of Proteins and Carbs produces 4 Calories while 1 g of Fat produces 9 Calories
790
Biochemistry
The MAP kimase pathway (including Growth hormone) uses Ras protein and GTP
(active) and GDP (inactove)
841
Pharmacology
Arsenic is found in insecticides, contaminated water and cause abd pain,vomiting,

diarrhea, hypotension and garlic odor breath. Treat with DIMERCARPOL
1018
Physiology
Fat is absorbed in Jejunem, While B12 and Bile salts are absorbed in Ileum
Shiga toxin (shiga like also) inactivates 60s ribosome by removing adenine from
rRNA, and inhibit protein synthesis in colon mucosa and renal endothelial (EHEC:
only e coli that does not produce glucuronidase and does not ferment sorbitol) While
ETEC and Yersinia enterotoxin increase cellular cGMP leading to diarrhea Only
enteroinvasive EIEC invade mucosa hence the I
1100
Microbiology
1136
Microbiology
Shigella need 10-500 bacteria to infect Very BadAss
1156
Pharmacology
Iron poisoning will cause diarrhea while lead will cause constipation
1169
Biostatistics
NPV and PPV depend on disease prevalence irrespectively of test sensitivity and
specifictiy
1251
Biochemistry
Trypsinogen is converted to Trypsin in duodenal of epithelium and in turn activates

other digestion proteins
1258
Pharmacology
Morphine cause smooth muscle contraction in sphincter of Oddi
1290
Pharmacology
Diphenoxylate (opioid and act on mu receptors ) given with diarrhea, but is given with
atropine to produce bad effects and discourage abuse and tolerance
1396
Pathology
Pseudomembranous colitis (C diff): White/yellow plaques membrane like on colono

composed of fibrin and inflamatorry Undercooked meat: cysticercosis : Seizures, SC
nodules, IM calcifications
1397
Microbiology
C diff toxins A: intestinal inflamation and fluid secretion B: Cytotoxic (affect actin
cytoskeletal structures an intracellular signaling)
1398
Microbiology
Clostridium mostly attack people with disturbed GI microbiome
1467
Immunology
Sabin (oral polio vaccine) has better IgA activity than Salk doing a better job at
mucosal entries
1525
Anatomy
Air in Biliary tree means GB, SB fistula for STEP 1
1596
Immunology
Unlike other parasites, Giardia is all about IgA defense and not eosinophils (involved
in Helminthic infections)
1807
Biochemistry
Riboflavin B2 is used in TCA cycle by transforming Succinate to ketoglutarate

forming FADH2 while the reaction before of Succinyl CoA to Succinate forms 1 GTP
used in Gluconeogenesis
1863
Pathology
Viral Hepatitis: hepatocyte necrosis (cellular swelling and cytoplasmic emptying

cused by loss of ATP and loss filament in the meshwork) and apoptosis ( in
apoptosis there cellular shrinking with nuclear fragmentation and esoniphilia
(Councilman body)with moninuclear infiltration
1918
Pathology
Atrophic Gastritis Affect the Body of stomach while H pylori zffects the Antrum first
then the Body
1927
Pathology
Viral Hepatitis cause Apoptotic Hepatocytites so get round acidophilic Councilman

BODIES (eosinophilic ) also seen in Yellow fever
1938
Physiology
Motilin is produced by Duodenal mucosa ans stimulates Smooth Muscle contraction

in Upper GI. erythromycin acts as a Motilin Agonist, causing Diarrhea. Ghrelin
(Hunger): Increase in Fasting, Decrease after Eating. Glucagonoma: DM, NEC
VIPoma (Pancreatic Islet Gumor): increase Cl- loss in stools, and excess H2O, Na+
and K+ follow, leading to Diarrhea. It also inhibits Gastric acid secretion. treated with
Somatostatin Gastrin: acid secretion and growth of gastric mucosa
1971
Physiology
Secretin, secreted by Duodenal S-cells in response to H+ in the duodenum, will

stimulate Bicarb secretion from pancreas. On the other ither hand, pancretic
enzymes are secreted following Vagal and CCK stimulus (like Gallbladder)
8283
Genetics
Linkage disequilibrium is when the frequency of alleles independently do not match

the frequency of having both alleles at the same time
8578
Biochemistry
In hepatic encephalopathy, excess ammonia will deplete alpha ketoglutarate, and

glutamate to convnert them into glutamine. Glutamine is bad for the cells and
accumulated, glutamate which is excitatory is no longer here, and alpha keto which is
needed for respiration is depleted too. Do the math.
10401
Microbiology
Fidaxomicin is used in resistant C diff
10583
Anatomy
The portal triad (Hepatic artery, portal vein and CBD ) run through the
hepatoduodenal ligament so if there is bleeding we clamp the ligament to rule in or
rule out any other cause of bleed
11591
In gerd Dysphagia is more consistent with ulceration while dysphagia and obsturction
goes more with strictures
11629
Behavioral
science
As a physician be RADICALLY AGAINST Herbal products especially if you are sure

they are bad
11771
Anatomy
Pudendal nerve which (S2-S4) which numbs the perineumand genitals also numbs
area when want to do external Hemorrhoids removal (Gives inferior rectal nerve).
Internal Hemorrhoids are innervated by Autonomic Inferior Hypogastric Plexus and
do not sense pain or temperature.
11782
Anatomy
The appendix is best identified by the converence of the 3 Taeniae Coli of the colon
11795
Anatomy
Chronic pancreatitis can cause splenic vein thrombosis causing short gastric vein
varicoses (Dr levi style)
11860
Bacteria in guts produce not only Vit K but also Folate
757
Physiology
General Principles
Free ribosome translation destination: Cytosol, Nucleosol, Mitochondria ( nuclear

proteins) and Peroxisome ( involve in anabolism and catabolism of fat (very long
chain FA) and also produce bile) RER destination: Membrane (cell membrane,
nuclear membrane), ER, Golgi, Lysosome --> Prepare to go out of cells
1028
Biochemistry
General Principles
During exercice the Ca2+ release in muscles will also activate glycogen pathway and
glycogenolysis hence the parallel association between muscle contraction and
gycogenolysis
1469
Genetics
General Principles
Rota and influenza like genetic shift through reassortment thats why they are
common and need to vaccinate many times (more efficient virulence than genetic
drift: pt mutation) Shift is Sudden wheras Drift is graDual (less killer machine)
1482
Biochemistry
General Principles
B6 is involved in transamination reaction where an amino group from an amino acid

goes to an alpha ketoacid making it an amino acid. B6 is involved in decaboxylation
reaction
1616
Physiology
General Principles
Circuit in Parallel: 1/Rt = 1/R1 + 1/R2 + 1/R3 (Think how circulation in the body which
is mainly in Parallel wants to be efficient) In series: Rt = R1 + R2 + R3
1712
Pharmacology
General Principles
Isoniazid metabolism by acetylation so we have fast and slow acetylators.
1714
Pharmacology
General Principles
T1/2:0.7xVd/Cl
1715
Pharmacology
General Principles
Lipophilic deug prefer liver exretion Mante2
1728
Genetics
General Principles
Lesh nyhan is X linked recessive while Galactosemia is AR
1912
Microbiology
General Principles
Thayer and Martin are selective and only ahve sex together but culture neisseria
BADDEEE
1970
Genetics
General Principles
Pleiotropy = One mutation and many many consequences
2025
Genetics
General Principles
Enhancers/Repressors can be anywhere in relation to the gene involved, while

promoter are 25-70 base pair upstream to start of gene
2029
Genetics
General Principles
Stop codon UAA UAG UGA are recognised by Realeasing Factor 1
2030
Genetics
General Principles
TATA box is a promotor (25 bases upstream) that bind to transcription factor and
RNA polymerase II (in Eukaryote, binding RNA polymerase alone is not enough) for
transcription initiation.CAAt box is also a promotor but 85 bases upstream
2031
Genetics
General Principles
N myc is a transcription factor and bind DNA
2033
Genetics
General Principles
Postranscriptional modification: (occur in nucleus) 5' capping Poly A tail (3' end):
when AAUUAAA (transcribed from DNA) is detected the cap is added (cap is not
transcribed from DNA), protects mRNA from degradation in chtoplasm Splicing:
Introns removal
7791
Genetics
General Principles
Methylation of Cytosine in DNA is implicated in gene silencing and hence in

Imprinting of disease ( why silent in mom not in kids for ex)
11514
Pathology
General Principles
Hand Hygiene is best way to prevent hospital infections
11674
Immunology
General Principles
Ubiquitin proteasome pathway: ubiquitin tag bad particles (like viral particles),
proteasomes come degrade them then they a presented on cell surface bound to
MHCI for presentation to cytotoxic CD8 cells
11847
Behavioral
science
General Principles
Preventable adverse event is defined as injury to a patient due to failure to follow

evidence based test practice guidelines
58
Pathology
Hematology & Oncology
Hep C (RNA virus) lacks reverse transcriptase and does not integrate into genome
ulnike DNA Hep B that do integrate
346
Biochemistry
VWF --> GP Ib (Bernard) --> GP IIb-IIIa (Glanzman). If you add ristocetin you will
activate GP Ib receptors on platelets and make it available for vWF binding. If still no
response then vWF vs GP Ib. If normal plasma is added and still no reponse to
ristocetin it is Bernard (coz vWF is contained in normal plasma)
465
Pathology
Factor V is when factor V is resistent to protein C deactivation
537
Immunology
Wiskott Aldrich is triad of Eczema, Thrombocytopenia (both appear early) and B, T

cells immunodeficiency appearing at 6-12 months.
540
Immunology
C1 binds to IgG and IgM (Pentameric, so binds better) to activate complement

system, at the hinge point of the heavy chain
559
Immunology
Immature T lymphocytes in Thymus cortex, express both CD4 and CD8
614
Pathology
Glioblastoma: Necrosis and vascular proliferation
787
Physiology
Hpecidin, secreted by liver will decrease intestinal Iron rate absorption. It is increased
in Inflammation, and high iron levels. It is decreased in hypoxia and erythropoeisis.
Low Hepcidin, increase intestinal absorption and release from Macrophage.
1029
Biochemistry
RBC dont do oxidative phosphorylation since they dont have ATP, and they dont
even produce enough ATP in Glycolysis coz they sacrifice 1,3 BPG (which usually
gives ATP by turning into 3-phosphoglycerate), by turning it into 2,3 BPG (LOGICAL
YA?)
1035
Biochemistry
NADPH can be synthesised through the oxidative pathway of HMP shunt but can
also be formed from the non oxidative pathway through Transketolase and
Transaldolase from Fructose6P instead of G6P
1039
Pathology
TNF alpha cause cachexia
1077
Pharmacology
Heparin attaches on AT III and and enhances its activity by inhibiting Xa and
thrombin, LMWH IS MORE SPECIFIC FOR Xa
1242
Biochemistry
In HbS valine take the place of glutamate in 6th position of the beta chain causing
new hydrophobic interactions hence sickling
1257
Pharmacology
Opioids has many sode effects like constipation nausea vomiting.. But build
to,erance to all and dont get side ffects anymore except for CONSTIPATION AND
MIOSIS
1338
Biochemistry
In acute porphyria, you can give heme which will inhibit ALAminuvic acid synthetase
and decrease accumulation of D ALA and porphorynohenc
1403
Genetics
AML M3 (15:17), and Retinoic acid receptor are malfounctional
1405
Pathology
AML (15-17t): Auer rods
1415
Biochemistry
In CN poisoining: (bind cytochrome a-a3) Nitrites bind Fe2+ --> Fe3+ (higher affinity
to CN and prevent its release to mitochondria) Another Antidote is Sodium
Thiosulfate which combines with CN forming Thiocyanate which is less toxic and
excreted in urine
1455
Biochemistry
In RBC, Heme is produced in Mitochondria firs 3 reactions, then cytosol. So when

RBC mature and lose their mitochondria, u cannot synthesize anymore heme
1455
Biochemistry
RBC cannot produce heme coz they dnt have Mitonchondria responsible for first and
last step of production
1474
Genetics
Radiation therapy works through breaking Double Strand DNA, and creating free
radicals too
1476
Biochemistry
Thymidine dimers are usually corrected by endonucleases
1496
Microbiology
I know its weird but Aplastic Crisis affect only RBC while Aplastic Anemia affects all
lines
1545
Physiology
CO poising will increase Carboxyhemoglobin (CO bound Hemoglobin) but does not
affect PaO2 since it competes with O2 in Hemoglobin not in plasma. It will not affect
Methemoglobin (Iron oxidized to Fe3+ due to Dapsone, Nitrite, Enzyme deficiencies
or Hemoglobinopathies) . CO poisoning will cause a Left Shift (Decreased O2
tendency to unload)
1614
Immunology
Isotype sworching occurs in germinal centers of LN
1647
Pharmacology
Ganciclovir can cause NEUTROPENIA. its effect increase with TMP SMX or
ZiDoVuDine coz also can cause BM supression
1654
Physiology
Patients who receive more than 5L/24 hrs of PRBC will have high levels of Citrate
(used to store blood), which in turn chelates Ca2+ and Mg2+, lowering their blood
level, causing parastheisa
1683
Immunology
Rhogam is an IgG antibody
1717
Pathology
Rb is active HypoPhosphorylated (its in kidss so we dont like much phosphorylation,,,

)
1753
Pathology
In Dysplasia there is reversible change in epithelial. Once the dysplastic cells have
breached the basement membrane it os no longer reversible
1754
Pathology
Lymphocyte bnign vs malignant: Monoclona T cell vs Polyclonal in infection (makes

sense)
1758
Pathology
bcl2 (oncogene on chromo 18) It inhibits apoptosis of tumor cells and facilitates
neoplastic growth.. In follicular lymphoma (B cell tumor) bcl-2 goes to ch 14 and is
over4 expressed RAS: component of MAP kinase path, transmits signals from cell
surface to nucleus (pancreatic, GB, colon, endometrium, thyroid ,lung cancers) DNA
mismatch repair: in Lynch syndrome (colon and stuff)
1786
Pathology
Pure red Cell aplasia is seen in : Thymoma, Lymphocytic Leukemia, and Parvovirus
B19 infection
1788
Genetics
Hemophilia is X-recessive
1796
Pathology
Erythropetein have bluish cytoplasm reticular precipitates of rRNA and is larger (also
lacks a nucleus)
1797
Pathology
Mosto Carcinogens enter body as inactive but P450 (monooxygenase) make them
so, and it depends on this system to determine succeptibility of individual
1819
Pharmacology
MDD1 code for a P glycoprotein a transmembrane ATP dependant efflux pump that
increase efflux of drugs and decrease influx of these chemo agents making the cells
resistant to chemo
1847
Biochemistry
Folate i s needed for Thymidine formation
1861
Pathology
Aplastic anemia (Thrombocytopenia, Anemia, and absent hematopoietic cell in

marrow) will have BM with fat infiltrate
1872
Pathology
Integrin bind cells to basement membrane by attaching it to FIBRONECTIN,

COLLAGEN, And LAMININin Extracelullar matrix
1873
Pathology
VEGF and Fibroblast Growth factor cause angiogenesis while epidermal growth
factor affect mitogenesis of hepatocytes and fibroblasts
1877
Pathology
Peau dorange is due to lymphatic obstruction
1890
Pharmacology
6-MP -(HGPRT)-> Active Metabolites 6-MP -(Xanthine Oxidase)-> Inactive

Metabolites (that why allopurinol will increase dose of 6-MP)
1911
Genetics
Follicular lymphoma 14:18 translocation causes Bcl2 overexpression
2018
Pharmacology
ETOPOS(second)ide block TOPOisomerase Second (II)
2086
Biochemistry
Thalassemia intermedia is associated with a muation three bases upstream from the
start codon (AUG) exchanging a puring with a pyrimidine
2133
Pathophysiology Hematology & Oncology
Thrombin II inhibtors will affect TT (throbin time) also PT PTT Xa inhibitor will affect
both in theory (in practice PT is barely affected coz of heparin neutralizer in the PT
reagent)
7643
Immunology
In EBV you get atypical CD8 T cells in circulation (large with eccentric nucleus) to
attack B cells infected (you also get atypical B cells but in much smaller proportion)
8276
Biochemistry
In Alternative Splicing, same gene will give different mRNA in different tissues
8371
Pharmacology
ralTEGRAvir: Inhibits HIV inTEGRAse, so that its DNA will no be well incorporated
11728
Pharmacology
In chemo induced nausea inhibiting Neurokunin is good too (Tfayli's talk)
11750
Pathology
Hairy cell leukemia will cause marrow fibrosis
11754
Pathology
Sclerotic means osteoblastic
11816
Biochemistry
Lead: ALA D, Ferrochelatase are affected B6: ALA S is affected
44
Microbiology
Infectious Diseases
Hep C envelope changes a lot coz its RNa dependant RNA polymerase has no
proofreading 3"-->5" exonuclease activity
46
Microbiology
Infectious Diseases
Hep B acquired by the fetus (transplacentally) or at birth (more commonly) is very

common if mom is HbeAg positive. They have very high replication rate and higher
rate of progression to chronic disease (the younger the higher the risk). On the other
hand they are rarely symptomatik and have mildly elevated LFTs
112
Immunology
Infectious Diseases
Local Candida is controlled by T cell (seen in HIV) wheras disseminated Candida is

controlled by neutrophils (seen in neutropenic)
376
Microbiology
Infectious Diseases
Atypical lymphocytes can be seen in Hep B, EBV and CMV and are non specific..
390
Pathology
Infectious Diseases
in 95% of pple hem B will resolve after acute attack
532
Microbiology
Infectious Diseases
Aspiration pneumonitis is like aspiration pneumonia but resolves on its own and
occur few hours after aspiration not days like pneumonia. Occurs by aspiration of
oral anaerobes not gastric!!!!
676
Immunology
Infectious Diseases
In TSST-1, the toxins which are superantigens activate T cells and Macrophage
819
Pharmacology
Infectious Diseases
Protease inhibitors navir cause metabolic stuff
822
Pathophysiology Infectious Diseases
Hep B are associated with HCC coz of the integration of DNA into host genome
963
Microbiology
Infectious Diseases
H. flu are blood loving, but needs factor X and NAD+ for growth. So wont grow on
sheep blood agar unless cultured with Staph that will povide her with NAD+
977
Microbiology
Infectious Diseases
Oxidase + comma shaped bacteria: cholera: grow in alkaline (so PPI or decrease
acidity will promote its proliferation) pylori: In acidic coz produce urease Campylo: in
42 degree They are all special
1091
Pharmacology
Infectious Diseases
In Tazocin, Tazobactam role is to decrease Piperacilin destruction (like Carbidopa)
1103
Microbiology
Infectious Diseases
Hib, in young children cause: MEningitis, pneumonia, bacteremia and epiglotitis (BIG
SHIT) While Sinusitis and OM are caused By NON TYPABLE H. flu
1137
Microbiology
Infectious Diseases
Salmonella Vi antigen (its virulence factor) makes it resistant to opsonization and

phagocytosis
1309
Microbiology
Infectious Diseases
Mycolic acid in Mycobacterium cell wall, is part of its virulence will make it acid fast as
in when then dye is given the bacteria will stain red on carbolfushin and is resistant to
decoloration when acid-alcohol decolorizing agent are given because of proper cell
wall. When Isoniazid is given it inhibits mycolic acid synthesis, so the bacteria will
lose its acid fast property and decolorize KatG (bacterial peroxidase) will tranform
INH to its active element.
1392
Microbiology
Infectious Diseases
Listeria (food borne) frows well on cold tpragure and can contaminate refregirated
food. It is a gram + with tumbling motility
1393
Pharmacology
Infectious Diseases
Losteria is nod responsive to ceftriaxone so also give ampicillin
1408
Microbiology
Infectious Diseases
the Herepsviruses family get their membrane from nuclear membrane of cells (unlike
the rest, get it for cell membrane.. NICE StufF)
1468
Immunology
Infectious Diseases
IFN alpha and beta are secreted in response to viral particles and decrease their
protein synthesis capacity and replication, promoting apoptosis
1550
Microbiology
Infectious Diseases
In primary herpes, a week course of acyclovir will reduce the disease but not prevent
recurrence (latent in sacral ganglia S2 S3 S4). On the other hand prophylaxis daily
valacyclovir will do the job
1551
Pharmacology
Infectious Diseases
Acyclovir (nucleoside analogs) coz like Adenosine
1593
Microbiology
Infectious Diseases
CMV is EBV with (-) heterophile test (as in fail to agglutinate horse erythrocyte)
1645
Pharmacology
Infectious Diseases
Acyclovir and ovirs are to be phosphorylated to become in their active forms
1649
Immunology
Infectious Diseases
In Influenza it is Antibodies against Hemaglutinin that primary protects against

infection
1670
Microbiology
Infectious Diseases
The 3 C's of measle + fever are prodromal to the rash
1965
Pharmacology
Infectious Diseases
Primaquine is given to kill liver stage malaria hypnozoite and thus preventing relapse.
Malaria consists of fever and sweating in a 48 h cycle
2110
Pharmacology
Infectious Diseases
Penicilln and Ceohalosporins bind to cell membrane proteins such as transpeptidase
2111
Pharmacology
Infectious Diseases
Cephalosporins resitance mechanis, by changing in penicilin binding protein

structure ( some of the protein remain normal so still have some binding) whereas in
beta lactamase in case of penicillin there is no binding at all coz antibiotics will all be
disabeled)
8288
Pharmacology
Infectious Diseases
Daptomycin (cover gram + and MRSA) work by depolarizing bacteria Ceels and
therefore inhibits DNA RNA fprmation and protein synthesis, but cause myopathy
and increase CPK
8593
Microbiology
Infectious Diseases
Alcohols are antisceptic coz they disrupt cell membranes..
11395
Microbiology
Infectious Diseases
Dengue fever has 4 serotypes. Chill infections vs Bad ones are due to diferrent
serotypes
11525
Microbiology
Infectious Diseases
IFN Gamma are produced by NK (T cells, stimulated IL12 from macrophage) and
again activate macrophage to kill phagocytosed pathogens
11547
Microbiology
Infectious Diseases
Cat bite: barto, pasteurella Dog: pasteur, strep, staph aureus Human: anaerobes,
strep, eikenella
11590
Pharmacology
Infectious Diseases
Abacavir (nrti) is associated with hypersensitivity in 10% of pple with HLA B57
11596
Microbiology
Infectious Diseases
Parotitis can occur in elederly (weird presentation: pre/postauricular swelling that

extends to mandible) which are dehydrated and intubated. But here it caused by
Staph most commonly and diagnosed by imaging and amylase levels
11670
Microbiology
Infectious Diseases
Neurocysticercosis (taenia solium) cystic brain lesion in Central america
11729
Pharmacology
Infectious Diseases
Acyclovir: viral inhibition of DNA polymerase
11766
Microbiology
Infectious Diseases
E coli is lactose fermenting, INDOLE (+) (coz they are indolent)
11822
Microbiology
Infectious Diseases
Roseola (HHV6): 3-5 days of fever (often have febrile seizures) than truncal rash
343
Genetics
Male Reproductive System Klienfelter 46 XXY, tall male with boobs aazospermia and mild mental retardation
807
Genetics
Male Reproductive System
1449
Embryology
SRY --> TDF --> Testes develop --> Sertoli (Secrete MIF --> Paramesonephric duct
PMD involute) Leydig cells (Produce Testosterone --> Transform Wolffian duct into
Male internal Genitalia; Epididymis, Vas Deferens) Testosterone --> DHT -->
Male Reproductive System Transform Genital Tubercle and Urogenital Sinus into Male external Genitalia (Penis,
Prostate) IN XY, IF NO SERTOLI CELLS YOU WOULD HAVE BOTH FEMALE AND
MALE INTERNAL GENITALIA BUT MALE EXTERNAL GENITALIA (coz MIG is not
here to involute PMD
11747
Anatomy
Male Reproductive System Prostate Ca spreads to bone through prostatic venous plexus first
11762
Anatomy
Deep ring: Internal Spermatic Fascia (coming from transversalis fascia) Superficial
ring: External Spermatic Fascia (External Oblique) COZ Deep Internal So in Crypto
Male Reproductive System
need to bring testicle from superficial ring which its opining is mainly External
spermatic fascia (coming from external oblique)
Pathology
Miscellaneous
(Multisystem)
Bilateral renal angiomyolipoma associated with Tuberous Sclerosi (AD, with Brain
Hamartoma and Ash leave spots)
701
Genetics
Miscellaneous
(Multisystem)
Achondroplasia is AD
1332
Biochemistry
Miscellaneous
(Multisystem)
In Homocyteinuria, homocysteine is not metabolised to cysteine due to cystathione

reductase problem
1502
Biochemistry
Miscellaneous
(Multisystem)
Alkaptonuria is a problem in converting Tyrosine to Fumarate (its TCA intermediate

equivalent) so its like the next step after Phenylketonuria. Homogentisic acid
dioxygenase deficiency so homogentisate (next step after tyrosine) accumulate. Get
Black urine, pigmentated face and other organs, arthropathy.
1504
Biochemistry
Miscellaneous
(Multisystem)
Many patients with Homocytinuria benefit from B6 as it will drive the reaction forward
to Cysthathione
11531
Behavioral
science
Miscellaneous
(Multisystem)
Always get a translator when it is not very clear
11532
Behavioral
science
Miscellaneous
(Multisystem)
Physician's burnout (emotional stress) while Physician fatigue refers to lack of sleep
11533
Behavioral
science
Miscellaneous
(Multisystem)
Cane and walker do not decrease the risk of fall according to studies. Just assist
CF patient are Infertile due to absent Vas Deferens bilaterally. In Kartegner sperm
are immotile but we have Vas
11549
Behavioral
science
Miscellaneous
(Multisystem)
For a nurse to show that she has understood the order she should repeat everything
and even the route of administration
11550
Behavioral
science
Miscellaneous
(Multisystem)
An elderly for discharge is best instructed with a checklist discharge list in case he
has no family members living with him
11602
Behavioral
science
Miscellaneous
(Multisystem)
Medicare cover people above 65 or younger with disabilities
11635
Anatomy
Miscellaneous
(Multisystem)
Most common site of compartment syndrome is Anterior compartment innervated by

Deep peroneal nerve
11678
Pharmacology
Miscellaneous
(Multisystem)
[Drug]=mg given/Vd
11757
Behavioral
science
Miscellaneous
(Multisystem)
Communication problem during patient patient handoff (teslime) is a major cause of

stupid errors
18
Pathology
Nervous System
in Hypoxic ischemic encephalopathy (in arrest) hippocampus is first damaged, then

neocortex and Purkinje of cerebellum
20
Histology
Nervous System
In brain infarcts, neutrophils come in the first 24-48 hrs, do not phagocytose
anything. Microglia (3-5 days later they deposit), then Astrocyte will cause peripheral
glial scar and get central cyst instead of necrosis
22
Pathology
Nervous System
if HTN and lacunar stroke and dont appear directly on CT but later it is due to HTN
arteriosclerosis and not Charcoud bouchard rupture that wld appear directly on CT
249
Pharmacology
Nervous System
In abscence followed up by generalised tonic clonic ethosuximide wont help. Use

Valproic acid
262
Pharmacology
Nervous System
Carbidopa is given with levodopa to inhibits levodopa conversion into dopamine

outside CNS (by being itself metabolised) but with carbidopa we will have more
dopamin in CNS and more SE like agitation and anxiety..
347
Pathology
Nervous System
subdural hemorrhage in babies is sign of abuse (shaken baby syndrome) and have
retinal hemorrhage
348
Pharmacology
Nervous System
Ramelteon, a melatonin agonist is used for insomnia in elderly.
357
Genetics
Nervous System
Blotchy red muscles fibers on Gomori trichome stain = Mitochondrial Myopathies

(Maternal Inheritance) --> Abnormal Mitochondria (increased in number, enlarged,
abnormally shaped) accumulate in the fibers making them look irregular in size and
shape. "Red Fagged Fiber" Examples: Myoclonic epilepsy with red ragged fibers
(MERRF), Leber optic neuropathy (Blindness), Mitochondrial encephalopathy
(stroke-like episodes) and lactic acidosis (MELAS)
397
Pathology
Nervous System
Slit lamp exam to Diagnose Kayser Fleisher
499
Pathology
Nervous System
The most common cause of spontaneous lobar hemorrhage in the elderly is

Cerebral Amyloid Angiopathy (same amyloid seen in Alzhemer) and most commonly
occurs in occipital and parietal lobes
502
Embryology
Nervous System
If acetylcholinesterase is found in amniotic fluid (shld be contained in neural tissues)

it means that there is neural tube defect with failure of fusion and hence this enzyme
is spilled in sac
509
Pharmacology
Nervous System
ETHosuximide block T type calcium cahnnels in THalamus. Used for Abscence

seizure
566
Anatomy
Nervous System
Pancoast cause ipsi Horner and ipsi shoulder and arm weakness and areflexia due
to brachial plexus involvement
590
Genetics
Nervous System
Alzheimer: Neurofibrillary tangles and A-Beta amyloid plaques. In Down syndrome

there is 3 copies of The Amyloid precursor protein gene.
591
Genetics
Nervous System
Stuff involved in Alzheimer: APP on chr21 Prenisilin 1 on chr14 Prenisllin 2 on chr1

ApopE4 involved in late onset familial Alzheimer
593
Pathology
Nervous System
In alzheimer, decrease acetylcholine in Meynert nucleus in hipoccampus (decreased

activity of acetyltransferase)
595
Pathology
Nervous System
Paraneoplastic process is autoimmune
598
Biochemistry
Nervous System
In thiamine deficiency u can get necrosis and hemorrhage of mamillary bodies, B1

will affect the activity of transketolase (main prob) and Pyruvate and Ketoglutarate
dehydrogenase
660
Pharmacology
Nervous System
In anesthetic if have high venoarterial difference then drug will directly go to muscle
and adipocytes then slower effect on brain Whereas potency is determined by MAC
673
Immunology
Nervous System
Ataxia telengiectasia: (AR), defect in DNA repair genes Cerebellar ataxis,

Oculicutaneous telengiectasia, repeated sinopulmonary infection and increased
incidemce of malignancy
735
Microbiology
Nervous System
Neisseia: Bean Shaped Gram - cocci in pairs(<60 especially in camps, dorms..) VS.
Strep pneumo: Lancet shaped, Gram + cocci in paiars (more common in pple >60)
775
Physiology
Nervous System
POMC is a polypeptide that give rise to ADH, MSH and Beta Endorphins.
776
Physiology
Nervous System
When Morphine binds to mu receptors it can will cwuse hyperpolarisation of the cell
in two ways: First and most importantly it will cause G coupled activation of K+
channel, increasing K+ efflux out of the cell, hyperpolarizing the cell. Secondly it will
decrease Ca+ influx into the cell (Think morphine acts like K(C)arl)
794
Pathology
Nervous System
Hippocampus atrophy is seen in Alzheimer
840
Genetics
Nervous System
Huntingtin proteins prevents acetylation of DNA making it more mute
851
Pharmacology
Nervous System
Potency of Anasthetic is related to MAC (minimal alveolar concentration)

(concentration at which 50% of people pass out) High blood/air partition coefficient
means high solubility so slower onset of action (coz stay in blood dont go to brain)
Potency: drugs needed to achieve a certain effect related to km Efficacy: maximal
effect
852
Pharmacology
Nervous System
Inhaled anesthetic will directly redistribute in muscles skeletal and fat
856
Pharmacology
Nervous System
IV anesthetic effect wean off after a short time because of redistribution of drug in
body
866
Pharmacology
Nervous System
Dantrolene is only used to treat heat stroke and malignant hyperthermia, not high
fever
871
Pathology
Nervous System
Liquefactive Necrosis: Lysosmal digestion of the tissue
913
Pathology
Nervous System
PMR: fatigue, fever, wight loss + Proximal muscle stifness
969
Pathology
Nervous System
Tetanus is diagnosed clinically
1006
Microbiology
Nervous System
In Neisseria CApsular Polysaccharide resist phagocytosis and stuff, but Outer

membrane Lipooligosaccaride (LOS or LPS) is the endotoxin associated with fucked
up disease
1048
Biochemistry
Nervous System
Vit A OD: Pseudotumor Cerebri, skin changes and Hepatosplenomegaly
1058
Pathology
Nervous System
Endomysial Inflammation: Poliomyositis Endoneural Inflammation: Guillain Barre
1149
Anatomy
Nervous System
Superficial peroneal: Eversion Deep Peroneal: Dorsiflexion
1150
Anatomy
Nervous System
Meningioma often occur in dural reflection. In falx cerebri patient can have leg
symtoms (beco it is in the medial homunculus)
1152
Pathology
Nervous System
Craniopharyngoma arising from anterior pituitary are calcified cysts containing

cholesterols crystals
1259
Pathology
Nervous System
Posterior fossa tumor in kids Medullo: Sheets of primitive cells(basophilic nuclei and
scant; small round blue cell, cystoplasm) with many mitotic figures Pilocytic
astrocytoma: Most common, Rosenthal fibers (are low grade and have better
prognosis) Ependymoma: walls of venticles and can cause hydrocephalus, they form
gland like structures called rosettes
1318
Physiology
Nervous System
Neuronal properties: Time constant: time it takes for membrane to achieve 63% of
new membrane potential Length constant: time it takes for impulse to go a certain
distance. Demyelination will decrease both, by Increasing axon Conductance and
having less Saltatory Conduction
1320
Pharmacology
Nervous System
In mysathemia crisis we shld increase dose of neostigmine
1323
Pharmacology
Nervous System
Organophosphate irreversibly inhibit cholinesterase in musc and nicot synapses so if

give atropine (only musc) u wont be helping muscular effects
1335
Biochemistry
Nervous System
In Maple syrup, avoid branched chain amino acid leucine Isolucine and Valine
(defect in alpha ketoacid dehydrogenase with deficient conversion of Leucine to
Acetyl CoA or Valine and Isoleucine to Propionyl CoA then Methylmalonyl then
Succinyl CoA)
1368
Pharmacology
Nervous System
Uterine relaxation is by B2 like in lungs..
1391
Microbiology
Nervous System
Listeria which is a B hemolytic gram + that moves and reproduce well in low
temperatures is common in children less than 3 months coz of their immature cell
mediated immunity
1399
Microbiology
Nervous System
TCA affect muscarinic not nicotinic
1402
Microbiology
Nervous System
Rabies virus goes in skin, then motor axon (and retrograde to cNS) then salivary
gland (thats why transmitted through bites)
1421
Genetics
Nervous System
Fragile X: CGG repeat --> Hypermethylation of Cytosine amd inactivation of

subsequent genes
1428
Biochemistry
Nervous System
In tRNA, the 3 ' part is responsible for amino acid attachement site (since t and 3)
1433
Behavioral
science
Nervous System
Conversion disorder is experiencing neurological symptoms that are not explained by

tests or exam, and is due to a stressor
1442
Pharmacology
Nervous System
Donepezil Cholinesterase inhibitor is used in Alzheimer
1443
Pharmacology
Nervous System
Benzo increase FREQuENCY of Cl channels not DURATION
1534
Embryology
Nervous System
NF is a neural crest tumor since it is a Schwann cells tumor. Like in Melanoma
1536
Histology
Nervous System
Thight junction is responsible of the nonfenestrated endothelial in BBB (cest logique)
1636
Anatomy
Nervous System
Musculucutaneous innervates biceps and suppinator (like when I do Dumbels) and

supply sensory lateral Forearm
1743
Anatomy
Nervous System
Ulnar nerve functions: Wrist flexion/adduction, fingers adduction/abduction and

sensation in 1.5 last fingers and flexion of 4th/5th digit
1749
Anatomy
Nervous System
Median nerve is sandwiched between Flexor digitorum superficialis and Flexor

Digitorum Profundus (easy since Median innervates digits)
1829
Anatomy
Nervous System
Holding a branch like a monkey can cause lower trunk of brachial plexus injury
affecting radial and ulnar nerves and muscles of hands
1853
Microbiology
Nervous System
immunity agaisnt neisseria mengitidis is antibodies against their polysaccaride

capsule
1966
Microbiology
Nervous System
enterovirus is most common cause of asceptic meningitis
1997
Microbiology
Nervous System
Botulinsm toxin inhibit Ach release wheras rabies bind on the recptors (toxin is killed
by heat)
2082
Microbiology
Nervous System
Treat toxo with pyrimethamine and sulfadiazine (clinda if sulfa allergy)
2083
Microbiology
Nervous System
Cns lymphoma are B cells
2089
Pharmacology
Nervous System
CYPROHEPATADINE, is an antihistamine with anti serotonergic, so used in excess

serotonin syndrome
2123
Behavioral
science
Nervous System
Acute stress disorder happen 3 days to 1 month from a bad event
8324
Microbiology
Nervous System
Rabies G(accumulate in open wound) lycoprotein spikes bind nicotine acetylcholine

receptors, activate them. And go to CNS in retrograde
8385
Biochemistry
Nervous System
Impairement of Ubiquitin proteasome system is involved in Parkinson and Alzheimer
8476
Pharmacology
Nervous System
Tryptans are serotonic agonist
8533
Microbiology
Nervous System
Staph epidedermis virulence is synthesis of an extracellular polysaccharide matric,

(adherent biofilms) when foreign bodies are inserted through skin (skin flora)
8564
Anatomy
Nervous System
IVH is bleed in germinal matrix
8878
Behavioral
science
Nervous System
In Narcolepsy or Cataplexy Hypocretin (1 or 2) which are secreted by the lateeral

Hypothlamus and usually promote wakefulness and inhibit REM sleep, are usually low
11458
Pharmacology
Nervous System
Baclofen, GABA B receptor agonist used for spasticity even of central cause like MS
11462
Pathology
Nervous System
Parkinson pple benefit from deep brain stimulation inhibiting Subthalamus eventually
increasing Thalamus inout
11568
Pathology
Nervous System
HIV associated dementia is suspected in AIDS patients with progressive cognitive

decline. Microglial nodules and groupd of activated macrophages/microglial cells
around necrosis that may fuse to form multinucleated giant cells
11574
Pathology
Nervous System
Damage to brainstem below or at level of red nucleus will cause decerebrate position
11576
Pathology
Nervous System
In brain calcification do not happen afer infarcts but in TUMORS
11632
Pathology
Nervous System
Overshooting is when lateral cerebellar is affected, when vermis (central) is affected

u get truncal ataxia
11665
Pharmacology
Nervous System
Treat status (even if febrile seizure) with lorazepam
11742
Anatomy
Nervous System
Infraiebital nerve runs along the orbital floor so in such a fracture causing
parasthesia in upper cheek, upper lip and upper gingiva and inferior rectus muscle
gets entrapped causing vertical nystagmus
11755
Physiology
Nervous System
GABa activation cause Chloride channel to open and causing a chloride flux inside
(passive down normal gradient)the cell hyper-polarizing its resting potential
11772
Anatomy
Nervous System
XI injury: Trapezius injury: Droopin gof shoulder, impaired abduction above

horizontal and Winging of Scapula (weird things)
11777
Anatomy
Nervous System
Femoral nerve passes through the Inguinal crease not the Femoral rin and canal
which contains lymphatic, vessels and lymph nodes
11793
Anatomy
Nervous System
During intubation, beware of atlantoaxial instability that can cause subluxation of the
vertebra and compression of SC and Vertebral arteries--> Paralysis
1646
Pharmacology
Ophthalmology
AIDS CD4<50 CMV Retinitis
11551
Microbiology
Ophthalmology
CMV cause chorioretinitis when in congenital infection
11841
Pharmacology
Ophthalmology
In glaucoma, prostaglandin will increase outflow of humor..
Physiology
Aspirin OD Fever, Tinnitus, Tachypnes): Mixed Resp Alkalosis (Stimulates medullary

centers, leading do Hyperventilation) with Anion Gap Met Acidosis (begin shortly
Poisoning & Environmental Afterward, as Aspirin Increase Lipolysis, Uncouples Oxidative Phosphorylation, and
Exposure
Inhibits Citric Acid Cycle --> Ketoacid, Lactate and Phruvate Accumulation). So you
get Normal pH with low pCO2 and low HCO3-. in compensation, pH will not return to
Normal but gets close to Normal Range.
1544
792
Pathophysiology
Pregnancy, Childbirth &

Puerperium
Unlike what seems intuitive Complete mole (46, XX or XY only paternal DNA) does
not contain fetal tissues and has a HONEY COMB or SNOWTORM appeance,
associated with preeclampsia, before 20 weeks, Hyperemesis, Hyperthyroid Partial
Mole are XXY or XXX but has mom and 2 papa sets so have fetal tissuesand only
presents with vaginal bleed and lower risk of malignancy
955
Genetics

Puerperium
In Aromatase deficiency female will have ambiguous genitalia and the excess of
Androgen that cannot be converted, will go to mom's circulation causing her
deepening of voice etc. unlike 21 hydroxylase deficiency that does not affect mommy
1464
Microbiology

Puerperium
Live vaccines: Smallpox, chickenpox, yellow fever, Rota, Intanasal Influenza, Sabin
for polio, MMR,
1772
Embryology

Puerperium
In fertilization, BHCG is detectable in serum 8 days later but 14 days later in urine
1822
Genetics

Puerperium
Patau: cleft lip,palate, omphalocele, holoprosencephaly, polydactyly, rocker bottom

feet
1823
Genetics

Puerperium
Patau 13: Cleft palate, Poly/Syndactyly, Omphalocele Edwards 18: Small brain
(prominent occipit), Small ears, Small mandible, Small sternum, Small clenched
hands + Eyes, Cardiac, GI defects (HE is small, so low HCG and Estriol)
1830
Genetics

Puerperium
Complete hydatiform mole is 46 XX or XY only from father while partial is triploidy 2/3
from father
1987
Physiology

Puerperium
During pregnancy, prolactin steadily increase along pregnancy but Progesterone and
Estrogen do not permit lactogenesis and promote Breast Growth and Development
with minor help of Peolactin
8325
Pathology

Puerperium
Congenital torticolis is 2-4 week after bitch it is due to malposition of head of abby in
utero or birth trauma. they resolve with stretching
8330
Physiology

Puerperium
Maternal diabetes is due to HPL which increases proteolysis, lipolysis, insulin

resistance and decrease gluconeogenesis. Estrogen, progesterone and cortisone
also play a role in maternal diabetes.
8406
Embryology

Puerperium
False twins are always Di Di in indentical twins land,arks are: 0-4: Di C Di A 4-8:
Mono C Di A 8-12: Mono Mono >12: Conjoined (4-8-12 landmarks)
247
Behavioral
science
Psychiatric/Behavioral &
Substance Abuse
Buspirone has a slow onset of action and is not a muscle relaxant, hence not
addictive
511
Behavioral
science
Substance Abuse
Tardive dyskinesia occur with lip smacking and many ticks due to antipsychotic
medications
519
Pharmacology
Substance Abuse
Lithium toxicity (ataxia, confusion, neuromuscular exitability) can be precipitated by

volume depletion, like with thiazide, ACE and with NSAIDS too
706
Pharmacology
Substance Abuse
Trazodone is gd in patient with insomnia (think of erection while sleeping)
1046
Behavioral
science
Substance Abuse
Bulimia patients, remain with their normal wights and do not have medical problems.
1165
Behavioral
science
Substance Abuse
PCP abuse will most likely result to trauma (fight etc.) more than seizure or cardiac
event
1234
Behavioral
science
Substance Abuse
Displacement: I am getting a divorce and am angry, so I shout at my daughter who

fogot to throw the garbage
1350
Behavioral
science
Substance Abuse
Reaction formation is when you act oppositely than what you feel. Splitting is when
you perceive people as either good or bad
1351
Behavioral
science
Substance Abuse
Supression is a mature defense mechanism involving a conscious choice not to dwell

on a particular thought or feeling. Rationalisation involve making excuses for
unacceptable feelings ; like a student explaining that poor performance was due to
trickiness of the exam
1352
Behavioral
science
Substance Abuse
Triazolam is a short acting benzo best used for sleep, Lorazepam is intermediate the
other DFC are long acting
1429
Behavioral
science
Substance Abuse
A boy whose parents are having a divorce and thinks that his dad is angry at him is
experiencing Projection, since he is likely angry at his parents he will think they are
angry at him too. This is common in peple who lack insight or their emotions,
motivations and feelings
1430
Behavioral
science
Substance Abuse
PPtm blues last maximum 10 days otherwise it is PPtm depression and require
treamtent (antidepressant, psychotherapy)
2001
Pharmacology
Substance Abuse
Cocaine inhibit reuptake of dopamine
2046
Behavioral
science
Substance Abuse
Delusional disorder is one step worse than Paranoid disorder, its like a paranoid man
who constantly think people are poisoning him
2053
Behavioral
science
Substance Abuse
Transference is when ur transfer your emotions associated with a significant person

to the person in the present
8327
Pharmacology
Substance Abuse
drugs with Serotonin Syndrome: antidepressant with serotonin stuff, Tramadol

Ondansetron Linezolid (DA FUCK) Triptans (SURE)
8954
Behavioral
science
Substance Abuse
Most cases of OD's are due to prescribed Opioids
10458
Behavioral
science
Substance Abuse
A patient requiring antibiotic for viral infection, don't tell them that it will cause
resistance, be sensitive and tell about the side effects and that other treatment are
better
10465
Behavioral
science
Substance Abuse
Children under the age of 6 do not understand death, so it is normal for them to hae
psychotic symptoms like seeing their grandma
11587
Behavioral
science
Substance Abuse
Bipolar I means only one criteria needed which is MANIA
11603
Behavioral
science
Substance Abuse
Phobia is treated with Exposure-based behavioral therapy
11618
Behavioral
science
Substance Abuse
Previous suicide attempt is the worse prognosis for people attempting suicide
11622
Behavioral
science
Substance Abuse
Persistent depressive disorder is when Major depressive disorder and Dysthemia

happen for more than 2 years
11737
Behavioral
science
Substance Abuse
Adjustment disorder is applicable for only 3 months following the stressor, beyond
that find another explanation
11743
Behavioral
science
Substance Abuse
In treatment-resistant schizophrenia use Clozapine. Beware of agranulocytosis so

monitor neutrophil count
11746
Behavioral
science
Substance Abuse
Cocaine withdrawal can cause psychosis, hyperphagia, hypersomnia
11785
Behavioral
science
Substance Abuse
With adolescence non compliant to insulin, finding a peer that need to take insulin
would increase compliance
11787
Behavioral
science
Substance Abuse
Stages of change (stopping alcohol) Precontemplation (denial) -> Contemplation

(realising the problem but not ready to act) -> Preparation (planning behavior
modification) -> Action -> Maintenance (maintening new behaviors)
11792
Behavioral
science
Substance Abuse
Factitious is inducing sickness to assume sick role, while malingering is pretending to

be sick or exaggerating symptoms to get drugs or whatever
11807
Behavioral
science
Substance Abuse
Bulimia nervosa is treated by Fluoxetine, nutritional changes and psychotherapy
11829
Behavioral
science
Substance Abuse
If someone tells u he wants Tramal and that Drs used to give him, first of all make
sure of the old prescriptions and stuff
11846
Behavioral
science
Substance Abuse
PTSD: SSRI + CBT
11848
Behavioral
science
Substance Abuse
OLANZAPINE CLOZAPINE (2nd generation): METABOLIC SYNDROME
108
Microbiology
Pulmonary & Critical Care
When aspergillus cause fungus ball in a cavity in lung it is colonizing and can be
asymptomatik
114
Microbiology
Cryptococcus most commonly cause meningoencephelitis
117
Microbiology
Cryptococcus capsule is the only fungus capsule made of polysaccharide and stains
red on Muciramine and show a clear zone on silver stain Usually use india ink for
cryptococcus
abscess formation is due to lysosomal ensyme release from neutrophils and

macrophage IFN gamma secreted by T helper after IL 12 (from neutrophils) is
secreted: make phagolysozome formation, NO release and granuloma and caseous
necrosis formation
According to Laplace law, small elastic spheres are more likely to collapse than
bigger ones with same surface tension. Think of distal small alveoli who receive the
least amount of air who are most prone to collapse. But Surfactant are most
concentrated in small alveoli coz of smaller areas and protect them from collapse by
increasing surface tension, this will establish equilibrium between alveoli of different
radius.
Submucosal serous and mucous glands (and Goblet cells) are present where there
is cartilage therefore end where at the smallest bronchi are absent in bronchiole and
further. And at this level epithelial will be completely changed from pseudostratified
columnar to simple cuboidal.on the other hand we can still find cilia until the level of
alveoli where they disappear and macrophage usually takes care of foreign bodies
Airway Resistance: 50% of resistance is in nares trachea etc. This Resistance

Increase in Medium sized Bronchi due to Turbulence of flow, but then decreased
significantly (lower than upper tract too) in Small Terminal Bronchiole <2mm due to
massive increase in summated surface area that will slow the flow and permit a more
laminar one. (Bronchitis patients seem more in respiratory distress than Pneumonia
patients, since there already high resistence in upper bronchi)
302
477
480
481
Pathology
Physiology
Histology
Physiology
483
Histology
Upper airways Pseudostratified columnar mucus secreting cells: nose, nasopharynx,

sinuses, tracheobronchial tree, Vestibular folds (false vocal cords) and laryngeal
vestibule are the lower half of posterior epiglottis and are columnar too Stratified
squamous: Mouth, oropharynx, laryngopharyns, anterior epiglottis, upper posterior
epiglottis, true vocal cords
484
Histology
In lungs Elastases are secreted by neutrophils and alveolar Macrophages. These

can cause terminal lung parenchyma (emphysema) if very high or left unchecked by
antiproteases activity (in alpha antitripsin deficiency)
486
Pathology
PCWP increase reviel Cardio problem and exlude Lungs NICEEE
488
Histology
In COPD we have Neutrophils and Alveolar Macrophages, releasing proteinases
528
Pathophysiology Pulmonary & Critical Care
CO2 level in ABG indicated ventilation status (if have upper obstruction no ventilation
so hypercapnia)
533
Pathology
Peptistreptococcus, pervotella, bacteroides and fusobacterium are the aneprbes pf

the mouth that cause aspiration pneumonia
534
Pathology
Lung tranplant: Hyperacute rejection: graft blood vessel spasm, diffuse intravascular
coagulation and ischemia Acute:1-2 weeks later, Cell mediated CD8 with
macrophage. Vascular damage, perivascular and peribronchial lymphocytic
infiltrates. Dyspnea, cough, fever, Perihilar and lobar opacities (CXR) Chronic:
bronchiolitis obliterans (small ones) Inflammation fibrosis of bronchiolar wall (in
Chronic renal transplant it is vascular unlike here)
535
Pathology
Bronchiolitis Obliterans: Chronic lung rejection (obstructive pattern) Lymphocytic

infiltrate, fibrosis and bronchiole destruction
552
Pathology
Lung Hamartomas: most common benign tumor is 50-60s and are peripheral coin
lesion. Disorganised cartilage, fibrous andd adipose tissue
565
Pathology
Mediastinal tumor cause IVC syndrome not superior sulcus (pancoast)
571
Immunology
NZT blue test in CGD is also called Dihydrodamine and can be positive by inducating
abscence green color in neutrophils
650
Pathology
Small cell of lung is thought to have a neuroendocrine origin
670
In Silicosis there is ineffective Macrophage Phagolysosomes, making those patients

more susceptible to TB
746
Immunology
MHCI is composed of MHCI and Beta2 microglobulin
762
Immunology
In order for naive T cells to turn into TH1 cells they need IL12. In turn, TH1 secrete
IgN Gamma to activate macrophage. So if you domt have Il12 you are susceptible to
TB so give IFN Gamma
796
Immunology
In Sarcoid it is mainly CD4 T cells involvement
797
Immunology
Sarcoidosis is Th1 response where IL2 and IFN gamma play a role in granuloma
formation while Th2 involve IL4 (Activate B cells and secrete IgE) and IL5
(Eosinophils and IgA formation)
799
Pathology
Complications of ob stuff: O2 use for ARDS in fetus: can cause upregulation of VEGF
and retinal vessel proliferation (neovascularixzation) potentially causing retinal
detachment and blindness Surfactant treatment complications: Hypoxia, HypoTN,
blockage of ET tube and pulmonary hemorrhage Terbutaline (tocolisis) to delay
labor: IVH, Hypoglycemia, Hypocalcemia and ileus
800
Embryology
By week 35 L/S ratio becomes 2:1 (lecithin is also known as phosphatidylcholine)
802
Genetics
In CF disfunctional protein do not undergo Post translational modification and we get

no CFTR and it is sent to proteasome
804
In CF (CFTR) gene, Lungs GI: (normally) have high content of Cl- and
Na+(decreased absorption) Sweat gland: (normally) low content so if have CF u
have high salts in glands bu the contrary in resp and GI (fun haa)
903
Pharmacology
Bosentan: Antagonist of endothelial receptors, used for idiopathic pulmonary

hypertension
958
Microbiology
Clumping of RBC at low Temperature means there is cold Agglutinins formation

(Mycoplasma, EBV..)
960
Microbiology
Legionella (pneumonia, diarrhea, high fever) cannot be detected on gram stain (think
of that syrian guy in Bassile, but need urine IgM) and is common in COPDers
962
Microbiology
Hib vaccine contains PRP and diphteria toxoid to produce AB against RPR, a
component of its capsule (think that when u say PRP u move ur epiglottis LoLllllll)
964
Microbiology
Nontypable H flu dont have capsule MMAKES SENSE
1195
Pharmacology
Oropharyngeal candidiasis: Nystatin
1373
Microbiology
Rhinovirus is (+) SS RNA so directly produce toxin (even if only RNA is injected)
whereas RSV and Influenaza are (-) SS RNA so need a specific Viral RNA
Polymerase to produce its (+) counterpart
1377
Microbiology
Envolope voruses have bilayer lipid outer membranes and destroyed by ether or
organic solvents
1414
Physiology
When CO2 enters RBC it produce HCO3- that is released again in Plasma. In order
to maintain neutrality of Plasma, Cl- enter RBC, which explains higher Cl- content in
Arteries than in Veins.
1460
In obstructive sleep apnea (obesity, tonsillar hypertrophy, hypothyroid), ABG during

the day are normal, can have erythrocytosis, can lead to Pulm HTN and RHF
1494
Physiology
Hyperventilation will cause Hypocapnea, that will constrict Cerebral Blood Vessels,
decreasing cerebral blood flow (hence the symptoms of dizziness, blurred vision),
since the brain is tricked and thinks its having good circulation getting rid of CO2.
Cerebral Blood Flow is Dependent on both O2 and CO2 contents.
1514
Physiology
CFTFR (chromosome 7) is a transmembrane ATP gated chloride channel
1519
Physiology
Lung physiology. After regular expiration FRV is left in the lungs and the pleural
pressure is at its lowest (absolute value) of -5, due to chest wall position creating a
negative pressure and alveolar elasticity causing a positive alveoli transmural
pressures (remember lungs tends to collapse) OUT - IN is pleural pressure, at this
instance alveolar pressure is null hence no air movement. Only in case of
pneumothorax when pleura is in contact with atmosphere, its pressure i
1521
Physiology
In Obstructive pattern Residual Volume is increased (look at them, they barreled

chest)
1522
Physiology
In PE (poor alveolar perfusion) the alveolar composition is close to that of the

trachea since no exchange is happening. Usually O2 should decrease and CO2
increase when going down the tree due to exchange. Exchange is perfusion limited,
since exchange is easily established across membrane except in fibrosis and
emphysema where wall is damaged and diffusion is difficult. In this case O2 in alveoli
is high since it is not going to the blood, but CO2 is not affected (high DC)
1523
Pharmacology
To induce asthmatic change in PFT's Exercice, histamine, cold air inhalation and
Metacholine (metacholine, cholinergic agonist) will cause airway constriction and
increase secretion. A decrease of >20% of FEV1 is diagnostic of asthma after
metacholine test.
1526
Physiology
PAO2 is derived from an equation and does not exactly accurately represents O2
content in all alveoli, therefore we get a normal PAO2 in Obstructive patients, with a
high PAO2-PaO2 value.
1535
Anatomy
Pain from diaphragmatic and mediastinal pleura are carried out by phrenic nerve; so
get neck and choulder referred pain ( think of the map; like an inverted T) the rest is
carried out by intercostal nerves
Interstitial lung disease (restrictive): both FEV1 and FVC are decreased, but FVC
decrease much more which explains the increase in FEV1/FVC ration. FEV1 is not
decreased that much coz interstitial fibrosis will cause traction of alveolar wall
(increased lung elastic recoil) causing supernormal expiratory flow when correcting
for lung volume.
1543
Physiology
1548
Physiology
Respiratory particles in bronchioles are cleared by mucociliary system. Beyond

terminal bronchioles, Macrophage do the job. Mucus-Secreting cells (Goblet cells)
are all along the respiratory trat but not in terminal bronchiole and farther where
surfactant line the walls.
1563
Physiology
Minute ventilation = TV . RR Alveolar ventilation = (TV - Dead space) . RR
1576
Microbiology
In transplant patients, ds DNA CMV (Intracellular and ctyplasmic incusion bodies)

pneumonia can happen
1582
Physiology
Hypoxemia: Normally pAO2: 104, paO2: 100 (we have complete diffusion but
difference is due to bronchial deoxygenated vein that drain in pulmonary veins)
Normal Alveolar-arterial gradient (10-15, since both are low, so alveolar problem):
hypoventilation, high altitudes (low O2 content) or decrease inspiratory capacity
(MGravis, Obesity) High A-a gradient (only arterial O2 is low): limited diffusion, R to L
shunt (cyanotic heart), V/Q mismatch (PE, pneumonia, Obstructive diseas
1583
Physiology
In COPD it js O2 that conteols Respiratory Drive and unlike what I Thought it is

Peripheral Chemoreceptors that controls that (carotid and aortic arch) Central
chemoreceptors are regulated by decrease pH not (but still low effect coz brain is
barely permeable to H+)
1585
Physiology
In LV heart failure, fluid accumulate in Lungs and decrease their Compliance.

Nothing to do with Alveolar Surface Tension and Surfactants.
1611
Immunology
Kartagener syndrome (ciliary dyskenesia due to Dynein arms defect) Is triad of

Chronic Sinusitis, Bronchitis and Situs Inversus
1620
Physiology
Pulmonary vascular resistance is lowest at FRC and it's also at FRC that alveolar
pressure is 0. Alveolar - pressure (inspiration) will narrow the vessels and lengthen
them causing pressure, while expiration will increase intrathoracic pressure also
increasing pressure in vessels.
1666
Microbiology
In patients > 65, post flu pneumonia is common and cause by Strep, Staph and Hib
1679
Microbiology
M. Pneumonia require cholesterol to grow on artificial media coz have no cell wall or
capsule so cholesterol to integrate in their cell membrane
1764
Immunology
Hib vaccine is conjugated with diphteria protein to switch immune reaction to T cell
independant to T cell dependant
1779
Microbiology
Spore forming bacteria resist heat
1801
Pathology
IL 1,6 and TNF alpha are the mediator of sytemic inflattion and stimulate liver
secretion of fibrinogen which increase ESR
1910
In pneumonia, green sputum is due to myeloperoxidase, a blue-green heme-based

enzyme that is released from neutrophil azurophilic granules and forms
hypocholorous acid
1925
Pathology
Allergens are stronger than cold air to induce an asthma ttack
1980
Physiology
High altitude AB: First low FiO2 will cause hypoxemia, which will result in
Hyperventilation subsequently Respiratory Alkalosis. Within 48 hours, kidneys will
respond causing Compensatory Metabolic Alkalosis. Therefore pH will be high
(Hyperventilation Respiratory Acidosis), pO2 low (Hypoxemia), pCo2 high
(Hyperventilation) and Bicarb low(metabolic acidosis)
1981
Physiology
PE: Hypoxemia + Respiratory Alkalosis (Hyperventilation Reaction)
1985
OSA can lead to pulmonary hypertension
2039
Genetics
RNA polym I: rRNA II: mRNA, microRNA (silencor, think of it like methylation)
smallRNA (involve in regulation and splicing) III: tRNA
8257
Microbiology
Legionella does not stain well on Gram stain and cause hyponatremia
8260
Air flow resistance: COPD, asthma, emphysema, or goiter obstruction: in these

patient the frequency of breathing will increase work of breathing, so they breathe
long and slowly to adjust While alveolar and elastic problems: the work of breathing
increase with increase TV so they breathe shallow and fast This is manifested by the
trough work of breathing on RR curve that is either lower or higher than 15
8519
Biostatistics
Analysis of variance is ANOVA
8703
Anatomy
When someone swallows a bone it can get lodged in piriform recess just behind the
epiglottis. Behinf the recess there is the Internal Branch of the Superior Laryngeal
Nerve and mediates the afferent of The cough Reflex. THINK OF SOMEONE
TRYING TO COUGH SO MUCH TO REMOVE THE BONE BUT THEN COULDNT
COUGH ANYMORE
11638
Microbiology
Nocadia (Lungs, CNS, Cutaneous) occurs also in uper lobes like TB, and are
branching Gram (+) confusing with fungi Contracted by spore inhalation or traumatic
inoculation on skin
Histology
Renal, Urinary Systems &

Electrolytes
In post strep glomerulonephritis we see Granular deposit in mesangium of basement

membrane with IgG, IgM and C3 deposition "Starry sky appearance"
Histology

Electrolytes
Goodpasture is part of RPG ( pasteur, with a RPG) so expect Crescent changes and
IgG and C3 in basement membrane
12
Pathology

Electrolytes
Post strep Glomerulonephritis: Hugh ASO, anti DNase B titers, Low C3 and total
complement levels (normal C4) and presence of cryoglobulin
28
Pathology

Electrolytes
In nephrotoc u lose a lot of albumin so liver increase albumin production. U retain a

lot of spdium coz of increase aldosterone
211
Pathology

Electrolytes
Partial Vs Complete Nephrogenic DI: In partial Urine osm with ADH urine OSM
recovers till 500, but in complete it does not recover at all
229
Pathology

Electrolytes
In IE glomerulonephritis can happen and it is an Immune complex mediated injury
275
Pharmacology

Electrolytes
Amphotericin is nephrotoxic so can cause anemia (low EPO) and will cause increase
permeability of distal tubules so will have HYPOKALEMIA AND HYPOMG and
possible heart problems
684
Physiology

Electrolytes
Furosemide works on Na-K-2Cl channels in TAL and also work by stimulating Renal
Prostaglandin Release (which normally dilate Afferent arteriole--> Increase RBP and
GFR and enhance drug Delivery). If you give NSAID you will constrict Afferents and
decrease delivery, resuming ascites or pleural effusion
685
Pharmacology

Electrolytes
Autotoxic: Furosemide, Aspirin, Aminoglycoside, cisplatin, Vanco
744
Immunology

Electrolytes
In chronic renal graft rejection you see vascular changes, tubular atrophy and
fibrosis, but neutrophils are not involved
750
Immunology

Electrolytes
In parasitic infection IgE will bind to parasite then their Fc portions bind eosinophils
that will in turn degranulate This is called Antibody-dependent- cell mediated toxicity
813
Pathophysiology

Electrolytes
Idiopathic hypercalciuria is the most common cause of calcium kidney stones (NL
serum Ca2+)
816
Pathology

Electrolytes
Vit B6 decrease Oxalate production and decrease chance of CAlcium Oxalate

formation
835
Pathology

Electrolytes
Beta lactam can cause acute interstitial nephritis
886
Pathology

Electrolytes
In recovery of ATN all electrolytes are low du to slowly recovering despite increase
UO
887
Pathology

Electrolytes
Ethylene glycol: tubular necrosis with balooning and vacuolisation of PCT + Ca

Oxalate stones
1049
Pathology

Electrolytes
Chronic NSAIDS wil cause CHronic Interstitial Nephrtis
1053
Pathology

Electrolytes
In recovery of ATN we get reepithelization of tubules
1054
Pathology

Electrolytes
Bence jones are large eosinophilic casts While in Hypersensitivity interstitial nephritis
we see eosinophils in blood
1161
Physiology

Electrolytes
ADH works on Cortical and Medullary portions of Collecting ducts but Cortical
segment is not involve in urea reabsorption but Medullary segment reabsorbs both
H2O and Urea
1211
Pharmacology

Electrolytes
Bethanecol given for post op ileus (cholinergic): BEDNA NEKOL POST OP
1524
Anatomy

Electrolytes
Regardless of a patient's status, reabsorption occur in proximal tubule.
1532
Physiology

Electrolytes
Liver: Angiotensinogen -(Renin produced in Juxtaglomerular cells in Kidneys)-> ATI

Lungs: ATI -(ACE)-> ATII (cause vasoconstriction in systemic arterioles) Adrenal
Glands: ATII Stimulates Aldosterone Production and Secretion
1554
Physiology

Electrolytes
Hypokalemia cause K+ reabsorption by a-intercalated discs in cortical portion of

collecting tubules, through K+/H+ ATPases (K+ in, H+ out; stimulated by Aldo in
HypoK; the reason why HypoK causes Alkalosis)(Apical), while Normal to High K+
level will permit K+ excretion through K+ channels (Apical) in Principal cells, with help
of Na+/K+ pump basolaterally which is activated with high K+ levels and Aldosterone
(also enhance Na+(in) and K+(out) channels permeabilities)
1555
Physiology

Electrolytes
Clearance=UrineConcentration.UrineFlowRate/PlasmaConcentration ClearanceCr(or
Inulin)=GFR ClearancePAH=RPF FF=GFR/RPF UrineFlowRate is the same so it
cancels in the Nominator and Denominator
1556
Physiology

Electrolytes
RPF (PAH clearance) reprensents plasma flow, but since plasma represents one
pprtion of blood, to get RBF, we divide RPF/(1-HCT), and here we get the Actual RBF
1559
Physiology

Electrolytes
Renal Excreation: Inulin and Mannitol: only Filteres, not secreted or reabsorbed
Glucose, Amino Acids, Na+, Urea: Filtered then most of it reabsorbed PAH, Creatine:
Filtered and Secreted (Cr is not exactly all secreted) FF (20%)= GFR/RPF with GFR:
Inulin clearance and RPF: PAH clearance (not very accurate coz Adipose tissues in
kidney do not filter or secrete RPH so this will underestimate RPF by 10%)
1588
Physiology

Electrolytes
Glomerulus filters a substance into Bowman's capsule which is the start of the
journey of filtered substance (filtration does not occur there)

Electrolytes
Proximal tubules substance concentration depends on wether water is reabsorbed

faster than them. So we have an increase by growing order of Na, K, Cl, Urea, Inulin,
Cr and PAH (The last 3 are almost not absorbed) While HCO3 (Actively reabsorbed
due to Carbonic Anhydrase), AA and Glucose (These 2 are vividly actively
reabsorbed) decrease significantly
1617
Physiology
1619
Physiology

Electrolytes
PAH is freely filtered in the glomerulus but it also secreted from peritubular capillaries
(proximal tubule) through a carrier transport (reabsorption is carrier mediated too
and can be saturated) and this process can be saturated, but filtration will remain.
Since PAH is usually fully filtered and secreted its clearance is used to calculate
Renal Plasma Flow (RPH: that usually decrease with afferent or efferent constriction;
Epi, Norepi, ATII)
1643
Pharmacology

Electrolytes
Foscarnet (pyrrophosphate analogue) chelates calcium and cause magnesium

wasting in kidneys, hence decrease PTH and further decrease in Ca. Low Ca and
and Mg can cause seizures
1651
Physiology

Electrolytes
Filtration Fraction = GFR / Renal Plasma Flow
1736
Embryology

Electrolytes
Kidney development: Intermediate mesoderm will form: Pronephros (disappear),

Mesonephros (give Wolffian ducts in male and Vestibular Gartner's ducts in
females), Metanephros duct (Collecting ducts, Minor and Majors Calyces, Renal
pelvis, Ureters) arising from caudal Mesonephros. Mentanephros duct (ureteric bud)
will induce formation of Metanephros Blastema in sacrum (Metanephros mesoderm:
Glomeruli, Bowmans's space, Proximal tubule, Loopf of Henle, Distal collecting
tubules)
1989
Biochemistry

Electrolytes
Fabri, deficiency in alpha galactosidase A and globoside ceramde trihexoside will

accumulate in tissues. First get angiokeratomas, hypohidrosis and acroparesthesia.
In late phase if enzyme is not replaced GET RENAL FAILURE COZ FABRENAL
2012
Physiology

Electrolytes
Urea is reabsorbed in the collecting duct through ADH effect on V2 receptors

(increase water and urea permeability). Urea will go in the medulla and permit the
concentration ability of kidneys.
2131
Pathology

Electrolytes
Membranous nephropathy is associated with IgG4 antibodies to phospholipases A2

receptor, which play a role in dvlpmnt of the disease (it the class V lupus nephritis) In
cryoglobulinemia: there is IgM deposits in glomerulus leading to basement mmbrane
thickening and cellular proliferation
8530
Immunology

Electrolytes
T helper produce IL2 which activates CD4, CD8 T cells, NK cells and monocytes
8541
Microbiology

Electrolytes
Shistozoma are contracted by Snails (makes sense)
8881
Physiology

Electrolytes
Serum Cr and GFR have an negative log function.
11040
Pathophysiology

Electrolytes
In diabetic urinary incontinence bladder ant sense full bladder and u wont void all
content, so have a large post void residue
11064
Pathophysiology

Electrolytes
Clacineurin inhibitors mediated toxicity: see vacuolization (yea NOT BAD) If Acute
rejection: See lymphocytic infiltrations
11786
Immunology

Electrolytes
Sirolimus bind to FKBP and this complex inhibits mTOR (signaling transduction)
hence inhibiting IL2 production
239
Pathology
Rheumatology/Orthopedics
Rheumatic Fever kills by Pancarditis not MS
& Sports
457
Pathology
PAN and hep B BIG DEAL
& Sports
627
Physiology
Genetic Factors are the Strongest Prognostic factors for Osteoporosis (Being black is
the best protective factors, as it will give you better bone density than if you take
& Sports
extra Ca2+ or Exercice)
628
Physiology
Black women have higher Bone Density and have lower risks of Fractures (Of
course). Lower BMI have lower Bone Density and higher risk of fracture (not what I
& Sports
thought)
634
Pathology
Hemiballism involves extremties
& Sports
638
Physiology
Indicators of: Osteoblastic activity: Bone-specific Alkaline Phosphatase Osteoclastic

activity: Tartrate-resistant acid phosphatase, Urinary Hydroxyproline and Urinary
& Sports
Deoxypyridinoline (most accurate one)
639
Physiology
Paget disease: increased numbers of abnormal osteoclasts, excessive bone turnover

and abnormal bone remodeling (osteoblast here plays its role, but the initial problem
Rheumatology/Orthopedics is in osteoclast) Osteoclast are multinucleated (2-5 but 100's in Paget) cells arising
& Sports
from the fusion of many mononuclear phagocytic cells due to Macrophage
colony-stimulating factors (M-CSF) and Receptor for Activated Nuclear Factor
kappa-B Ligand (RANK-L) which are produced by Osteoblasts and BM stemal cels
646
Microbiology
Kids get osteomylitis with staph
& Sports
667
Pathology
Rheumatology/Orthopedics Churg Strauss also cause Mononeuritis due to involvement of the epineural vessels
& Sports
of peripheral nerves
699
Pharmacology
Bisphosphonate are pyrophosphate analogues and inhibits oscteoclasts
& Sports
719
Pharmacology
In RA DMARDs take a lot to work whereas Steroid and NSAIDs are about rapid relief
& Sports
721
Pathology
Osteomylitis affect metaphysis of long bones (in children hematogenous osteo)
& Sports
741
Immunology
Serum sickness is a type III hypersensitivity associated with monoclonal antibodies or

non-human Immunoglobulin (e.g: antitoxin) and sometimes with non-protein drugs
(penicillin, cefaclor, TMP-SMX). It is complement induced and get
& Sports
Hypocomplemtemia, and C5a will induce neutrophil chemotaxis, marginalization,
hence neutropenia.
752
Immunology
HLA associated in diseases and stuf autoimmune are of class I. (HLA=MHC)
& Sports
753
Pathophysiology
Rheumatology/Orthopedics Monitor Ankylosing spondilitis by chest wall expansion (that is limited with advanced
& Sports
disease leading to hypoventilation)
754
Immunology
Rheumatology/Orthopedics Rheumatoid factor: Secreted IgM from plasma cells, against Fc receptors of IgG.
& Sports
Immune complex will deposit then
858
Pharmacology
Colchicine inhibit tubulin polymerization hence inhibit lymphocyte migration
& Sports
982
Pathophysiology
In Osteoporosis: Calcium, PO4 and PTH are Normal
& Sports
987
Physiology
Rheumatology/Orthopedics Paget disease (increase osteoclast activity): bone pain, Increased ALKPhosph with
& Sports
mosaic pattern of lamellar bone.
1159
Histology
Osteocyte connect together through Gap Junctions
& Sports
1168
Pharmacology
Colchicine will cause GI symptoms (coz like chemo, inhibits microtubules)
& Sports
1382
Physiology
Rheumatology/Orthopedics Resting membrane potential is established by the high K+ Efflux and minimal Na+
& Sports
influx. (Through non-gated channels)
1394
Microbiology
Rheumatology/Orthopedics When have gas gangrene, its clostridiu perfringens and also can cause food
& Sports
poisonong (reheated meat) reheated rice: B. cerus
1450
Pathophysiology
Gout is associated with Myeloproliferative disorders (e.g: polycythemia vera..)
& Sports
1664
Physiology
On electron micrograph the Z line appears much darker than the M line. And only the
Rheumatology/Orthopedics H band contains purely thich filament. And only the A band (corresponds to the
& Sports
whole length of thick filament) is not variable in size and does not change during
muscle contraction
1682
Anatomy
Rheumatology/Orthopedics In Oustretched hand fall u can have Scaphoid fracture or Lunate dislocation
& Sports
compressing Median nerve causing Numbness of hand
1684
Embryology
Rheumatology/Orthopedics Caudal agenesis (sacral agenesis): lower extremety paralysis (are smaller), Urinary
& Sports
incontinence SEEN IN DM MOTHERS
1858
Physiology
Muscle: Type I fibers: Slow twitch, Require low level sustained force, have high
Myoglobin and Mitochondria so look red (rely on aerobic respiration); Postural
muscles like Soleus, Paraspinal, Type II: Rapid Forceful movements. IIb: Anaerobic
& Sports
Glycogenolysis then Glycolysis (High Glycogen content). IIa: Fast twitch but with
Aerobic Respiration (Intermediate between Type I and Type IIb)
1874
Pathology
Contracture: Fibroblasts with increase metalloproteinase
& Sports
1896
Pathology
Parvo can imitate RA but is self limiting
& Sports
1956
Anatomy
Femoral head is supplied by Medial Circumflex femoral Artery
& Sports
1969
Anatomy
the fibula is lateral, and ACL goes towards inside (out to in)
& Sports
Physiology
In Myastemia Gravis, the antibodies (act like Curare) will bind the Acholine receptors
and preventing ACh of opening cation channels (Na+, K+; they are within the ACh
Rheumatology/Orthopedics receptor), therefore we have a reduced motor-end plate potential. Unlike
& Sports
Eaton-Lambert or Botulism (Block release. Of ACh from presynaptic terminal) the
synaptic ACh concentration is normal. Hemicholinium: block reuptake of choline into
presynapse depleting ACh stores in presynapse
2062
Physiology
In Mysthemia Gravis, the use of Cholinesterase Inhibitors is non selective therefore

increase the activity of ACh in muscarinic receptors too (Unwanted side effect).
Therefore Scopalamine (so is Hyosciamine) is given which is a selective Muscarinic
& Sports
ACh receptor Antagonist (such as the gut, cramp, nausea, diarrhea, sweating).
Pilocarpine is a non selective ACh receptor agonist and reduces the side effects.
2090
Biochemistry
Rheumatology/Orthopedics If someone has increased PRPP production he will have increased purines and then
& Sports
uric acid and gout
Physiology
Skeletal muscle contraction: ACh will bind post synaptic receptors, opens
post-synaptic ligand-gated ion channels causing depolarization of muscle cells. Then
Rheumatology/Orthopedics Ca2+ is released from SR. Ca2+ will bind to Troponin on the C site (Troponin C:
& Sports
Ca2+ binding site, Troponin T: attaches Troponin to Tropomyosin, Troponin I:
attaches Troponin-Tropomyosin complex to Actin) When bound to Ca2+, it will rotate
tropomyosin exposing Actin's myosin binding site allow Actin-Myosin interaction
8266
Physiology
Golgi tendons system (at muscle-tendon junction) are sensitive for Active stretch in
Rheumatology/Orthopedics Muscles , and is a feedback system that monitor and maintains muscle force. (not
& Sports
passive ones).they are responsible for the involuntary release of weights when hitting
the gym, to prevent muscular injury.
8523
Pharmacology
mab: Monoclonal AB cept: reCEPTor molecule nih: kinase INHbitor
& Sports
8579
Anatomy
Annular ligament is fucked up when a childs arm is being stretched in extended

pronated position like i used to do to Karim. Patient will be in extended pronated arm
& Sports
position, wont be able to move it again. Reduce it by flexing and supinating
8670
Anatomy
Rheumatology/Orthopedics Scaphoid fracture in outstrectched hand can lead to avascular necrosis and it is the
& Sports
most common complication
10930
Pharmacology
Calcium bicarb when given need acidic invironment for Ca to be absorbed
& Sports
11564
Pharmacology
Dronate inhibit osteoclast mediated resorption (similar to pyrrophosphate and bind to

hydroxyapatite) so osteoclast that is eating bone takes dronates andd dont adhere
& Sports
on more bone for resorption
11646
Pathophysiology
Rheumatology/Orthopedics in polymyositis: have ANA ANTI JO-1 (aka anti histidyl tRNA synthestase DAA
& Sports
FUCKKKKKKK)
11653
Pathology
Rheumatology/Orthopedics MC cune albright: mutatuin in GNAS gene CAfe au lait, precocious puberty and
& Sports
fibrous dysplasisa
11684
Anatomy
Extensor muscle of the wrist attach on lateral epicondyle it is a bit intuitive
& Sports
2061
7592
11727
Anatomy
In sciatica there is compression of the sciatic nerve in the Greater sciatic foramen
often due to HYPERTROPHY OF PIRIFORMIS MUSCLE (passes in the canal;
& Sports
involved in extrnal hip rotation)
11749
Pharmacology
Azathiprine-> 6MP-> purine metabolism so if give ALLopurinolu inhibit this
& Sports
11770
Pathophysiology
Temporal arteritis is cell mediated with production of cytokines (IL6..)
& Sports
11799
Anatomy
Injury of ankle (inversion) think only of talofibular
& Sports
11830
Anatomy
Rheumatology/Orthopedics Penis drains in superficial inguinal nodes excpet for gland which drain into deep (coz
& Sports
very sensitive and goes deeeep)
1125
Behavioral
science
Social Sciences
(Ethics/Legal/Professional)
A woman having tubal ligation is not required to have her partner's consent
1235
Behavioral
science
Social Sciences
PCP should educate about exercice, smoking cessation etc. while the attending at
hospital should DNR DNI objectives to very sick patients
1237
Behavioral
science
Social Sciences
When a patient refuses to know his diagnosis before directly accepting dig further
and ask why
1238
Behavioral
science
Social Sciences
Eventhough people have full authorities on themselves you are to report suicidal
plans, or someone with EBV willing to play rugby (risk of splenic rupture)
2057
Behavioral
science
Social Sciences
Eventhough pregnancy stuff are not be adressed to parents in minor, abortions

should be adressed to parents.
2058
Behavioral
science
Social Sciences
Drunk people who want to leave the ER are not allowed to do so until they get sober
2059
Behavioral
science
Social Sciences
Patient has the right not to know informations
7767
Behavioral
science
Social Sciences
If Dr. is not comfortable with patient's decision he has the right to refer to another Dr.
who is comfortable with doing what the patient wants. (like Abortions)
10290
Behavioral
science
Social Sciences
Hospice care is for people with life expectancy of less than 6 months from now
10463
Behavioral
science
Social Sciences
Drs. should not receive gifts, unless of token values (less than 10$; cookies etc.)
10464
Behavioral
science
Social Sciences
Romantic relationships with patient is inapropriate and it is even inapropriate to ask

the patient to change Dr. then date her.
10488
Behavioral
science
Social Sciences
Dont rely on a translator if hes not professional when it comes to consents and stuff
10509
Behavioral
science
Social Sciences
If a colleague asks you about a patient in the elevator, tell him that you'll discuss it
later with him, but don't demean him by telling him that you cannot discuss it and that
it is against policy
10533
Behavioral
science
Social Sciences
In minors Call Ethic Commity if it is really not clear what to do, but if it's clear get a
court mandate to go for treatment
10534
Behavioral
science
Social Sciences
A health care proxy (signed on paper) beats any relative or person when taking
decision to unconscious patient
10542
Behavioral
science
Social Sciences
If someone passed out and his friend said that the patient doesn't want resuscitation
don't believe him unless he has an official note from him or he is designated the
health proxy
10545
Behavioral
science
Social Sciences
Unlike real life, consent forms should be obtained by the physician performing the
procedure as he is most qualified to describe the procedure, its complications and to
answer the patient's questions
11518
Behavioral
science
Social Sciences
If you can't educate an illeterate (or low education level) patient about his disease
use alternative learning methods like visual recources

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Allergy & Immunology

Pathophysiology Allergy & Immunology

Allergy & Immunology

Protein M is the main virulence of strep pyogenous as it inactivates phagocytosis,

Allergy & Immunology

Allergy & Immunology

Allergy & Immunology

Allergy & Immunology

Tryptase is a specific marker for mast cells amd is useful in anaphylaxis

Allergy & Immunology

Biostatistics & Epidemiology

Biostatistics & Epidemiology

Biostatistics & Epidemiology

95% CI that value is between X+/- Y Y is 1.96 (SD/rootsquare N) aka (SE) if it is as

Biostatistics & Epidemiology

Transposition of Great Arteries is failite of Aorticoopulmonary spiral septum to

0-4 hr post mi the myocardium is normal on histology. 4-12: coagulation necrosis,

Pathophysiology Cardiovascular System

Hibernating myocardium refers to the presence of ledt ventricular systolic dysfunction

In dilated Myopathy (also in ischemic myopathy): Contractile function is decrease but

Pathophysiology Cardiovascular System

Constrictive pericarditis is chronic

In HOCM we use bb ccb disopyramide and diuretics or dilators

Prevent NIACIN FLushing BY NSAIDS

Pathophysiology Cardiovascular System

LHF will cause RHF by congestion pulmonary veins leading to vasoconstriction of

Pathophysiology Cardiovascular System

Pathophysiology Cardiovascular System

Pulmonary HTN cause irreversible damage to pulmonary arteries while RV

Aschoff bodies are seen in heart rheumatic fever

In tubes velocities: V1A1=V2A2=Cte (considering incompressible tubes, assuming

Pathophysiology Cardiovascular System

Metastatic calcification occurs in cell necrosis (like in old aortic valve)

Pathophysiology Cardiovascular System

only Aureus is coagulase + among the Staphes

Statins and fibrates have fucked up effects on muscles

In PSVT adenosine will cause chest burning and flushing

Amiodarone (class III K+ channel blocker of cardiac pacemaker cells so decrease

Pathophysiology Cardiovascular System

MR is severed with volume overload so when have S3 u know MR is at its max

Viridans are acquired after dental procedure if have cardiac structural

Doxorubicin cause dose related dilated cardiomyopathy by creating free radicals..

Cilostazol is used in PAD, reduce,atelt activation and cause vasodilation

ANP, BNP, NO --> increase cGMP --> relaxation of smooth muscle

if have cough with ACE go for ARBs

Dobutamine affects B1 and lesser B2 and A1. So increase HR and Contractility

FLAT CHAMP INCREASE cAMP

CO= O2 consumption/ AV O2 difference

In exercise PaO2 and PaCO2 do not change but CO and HR increase to

Flow (Q)= dP/R Remember U=R.I R= v.L/r4 Q=r4.(dP/v.L) So if flow decrease by X in

Pulsus Paradoxus usually happens in Tamponade but can also happen in

Phentolamine is competetive alha blocker wheras phenoxybenzamine is a non

ACh and Adenosine reduce phase 4 of spontaneous depolarisation, in cardiac

Holosystolic murmur, that increase during inspiration is only tricuspid regurgitation

Thiazide increase GLUC Glucose, LDL, Uric Acid, Ca

BNP (natriuretic peptide) is released in response to atrial and ventricular stretching

Pathophysiology Cardiovascular System

Zinc deficiency causes acrodermatitis enteropathica, infertility and Growth retardation

Vitiligo: loss of melanocyte (autoimmune pooly understood) in albinism have

In Hartnup disease you have decrease Tryptophan absorption in guts and

Post auricular lymphadenopathy makes us more suspicious towards rubella rather

Androgenic alopecia have Polygenic Inheritance patterns

Lymhedema (like post mastectomy) increase risk of Angiosarcoma