Board Exam Review Pearls (physician)

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    ͞Faculty List of Your Legion Are Bruce, Salma, Mike and Francis͟ Faculty (group) List ʹ Listeria Of Your ʹ Yersinia Legion ʹ Legionella Are Bruce ʹ Brucella Salma ʹ Salmonella typhi Mike ʹ Mycobacterium Francis ʹ Francisella tularensis Contributed by: Jericho Robert Pineda, MD c
     
 ͞Medical Schools Let Confident People In͟ Medical ʹ Middle Thyroid Schools ʹ Superior Thyroid Let ʹ Lingual Confident ʹ Common Facial People ʹ Pharyngeal In ʹ Inferior Petrosal Sinus Contributed by: Rowena Grace Garcia, MD c
  
   
 ͞Left Hand Side͟ Left ʹ Left Gastric a. Hand ʹ Hepatic a. Side ʹ Splenic a. Contributed by: Rowena Grace Garcia, MD c
    
  
   !  ͞The Duck Between 2 Gooses͟ Thoracic Duct is between the Esophagus and Azygous Vein. Contributed by: Rowena Grace Garcia, MD Did you know that alcohol promotes dieresis not directly (i.e. acting on the tubules) but indirectly by decreasing ADH secretion? So as with lithium as a side effect and with demeclocycline primarily to treat SIADH. Contributed by: Christopher George Mapa, MD Dorsal Medulla ʹ normal breathing rhythm, inspiratory drive Ventral Medulla ʹ active expiration Lower Pons ʹapneustic center, responsible for deep prolonged breathing Upper Pons ʹpneumotaxic center, inhibits inspiration causing increased respiratory rate Contributed by: Christopher George Mapa, MD Norepinephrine is the only neurotransmitter with documented negative feedback inhibition. Therapeutic dose stimulates the sympathetic nervous system but increased circulating norepinephrine sends a negative feedback signal to the brain causing general inhibitory effect. ---Katzung & Joram Contributed by: Hyacinth Claire Tanseco, MD

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+ Crude Birth Rate Crude Death Rate Cause-Specific Death Rate

Age-Specific Death Rate Contributed by: Hyacinth Claire Tanseco, MD

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+ Infant Mortality Neonatal Mortality Maternal Mortality Post-Neonatal Mortality Contributed by: Hyacinth Claire Tanseco, MD Popcorn calcification ʹ Chondrosarcoma Soap Bubble ʹ Giant Cell Ground Glass ʹ Fibrodysplasia Sunburst Appearance ʹ Osteosarcoma Onion Skin Appearance ʹ Ewing͛s Sarcoma Contributed by: Christopher Tambo, MD Patients with Ventricular Tachycardia When hemo-stable, use Lidocaine. When hemo-unstable, SYNCH CARDIOVERSION 1-2.5 j/kg in Pedia Patients with Supraventricular Tachycardia SYNCH CARDIOVERSION 0.25-0.50 J/kg x2 if unsuccessful ---Baby Nelson Contributed by: Christopher Tambo, MD ,
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 H1 ʹ smooth muscle H2 ʹ stomach, heart, mast cells H3 ʹ nerve endings and CNS Contributed by: Christopher Tambo, MD -!
 
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  Phenylalanine to tyrosine ʹ thyrosine (thyroxine), dopamine (melanin, norepinephrine, epinephrine) Tryptophan ʹ serotonin, niacin (NAD, NADP), melatonin Arginine ʹ nitric oxide, creatinine, urea Glutamate ʹ GABA Histidine ʹhistamine Glycine ʹ porphyrin (heme) Contributed by: Christopher Tambo, MD c/#'  Prophylaxis ʹ propranolol, valproic acid, topiramate Acute Attack ʹ ergotamine, sumatriptan Contributed by: Bernice Plana, MD c
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 ͞TLC For Nadia͟ T ʹ thiamine pyrophosphate L ʹ lipoic acid C ʹ CoA For ʹ FAD Nadia ʹ NAD Contributed by: Christopher Tambo, MD

ATROPHIC VAGINITS is the most common cause of vaginal bleeding in post-menopausal women. Contributed by: Rochee De Leon, MD 


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  Helper T Cells ʹ CD4, TCR, CD3, CD28, CD40L Cytotoxic T Cells ʹ CD8, TCR, CD3 B Cells ʹ IgM, B7, CD19, CD20, CD21, CD40, MHC II Macrophages ʹ MHC II, B7, CD40, CD14, receptors for Fc and C3b Natural Killer Cells ʹ receptors for MHC I, CD16, CD56 All cells except mature RBCs ʹ MHC I Contributed by: Christopher Tambo, MD 

 
 DOC for anaerobes ABOVE the diaphragm, use clindamycin. DOC for anaerobes BELOW the diaphragm, use metronidazole. ---USMLE First Aid, Step 1 c       Trop I ʹ 4 hours to 7 days  most specific CK-MB ʹ 1st 24 hours  first to elevate nd th LDH ʹ 2 to 7 day Contributed by: Alain Blue Tuazon, MD

#"- %,&/$ Strawberry tongue ʹ Scarlet fever, Kawasaki disease Strawberry cervix ʹ Trichomoniasis Strawberry gallbladder ʹ cholesterolosis Cherry-red spot ʹ CRAO, Niemann-Picks disease, Tay Sachs͛ disease Bunch of grapes ʹ Sarcoma botyroides Apple-green birefringence ʹ amyloidosis Currant jelly ʹ intussusceptions, Klebsiella pneumonia Lemon sign ʹ spina bifida Banana sign ʹ spina bifida Banana-shaped left ventricle on ECG ʹ hypertrophic cardiomyopathy Peau d͛ orange ʹ invasive breast CA Bitter almond odor ʹ cyanide poisoning Sweet garlic odor ʹ arsenic Contributed by: Jimmy Dumlao, MD Primary Hyperaldosteronism (Conns) ʹ low plasma rennin Secondary Hyperaldosteronism ʹ high plasma rennin Primary Adrenal Insufficiency (Addison͛s) ʹ hyperpigmentation Secondary Adrenal Insufficiency (Addison͛s) ʹ without hyperpigmentation '#- Acute ʹ Staph aureus Subacute ʹ Viridans strep (S. sanguis) & Group D strep (Enterococci) In IV drug users ʹ Staph epidermidis & Candida albicans (TV endocarditis) , %- Hep A ʹ feco-oral ʹ Picornavirus Hep B ʹ STD ʹ Hepadnavirus

Hep C ʹ BT ʹ Flavivirus Hep D ʹ HbsAg ʹ Deltavirus Hep E ʹ feco-oral ʹ Calicivirus %c'  Normally: The striatum communicates with the thalamus and cerebral cortex via: 1 ʹ direct pathway (excitatory) through D1 receptors (Gs so increased adenylyl cyclase, increased cAMP); and 2 ʹ indirect pathway (inhibitory) through D2 receptors (Gi so decreased adenylyl cyclase, decreased cAMP). Dopamine excites the direct pathway and inhibits the indirect pathway. So overall, dopamine is excitatory. In Parkisonism: Since dopamine inhibits the indirect (inhibitory) pathway and excites the direct (excitatory) pathway, destruction of dopaminergic neurons is overall, inhibitory. Contribued by: Bernice Plana, MD c
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  1 ʹ HAV M3 (read as ͞have me͟): H1, ɲ1, V1, M1, M3 Action: activates Gq  phospholipase C  (1) increases IP3  increases intracellular Ca; and (2) increases DAG  increases protein kinase C. 2 ʹ DB HBV: D1, ɴ1, H2, ɴ2, V2 Action: activates Gs  stimulates adenylyl cyclase  increases cAMP 3 ʹ MAD 2i: M2, ɲ2, D2 Action: activates Gi  inhibits adenylyl cyclase  decreases cAMP ---BRS Physiology Contributed by: Bernice Plana, MD %-cc
 ʹ laminated, concentric, calcific spherules seen in: P ʹ Papillary adenocarcinoma of the thyroid S ʹ Serous papillary cystadenocarcinoma of the ovary M ʹ Meningioma M ʹ Malignant Mesothelioma ---USMLE First Aid, Step 1   
  
#   1 ʹ Coronary Sinus (great, middle/medium and small cardiac veins) 2 ʹ Anterior Cardiac Vein 3 ʹ Smallest Cardiac Vein or Venae Cordis Minimae 4 ʹ SVC 5 ʹ IVC & - Tricuspid Valve ʹ 3 cusps (anterior, septal, inferior) Mitral Valve ʹ 2 cusps (anterior, posterior) Pulmonary Valve ʹ 3 semilunar cusps (1 posterior, 2 anterior) Aortic Valve ʹ 3 semilunar cusps (1 anterior, 2 posterior) AORTIC SINUSES (bulge from 3 semilunar cusps): 1 anterior ʹ becomes Right coronary artery 2 posterior ʹ Left posterior becomes Left coronary artery Contributed by: Bernice Plana, MD MRH ʹ mitral regurgitation, holosystolic VSDH ʹ VSD, holosystolic

PDAH ʹ PDA, holosystolic ASS ʹ aortic stenosis, systolic MPM ʹ mitral prolapsed, midsystolic ARD ʹ aortic regurgitation, diastolic MSD ʹ mitral stenosis, diastolic TSD ʹ tricuspid stenosis, diastolic Contributed by: Caryl De Guzman, MD

# %- Simpsons, Tuckers ʹ for traction, with pelvic curve Kiellands ʹ for fetal rotation, without pelvic curve Bartons ʹ for transverse arrest Pipers ʹ for after coming head in breech c
  

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11)  st th 1 to 6 months ʹ ͞Randy Santiago Trying Hard Raw Talaga͟ th 7 to 12th months ʹ ͞Sharon Cuneta Pa Ctue With Snookie͟ 1 Randy ʹ regard 2 Santiago ʹ social smile 3 Trying ʹ turns head 4 Hard ʹ holds head 5 Raw ʹ rolls over 6 Talaga ʹ transfers objects 7 Sharon ʹ sites briefly 8 Cuneta ʹ creeps 9 Pa ʹ pulls up 10 Cute ʹ cruises 11 With ʹ walks with support 12 Snookie ʹ stands Contributed by: Ma. Raissa Paje, MD Breastmilk Jaundice ʹ occurs after 7th day; may be d/t glucoronidase, responsible for jaundice; STOP breastfeeding for 1-2- days. th Breastfeeding Jaundice ʹ occurs after 7 day; d/t decreased milk intake; increase breastfeeding. Contributed by: Rochee De Leon, MD

, UTZ ʹ 8 weeks AOG Doppler ʹ 10-12 weeks AOG Stethoscope ʹ 18 weeks AOG Contributed by: Ma. Nenita Flor Consolacion, MD Most common ASD ʹ ostium secundum Most common COA anomaly ʹ bicuspid aortic valve ͞Tet͟ spells (extreme hypoxia) ʹ found in TOF Most cmoon VSD ʹ perimembranous Contributed by: Ma. Nenita Flor Consolacion, MD  
 
  ʹ dilated submucosal veins of superios rectal plexus 3 sites: L lateral ʹ 3 o͛ clock R posterior lateral ʹ 7 o͛ clock R anterolateral ʹ 11 o͛ clock

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  ʹ inferior hemorrhoidal plexus dilation below dentate line Contributed by: Caryl De Guzman, MD -3 !4"
  
2 ʹ number of death 50 years and above divided by total deaths in the same year multiplied by 100  high result means people get old first before they die Contributed by: Marianne Mananghaya-Alonzo, MD - 
5 c   RBCs Leukocytes Lens Cornea Kidney medulla Testes Contributed by: Marita Deang, MD Duodenal Ulcers ʹ pain Decrease with food intake  weight gain Gastric Ulcers ʹ pain Greater with food intake  weight loss Contributed by: Marita Deang, MD Aliskiren (Rasilez) ʹ direct rennin inhibitor that blocks the conversion of angiotensinogen to angiotensin I thus decreaseing angiotensin II which is a potent blood pressure elevating enzyme. Contributed by: Donna Cruz-Segador, MD PANCREATIC CA Surgical dictum: Vague abdominal pain with weight loss, with or without jaundice, in an older patient (50 y/o and above) is pancreatic CA until proven otherwise. Cigarette smoking is the most clearly established risk factor. Contributed by: Marita Deang, MD rd

3 NSD is still covered by Philhealth, according to the 2006 pamphlet. Contributed by: Joseph Ilao, MD