HIGHEST Yield Pearls for MRCP 1 2 & PACES
1) Hepatitis "D" Virus has HIGHEST mortality in ALL people EXCEPT#Pregnancy.
In Pregnant women: MOST LETHAL is Hepatitis E virus.
2) "While calculating Serum Osmolality the serum Na is multiplied by 2 to account for the accompanying ANIONS (mostly Cl- & HCO3-)."
3) Most Common cause of Metastasis to LIVER is primary cancers of Lung.
LLLLLungs send metastasis to LLLLLLiver.
4) Ketamine is the ONLY induction agent that causes Bronchodilation.
Again:
Ketamine is the ONLY induction agent that causes Bronchodilation.
5) AANNencephaly: failure of AANNterior neuropore to close.(at day 25)
SSSpinda bifida: failure of poSSSterior neuropore to close.(at day 27)
6) Muscle Spindles: Innervated by 1a fibers - cause skeletal muscle to CONTRACT.
GTOs: innervated by 1b - cause contracting muscle to RELAX
7) In SSSpontaneous pneumothorax: trachea shifts to ipSSSilateral side.
In TTTension pneumothorax: trachea deviates to conTTTralateral side.
8) Antibiotics SAFE in pregnancy:
All Penicillins.
All Cephalosporins.
All Carbapenems.
Aztreonam.
Azithromycin.
Nitrofurantoin (Avoid in last trimester bcoz can cause hemolysis in G6PD deficient fetus).
Metronidazole (SAFE in ALL trimesters).
9) MICROcytic anemia + NORMAL iron studies* = Thalassemia.
*Iron studies = Serum Ferritin, TIBC etc
10) Know the difference:
Atopic Dermatitis: Type-1 HS (Hyper Sensitivity)
Contact Dermatitis: Type 4 HS.
11) In CHRONIC Hepatitis:
Check serum ALT to monitor THERAPY response (Follow-up)
Check PT for look (rule out) Acute Liver FAILURE.
12) IN Nephron:
Maximum reabsorption of H2O take place in Proximal Convoluted Tubules, REGARDLESS to ADH status (present or absent).
13) Generally:
Mass in ANTERIOR Mediastinum =THYMOMA.
Mass in POSTERIOR Mediastinum = NEUROGENIC TUMOR.
14) Most Common Congenital heart "Lesion" = Bicuspid aortic valve.
Most Common Congenital heart "Defect" = VSD.
15) Increased neural activity before a SKILLED Voluntary movement is first seen in the "CORTICAL ASSOCIATION AREAS".
16) Ampullary region of Uterine tube:
WIDEST part of the Fallopian.
MOST COMMON SITE of Ectopic Pregnancy &
MOST COMMON SITE of Fertilization.
17) The ONLY gynecological cancer that is staged clinically, NOT surgically is cervical cancer.
18) The ONLY hematologic disease that cause hyperchromic microcytosis is Hereditary Spherocytosis.
19) The ONLY hematologic disease that cause iron deficiency anemia DESPITE increase RBCs is Polycythemia Vera.
20) The MOST COMMON thyroid CA is Papillary (P-opular).
It also has P-sammoma bodies on histology.
It causes P-alpable lymph nodes (lymphatic spread)
21) ALL Quinolones lack anaerobic coverage EXCEPT Moxifloxacin.
22) COLD sensations are transmitted by myelinated "A-delta" fibers.
WARM sensations are transmitted by unmyelinated "C" fibers.
23) Sigmoid Colon:
I) MOST COMMON (MC) site of Colorectal Carcinoma.
II) MC site of Volvulus in Elderly adults (in young -> Cecum).
II) MC site of Diverticulosis.
24) Homocysteine level is ELEVATED in BOTH (Vit B 12 & Folate deficiencies) While Methylmalonic Acid level is NORMAL in Folate & ELEVATED in B12.
25) ALL ß-blockers are safe during gestation EXCEPT atenolol.
Once more:
ALL ß-blockers are safe during gestation EXCEPT atenolol.
26) Ectopic Pregnancy:
Most Common site: Ampulla.
Most common site for Rupture: Isthmus.
27) In SIADH = Serum Osmolarity DECreased
In Water Deprivation : Serum Osmolarity HIGH or Normal (NEVERDecreased)
28) Oral Cavity:
Premalignant CONDITIONS = Submucous Fibrosis & Lichen planus.
Premalignant LESIONS = Erythroplakia & Leukoplakia.
29) All the EXTENSION movements (Elbow, Wrist, Fingers) of Upper Limb is innervated by Radial Nerve.
30) Treatment of Hyperthyroidism in Pregnancy:
Propylthiouracil in FIRST trimester.
Methimazole AFTER the first trimester.
[If they didn't mention Trimester in question then SELECT PropylThioUracil (PTU)]
31) Urine extravasation in:
Rupture of
Penile urethra -> SCROTUM
Bulbar -> SUPERFICIAL perenial pouch
Prostatatic urethra -> DEEP perenial pouch
32) All RNA viruses replicate in the cytoplasm of the host cell EXCEPT Influenza & HIV.
All RNA viruses are single stranded EXCEPT Reovirus.
All DNA viruses replicate in the nucleus of the host cell EXCEPT Poxvirus.
All DNA viruses are double stranded EXCEPT Parvovirus.
33) Tamoxifen is an estrogen receptor AGONIST in the uterus.
Raloxifene is an estrogen receptor ANTAGONIST in the uterus.
Tamoxifen for PREmenopausal women with high risk for breast cancer.
Raloxifene for POSTmenopausal women with high risk for breast cancer.
34) Isolated 6th cranial nerve palsy causes HORIZONTAL diplopia.
Isolated 4th cranial nerve palsy causes VERTICAL diplopia.
35) Diagnostic Test for Streptococcal INFECTION: blood CULTURE.
Diagnostic Test for Strep infection COMPLICATIONS (Rh. Fever/PS-GN) : ASO titre.
36) E. Coli is the:
MOST COMMON cause of Pyogenic Peritonitis (visceral perforation).
&
MOST COMMON cause of Spontaneous Bacterial Peritonitis.
37) Most Common aspiration site is Right LOWER lobe (doesn't matter pt is standing, sitting, supine or dancing)
EXCEPTION: ONLY in ONE condition it can aspirate to Middle or even Upper lobe => in right sided position.
38) Pt CAN'T stand on his/her toes : Rupture of #ACHILLES tendon.
Pt can STAND on his/her toes but feel PAIN : Rupture of #PLANTARIS tendon.
39) The main cause of Edema in Nephrotic Syndrome is Sodium Retention, NOT
Hypoalbuminemia.
(The Hypoalbuminemia is LESS important contributor)
40) Know the Difference:
Antibodies form IN: Spleen.
Antibodies form BY: Plasma Cells.
41) Q fever:
The ONLY rickettsial disease WITHOUT a rash.
The ONLY rickettsial disease NOT needing vector for transmission.
42) Nasal deformity + granuloma + Acid Fast Bacilli = Leprosy.
Nasal deformity + granuloma + hematuria & positive c-ANCA = Wegner’s Disease.
43) Polycystic Kidney Disease:
The most common cause of Death is #ESRD - Renal failure.
[Ruptured Berry Aneurysm (SAH) is NOT correct]
44) Chronic hepatitis B is the most common cause of HCC worldwide with
chronic hepatitis C being the most common cause in Europe.
45) Location of Melanocytes in the skin: Stratum basalis (the deepest layer of the five EPIdermis layers.)
46) Fossa navicularis is the only part of male urethra that is NOT lined by transitional epithelium. It is lined by non-keratinized squamous epithelium.
47) Down syndrome and Leukemia :
- Younger than 5 year old --> AML (M7 subtype)
- Older than 5 year old --> ALL
48) Respiratory Bronchioles:
- FUNCTIONALLY separate the Upper & Lower respiratory tract.
- Lymphatic channels begin at this level & flow upward.
49)
History of Asbestos exposure: Mesothelioma.
History of Smoking: Bronchogenic carcinoma.
History of BOTH (Smoking + Asbestos exposure) : Bronchogenic carcinoma.
50) The Key feature of SHOCK is TISSUE HYPOPERFUSION, not a specific level of systemic arterial Blood Pressure.
51) The most ACCURATE noninvasive index of core temperature is Esophageal temperature.
(Esophageal > Rectal > Oral)
52) Syndromes & Congenital Heart Defect:
Down ⇒ AVSDs.
Turner ⇒ Coarctation of Aorta.
Marfan ⇒ Aortic Aneurysm.
Williams ⇒ Aortic stenosis.
Noonan ⇒ Pulmonary stenosis.
53)
X-linked recessive diseases:
Males - ALWAYS Cases, NEVER Carriers.
Females - ALWAYS Carriers, NEVER Cases.
54)
Oral Cavity:
Premalignant #conditions = Submucous Fibrosis & Lichen planus.
Premalignant #Lesions = Erythroplakia & Leukoplakia.
55)
Infarction of the pituitary as seen in Sheehans syndrome produces coagulative (#NOT liquefactive) necrosis.
56)
The EARLIEST sign of Salicylate (Aspirin) toxicity is often Hyperventilation & Respiratory Alkalosis.
If NO such Option: Select "Tinnitus"
57)
Location of Melanocytes in the skin: Stratum basalis (the deepest layer of the five Epidermis layers) OR in another words "Melanocytes are Present in Epidermis.
58)
The Hippocampus is the first area to be damaged during global cerebral ischemia.
59)
Embryological origin of the tongue:
Ant 2/3rd - 1st branchial arch.
Post 1/3rd - 3rd & 4th branchial arches.
Muscles - Occipital myotomes.
60)
Hypertensive arteriolar sclerosis can cause lacunar infarcts:
Pure Motor stroke - post limb of internal capsule.
Pure Sensory stroke - VPL/VPM of Thalamus.
61)
Chronic hepatitis B is the most common cause of HCC worldwide.
62)
First nerve to get affected in Cavernous Sinus Thrombosis. CN VI (Abducens)
63)
Fall on out stretched hand, most common nerve to be lesioned = Median (Lunate displacement)
64)
Regarding TB:
#ghon Complex - ONLY in #primary T.B.
#cavitation - ONLY in #secondary T.B.
Calcification, Positive PPD, Caseating granuloma - in BOTH
65)
Appendix is the Most Common site for carcinoid tumor.
Appendix is the Most Common site for carcinoid tumor.
66)
n. MMMMeninGGGGitidis ferments MMMMaltose & GGGGlucose.
n. GGGGonorrhoeae ferments ONLY GGGGlucose.
LAST but NOT the least
:: Hematology Key Concept Pearls ::
I) Microcytic Anemia with Low Ferritin & High TIBC = Iron deficiency Anemia.
II) Microcytic Anemia with High Ferritin & Low TIBC = Anemia of Chronic Disease.
III) Microcytic Anemia with High Serum Iron = Sideroblastic Anemia.
IV) Microcytic Anemia with NORMAL Iron studies = Thalassemia.
________
TIBC = Total Iron Binding Capacity
Ferritin = Stored Iron
1) Hepatitis "D" Virus has HIGHEST mortality in ALL people EXCEPT#Pregnancy.
In Pregnant women: MOST LETHAL is Hepatitis E virus.
2) "While calculating Serum Osmolality the serum Na is multiplied by 2 to account for the accompanying ANIONS (mostly Cl- & HCO3-)."
3) Most Common cause of Metastasis to LIVER is primary cancers of Lung.
LLLLLungs send metastasis to LLLLLLiver.
4) Ketamine is the ONLY induction agent that causes Bronchodilation.
Again:
Ketamine is the ONLY induction agent that causes Bronchodilation.
5) AANNencephaly: failure of AANNterior neuropore to close.(at day 25)
SSSpinda bifida: failure of poSSSterior neuropore to close.(at day 27)
6) Muscle Spindles: Innervated by 1a fibers - cause skeletal muscle to CONTRACT.
GTOs: innervated by 1b - cause contracting muscle to RELAX
7) In SSSpontaneous pneumothorax: trachea shifts to ipSSSilateral side.
In TTTension pneumothorax: trachea deviates to conTTTralateral side.
8) Antibiotics SAFE in pregnancy:
All Penicillins.
All Cephalosporins.
All Carbapenems.
Aztreonam.
Azithromycin.
Nitrofurantoin (Avoid in last trimester bcoz can cause hemolysis in G6PD deficient fetus).
Metronidazole (SAFE in ALL trimesters).
9) MICROcytic anemia + NORMAL iron studies* = Thalassemia.
*Iron studies = Serum Ferritin, TIBC etc
10) Know the difference:
Atopic Dermatitis: Type-1 HS (Hyper Sensitivity)
Contact Dermatitis: Type 4 HS.
11) In CHRONIC Hepatitis:
Check serum ALT to monitor THERAPY response (Follow-up)
Check PT for look (rule out) Acute Liver FAILURE.
12) IN Nephron:
Maximum reabsorption of H2O take place in Proximal Convoluted Tubules, REGARDLESS to ADH status (present or absent).
13) Generally:
Mass in ANTERIOR Mediastinum =THYMOMA.
Mass in POSTERIOR Mediastinum = NEUROGENIC TUMOR.
14) Most Common Congenital heart "Lesion" = Bicuspid aortic valve.
Most Common Congenital heart "Defect" = VSD.
15) Increased neural activity before a SKILLED Voluntary movement is first seen in the "CORTICAL ASSOCIATION AREAS".
16) Ampullary region of Uterine tube:
WIDEST part of the Fallopian.
MOST COMMON SITE of Ectopic Pregnancy &
MOST COMMON SITE of Fertilization.
17) The ONLY gynecological cancer that is staged clinically, NOT surgically is cervical cancer.
18) The ONLY hematologic disease that cause hyperchromic microcytosis is Hereditary Spherocytosis.
19) The ONLY hematologic disease that cause iron deficiency anemia DESPITE increase RBCs is Polycythemia Vera.
20) The MOST COMMON thyroid CA is Papillary (P-opular).
It also has P-sammoma bodies on histology.
It causes P-alpable lymph nodes (lymphatic spread)
21) ALL Quinolones lack anaerobic coverage EXCEPT Moxifloxacin.
22) COLD sensations are transmitted by myelinated "A-delta" fibers.
WARM sensations are transmitted by unmyelinated "C" fibers.
23) Sigmoid Colon:
I) MOST COMMON (MC) site of Colorectal Carcinoma.
II) MC site of Volvulus in Elderly adults (in young -> Cecum).
II) MC site of Diverticulosis.
24) Homocysteine level is ELEVATED in BOTH (Vit B 12 & Folate deficiencies) While Methylmalonic Acid level is NORMAL in Folate & ELEVATED in B12.
25) ALL ß-blockers are safe during gestation EXCEPT atenolol.
Once more:
ALL ß-blockers are safe during gestation EXCEPT atenolol.
26) Ectopic Pregnancy:
Most Common site: Ampulla.
Most common site for Rupture: Isthmus.
27) In SIADH = Serum Osmolarity DECreased
In Water Deprivation : Serum Osmolarity HIGH or Normal (NEVERDecreased)
28) Oral Cavity:
Premalignant CONDITIONS = Submucous Fibrosis & Lichen planus.
Premalignant LESIONS = Erythroplakia & Leukoplakia.
29) All the EXTENSION movements (Elbow, Wrist, Fingers) of Upper Limb is innervated by Radial Nerve.
30) Treatment of Hyperthyroidism in Pregnancy:
Propylthiouracil in FIRST trimester.
Methimazole AFTER the first trimester.
[If they didn't mention Trimester in question then SELECT PropylThioUracil (PTU)]
31) Urine extravasation in:
Rupture of
Penile urethra -> SCROTUM
Bulbar -> SUPERFICIAL perenial pouch
Prostatatic urethra -> DEEP perenial pouch
32) All RNA viruses replicate in the cytoplasm of the host cell EXCEPT Influenza & HIV.
All RNA viruses are single stranded EXCEPT Reovirus.
All DNA viruses replicate in the nucleus of the host cell EXCEPT Poxvirus.
All DNA viruses are double stranded EXCEPT Parvovirus.
33) Tamoxifen is an estrogen receptor AGONIST in the uterus.
Raloxifene is an estrogen receptor ANTAGONIST in the uterus.
Tamoxifen for PREmenopausal women with high risk for breast cancer.
Raloxifene for POSTmenopausal women with high risk for breast cancer.
34) Isolated 6th cranial nerve palsy causes HORIZONTAL diplopia.
Isolated 4th cranial nerve palsy causes VERTICAL diplopia.
35) Diagnostic Test for Streptococcal INFECTION: blood CULTURE.
Diagnostic Test for Strep infection COMPLICATIONS (Rh. Fever/PS-GN) : ASO titre.
36) E. Coli is the:
MOST COMMON cause of Pyogenic Peritonitis (visceral perforation).
&
MOST COMMON cause of Spontaneous Bacterial Peritonitis.
37) Most Common aspiration site is Right LOWER lobe (doesn't matter pt is standing, sitting, supine or dancing)
EXCEPTION: ONLY in ONE condition it can aspirate to Middle or even Upper lobe => in right sided position.
38) Pt CAN'T stand on his/her toes : Rupture of #ACHILLES tendon.
Pt can STAND on his/her toes but feel PAIN : Rupture of #PLANTARIS tendon.
39) The main cause of Edema in Nephrotic Syndrome is Sodium Retention, NOT
Hypoalbuminemia.
(The Hypoalbuminemia is LESS important contributor)
40) Know the Difference:
Antibodies form IN: Spleen.
Antibodies form BY: Plasma Cells.
41) Q fever:
The ONLY rickettsial disease WITHOUT a rash.
The ONLY rickettsial disease NOT needing vector for transmission.
42) Nasal deformity + granuloma + Acid Fast Bacilli = Leprosy.
Nasal deformity + granuloma + hematuria & positive c-ANCA = Wegner’s Disease.
43) Polycystic Kidney Disease:
The most common cause of Death is #ESRD - Renal failure.
[Ruptured Berry Aneurysm (SAH) is NOT correct]
44) Chronic hepatitis B is the most common cause of HCC worldwide with
chronic hepatitis C being the most common cause in Europe.
45) Location of Melanocytes in the skin: Stratum basalis (the deepest layer of the five EPIdermis layers.)
46) Fossa navicularis is the only part of male urethra that is NOT lined by transitional epithelium. It is lined by non-keratinized squamous epithelium.
47) Down syndrome and Leukemia :
- Younger than 5 year old --> AML (M7 subtype)
- Older than 5 year old --> ALL
48) Respiratory Bronchioles:
- FUNCTIONALLY separate the Upper & Lower respiratory tract.
- Lymphatic channels begin at this level & flow upward.
49)
History of Asbestos exposure: Mesothelioma.
History of Smoking: Bronchogenic carcinoma.
History of BOTH (Smoking + Asbestos exposure) : Bronchogenic carcinoma.
50) The Key feature of SHOCK is TISSUE HYPOPERFUSION, not a specific level of systemic arterial Blood Pressure.
51) The most ACCURATE noninvasive index of core temperature is Esophageal temperature.
(Esophageal > Rectal > Oral)
52) Syndromes & Congenital Heart Defect:
Down ⇒ AVSDs.
Turner ⇒ Coarctation of Aorta.
Marfan ⇒ Aortic Aneurysm.
Williams ⇒ Aortic stenosis.
Noonan ⇒ Pulmonary stenosis.
53)
X-linked recessive diseases:
Males - ALWAYS Cases, NEVER Carriers.
Females - ALWAYS Carriers, NEVER Cases.
54)
Oral Cavity:
Premalignant #conditions = Submucous Fibrosis & Lichen planus.
Premalignant #Lesions = Erythroplakia & Leukoplakia.
55)
Infarction of the pituitary as seen in Sheehans syndrome produces coagulative (#NOT liquefactive) necrosis.
56)
The EARLIEST sign of Salicylate (Aspirin) toxicity is often Hyperventilation & Respiratory Alkalosis.
If NO such Option: Select "Tinnitus"
57)
Location of Melanocytes in the skin: Stratum basalis (the deepest layer of the five Epidermis layers) OR in another words "Melanocytes are Present in Epidermis.
58)
The Hippocampus is the first area to be damaged during global cerebral ischemia.
59)
Embryological origin of the tongue:
Ant 2/3rd - 1st branchial arch.
Post 1/3rd - 3rd & 4th branchial arches.
Muscles - Occipital myotomes.
60)
Hypertensive arteriolar sclerosis can cause lacunar infarcts:
Pure Motor stroke - post limb of internal capsule.
Pure Sensory stroke - VPL/VPM of Thalamus.
61)
Chronic hepatitis B is the most common cause of HCC worldwide.
62)
First nerve to get affected in Cavernous Sinus Thrombosis. CN VI (Abducens)
63)
Fall on out stretched hand, most common nerve to be lesioned = Median (Lunate displacement)
64)
Regarding TB:
#ghon Complex - ONLY in #primary T.B.
#cavitation - ONLY in #secondary T.B.
Calcification, Positive PPD, Caseating granuloma - in BOTH
65)
Appendix is the Most Common site for carcinoid tumor.
Appendix is the Most Common site for carcinoid tumor.
66)
n. MMMMeninGGGGitidis ferments MMMMaltose & GGGGlucose.
n. GGGGonorrhoeae ferments ONLY GGGGlucose.
LAST but NOT the least
:: Hematology Key Concept Pearls ::
I) Microcytic Anemia with Low Ferritin & High TIBC = Iron deficiency Anemia.
II) Microcytic Anemia with High Ferritin & Low TIBC = Anemia of Chronic Disease.
III) Microcytic Anemia with High Serum Iron = Sideroblastic Anemia.
IV) Microcytic Anemia with NORMAL Iron studies = Thalassemia.
________
TIBC = Total Iron Binding Capacity
Ferritin = Stored Iron
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