High yield points

By | March 3, 2017
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Cardiovascular System

  1. Temporal arthritis (Giant cell arthritis) is best diagnosed by temporal artery biopsy.
  2. Diplopia ,jaw claudication and temporal headache is clinical feature of Giant cell arthritis.
  3. Foam cell in atherosclerosis is actually macrophage
  4. Burger disease or Thromboangiitis obliterans is related to smoking
  5. Ployarteritis nodusa(PAN) involve  all the system but spares Lung (pulmonary artery)
  6. Ployarteritis nodusa(PAN) is associated with Hepatitis B
  7. Churg-strauss syndrome= Asthma + eosinophilia + granulomatous vacuities.
  8. loss of pulse in upper extremities and hypertension occur in Takayasu arteritis which meanly affecting the aorta and its branch. It is also known as pulse-less disease.
  9. The most common congenital heart defect in infancy is ventricular septal defect(VSD).
  10. The most congenital heart defect in adult is atrial septal defect(ASD)
  11. Ostium secundum defect is the  most common form of ASD.
  12. Marfan syndrome is the risk factor for  aortic dissection, mitral valve prolapase and spontaneous Pneumothorax.
  13. HIV is associated with Kaposi sarcoma.
  14. Essential or idiopathic hypertension is the most common and account for 95 % cause of hypertension.
  15. Abdominal aortic aneurysm is by far the most common type of large vessels aneurysm, 95% have associated atheromatous degeneration ,95% occur below renal arteries and  patient present with central abdominal pain and pulsatile mass.
  16. In Mycotic aneurysm the term “Mycotic” is misnomer because, although it indicate infection as the cause of aneurysm it is due to bacteria not fungi.
  17. Aortic dissection present with inter-scapular pain(when descending aorta involve) and anterior chest pain(when ascending aorta involve), onset of which is sudden , sever in nature  and tearing by character, Hypertension and marfan syndrome is the main risk factor.
  18. The most common coronary artery involve in myocardial infarction is left anterior descending coronary artery.
  19. The most common cause of right heart failure is left heart failure.
  20. Most common primary cardiac tumor in adult= Myxoma
  21. Most common primary cardiac tumor in children= Rhabdomyoma
  22. Most common heart tumor= metastatic
  23. Aortic stenosis is the most common of all valvular abnormalities.
  24. Tetralogy of Fallot is the most common cyanotic congenital heart lesion which is compatible with life.
  25. The valve which is Most commonly affected in infective Endocarditis is mitral value
  26. The valve which most commonly affected in IV drug user with infective Endocarditis is tricuspid valve
  27. Widened Mediastinum on X-Ray is the most common finding in thoracic aortic rupture.

 

Hematology

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  1. Most common leukemia in children is ALL.
  2. Most common leukemia in adult is AML.
  3. Philadelphia chromosome is associated with CML.
  4. Smudge cell on blood cell is are characteristic of CLL.
  5. Leukocytosis and Massive splenomegaly (cause dragging sensation) = CML
  6. Leukocytosis , splenomegaly and painless lymphadenopathy= CLL
  7. Positive nuclear staining for tdt (DNA polymerase) is the Hallmark of ALL.
  8. The staging system of Hodgkin lymphoma is “The Ann Arbor Staging system”
  9. The most common cause of vitamin B-12 deficiency is pernicious anemia.
  10. The most common cause of folate deficiency is alcohol .
  11.  Auto-splenectomy is occur in sickle cell anemia and celiac disease.
  12. Itching after hot shower with dizziness and splenomegaly is found in Polycythemia.
  13. In Aplastic anemia splenomegaly is characteristically absent.
  14. Increase MCHC only occur in Hereditary spherocytosis that’s why it is also called Normocytic hyperchromic anemia .
  15. Hb-F protect us from sickling in sickle cell anemia .
  16. Hb electrophoresis is the most accurate test for sickle cell anemia.
  17. PNH is the only hemolytic anemia caused by an “acquired” intrinsic defect in cell Membrane.
  18. Extra-vascular hemolysis occur in sickle cell anemia and hereditary spherocytosis.
  19. Intra-vascular hemolysis occur in PNH and G6PD deficiency.
  20. Warm antibody auto immune hemolytic anemia (AIHA) is the most common hemolytic anemia (70%) and is IgG mediated.
  21. Cold agglutinin disease is less common(30%) and igM mediated.
  22. Reticulocytosis is most commonly seen in hemolytic anemia.
  23. Phytates ,Tannates, phosphate, oxalate and carbonate all these have negative influence on iron absorption.
  24. Vitamin –C , citrate and glucose all help to convert ferric iron to ferrous iron which is easily absorbable.
  25. Intestinal absorption of iron occur mainly in ferrous form which found in most  abundant  in meat.
  26. Iron deficiency anemia is Microcytic hypochromic anemia.
  27. Sickle cell disease: in Heterozygous condition which is also called sickle cell trait i-e hbs contain two population of RBC, contain 60% normal and 40% is sickle Hb (hbs). This is protective against  falciparum malaria
  28. Sickle cell disease: in homozygous condition which is also called sickle cell anemia i-e Hbss . It contain 100% Hbs with no normal cell . This is not protective against  falciparum malaria
  29. Sickling Is precipitated by hypoxia, dehydration, acidosis and infection(To remember HIDA).
  30. Vaso-occlusive crises is the most common crises in sick cell anemia which cause hand and foot syndrome(Dactylitis) and acute chest syndrome(which is the most common cause of death in adults).
  31. Clinical finding of sickle cell anemia is , susceptibility to infection like ostemyelitis , meningitis  and sepsis, three kind of crises like Vaso-occlusive crises, Aplastic crises and sequestration crises.
  32. Splenomegaly is most common and prominent in hereditary spherocytosis than any other form of hemolytic anemia .
  33. Beta Thalassemia major also called Cooley’s  anemia : Hb electrophoresis show absent HbA ,markedly raised HbF and HbA2 normal, high or low.
  34. Beta Thalassemia minor: Hb electrophoresis show decrease HbA, normal HbF and raised HbA2.
  35. Patient of beta Thalassemia major who are on high blood transfusion is an increase risk of Iron overload.
  36. The most common cause of anemia of chronic disease (ACD) is rheumatoid arthritis and tuberculosis.
  37. Leukocyte Alkaline Phosphates(LAP) score can different between leukemoid reaction and leukemia which is low in leukemia and high in leukemoid reaction.

 

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Pulmonology

  1. The most aggressive ,a highly malignant and metastatic lung carcinoma is small cell carcinoma and the most common carcinoma of lung is Squamous cell carcinoma but having best prognosis.
  2. The most common cause of pulmonary thrombo –Embolism is the deep venous thrombosis (DVT). 80% arise from DVT  in leg.
  3. Pleural plaques is the characteristic feature of mesothelioma.
  4. Asthma is chronic inflammatory Reversible disorder.
  5. COPD cause irreversible obstruction of air flow for which smoking is the most important risk factor .
  6. Bronchiectasis: Cystic fibrosis is the most common congenital cause of bronchiectasis in US and Tuberculosis is the most common acquired cause of bronchiectasis worldwide.
  7. Hypersensitivity pneumanitis which is also known “extrinsic allergic alveolitis” result from inhalation of wide variety of Organic antigens like farmer lung which result from Mouldy hay , Bird fanciers lung which result from avian execrate, proteins and feather etc.
  8. Investigation of choice for asthma is PFTS. Remember eosinophilia  is non-specific  test because it also occur in other condition like parasitic infection.
  9. Centriacinar is the most common type of emphysema which affect upper lobes.
  10. Renal cell carcinoma can produce many paraneoplastic  syndrome like producing erythropoietin , PTH-related peptid, renin and gonadotrophin which cause systemic effects.
  11. Pulmonary Hemartoma is the most common benign tumor of lung.
  12. TB of  vertebral body is called Potts disease.
  13. The most common site for extra –pulmonary  TB is kidney.
  14. Bronchial carcinoma clinical presentation: Hoarseness in bronchial carcinoma is due to recurrent laryngeal nerve palsy, dysphagia in bronchial carcinoma is due to esophageal invasion.
  15. Tuberculous  cavities is the most common risk factor for Aspergilloma (fungal Ball).
  16. The most common cancer in male is prostatic carcinoma.
  17. The most common cancer in female is breast carcinoma.
  18. The most common cancer leading to death in both man and women is lung carcinoma.
  19. The main source of injury to lung in adult respiratory distress syndrome is neutrophil.

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