Severity of mitral stenoisis depends upon the following factors- Loudness of S1, Left atraial enlargement, Calcification of the

valve and A2- opening snap gap. Addisons disease = Adrenal deficiency- Hyponatremaia, hypokalaemia, hypotension, hyperpigmentation due to high level of ACTH. Periodic weakness is due to Myesthenia gravis,hypokalaemia, hypophosphatemia. Cold antibodies are seen in- Syphilis, mycoplasma, lymphoma and infectious mononucleosis. SLE like syndrome- Phenytoin, penicillamine, hydralazine, procanamide. Cystic fibrosis - autosomal recessive Sex linked recessive- G6PD deficiency, Hemophilia Focal glomerulo-nephritis- Post- streptococcal. Hypersegmented polymorphs- in macrocytic anaemia- B12/ folate deficiency. Mononeuritis multiplex is seen in Leprosy. Period of maximal infectivity in rubella 5-6 week. Intestinal parasite in immuno-compromised patient is Strongyloids- it also completes it entire life cycle in human body. Paradoxical splitting in AS, severe HTN, co-arcatation of aorta, left bundle branch block. Hypervitaminosis- A causes- Anorexia, Loss of hair, bony swelling, hypertension, peripheral neurtis. Central necrosis in liver is seen in CCl4 poisoning and CCF. Peripheral necrosis in liver is due to phosphorus poisoning.

Commonest complication of mumps in child is aseptic meningitis. Commonest complication of mumps is adult is orchitis. Mumps incubation period is 18 days. Commonest complication of measles in child is secondary bacterial pneumonia. SAH best investigated by CT scan. Constritive pericarditis is seen in- uremia, tuberculosis, and purulent pericardial effusion. Commonest cardiomyopathy- DCM Commonest congenital heart disease is VSD. Commonest congenital cyanotic heart disease is TOF. Commonest congenital heart disease in adult is bicuspid aortic valve. Widows artery is left anterior descending artery. TOF= VSD, RVH, PS and over riding of aorta. SAH is due to rupture of Berrys aneurysm. Giant A wave- PS, TS and pulmonary HTN. Canon A wave seen in TR and complete heart block. Downs syndrome- trisomy 21 Edwards syndrome- trisomy 18 Pataus syndrome trisomy 13. Klinefilters syndrome- 47XXY Achondroplasia- Autosomal dominant. Ankylosing spondylitis- HLA-B27. Vitamin resistant rickets is transmitted as X-linked dominant. Most deaths in MI occur with in the first hour. Red- currant jelly sputum in Klebsiella pneunmoniae pneumonia.

Glutamic acid goes and valine visits at 6th positon of aminoacid chain in sickle cell anaemia. Osteo- arthritis= PIP- Bouchards node. DIP Heberdens node. Feltys syndrome- RA+ splenomegaly + neutropenia. Caplans syndrome = RA+ pneumoconiosis. Shrinking lungs- SLE Wireloop nephrosis, Libmann Sach endocarditis- SLE. Caudate nucleus lesion leads to chorea. Meningococcal meningitis prophylaxis Rifampcin. Broad cast in urine is diagnostic of chronic glomerulonephritis. Dissociated sensory loss is seen in- Syringomyelia. Prophylactic dose of tetanus immunoglobulin is 250 IU. Cyanide poisoning treatment is amyl nitrate. Bloody mucoid diarrhea is seen in shigella, salmonella, and campylobacter. Rice water stool is seen in Vibrio cholerae. Hamman Rich syndrome treated with steroid. Hemiballism is caused by lesion in contralateral subthalamic nuclei. Niacin deficiency- diarrhea / dermatitis / dementia Staphylococcus aureus commensal in nose. Saddle back type of temperature is seen in dengue fever. Tall tented T waves seen in hyperkalaemia. U wave in hypokalaemia. Hypercalcemai-short QT interval. Hypocalcemia- prolonged QT interval. MI death occurs in first hour and first day, cause is ventricular fibrillation. Bence Jones protein- Mutliple myeloma. Liver biopsy is done by Vim Silvermann needle. Dresslersyndrome is post- myocardial infection. KF ring is seen in hepato lenticular degeneration.

Pin point pupil, pyrexai and unconsciousness seen in pontine hemorrhage. Crackling crepitation is seen in interstitial lung disease. VF treat with DC cardioversion. Hyperpathia is seen in thalamic syndrome. Christmas disease is factor IX deficiency. Levamisole is immunostimulant. Fenfluramine is used to treat obesity. Black urine is seen in Alkaptonuria, black water fever, melanuria and bilirubinuria. Green urine is seen in- oxalate poisoning. Angular fissure is treated with riboflavin. Geographic tongue does not require the treatment. Low glucose in pleural effusion is seen in RA, mesothelioma, empyema, Pardees sign is seen in MI. Insensible daily water loss is 800 1000ml. Earliest change to occur in puberty in boys is enlargement of testes. Rash in measles occur occurs in 4th day of fever.