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COH – MSN – ONE LINER IMP POINTS

KEY IMPORTANTS

OT TECHNIQUE, SURGERY ONE LINER POINTS.

  1. Aseptic technique is the cornerstone of infection prevention in the operation theatre (OT).
  2. Laminar airflow with HEPA filters reduces airborne contamination during surgeries.
  3. Positive pressure ventilation prevents contaminated air from entering the OT.
  4. Autoclaving at 121°C for 15–20 minutes is the gold standard for sterilizing surgical instruments.
  5. Ethylene oxide (ETO) sterilization is used for heat-sensitive medical equipment.
  6. Bacillocid is a broad-spectrum disinfectant commonly used for OT surface sterilization.
  7. Terminal cleaning of the OT is done at the end of each day to maintain sterility.
  8. Surgical scrub time is typically 5 minutes for the first case and 3 minutes for subsequent cases.
  9. Closed gloving technique is preferred for maintaining sterility during surgical procedures.
  10. Trendelenburg position is used in lower abdominal and pelvic surgeries to improve venous return.
  11. Lithotomy position is commonly used for gynecological and urological surgeries.
  12. Fenestrated drapes are used to isolate the surgical site while maintaining a sterile field.
  13. Absorbable sutures like Vicryl and PDS do not require removal as they degrade naturally.
  14. Non-absorbable sutures such as silk and nylon are used for skin closure and require removal.
  15. Cutting needles are ideal for suturing tough tissues like the skin.
  16. Tapered needles are used for delicate, soft tissues like intestines and blood vessels.
  17. Malignant hyperthermia, a life-threatening reaction to anesthesia, is treated with dantrolene.
  18. Aldrete score ≥9 indicates readiness for discharge from the post-anesthesia care unit (PACU).
  19. Spinal anesthesia is injected into the subarachnoid space, typically at the L3–L4 level.
  20. Epidural anesthesia is administered in the epidural space, commonly for labor analgesia.
  21. Local anesthetic toxicity is treated with lipid emulsion therapy.
  22. Conscious sedation allows patients to remain awake but relaxed during minor procedures.
  23. Post-operative NPO status is maintained until bowel sounds return after abdominal surgery.
  24. Early ambulation post-surgery helps prevent deep vein thrombosis (DVT) and pneumonia.
  25. Post-operative urinary output should be at least 0.5 mL/kg/hour to ensure renal function.
  26. Hypotension after surgery often indicates bleeding or hypovolemia and requires immediate assessment.
  27. Wound dehiscence requires covering with sterile saline-soaked gauze and urgent surgical evaluation.
  28. Airway obstruction is the most common cause of post-operative respiratory complications.
  29. Patient-controlled analgesia (PCA) allows patients to manage their own pain medication safely.
  30. Time-out procedure is a mandatory surgical safety step before any incision is made.
  31. Hypoxia signs in post-op patients include restlessness, agitation, and cyanosis.
  32. Informed consent is legally required before any surgical procedure, except in emergencies.
  33. DVT prophylaxis includes compression stockings and anticoagulant therapy post-operatively.
  34. Pulmonary embolism (PE) presents with sudden chest pain, dyspnea, and requires immediate intervention.
  35. Post-dural puncture headache is a common complication of spinal anesthesia, treated with hydration and analgesics.
  36. Fowler’s position is used post-operatively to reduce the risk of aspiration and improve lung expansion.
  37. Hemorrhagic shock after surgery is managed with rapid fluid resuscitation and blood transfusions.
  38. NG tube decompression is used to manage paralytic ileus post-abdominal surgery.
  39. Capnography is used during anesthesia to monitor end-tidal CO₂, ensuring adequate ventilation.
  40. Urinary retention post-surgery may require bladder catheterization for relief.
  41. Anticholinergic drugs like atropine reduce secretions during general anesthesia.
  42. Ondansetron is commonly used for the prevention of post-operative nausea and vomiting.
  43. Surgical sponges and instruments must be counted before and after surgery to prevent retained foreign bodies.
  44. Hypothermia in the post-op period can be prevented with warming blankets and fluid warmers.
  45. Splinting an incision with a pillow reduces pain when coughing after abdominal surgery.
  46. First post-op dressing change is typically done by the surgeon unless there’s excessive bleeding.
  47. Pneumonia prevention post-op includes incentive spirometry and deep breathing exercises.
  48. Early signs of shock include tachycardia, cool clammy skin, and hypotension.
  49. Suction equipment must be checked and ready for immediate use during surgery.
  50. Anaphylactic reactions to anesthesia require immediate administration of epinephrine.
  51. Retention sutures are used in high-tension wounds to prevent dehiscence.
  52. Anesthesia reversal agents include naloxone (opioids) and flumazenil (benzodiazepines).
  53. Deep breathing exercises post-op help prevent atelectasis.
  54. Leg exercises are encouraged post-op to promote circulation and prevent thromboembolic events.
  55. Hand hygiene is the single most effective measure to prevent surgical site infections.
  56. Perioperative antibiotic prophylaxis should be given within 60 minutes before incision.
  57. GCS score ≤8 indicates a severe impairment of consciousness and requires airway protection.
  58. Cricoid pressure during intubation reduces the risk of aspiration.
  59. Hypoglycemia should be monitored in diabetic patients post-operatively.
  60. Esmarch bandage is used to exsanguinate a limb before applying a tourniquet in limb surgeries.
  61. Rapid sequence induction (RSI) is used in patients at high risk of aspiration during anesthesia.
  62. NPO guidelines: No solid food for 6–8 hours and clear fluids allowed up to 2 hours before surgery.
  63. Patient positioning during surgery should prevent nerve injury and pressure ulcers.
  64. Post-operative cognitive dysfunction (POCD) is more common in elderly patients after general anesthesia.
  65. Venous air embolism risk increases in surgeries performed in the sitting position.
  66. Hypokalemia can cause post-op ileus and arrhythmias, requiring electrolyte correction.
  67. Chest physiotherapy post-op aids in lung expansion and secretion clearance.
  68. Splenectomy patients require vaccinations against encapsulated organisms post-operatively.
  69. Positive pressure ventilation can cause barotrauma if not carefully monitored.
  70. Jackson-Pratt drain is a closed-suction device commonly used in post-op wound management.
  71. Nasogastric tube placement helps decompress the stomach after abdominal surgeries.
  72. Surgical site infections (SSI) usually present within 30 days post-op with redness, swelling, and pus.
  73. Bair Hugger device helps maintain normothermia during surgery.
  74. Sterile gloves must be changed immediately if torn or contaminated during surgery.
  75. Hypovolemia is the most common cause of hypotension in the immediate post-op period.
  76. Delirium tremens can occur post-op in alcohol-dependent patients if not managed properly.
  77. T-tube is used to drain bile after common bile duct surgeries.
  78. Oliguria (<30 mL/hr urine output) post-op may indicate hypovolemia or renal impairment.
  79. Air embolism is managed by placing the patient in the left lateral decubitus and Trendelenburg position.
  80. Surgical safety checklist reduces surgical complications and improves patient outcomes.
  81. Pain management post-op should include both pharmacological and non-pharmacological methods.
  82. Suction drain output should be monitored for color, consistency, and volume.
  83. Anticoagulant prophylaxis is critical in post-op orthopedic surgeries to prevent DVT.
  84. Hypocalcemia after thyroid surgery presents with tetany and requires calcium supplementation.
  85. Post-op hypotension unresponsive to fluids may indicate internal bleeding or sepsis.
  86. Return of bowel sounds is the earliest sign of resolving post-op ileus.
  87. Tracheostomy care requires sterile technique to prevent infection.
  88. Anesthesia machine checks are mandatory before starting any surgical procedure.
  89. Positive fluid balance post-op may indicate fluid overload or poor renal function.
  90. Glucose monitoring is essential in diabetic patients to prevent hyperglycemia post-op.
  91. Vigilant airway monitoring is crucial during emergence from anesthesia.
  92. Bladder scan helps assess urinary retention post-operatively without catheterization.
  93. Hypomagnesemia post-op can cause arrhythmias and should be corrected promptly.
  94. Vascular surgeries require strict BP control post-op to prevent bleeding complications.
  95. Ankle pumps and leg lifts prevent venous stasis post-surgery.
  96. Dressing changes should be done with aseptic technique to prevent SSIs.
  97. NG tube drainage should be monitored for amount, color, and consistency post-operatively.
  98. PCA pumps should be set up and monitored by trained nursing staff only.
  99. Shock position (Trendelenburg) can temporarily improve circulation in hypotensive patients.
  100. Hypoxia is the most common cause of agitation in post-operative patients.

Important One-Liner Points on Neurological Disorders

  1. Glasgow Coma Scale (GCS) is used to assess the level of consciousness in neurological patients.
  2. Increased intracranial pressure (ICP) is indicated by Cushing’s triad: hypertension, bradycardia, and irregular respiration.
  3. Meningitis presents with fever, neck stiffness, and altered mental status (classic triad).
  4. Brudzinski’s sign is positive when neck flexion causes involuntary hip and knee flexion, indicating meningeal irritation.
  5. Kernig’s sign is positive when there is resistance and pain with knee extension while the hip is flexed.
  6. Papilledema is a key sign of increased intracranial pressure.
  7. CT scan without contrast is the first investigation for suspected stroke.
  8. Ischemic stroke is managed with thrombolytic therapy (tPA) within 4.5 hours of symptom onset.
  9. Hemorrhagic stroke requires blood pressure control and surgical intervention if indicated.
  10. Transient ischemic attack (TIA) is a mini-stroke with symptoms resolving within 24 hours.
  11. Seizures are classified as focal (partial) or generalized based on the area of brain involvement.
  12. Status epilepticus is a medical emergency defined as continuous seizure activity lasting >5 minutes.
  13. Lorazepam or diazepam is the first-line drug for status epilepticus.
  14. Epilepsy is diagnosed after two or more unprovoked seizures.
  15. Phenytoin toxicity can cause nystagmus, ataxia, and gingival hyperplasia.
  16. Migraine aura typically presents with visual disturbances like flashing lights or blind spots.
  17. Triptans are the first-line treatment for acute migraine attacks.
  18. Cluster headaches are severe, unilateral headaches with tearing and nasal congestion.
  19. Parkinson’s disease is characterized by resting tremor, bradykinesia, rigidity, and postural instability.
  20. Levodopa-carbidopa is the gold standard for Parkinson’s disease treatment.
  21. Myasthenia gravis presents with muscle weakness that worsens with activity and improves with rest.
  22. Edrophonium (Tensilon) test is used to diagnose myasthenia gravis.
  23. Guillain-Barré syndrome (GBS) is an acute demyelinating condition causing ascending paralysis.
  24. Plasmapheresis or IVIG is the treatment of choice for Guillain-Barré syndrome.
  25. Multiple sclerosis (MS) is an autoimmune demyelinating disease with relapsing-remitting symptoms.
  26. MRI with contrast is the diagnostic tool of choice for multiple sclerosis.
  27. Optic neuritis is often the first presenting symptom of multiple sclerosis.
  28. Alzheimer’s disease is the most common cause of dementia in the elderly.
  29. Donepezil and rivastigmine are used to manage symptoms of Alzheimer’s disease.
  30. Amyotrophic lateral sclerosis (ALS) causes progressive muscle weakness without sensory loss.
  31. Bell’s palsy is an acute, unilateral facial nerve paralysis, often idiopathic.
  32. Steroids are the main treatment for Bell’s palsy.
  33. Trigeminal neuralgia causes severe, stabbing facial pain triggered by touch or movement.
  34. Carbamazepine is the drug of choice for trigeminal neuralgia.
  35. Huntington’s disease is a genetic disorder causing chorea, psychiatric symptoms, and cognitive decline.
  36. Subdural hematoma is common in elderly patients and alcoholics due to brain atrophy.
  37. Extradural (epidural) hematoma often presents with a lucid interval after head trauma.
  38. Basilar skull fracture can cause raccoon eyes, Battle’s sign, and CSF rhinorrhea or otorrhea.
  39. Decerebrate posturing indicates brainstem damage and is worse than decorticate posturing.
  40. Spinal cord injury above C5 can cause respiratory paralysis due to diaphragm involvement.
  41. Brown-Séquard syndrome results from hemisection of the spinal cord, causing ipsilateral motor loss and contralateral pain/temp loss.
  42. Cauda equina syndrome presents with saddle anesthesia, bowel/bladder dysfunction, and is a surgical emergency.
  43. Encephalitis often presents with fever, headache, seizures, and altered mental status.
  44. Herpes simplex virus is the most common cause of viral encephalitis.
  45. Brain abscess typically presents with headache, fever, and focal neurological deficits.
  46. Cerebral palsy is a non-progressive motor disorder caused by brain injury in the developing fetus or infant.
  47. Hydrocephalus is characterized by increased CSF accumulation, leading to increased intracranial pressure.
  48. Normal pressure hydrocephalus (NPH) presents with the triad: gait disturbance, dementia, and urinary incontinence.
  49. Cerebral aneurysms can cause subarachnoid hemorrhage, presenting as the “worst headache of life.”
  50. Meningiomas are usually benign, slow-growing brain tumors arising from the meninges.
  51. Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor.
  52. Spinal cord tumors can cause back pain, motor weakness, and sensory deficits.
  53. Herniated intervertebral disc can cause radicular pain, commonly affecting the lumbar spine.
  54. Lhermitte’s sign (electric shock sensation down the spine) is seen in multiple sclerosis.
  55. Romberg’s test helps assess proprioception and cerebellar function.
  56. Babinski sign indicates upper motor neuron lesion when the great toe dorsiflexes upon plantar stimulation.
  57. Pronator drift test is used to detect subtle upper motor neuron weakness.
  58. Post-concussion syndrome includes headache, dizziness, and cognitive disturbances after a head injury.
  59. Neurogenic shock occurs after spinal cord injury, causing hypotension and bradycardia.
  60. Autonomic dysreflexia is a life-threatening complication of spinal cord injury above T6, causing severe hypertension.
  61. Charcot-Marie-Tooth disease is an inherited peripheral neuropathy causing foot drop and muscle wasting.
  62. Muscular dystrophies are genetic disorders causing progressive muscle weakness (e.g., Duchenne’s).
  63. Cerebrospinal fluid (CSF) analysis is essential in diagnosing infections like meningitis and subarachnoid hemorrhage.
  64. Xanthochromia in CSF indicates subarachnoid hemorrhage.
  65. EEG (electroencephalogram) is used to diagnose epilepsy and other seizure disorders.
  66. Carotid endarterectomy is performed to prevent strokes in patients with significant carotid artery stenosis.
  67. Myoclonic seizures involve sudden, brief jerking movements without loss of consciousness.
  68. Absence seizures (petit mal) are brief episodes of staring, common in children.
  69. Cushing’s reflex indicates raised ICP with bradycardia, hypertension, and irregular breathing.
  70. Hypoglycemia can mimic stroke symptoms; always check blood sugar in altered mental status.
  71. Nuchal rigidity is a hallmark sign of meningeal irritation.
  72. Ataxia refers to lack of muscle coordination, commonly due to cerebellar dysfunction.
  73. Dysarthria is slurred or slow speech due to motor control issues.
  74. Aphasia is an impairment in language ability, commonly due to stroke in the dominant hemisphere.
  75. Wernicke’s aphasia affects comprehension, while Broca’s aphasia affects speech production.
  76. Paresthesia refers to abnormal sensations like tingling or “pins and needles.”
  77. Resting tremor is characteristic of Parkinson’s disease, while intention tremor suggests cerebellar lesions.
  78. Syncope is a transient loss of consciousness due to reduced cerebral perfusion.
  79. Vertigo is a false sensation of movement, often due to vestibular dysfunction.
  80. Guillain-Barré syndrome often follows viral infections like Campylobacter jejuni.
  81. Botulism toxin causes descending paralysis and is associated with canned food poisoning.
  82. Neurofibromatosis is a genetic disorder causing café-au-lait spots and nerve tumors.
  83. Tonic-clonic seizures involve stiffening (tonic) followed by jerking (clonic) of muscles.
  84. Vagus nerve stimulation is a treatment option for drug-resistant epilepsy.
  85. Amyloid plaques and neurofibrillary tangles are pathological hallmarks of Alzheimer’s disease.
  86. Essential tremor improves with alcohol consumption, unlike Parkinson’s tremor.
  87. Miller Fisher syndrome is a variant of Guillain-Barré with ophthalmoplegia, ataxia, and areflexia.
  88. Subarachnoid hemorrhage can cause photophobia and neck stiffness due to meningeal irritation.
  89. Hypokalemia can cause muscle weakness and paralysis, mimicking neurological disorders.
  90. Wernicke’s encephalopathy is due to thiamine deficiency, seen in chronic alcoholics.
  91. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotic drugs with fever and rigidity.
  92. Cervical spine injury should be assumed in all trauma patients with altered mental status.
  93. Lead poisoning can cause peripheral neuropathy, especially in children.
  94. Tay-Sachs disease is a genetic disorder causing neurodegeneration in infants.
  95. Neurogenic bladder results from nerve damage affecting bladder control.
  96. Hyperreflexia is a sign of upper motor neuron lesions.
  97. Hyporeflexia suggests lower motor neuron involvement.
  98. Cerebellar lesions cause dysmetria, dysdiadochokinesia, and ataxia.
  99. Locked-in syndrome results from brainstem injury where the patient is conscious but unable to move.
  100. Tension headaches are bilateral, pressing, and not aggravated by physical activity.

Important One-Liner Points on Breast and Integumentary Disorders


Breast Disorders

  1. Fibroadenoma is the most common benign breast tumor in young women.
  2. Breast cancer most commonly arises from the ductal epithelium (invasive ductal carcinoma).
  3. Triple assessment for breast lumps includes clinical examination, imaging (mammography/ultrasound), and biopsy.
  4. Peau d’orange appearance in the breast indicates lymphatic obstruction, often seen in breast cancer.
  5. Paget’s disease of the breast presents as eczematous changes around the nipple, often associated with underlying carcinoma.
  6. Mammography is the gold standard for breast cancer screening, especially in women over 40.
  7. Tamoxifen is a selective estrogen receptor modulator used in hormone receptor-positive breast cancer.
  8. BRCA1 and BRCA2 mutations significantly increase the risk of breast and ovarian cancers.
  9. Mastitis is an infection of the breast tissue, common in breastfeeding women, caused by Staphylococcus aureus.
  10. Breast cysts are fluid-filled sacs commonly found in women aged 35–50 and are usually benign.
  11. Gynecomastia is the benign enlargement of male breast tissue, often due to hormonal imbalances or medications.
  12. Sentinel lymph node biopsy is performed to assess the spread of breast cancer.
  13. Inflammatory breast cancer is an aggressive form of breast cancer presenting with redness, swelling, and warmth.
  14. Breast self-examination (BSE) should be performed monthly after menstruation.
  15. Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer confined within the ducts.
  16. Lumpectomy with radiation therapy is a breast-conserving treatment for early-stage breast cancer.
  17. Nipple discharge that is bloody or unilateral warrants further investigation for malignancy.
  18. Fine needle aspiration cytology (FNAC) is used for quick evaluation of breast lumps.
  19. Hormone receptor-positive breast cancers respond well to endocrine therapy like tamoxifen or aromatase inhibitors.
  20. Triple-negative breast cancer lacks estrogen, progesterone, and HER2 receptors, making it more aggressive.

Integumentary (Skin) Disorders

  1. Psoriasis is a chronic autoimmune skin condition characterized by silvery scales on erythematous plaques.
  2. Koebner phenomenon refers to the appearance of new skin lesions at sites of trauma, commonly seen in psoriasis.
  3. Melanoma is the most dangerous type of skin cancer, often identified using the ABCDE criteria (Asymmetry, Border, Color, Diameter, Evolving).
  4. Basal cell carcinoma is the most common skin cancer, typically slow-growing with a pearly appearance.
  5. Squamous cell carcinoma often presents as a scaly, ulcerated lesion, commonly on sun-exposed areas.
  6. Vitiligo is characterized by depigmented white patches due to the loss of melanocytes.
  7. Acne vulgaris is caused by inflammation of the pilosebaceous units, common during adolescence.
  8. Eczema (atopic dermatitis) presents with dry, itchy, inflamed skin, often linked to allergies.
  9. Tinea infections (ringworm) are fungal infections of the skin caused by dermatophytes.
  10. Scabies is caused by the mite Sarcoptes scabiei, leading to intense itching, especially at night.
  11. Pemphigus vulgaris is an autoimmune blistering disorder characterized by flaccid blisters and positive Nikolsky’s sign.
  12. Bullous pemphigoid presents with large, tense blisters, commonly in the elderly.
  13. Urticaria (hives) is a hypersensitivity reaction causing itchy, raised wheals.
  14. Erythema multiforme presents with target-like lesions, often triggered by infections or medications.
  15. Stevens-Johnson syndrome (SJS) is a severe skin reaction with mucosal involvement, often drug-induced.
  16. Contact dermatitis occurs due to skin exposure to allergens or irritants.
  17. Alopecia areata is an autoimmune condition causing sudden, patchy hair loss.
  18. Onychomycosis is a fungal infection of the nails causing thickening and discoloration.
  19. Hidradenitis suppurativa is a chronic inflammatory skin condition affecting apocrine glands, leading to abscesses and scarring.
  20. Cellulitis is a bacterial skin infection causing redness, warmth, swelling, and pain, commonly due to Streptococcus or Staphylococcus.
  21. Necrotizing fasciitis is a rapidly progressing soft tissue infection, often called “flesh-eating disease.”
  22. Vitiligo treatment includes topical corticosteroids, phototherapy, and depigmentation therapy in severe cases.
  23. Erythroderma is widespread skin redness and scaling involving over 90% of the body surface area.
  24. Ichthyosis vulgaris is characterized by dry, scaly skin resembling fish scales.
  25. Molluscum contagiosum is a viral skin infection causing small, umbilicated papules.
  26. Lichen planus presents with pruritic, purple, polygonal, planar papules, often affecting the wrists and oral mucosa.
  27. Herpes zoster (shingles) is caused by reactivation of the varicella-zoster virus, presenting with a painful dermatomal rash.
  28. Rosacea is a chronic skin condition causing facial redness, flushing, and visible blood vessels.
  29. Pityriasis rosea presents with a “herald patch” followed by a Christmas-tree pattern rash.
  30. Dermatitis herpetiformis is associated with celiac disease and presents with intensely itchy vesicles on elbows and knees.
  31. Seborrheic dermatitis affects oily areas like the scalp and face, causing flaky, greasy scales.
  32. Keloids are overgrowths of scar tissue that extend beyond the original wound.
  33. Hyperpigmentation can be caused by conditions like Addison’s disease or post-inflammatory changes.
  34. Lupus erythematosus can cause a characteristic butterfly rash on the face.
  35. Vitiligo is often associated with other autoimmune disorders like thyroid disease and type 1 diabetes.
  36. Hemangiomas are benign vascular tumors commonly seen in infants, often resolving spontaneously.
  37. Melasma causes hyperpigmented patches on the face, often triggered by sun exposure or pregnancy.
  38. Actinic keratosis is a precancerous skin lesion due to sun damage, with a risk of progression to squamous cell carcinoma.
  39. Xanthelasma are yellowish plaques on the eyelids, often associated with hyperlipidemia.
  40. Cherry angiomas are benign, bright red papules common in older adults.
  41. Pilonidal cysts occur near the tailbone and can become infected, causing pain and swelling.
  42. Decubitus ulcers (pressure sores) develop due to prolonged pressure, especially over bony prominences.
  43. Frostbite causes tissue damage due to freezing, leading to numbness, blisters, and blackened skin.
  44. Sunburn is an acute inflammatory reaction of the skin caused by excessive UV radiation exposure.
  45. Hyperhidrosis is excessive sweating, often treated with antiperspirants or botulinum toxin injections.
  46. Sebaceous cysts are non-cancerous, slow-growing bumps filled with sebum.
  47. Warts are caused by the human papillomavirus (HPV), presenting as rough, raised lesions.
  48. Impetigo is a contagious bacterial skin infection with honey-colored crusts, common in children.
  49. Vitiligo lesions are depigmented, not hypopigmented, meaning they completely lack melanin.
  50. Polymorphic light eruption is a sun-induced rash presenting with itchy red bumps.
  51. Tinea versicolor is a superficial fungal infection causing hypopigmented or hyperpigmented patches.
  52. Boils (furuncles) are painful, pus-filled bumps caused by infected hair follicles.
  53. Abscess is a localized collection of pus that requires incision and drainage.
  54. Angioedema is rapid swelling of the deeper layers of the skin, often due to an allergic reaction.
  55. Neurofibromatosis type 1 presents with café-au-lait spots, neurofibromas, and axillary freckling.
  56. Vitiligo can be differentiated from tinea versicolor by the absence of scaling.
  57. Leprosy (Hansen’s disease) causes hypopigmented, anesthetic skin patches with peripheral nerve thickening.
  58. Erysipelas is a superficial skin infection with well-demarcated, raised borders, caused by Streptococcus.
  59. Shingles vaccination is recommended for adults over 50 to prevent herpes zoster.
  60. Kaposi’s sarcoma is a vascular tumor associated with HIV/AIDS, presenting as purple skin lesions.
  61. Acanthosis nigricans presents as dark, velvety skin thickening, often linked to insulin resistance.
  62. Nail clubbing can be a sign of chronic hypoxia, lung cancer, or heart disease.
  63. Nail pitting is commonly seen in psoriasis.
  64. Beau’s lines are horizontal grooves in the nails, indicating a history of severe illness or stress.
  65. Terry’s nails show a white discoloration with a pink distal band, often associated with liver disease.
  66. Onycholysis is the separation of the nail from the nail bed, commonly due to trauma or fungal infection.
  67. Paronychia is an infection of the skin around the nails, often caused by bacteria or fungi.
  68. Hirsutism refers to excessive hair growth in women in a male pattern distribution.
  69. Vitiligo is not contagious and does not affect physical health, but can have psychological effects.
  70. Milia are small white cysts commonly seen on the face of newborns.
  71. Dandruff is a mild form of seborrheic dermatitis affecting the scalp.
  72. Scalded skin syndrome is caused by Staphylococcus aureus, leading to widespread skin peeling in infants.
  73. Lichen simplex chronicus results from chronic scratching, causing thickened, leathery skin.
  74. Granuloma annulare presents as ring-shaped, reddish bumps on the skin, often self-limiting.
  75. Telangiectasia are small, dilated blood vessels visible on the skin surface.
  76. Ichthyosis refers to dry, scaly skin conditions resembling fish scales.
  77. Porphyria cutanea tarda causes blistering skin lesions on sun-exposed areas, linked to liver disease.
  78. Epidermolysis bullosa is a genetic condition causing fragile skin that blisters easily.
  79. Xerosis refers to abnormally dry skin, common in elderly individuals.
  80. Vitiligo treatment may involve topical corticosteroids, phototherapy, and cosmetic camouflage.

Important One-Liner Points on Metabolic and Endocrine Disorders.


1. Metabolic Disorders

  1. Diabetes mellitus is characterized by chronic hyperglycemia due to insulin deficiency or resistance.
  2. Type 1 diabetes is an autoimmune condition resulting in absolute insulin deficiency.
  3. Type 2 diabetes is caused by insulin resistance and relative insulin deficiency.
  4. HbA1c ≥6.5% is diagnostic of diabetes mellitus.
  5. Diabetic ketoacidosis (DKA) presents with hyperglycemia, ketonemia, and metabolic acidosis.
  6. Kussmaul respiration is a deep, labored breathing pattern seen in DKA.
  7. Hyperosmolar hyperglycemic state (HHS) occurs in type 2 diabetes with severe hyperglycemia without ketosis.
  8. Metformin is the first-line oral drug for type 2 diabetes management.
  9. Hypoglycemia is defined as blood glucose <70 mg/dL, causing sweating, tremors, and confusion.
  10. Glucagon injection is used to treat severe hypoglycemia in unconscious patients.
  11. Obesity is defined as a body mass index (BMI) ≥30 kg/m².
  12. Metabolic syndrome includes abdominal obesity, hypertension, hyperglycemia, low HDL, and high triglycerides.
  13. Phenylketonuria (PKU) is a genetic disorder caused by phenylalanine hydroxylase deficiency, leading to mental retardation if untreated.
  14. Maple syrup urine disease is characterized by sweet-smelling urine due to branched-chain amino acid metabolism defects.
  15. Gout is caused by hyperuricemia, leading to joint inflammation and uric acid crystal deposition.
  16. Allopurinol is used to lower uric acid levels in chronic gout.
  17. Wilson’s disease is a disorder of copper metabolism causing liver and neurological damage.
  18. Kayser-Fleischer rings in the cornea are characteristic of Wilson’s disease.
  19. Hemochromatosis is iron overload disorder causing liver cirrhosis, diabetes, and skin pigmentation.
  20. Hypokalemia causes muscle weakness, cramps, and cardiac arrhythmias.
  21. Hyperkalemia can cause life-threatening cardiac arrhythmias, treated with calcium gluconate.
  22. Hyponatremia presents with confusion, seizures, and can be caused by SIADH.
  23. Hypernatremia leads to dehydration symptoms like thirst, irritability, and lethargy.
  24. Hypocalcemia causes tetany, positive Chvostek’s and Trousseau’s signs.
  25. Hypercalcemia symptoms include “stones, bones, groans, and psychic overtones.”
  26. Vitamin D deficiency causes rickets in children and osteomalacia in adults.
  27. Scurvy is due to vitamin C deficiency, causing bleeding gums and poor wound healing.
  28. Beriberi results from thiamine (vitamin B1) deficiency, affecting the heart and nervous system.
  29. Wernicke-Korsakoff syndrome is caused by thiamine deficiency, common in chronic alcoholics.
  30. Obesity-related complications include type 2 diabetes, hypertension, and cardiovascular disease.

2. Endocrine Disorders

  1. Pituitary adenomas can cause hormonal imbalances, including prolactinomas leading to galactorrhea.
  2. Acromegaly is caused by excess growth hormone in adults, leading to enlarged hands, feet, and facial features.
  3. Gigantism occurs due to growth hormone excess before epiphyseal plate closure in children.
  4. Diabetes insipidus (DI) is characterized by polyuria and polydipsia due to ADH deficiency or resistance.
  5. SIADH (Syndrome of Inappropriate ADH Secretion) causes hyponatremia due to water retention.
  6. Hypothyroidism presents with fatigue, weight gain, cold intolerance, and bradycardia.
  7. Hashimoto’s thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions.
  8. Myxedema coma is a life-threatening complication of severe hypothyroidism.
  9. Hyperthyroidism (thyrotoxicosis) presents with weight loss, heat intolerance, tremors, and palpitations.
  10. Graves’ disease is the most common cause of hyperthyroidism, associated with exophthalmos.
  11. Thyroid storm is a life-threatening exacerbation of hyperthyroidism.
  12. Goiter is an enlargement of the thyroid gland due to iodine deficiency or thyroid disorders.
  13. Fine-needle aspiration biopsy (FNAB) is the investigation of choice for thyroid nodules.
  14. Cretinism is congenital hypothyroidism leading to mental retardation and growth failure.
  15. Addison’s disease is primary adrenal insufficiency causing hypotension, hyperpigmentation, and electrolyte imbalance.
  16. Adrenal crisis is an emergency requiring immediate hydrocortisone administration.
  17. Cushing’s syndrome results from excess cortisol, causing moon face, buffalo hump, and central obesity.
  18. Dexamethasone suppression test is used to diagnose Cushing’s syndrome.
  19. Pheochromocytoma is a catecholamine-secreting tumor causing episodic hypertension, headache, and sweating.
  20. 24-hour urinary metanephrines are used to diagnose pheochromocytoma.
  21. Primary hyperaldosteronism (Conn’s syndrome) causes hypertension and hypokalemia.
  22. Parathyroid hormone (PTH) regulates calcium and phosphate metabolism.
  23. Hyperparathyroidism leads to hypercalcemia, bone resorption, and kidney stones.
  24. Hypoparathyroidism causes hypocalcemia with neuromuscular irritability.
  25. Insulinoma is a pancreatic tumor causing hypoglycemia due to excess insulin secretion.
  26. Glucagonoma causes diabetes, weight loss, and a characteristic rash (necrolytic migratory erythema).
  27. Multiple endocrine neoplasia (MEN) syndromes involve tumors in multiple endocrine glands.
  28. MEN 1 involves tumors of the parathyroid, pancreas, and pituitary.
  29. MEN 2 includes medullary thyroid carcinoma, pheochromocytoma, and parathyroid hyperplasia.
  30. Thyroid peroxidase antibodies are present in autoimmune thyroid disorders like Hashimoto’s thyroiditis.
  31. Thyroid function tests (TFTs) include TSH, free T4, and free T3 measurements.
  32. Radioactive iodine uptake (RAIU) scan helps differentiate causes of hyperthyroidism.
  33. Hypopituitarism causes deficiencies in multiple hormones, often due to pituitary tumors.
  34. Sheehan’s syndrome is postpartum pituitary necrosis leading to hypopituitarism.
  35. Galactorrhea is inappropriate lactation, often due to prolactinomas.
  36. Hyperprolactinemia can cause infertility, amenorrhea, and galactorrhea in women.
  37. Prolactin-secreting tumors are treated with dopamine agonists like bromocriptine or cabergoline.
  38. Craniopharyngiomas are benign brain tumors affecting the pituitary in children.
  39. Diabetic foot ulcers result from neuropathy, poor circulation, and infection.
  40. Glucocorticoids have anti-inflammatory and immunosuppressive effects.
  41. Primary hyperaldosteronism leads to metabolic alkalosis due to potassium loss.
  42. Hyperandrogenism in women causes hirsutism, acne, and menstrual irregularities.
  43. Polycystic ovary syndrome (PCOS) is associated with insulin resistance and hyperandrogenism.
  44. Thyroid nodules are more likely malignant if they are hard, fixed, and rapidly growing.
  45. Medullary thyroid carcinoma is associated with MEN 2 syndromes.
  46. Hypoglycemia unawareness occurs in long-standing diabetics due to autonomic neuropathy.
  47. Insulin resistance is a hallmark of metabolic syndrome and type 2 diabetes.
  48. Vitamin D toxicity causes hypercalcemia, leading to weakness, nausea, and kidney stones.
  49. Rickets presents with bowing of the legs in children due to vitamin D deficiency.
  50. Cushing’s disease refers specifically to pituitary ACTH-secreting tumors causing Cushing’s syndrome.
  51. Adrenal adenomas are the most common cause of Cushing’s syndrome.
  52. Thyroid storm management includes beta-blockers, antithyroid drugs, and supportive care.
  53. Hypothyroidism during pregnancy requires increased levothyroxine dosage.
  54. Diabetic retinopathy is a common microvascular complication of diabetes leading to vision loss.
  55. Diabetic nephropathy presents with proteinuria and is managed by controlling blood sugar and BP.
  56. Glycemic control in diabetics reduces the risk of microvascular complications.
  57. Hypokalemia management includes potassium supplementation and correcting the underlying cause.
  58. Osteoporosis is characterized by low bone density, increasing fracture risk.
  59. Bisphosphonates are the first-line treatment for osteoporosis.
  60. Hyperglycemia symptoms include polyuria, polydipsia, and weight loss.
  61. Insulin therapy is required for type 1 diabetes and uncontrolled type 2 diabetes.
  62. Goiter in iodine deficiency is due to compensatory thyroid enlargement.
  63. Thyroid-binding globulin (TBG) levels affect total but not free thyroid hormone levels.
  64. Congenital adrenal hyperplasia (CAH) leads to cortisol deficiency and androgen excess.
  65. Growth hormone deficiency in children causes short stature and delayed growth.
  66. Hypocalcemia treatment includes calcium gluconate IV in emergencies.
  67. Primary hypothyroidism shows high TSH and low T4 levels.
  68. Secondary hypothyroidism has low TSH and low T4 due to pituitary failure.
  69. Hyperglycemic hyperosmolar state (HHS) occurs without significant ketosis.
  70. Foot care education is essential in diabetics to prevent foot ulcers and amputations.

Important One-Liner Points on Hematological and Ophthalmic Disorders.


Hematological Disorders

  1. Anemia is defined as a decrease in hemoglobin concentration, red blood cells, or hematocrit levels.
  2. Iron deficiency anemia is the most common type of anemia worldwide.
  3. Microcytic hypochromic anemia is typically seen in iron deficiency and thalassemia.
  4. Pernicious anemia is caused by vitamin B12 deficiency due to intrinsic factor deficiency.
  5. Megaloblastic anemia is caused by vitamin B12 or folate deficiency, leading to large, immature red cells.
  6. Aplastic anemia results from bone marrow failure causing pancytopenia.
  7. Hemolytic anemia is characterized by increased destruction of red blood cells.
  8. Sickle cell anemia is caused by a mutation in the β-globin gene, leading to abnormal hemoglobin S.
  9. Thalassemia is a genetic disorder causing defective hemoglobin synthesis.
  10. G6PD deficiency causes hemolytic anemia triggered by infections, drugs, or fava beans.
  11. Polycythemia vera is a myeloproliferative disorder causing increased red blood cell mass.
  12. Leukemia is a cancer of white blood cells with abnormal proliferation in the bone marrow.
  13. Acute lymphoblastic leukemia (ALL) is the most common childhood cancer.
  14. Chronic myeloid leukemia (CML) is associated with the Philadelphia chromosome (t(9;22) translocation).
  15. Hodgkin’s lymphoma is characterized by Reed-Sternberg cells on biopsy.
  16. Non-Hodgkin’s lymphoma includes a diverse group of lymphoid cancers.
  17. Multiple myeloma is a cancer of plasma cells, leading to bone lesions, anemia, and renal failure.
  18. Bleeding time (BT) is prolonged in platelet disorders like thrombocytopenia.
  19. Prothrombin time (PT) measures the extrinsic pathway of coagulation, prolonged in liver disease.
  20. Activated partial thromboplastin time (aPTT) measures the intrinsic pathway, prolonged in hemophilia.
  21. Hemophilia A is caused by factor VIII deficiency.
  22. Hemophilia B (Christmas disease) is caused by factor IX deficiency.
  23. Von Willebrand disease is the most common inherited bleeding disorder.
  24. Disseminated intravascular coagulation (DIC) involves widespread clotting and bleeding due to consumption of clotting factors.
  25. Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder causing low platelet count.
  26. Warfarin is monitored using PT/INR levels.
  27. Heparin-induced thrombocytopenia (HIT) is an immune-mediated reaction to heparin.
  28. Spherocytosis is a hereditary condition causing round red blood cells and hemolytic anemia.
  29. Coombs test is used to diagnose autoimmune hemolytic anemia.
  30. Iron studies (serum iron, ferritin, TIBC) help differentiate types of anemia.
  31. Ferritin is an acute-phase reactant and a marker of iron stores in the body.
  32. Bone marrow biopsy is the gold standard for diagnosing leukemia and aplastic anemia.
  33. Pica (craving non-food substances) is a symptom of iron deficiency anemia.
  34. Splenomegaly is commonly seen in hemolytic anemias, infections, and hematologic malignancies.
  35. Neutropenia increases the risk of infections, especially bacterial and fungal.
  36. Erythropoietin is used to treat anemia in chronic kidney disease.
  37. Hypersegmented neutrophils are seen in megaloblastic anemia.
  38. Target cells are seen in conditions like thalassemia and liver disease.
  39. Dactylitis (hand-foot syndrome) is an early manifestation of sickle cell anemia in infants.
  40. Hemosiderosis is iron overload, often due to repeated blood transfusions.
  41. Plasma exchange (plasmapheresis) is used in conditions like thrombotic thrombocytopenic purpura (TTP).
  42. Cryoprecipitate is rich in fibrinogen and factor VIII, used in bleeding disorders.
  43. Vitamin K deficiency causes bleeding due to impaired synthesis of clotting factors II, VII, IX, and X.
  44. Bence Jones protein in urine is a marker for multiple myeloma.
  45. Folic acid supplementation is crucial in pregnancy to prevent neural tube defects.
  46. Hemoglobin electrophoresis helps diagnose hemoglobinopathies like sickle cell disease and thalassemia.
  47. Cold agglutinin disease is a form of autoimmune hemolytic anemia triggered by cold temperatures.
  48. Pernicious anemia increases the risk of gastric carcinoma due to chronic atrophic gastritis.
  49. Reticulocyte count indicates bone marrow activity in response to anemia.
  50. Lymphadenopathy is a common sign in lymphomas and leukemias.

Ophthalmic Disorders

  1. Conjunctivitis (pink eye) is inflammation of the conjunctiva, commonly viral, bacterial, or allergic.
  2. Cataract is the opacification of the lens, leading to progressive, painless vision loss.
  3. Glaucoma is characterized by increased intraocular pressure, damaging the optic nerve.
  4. Open-angle glaucoma is the most common type, with gradual vision loss.
  5. Acute angle-closure glaucoma is an emergency with sudden eye pain, blurred vision, and halos around lights.
  6. Timolol is a beta-blocker used to reduce intraocular pressure in glaucoma.
  7. Macular degeneration causes central vision loss, commonly in the elderly.
  8. Diabetic retinopathy is a leading cause of blindness, characterized by retinal hemorrhages and exudates.
  9. Hypertensive retinopathy shows signs like arteriovenous (AV) nicking and cotton wool spots.
  10. Retinal detachment presents with flashes of light, floaters, and a curtain-like shadow over vision.
  11. Uveitis is inflammation of the uveal tract, causing eye pain, redness, and photophobia.
  12. Keratitis is corneal inflammation, often caused by infections like herpes simplex virus.
  13. Acanthamoeba keratitis is associated with contact lens use and poor hygiene.
  14. Pterygium is a benign growth of the conjunctiva, often due to UV exposure.
  15. Pinguecula is a yellowish conjunctival nodule, commonly on the nasal side.
  16. Optic neuritis presents with sudden vision loss and pain on eye movement, often linked to multiple sclerosis.
  17. Papilledema is optic disc swelling due to increased intracranial pressure.
  18. Strabismus is misalignment of the eyes, commonly treated with corrective lenses or surgery.
  19. Amblyopia (lazy eye) is decreased vision in one eye due to poor development during childhood.
  20. Diplopia (double vision) occurs due to misalignment of the eyes or cranial nerve palsies.
  21. Hordeolum (stye) is an acute infection of the eyelid gland, often staphylococcal.
  22. Chalazion is a chronic granulomatous inflammation of the meibomian gland.
  23. Blepharitis is inflammation of the eyelid margins, causing redness and crusting.
  24. Dacryocystitis is an infection of the lacrimal sac, leading to pain and swelling near the inner corner of the eye.
  25. Ectropion is the outward turning of the eyelid, while entropion is inward turning.
  26. Proptosis (exophthalmos) is a hallmark of thyroid eye disease (Graves’ orbitopathy).
  27. Retinitis pigmentosa causes progressive peripheral vision loss and night blindness.
  28. Color blindness is usually inherited and affects the ability to distinguish certain colors.
  29. Presbyopia is age-related loss of near vision due to decreased lens elasticity.
  30. Myopia (nearsightedness) is corrected with concave lenses, while hyperopia (farsightedness) is corrected with convex lenses.
  31. Astigmatism is caused by irregular curvature of the cornea, leading to blurred vision.
  32. Corneal abrasion presents with eye pain, tearing, and a foreign body sensation.
  33. Hyphema is the presence of blood in the anterior chamber of the eye, usually due to trauma.
  34. Chemical eye injuries require immediate irrigation with copious water or saline.
  35. Central retinal artery occlusion (CRAO) causes sudden, painless vision loss and a cherry-red spot on fundoscopy.
  36. Central retinal vein occlusion (CRVO) presents with sudden vision loss and a “blood and thunder” appearance on fundoscopy.
  37. Anterior ischemic optic neuropathy (AION) causes sudden vision loss, often in patients with giant cell arteritis.
  38. Fluorescein staining is used to detect corneal abrasions and ulcers.
  39. Slit-lamp examination allows detailed inspection of the anterior segment of the eye.
  40. Tonometry is used to measure intraocular pressure, important in glaucoma management.
  41. Visual field testing helps detect peripheral vision loss in conditions like glaucoma.
  42. Fundoscopy is used to examine the retina, optic disc, and blood vessels.
  43. Eye patching is contraindicated in corneal ulcers as it can worsen the infection.
  44. Photophobia (light sensitivity) is common in uveitis, meningitis, and corneal conditions.
  45. Tearing (epiphora) can result from blocked nasolacrimal ducts or excessive tear production.
  46. Dry eye syndrome is due to decreased tear production or increased evaporation.
  47. Ptosis (drooping of the upper eyelid) can be caused by oculomotor nerve palsy or myasthenia gravis.
  48. Amaurosis fugax is transient vision loss due to temporary retinal ischemia.
  49. Cataract surgery is the definitive treatment for significant vision impairment due to cataracts.
  50. Argon laser photocoagulation is used to treat proliferative diabetic retinopathy.

Important One-Liner Points on Cardiovascular Disorders


1. Basic Anatomy and Physiology

  1. The heart has four chambers: two atria and two ventricles.
  2. SA node is the natural pacemaker of the heart, initiating electrical impulses.
  3. Normal heart rate ranges from 60–100 beats per minute in adults.
  4. Cardiac output (CO) is calculated as heart rate × stroke volume.
  5. Coronary arteries supply oxygen-rich blood to the heart muscle.
  6. The left ventricle is the strongest chamber and pumps oxygenated blood to the body.
  7. Systole refers to the contraction phase, while diastole is the relaxation phase of the cardiac cycle.
  8. Baroreceptors help regulate blood pressure by sensing changes in arterial pressure.

2. Hypertension (High Blood Pressure)

  1. Hypertension is defined as BP ≥140/90 mmHg on multiple readings.
  2. Primary (essential) hypertension has no identifiable cause, while secondary hypertension has an underlying condition.
  3. ACE inhibitors (e.g., enalapril) are first-line drugs for hypertension management.
  4. Hypertensive crisis is a BP >180/120 mmHg, requiring immediate medical attention.
  5. Lifestyle changes (diet, exercise, reduced salt intake) are crucial in hypertension management.

3. Coronary Artery Disease (CAD) & Angina

  1. Atherosclerosis is the buildup of plaques in arteries, leading to CAD.
  2. Stable angina occurs with exertion and is relieved by rest or nitroglycerin.
  3. Unstable angina is chest pain at rest and is a medical emergency.
  4. Nitroglycerin relieves angina by dilating coronary arteries.
  5. Troponin levels are the most specific markers for myocardial infarction (MI).
  6. ECG changes in MI include ST-segment elevation (STEMI) or depression (NSTEMI).
  7. MONA protocol (Morphine, Oxygen, Nitrates, Aspirin) is used in acute MI management.
  8. Beta-blockers reduce heart workload and improve survival after MI.

4. Heart Failure

  1. Heart failure is the inability of the heart to pump sufficient blood to meet the body’s needs.
  2. Left-sided heart failure causes pulmonary symptoms like dyspnea and orthopnea.
  3. Right-sided heart failure leads to peripheral edema, ascites, and jugular vein distension.
  4. Ejection fraction (EF) <40% indicates systolic heart failure.
  5. Diuretics (e.g., furosemide) relieve symptoms of fluid overload in heart failure.
  6. ACE inhibitors and beta-blockers improve survival in heart failure patients.

5. Arrhythmias (Abnormal Heart Rhythms)

  1. Atrial fibrillation (AF) is the most common arrhythmia, increasing stroke risk.
  2. Warfarin or NOACs are used to prevent stroke in AF patients.
  3. Bradycardia is a heart rate <60 bpm; may require a pacemaker if symptomatic.
  4. Tachycardia refers to a heart rate >100 bpm; can be supraventricular or ventricular.
  5. Ventricular fibrillation (VF) is life-threatening and requires immediate defibrillation.
  6. ECG (Electrocardiogram) is the primary diagnostic tool for arrhythmias.
  7. Sinus arrhythmia is a normal variation in heart rate with breathing in young individuals.

6. Valvular Heart Diseases

  1. Mitral stenosis is commonly caused by rheumatic heart disease.
  2. Aortic stenosis leads to syncope, angina, and heart failure (classic triad).
  3. Mitral regurgitation causes a holosystolic murmur best heard at the apex.
  4. Aortic regurgitation presents with a bounding pulse and a diastolic murmur.
  5. Valve replacement surgery may be needed in severe valvular diseases.

7. Congenital Heart Diseases

  1. Tetralogy of Fallot is the most common cyanotic congenital heart defect.
  2. Patent ductus arteriosus (PDA) is common in premature infants, causing a continuous “machinery” murmur.
  3. Atrial septal defect (ASD) causes a fixed split of the second heart sound.
  4. Ventricular septal defect (VSD) is the most common congenital heart defect.
  5. Coarctation of the aorta presents with high BP in the arms and low BP in the legs.

8. Cardiomyopathy

  1. Dilated cardiomyopathy is the most common type, causing ventricular dilation and systolic dysfunction.
  2. Hypertrophic cardiomyopathy can cause sudden cardiac death in young athletes.
  3. Restrictive cardiomyopathy leads to impaired ventricular filling.
  4. Echocardiography is the key diagnostic tool for cardiomyopathies.

9. Pericardial Diseases

  1. Pericarditis presents with sharp chest pain that improves when sitting up and leaning forward.
  2. Pericardial friction rub is the hallmark sign of pericarditis on auscultation.
  3. Cardiac tamponade causes Beck’s triad: hypotension, muffled heart sounds, and jugular venous distension.
  4. Pulsus paradoxus (drop in BP >10 mmHg during inspiration) indicates cardiac tamponade.
  5. Pericardiocentesis is the treatment for cardiac tamponade.

10. Vascular Disorders

  1. Deep vein thrombosis (DVT) presents with leg swelling, pain, and redness.
  2. Pulmonary embolism (PE) causes sudden shortness of breath, chest pain, and hypoxia.
  3. Virchow’s triad (stasis, hypercoagulability, endothelial injury) contributes to thrombosis.
  4. D-dimer is elevated in thrombotic conditions like DVT and PE.
  5. Aortic dissection causes severe, tearing chest or back pain and is a medical emergency.
  6. Ankle-brachial index (ABI) <0.9 indicates peripheral artery disease (PAD).
  7. Claudication is leg pain on exertion due to PAD.
  8. Raynaud’s phenomenon causes color changes (white-blue-red) in fingers due to cold exposure.
  9. Varicose veins result from valve insufficiency in superficial veins.
  10. Buerger’s disease (thromboangiitis obliterans) is associated with smoking and causes limb ischemia.
  11. Aneurysm is an abnormal dilation of an artery, commonly the abdominal aorta.

11. Infective Endocarditis

  1. Infective endocarditis presents with fever, heart murmur, and vascular phenomena.
  2. Janeway lesions (painless) and Osler nodes (painful) are signs of endocarditis.
  3. Duke criteria are used for the diagnosis of infective endocarditis.
  4. IV antibiotics are the mainstay of treatment for infective endocarditis.

12. Rheumatic Heart Disease

  1. Rheumatic fever follows a streptococcal throat infection and can damage heart valves.
  2. Jones criteria are used to diagnose rheumatic fever.
  3. Penicillin prophylaxis prevents recurrent rheumatic fever in affected individuals.

13. Shock and Cardiac Emergencies

  1. Cardiogenic shock results from pump failure, causing hypotension and poor perfusion.
  2. Hypovolemic shock is due to blood or fluid loss, treated with fluids and blood products.
  3. Septic shock is caused by infection leading to vasodilation and hypotension.
  4. Anaphylactic shock is a severe allergic reaction treated with epinephrine.
  5. Defibrillation is used for pulseless ventricular tachycardia and ventricular fibrillation.
  6. CPR (Cardiopulmonary Resuscitation) uses a compression-to-ventilation ratio of 30:2 in adults.

14. Diagnostic Tools in Cardiology

  1. Echocardiography is the best non-invasive test to assess heart structure and function.
  2. Stress testing helps diagnose coronary artery disease.
  3. Coronary angiography is the gold standard for diagnosing coronary artery blockages.
  4. Holter monitor records heart rhythms over 24–48 hours to detect arrhythmias.
  5. BNP (B-type natriuretic peptide) is elevated in heart failure.

15. Cardiac Procedures and Surgeries

  1. Percutaneous coronary intervention (PCI) is a procedure to open blocked coronary arteries.
  2. CABG (Coronary artery bypass grafting) is surgery to restore blood flow to the heart.
  3. Pacemaker implantation treats bradyarrhythmias and heart block.
  4. Implantable cardioverter-defibrillator (ICD) prevents sudden cardiac death in high-risk patients.
  5. Cardioversion restores normal heart rhythm in arrhythmias like atrial fibrillation.

16. Lipid Disorders and Atherosclerosis

  1. High LDL cholesterol increases the risk of atherosclerosis and cardiovascular disease.
  2. Statins are the first-line drugs for lowering LDL cholesterol.
  3. Hypertriglyceridemia increases the risk of pancreatitis.

17. Miscellaneous

  1. Pulsus alternans indicates severe left ventricular dysfunction.
  2. Corrigan’s pulse (water hammer pulse) is seen in aortic regurgitation.
  3. S3 heart sound suggests heart failure, while S4 indicates stiff ventricles.
  4. Brugada syndrome is a genetic condition that increases the risk of sudden cardiac death.
  5. Heart sounds are best heard with the diaphragm of the stethoscope for high-pitched sounds.
  6. Sinus tachycardia is often a physiological response to fever, dehydration, or stress.
  7. Elevated JVP (jugular venous pressure) suggests right heart failure or fluid overload.
  8. Paradoxical pulse is a drop in systolic BP during inspiration, seen in tamponade.
  9. Hyperkalemia causes peaked T waves on ECG and can lead to cardiac arrest.
  10. Chest pain radiating to the left arm or jaw is classic for myocardial infarction.

Important One-Liner Points on ENT Disorders and Sexually Transmitted Diseases (STDs)


ENT (Ear, Nose, and Throat) Disorders

  1. Otitis externa is an infection of the external ear canal, commonly known as “swimmer’s ear.”
  2. Otitis media is a middle ear infection, often following an upper respiratory tract infection.
  3. Cholesteatoma is an abnormal skin growth in the middle ear, causing chronic ear discharge.
  4. Sensorineural hearing loss affects the inner ear or auditory nerve, often irreversible.
  5. Conductive hearing loss occurs due to obstruction or damage in the outer or middle ear.
  6. Rinne’s test compares air conduction to bone conduction to differentiate hearing loss types.
  7. Weber’s test helps determine unilateral hearing loss by lateralizing sound.
  8. Meniere’s disease presents with vertigo, tinnitus, hearing loss, and a feeling of ear fullness.
  9. Presbycusis is age-related hearing loss, primarily affecting high-frequency sounds.
  10. Acoustic neuroma (vestibular schwannoma) is a benign tumor causing unilateral hearing loss and balance issues.
  11. Tinnitus is the perception of ringing or buzzing in the ears without an external source.
  12. Barotrauma occurs due to pressure changes affecting the middle ear, common in divers and air travelers.
  13. Perforated eardrum can result from infection, trauma, or sudden pressure changes.
  14. Sinusitis is inflammation of the paranasal sinuses, causing facial pain and nasal congestion.
  15. Deviated nasal septum (DNS) can cause nasal obstruction and recurrent sinus infections.
  16. Epistaxis (nosebleed) commonly arises from Kiesselbach’s plexus in the anterior nasal septum.
  17. Allergic rhinitis is an IgE-mediated response causing sneezing, itching, and a runny nose.
  18. Nasal polyps are soft, painless growths in the nasal passages, often linked to allergies.
  19. Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep.
  20. Laryngitis is inflammation of the larynx, causing hoarseness and voice loss.
  21. Stridor is a high-pitched sound indicating upper airway obstruction.
  22. Epiglottitis is a life-threatening infection causing severe sore throat, drooling, and airway obstruction.
  23. Tonsillitis is inflammation of the tonsils, often caused by streptococcal infection.
  24. Peritonsillar abscess (quinsy) presents with severe sore throat, muffled voice, and uvular deviation.
  25. Pharyngitis is inflammation of the pharynx, commonly viral or bacterial in origin.
  26. Hoarseness lasting >2 weeks should be evaluated for laryngeal cancer, especially in smokers.
  27. Vocal cord nodules are benign lesions due to voice overuse, common in singers and teachers.
  28. Thyroglossal duct cyst presents as a midline neck mass that moves with swallowing.
  29. Branchial cleft cyst appears as a lateral neck swelling, often presenting after an upper respiratory infection.
  30. Ludwig’s angina is a severe cellulitis of the floor of the mouth, risking airway obstruction.
  31. Recurrent laryngeal nerve injury during thyroid surgery can cause hoarseness.
  32. Otoscopic examination is essential for diagnosing ear infections and eardrum abnormalities.
  33. Mastoiditis is a complication of untreated otitis media, presenting with postauricular swelling.
  34. Vertigo is a sensation of spinning, often due to inner ear disorders like BPPV.
  35. Benign paroxysmal positional vertigo (BPPV) causes brief episodes of vertigo triggered by head movements.
  36. Caloric testing assesses vestibular function by irrigating the ear canal with warm or cold water.
  37. Rhinoscopy allows visualization of the nasal cavity for diagnosis of polyps, tumors, or infections.
  38. Septoplasty is a surgical procedure to correct a deviated nasal septum.
  39. Adenoid hypertrophy can cause nasal obstruction, snoring, and recurrent ear infections in children.
  40. Foreign bodies in the nose or ear are common in children and require careful removal.

Sexually Transmitted Diseases (STDs)

  1. Chlamydia trachomatis is the most common bacterial STD worldwide.
  2. Gonorrhea is caused by Neisseria gonorrhoeae, leading to purulent discharge in men and asymptomatic infection in women.
  3. Syphilis is caused by Treponema pallidum, presenting in stages (primary, secondary, latent, tertiary).
  4. Primary syphilis presents with a painless ulcer (chancre) at the infection site.
  5. Secondary syphilis causes a rash on the palms and soles, mucosal lesions, and lymphadenopathy.
  6. Tertiary syphilis can affect the heart, brain, and other organs, leading to gummatous lesions.
  7. Dark-field microscopy is used to detect Treponema pallidum in syphilitic lesions.
  8. Penicillin G is the treatment of choice for all stages of syphilis.
  9. Herpes simplex virus (HSV) causes painful genital ulcers and recurrent outbreaks.
  10. Acyclovir is the first-line treatment for genital herpes.
  11. Human papillomavirus (HPV) causes genital warts and increases the risk of cervical cancer.
  12. HPV vaccine prevents infection with high-risk HPV strains causing cervical cancer.
  13. Trichomoniasis is caused by Trichomonas vaginalis, leading to a frothy, greenish vaginal discharge.
  14. Metronidazole is the drug of choice for trichomoniasis.
  15. Bacterial vaginosis (BV) is caused by an imbalance of vaginal flora, leading to a fishy-smelling discharge.
  16. Clue cells on microscopy are diagnostic of bacterial vaginosis.
  17. Pelvic inflammatory disease (PID) is an ascending infection of the female reproductive tract, often due to chlamydia or gonorrhea.
  18. Epididymitis presents with scrotal pain and swelling, commonly caused by chlamydia or gonorrhea in sexually active men.
  19. Urethritis causes dysuria and discharge; can be gonococcal or non-gonococcal.
  20. Lymphogranuloma venereum (LGV) is caused by certain strains of chlamydia, leading to genital ulcers and swollen lymph nodes.
  21. Chancroid is a painful genital ulcer caused by Haemophilus ducreyi.
  22. Granuloma inguinale (donovanosis) causes painless, beefy-red ulcers and is caused by Klebsiella granulomatis.
  23. HIV (Human Immunodeficiency Virus) attacks the immune system, leading to AIDS if untreated.
  24. Antiretroviral therapy (ART) is used to manage HIV infection.
  25. Hepatitis B and C are blood-borne infections that can be transmitted sexually.
  26. Zidovudine (AZT) is an antiretroviral drug used in HIV prevention and treatment.
  27. Hepatitis B vaccine provides protection against sexually transmitted hepatitis B infection.
  28. Crabs (pubic lice) cause intense itching in the pubic area and are spread through sexual contact.
  29. Scabies is caused by a mite infestation, leading to severe itching and is sexually transmissible.
  30. Molluscum contagiosum causes small, pearly papules with central umbilication, spread through skin contact.
  31. Pre-exposure prophylaxis (PrEP) reduces the risk of HIV transmission in high-risk individuals.
  32. Post-exposure prophylaxis (PEP) should be started within 72 hours of potential HIV exposure.
  33. Candidiasis causes white, curd-like vaginal discharge, often due to Candida albicans overgrowth.
  34. Reiter’s syndrome (reactive arthritis) is associated with chlamydial infections, causing arthritis, uveitis, and urethritis.
  35. Vertical transmission refers to the passing of an infection from mother to child during childbirth.
  36. Condom use reduces the risk of transmission of most STDs, including HIV.
  37. Genital ulcers can be caused by herpes, syphilis, chancroid, or donovanosis.
  38. VDRL and RPR tests are used to screen for syphilis.
  39. Confirmatory test for syphilis is the FTA-ABS (fluorescent treponemal antibody absorption test).
  40. Cervical cancer screening with Pap smear helps detect precancerous changes caused by HPV.
  41. Partner notification and treatment are essential in managing STDs to prevent reinfection.
  42. Gonorrhea and chlamydia are often co-infections and treated together with ceftriaxone and azithromycin.
  43. Pelvic inflammatory disease increases the risk of infertility and ectopic pregnancy.
  44. Neonatal conjunctivitis can result from chlamydia or gonorrhea during childbirth.
  45. Fitz-Hugh-Curtis syndrome is perihepatitis associated with PID.
  46. HPV types 16 and 18 are high-risk strains for cervical cancer.
  47. Gardasil vaccine protects against HPV types 6, 11, 16, and 18.
  48. Ectopic pregnancy risk increases with a history of PID.
  49. Donovan bodies are seen in granuloma inguinale on microscopic examination.
  50. Syphilis can be congenital if transmitted from mother to baby during pregnancy.
  51. Chancre in syphilis is painless, while chancroid is painful.
  52. Gonococcal arthritis presents with joint pain, fever, and skin lesions.
  53. Herpes zoster is not an STD but can affect the genital area in rare cases.
  54. Acyclovir resistance can occur in immunocompromised patients with recurrent herpes.
  55. Hepatitis C has no vaccine but is curable with antiviral therapy.
  56. High vaginal swab is used to diagnose various vaginal infections.
  57. Serological tests are essential for diagnosing HIV, syphilis, and hepatitis.
  58. Liver function tests are important in managing hepatitis B and C infections.
  59. STIs can increase HIV transmission risk due to mucosal damage.
  60. Early diagnosis and treatment of STDs are crucial to prevent complications and transmission.

Important One-Liner Points on Musculoskeletal Disorders and Emergency Management


Musculoskeletal Disorders

  1. Osteoporosis is characterized by decreased bone density, increasing fracture risk.
  2. Calcium and vitamin D supplementation are key in osteoporosis prevention and management.
  3. Osteoarthritis (OA) is a degenerative joint disease causing joint pain and stiffness, especially in weight-bearing joints.
  4. Rheumatoid arthritis (RA) is an autoimmune disorder causing symmetric joint inflammation and deformity.
  5. Morning stiffness lasting >1 hour is a hallmark of rheumatoid arthritis.
  6. Gout is caused by uric acid crystal deposition in joints, leading to sudden, severe joint pain.
  7. Allopurinol is used for long-term management of gout to reduce uric acid levels.
  8. Ankylosing spondylitis is an inflammatory disease causing fusion of the spine, leading to a “bamboo spine” appearance on X-ray.
  9. Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-organ involvement, including joints.
  10. Polymyalgia rheumatica presents with proximal muscle stiffness and pain, often associated with giant cell arteritis.
  11. Tennis elbow (lateral epicondylitis) is caused by overuse of forearm muscles.
  12. Carpal tunnel syndrome is due to median nerve compression, causing numbness and tingling in the hand.
  13. Phalen’s test and Tinel’s sign are used to diagnose carpal tunnel syndrome.
  14. Fibromyalgia causes widespread musculoskeletal pain, fatigue, and sleep disturbances.
  15. Paget’s disease of bone leads to abnormal bone remodeling and deformities.
  16. Osteomyelitis is an infection of the bone, often requiring antibiotics and sometimes surgical debridement.
  17. Compartment syndrome is a surgical emergency causing severe pain and potential muscle/nerve damage.
  18. Fractures are classified as open (compound) or closed (simple) based on skin integrity.
  19. Greenstick fractures are incomplete fractures commonly seen in children.
  20. Colles’ fracture is a distal radius fracture often resulting from a fall on an outstretched hand.
  21. Hip fractures are common in the elderly and often require surgical fixation.
  22. X-ray is the first-line imaging for suspected fractures.
  23. RICE (Rest, Ice, Compression, Elevation) is the initial management for sprains and strains.
  24. Dislocation occurs when bones are forced out of their normal position in a joint.
  25. Reduction is the process of realigning dislocated joints or fractured bones.
  26. Osteosarcoma is the most common primary bone cancer, typically affecting adolescents.
  27. Ewing’s sarcoma is a malignant bone tumor common in children and young adults.
  28. Bone metastases are most commonly from cancers of the breast, prostate, and lung.
  29. Kyphosis is an exaggerated forward curvature of the thoracic spine.
  30. Scoliosis is a lateral curvature of the spine, often diagnosed in adolescence.
  31. Lordosis refers to an exaggerated inward curve of the lumbar spine.
  32. Bursitis is inflammation of the bursae, leading to joint pain and swelling.
  33. Tendinitis is inflammation of a tendon, often due to overuse.
  34. Slipped capital femoral epiphysis (SCFE) occurs in adolescents and requires prompt surgical intervention.
  35. Osteogenesis imperfecta is a genetic disorder causing brittle bones and frequent fractures.
  36. Rickets is caused by vitamin D deficiency, leading to soft, weak bones in children.
  37. Stress fractures are small cracks in the bone due to repetitive force or overuse.
  38. Joint aspiration can help diagnose septic arthritis or crystal-induced arthritis like gout.
  39. Septic arthritis is an emergency, requiring urgent drainage and IV antibiotics.
  40. Meniscal tears in the knee often result from twisting injuries and cause locking or clicking.

Emergency Management

  1. ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) is the foundation of emergency care.
  2. Airway management is the first priority in any emergency situation.
  3. Endotracheal intubation is used to secure the airway in unconscious or critically ill patients.
  4. Bag-valve mask ventilation provides temporary respiratory support in emergencies.
  5. Cardiopulmonary resuscitation (CPR) involves chest compressions and rescue breaths to restore circulation and breathing.
  6. Defibrillation is used for shockable cardiac rhythms like ventricular fibrillation and pulseless ventricular tachycardia.
  7. Automated external defibrillator (AED) can be used by laypersons for sudden cardiac arrest.
  8. Triage is the process of prioritizing patients based on the severity of their condition.
  9. Hypovolemic shock results from significant blood or fluid loss, requiring fluid resuscitation.
  10. Septic shock is a life-threatening condition caused by severe infection and requires prompt antibiotics and fluids.
  11. Anaphylactic shock is treated with intramuscular epinephrine as the first-line intervention.
  12. Glasgow Coma Scale (GCS) assesses the level of consciousness in trauma and emergency patients.
  13. FAST (Focused Assessment with Sonography in Trauma) is used to detect internal bleeding.
  14. Tension pneumothorax requires immediate needle decompression followed by chest tube insertion.
  15. Hemothorax is managed with chest tube drainage to remove blood from the pleural space.
  16. Flail chest results from multiple rib fractures, causing paradoxical chest movement.
  17. Spinal immobilization is crucial in trauma patients with suspected spinal injuries.
  18. Cervical collars are used to stabilize the neck in suspected cervical spine injuries.
  19. Massive transfusion protocol (MTP) is initiated for patients with severe hemorrhage.
  20. Cricothyrotomy is an emergency procedure to establish an airway when intubation fails.
  21. Hypoglycemia in unconscious patients is treated with IV dextrose.
  22. Stroke management includes rapid assessment with the FAST (Face drooping, Arm weakness, Speech difficulty, Time) mnemonic.
  23. Thrombolytic therapy (tPA) is used in ischemic stroke if given within 4.5 hours of symptom onset.
  24. Chest pain evaluation in the ER includes ECG, troponin levels, and oxygen therapy.
  25. Acute myocardial infarction (MI) management follows the MONA protocol (Morphine, Oxygen, Nitrates, Aspirin).
  26. Pulmonary embolism (PE) is managed with anticoagulation and thrombolysis in severe cases.
  27. Heat stroke is a medical emergency requiring rapid cooling and hydration.
  28. Hypothermia is managed by gradual rewarming, both externally and internally.
  29. Burns are classified as first, second, or third degree based on depth.
  30. Rule of Nines is used to estimate the total body surface area affected by burns.
  31. Fluid resuscitation in burns follows the Parkland formula: 4 mL × body weight (kg) × % TBSA burned.
  32. Smoke inhalation injury can cause airway compromise even without external burns.
  33. Carbon monoxide poisoning is treated with 100% oxygen or hyperbaric oxygen therapy.
  34. Poisoning management includes airway protection, decontamination, and antidote administration if available.
  35. Activated charcoal is used to reduce absorption of certain toxins if given early.
  36. Seizures in emergencies are treated initially with benzodiazepines like lorazepam.
  37. Status epilepticus is a medical emergency requiring immediate treatment to prevent brain damage.
  38. Traumatic brain injury (TBI) requires monitoring for signs of increased intracranial pressure.
  39. Compartment syndrome requires emergent fasciotomy to relieve pressure.
  40. Open fractures are orthopedic emergencies requiring prompt debridement and antibiotics.
  41. Amputation injuries should be managed by controlling bleeding and preserving the amputated part for possible reattachment.
  42. Drowning victims require immediate CPR and airway management.
  43. Foreign body airway obstruction is managed with the Heimlich maneuver in conscious adults.
  44. Acute abdomen refers to severe abdominal pain requiring urgent evaluation for conditions like appendicitis, perforation, or obstruction.
  45. Testicular torsion is a surgical emergency causing sudden scrotal pain, requiring immediate detorsion.
  46. Ectopic pregnancy can cause life-threatening internal bleeding and requires prompt diagnosis and management.
  47. Acute appendicitis presents with right lower quadrant pain and requires surgical removal.
  48. Peritonitis is inflammation of the peritoneum, often due to infection or perforation, requiring emergency surgery.
  49. Sepsis management follows the “Sepsis Six”: oxygen, blood cultures, IV antibiotics, IV fluids, lactate measurement, and urine output monitoring.
  50. Tachycardia is often the first sign of clinical deterioration in critically ill patients.
  51. Intubation drugs include rapid-sequence induction agents like etomidate and succinylcholine.
  52. Needle thoracostomy is performed in the second intercostal space for tension pneumothorax.
  53. Pelvic fractures can cause massive bleeding and require stabilization with pelvic binders.
  54. Hemorrhagic shock is classified into four stages based on blood loss severity.
  55. Laryngeal mask airway (LMA) is used as an alternative to endotracheal intubation in difficult airway scenarios.
  56. Mass casualty triage prioritizes treatment based on survivability using color-coded tags.
  57. Intraosseous (IO) access is used for emergency vascular access when IV access is difficult.
  58. Resuscitation fluids include crystalloids (normal saline, lactated Ringer’s) and blood products.
  59. Acute allergic reactions are treated with antihistamines, corticosteroids, and epinephrine if severe.
  60. Disaster management involves mitigation, preparedness, response, and recovery phases.

Important One-Liner Points on Oncological Disorders.


1. Basic Concepts in Oncology

  1. Cancer is the uncontrolled growth and spread of abnormal cells in the body.
  2. Oncology is the branch of medicine that deals with the prevention, diagnosis, and treatment of cancer.
  3. Carcinoma arises from epithelial cells, while sarcoma originates from connective tissues like bone and muscle.
  4. Leukemia is cancer of the blood-forming tissues, leading to an overproduction of abnormal white blood cells.
  5. Lymphoma is a cancer of the lymphatic system, including Hodgkin’s and non-Hodgkin’s lymphoma.
  6. Metastasis is the spread of cancer cells from the primary site to distant organs.
  7. Benign tumors are non-cancerous and do not spread, while malignant tumors are cancerous and invasive.
  8. TNM staging system is used to classify cancer based on Tumor size (T), Node involvement (N), and Metastasis (M).
  9. Grading of cancer refers to the degree of differentiation of tumor cells.
  10. Carcinogens are substances that can cause cancer, such as tobacco, radiation, and certain chemicals.

2. Common Types of Cancers

  1. Lung cancer is the leading cause of cancer-related deaths worldwide.
  2. Smoking is the primary risk factor for lung cancer.
  3. Breast cancer is the most common cancer in women globally.
  4. BRCA1 and BRCA2 mutations increase the risk of breast and ovarian cancers.
  5. Prostate cancer is the most common cancer in men, often detected by elevated PSA levels.
  6. Colorectal cancer often develops from precancerous polyps in the colon or rectum.
  7. Cervical cancer is strongly associated with Human Papillomavirus (HPV) infection.
  8. HPV vaccination helps prevent cervical cancer.
  9. Liver cancer is commonly linked to chronic hepatitis B and C infections.
  10. Pancreatic cancer has a poor prognosis due to late diagnosis.

3. Hematologic Cancers

  1. Acute lymphoblastic leukemia (ALL) is the most common cancer in children.
  2. Chronic myeloid leukemia (CML) is associated with the Philadelphia chromosome (t(9;22) translocation).
  3. Hodgkin’s lymphoma is characterized by the presence of Reed-Sternberg cells on biopsy.
  4. Multiple myeloma is a cancer of plasma cells, causing bone pain, anemia, and kidney failure.
  5. Bence Jones protein in urine is a diagnostic marker for multiple myeloma.

4. Cancer Diagnosis and Screening

  1. Biopsy is the gold standard for cancer diagnosis.
  2. Mammography is the screening test for breast cancer.
  3. Pap smear is used for cervical cancer screening.
  4. Colonoscopy is the gold standard for colorectal cancer screening.
  5. PSA (Prostate-Specific Antigen) is used to screen for prostate cancer.
  6. CT scan, MRI, and PET scan are imaging modalities for cancer staging and detection.
  7. Tumor markers like CEA, CA-125, and AFP help monitor treatment response and recurrence.
  8. Fine Needle Aspiration Cytology (FNAC) is a minimally invasive procedure to diagnose superficial tumors.

5. Cancer Treatment Modalities

  1. Surgery is the primary treatment for many localized cancers.
  2. Radiation therapy uses high-energy rays to kill cancer cells.
  3. Chemotherapy involves the use of drugs to kill or slow the growth of cancer cells.
  4. Targeted therapy focuses on specific molecules involved in cancer growth and survival.
  5. Immunotherapy boosts the body’s immune system to fight cancer.
  6. Hormonal therapy is used in hormone-sensitive cancers like breast and prostate cancer.
  7. Bone marrow transplantation is used in hematologic cancers like leukemia and lymphoma.

6. Chemotherapy and Side Effects

  1. Neutropenia is a common side effect of chemotherapy, increasing infection risk.
  2. Alopecia (hair loss) is a reversible side effect of many chemotherapy drugs.
  3. Nausea and vomiting are common during chemotherapy and managed with antiemetics.
  4. Mucositis refers to inflammation of the mucous membranes due to chemotherapy or radiation.
  5. Cisplatin can cause nephrotoxicity and ototoxicity.
  6. Doxorubicin can cause cardiotoxicity, requiring regular cardiac monitoring.
  7. Methotrexate toxicity is managed with leucovorin (folinic acid) rescue therapy.
  8. Vincristine can cause peripheral neuropathy as a dose-limiting side effect.

7. Radiation Therapy

  1. External beam radiation is the most common form of radiation therapy.
  2. Brachytherapy involves placing radioactive material inside or near the tumor.
  3. Radiation dermatitis is a common skin reaction to radiation therapy.
  4. Fatigue is the most common long-term side effect of radiation therapy.
  5. Radiation therapy can cause secondary cancers years after treatment.

8. Oncological Emergencies

  1. Tumor lysis syndrome (TLS) occurs after rapid tumor breakdown, leading to electrolyte imbalances.
  2. Hypercalcemia of malignancy causes confusion, dehydration, and cardiac arrhythmias.
  3. Superior vena cava syndrome (SVCS) presents with facial swelling, dyspnea, and distended neck veins.
  4. Spinal cord compression is an emergency causing back pain, weakness, and bowel/bladder dysfunction.
  5. Febrile neutropenia requires urgent broad-spectrum antibiotics due to high infection risk.
  6. Pericardial tamponade in cancer patients can cause hypotension, muffled heart sounds, and jugular venous distension.

9. Risk Factors and Prevention

  1. Tobacco use is the leading cause of preventable cancer deaths worldwide.
  2. Excessive alcohol consumption increases the risk of head, neck, liver, and breast cancers.
  3. Obesity is a risk factor for several cancers, including breast, colon, and endometrial cancers.
  4. Sun exposure increases the risk of skin cancers like melanoma.
  5. Occupational exposure to asbestos increases the risk of mesothelioma.
  6. Family history of cancer increases the risk of developing certain hereditary cancers.
  7. Regular screening and vaccination are effective in cancer prevention.

10. Pediatric Cancers

  1. Neuroblastoma is the most common extracranial solid tumor in children.
  2. Wilms’ tumor (nephroblastoma) is a kidney cancer common in young children.
  3. Retinoblastoma presents with a white pupillary reflex (leukocoria) in infants.
  4. Acute lymphoblastic leukemia (ALL) has the highest cure rate among childhood cancers.

11. Breast Cancer Specifics

  1. Triple-negative breast cancer lacks estrogen, progesterone, and HER2 receptors, making it more aggressive.
  2. Tamoxifen is used for hormone receptor-positive breast cancer.
  3. Sentinel lymph node biopsy helps determine the spread of breast cancer.
  4. Paget’s disease of the nipple can be a sign of underlying breast cancer.

12. Gastrointestinal Cancers

  1. Esophageal cancer is commonly squamous cell carcinoma or adenocarcinoma.
  2. Gastric cancer is associated with H. pylori infection and dietary risk factors.
  3. Pancreatic cancer often presents with painless jaundice and weight loss.
  4. Colorectal cancer risk increases with age, family history, and inflammatory bowel disease.
  5. Fecal occult blood test (FOBT) is used for colorectal cancer screening.

13. Genitourinary Cancers

  1. Bladder cancer is strongly linked to smoking and occupational exposures.
  2. Testicular cancer is the most common cancer in young men aged 15-35 years.
  3. Prostate cancer often grows slowly and may not cause symptoms initially.
  4. Renal cell carcinoma presents with hematuria, flank pain, and a palpable mass.

14. Skin Cancers

  1. Basal cell carcinoma is the most common type of skin cancer, rarely metastasizing.
  2. Squamous cell carcinoma can metastasize if untreated, often linked to sun exposure.
  3. Melanoma is the deadliest form of skin cancer, identified using the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolution).

15. Head and Neck Cancers

  1. Squamous cell carcinoma is the most common type of head and neck cancer.
  2. HPV infection is a risk factor for oropharyngeal cancers.
  3. Leukoplakia is a white patch in the mouth that may be precancerous.
  4. Persistent hoarseness can be an early sign of laryngeal cancer.

16. Paraneoplastic Syndromes

  1. SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion) can occur with small cell lung cancer.
  2. Hypercalcemia is a common paraneoplastic syndrome associated with lung, breast, and kidney cancers.
  3. Cushing’s syndrome can be a paraneoplastic manifestation in small cell lung cancer.
  4. Dermatomyositis can be a paraneoplastic sign of underlying malignancy.

17. Cancer Pain Management

  1. Opioids are the cornerstone of cancer pain management.
  2. Adjuvant therapies like antidepressants and anticonvulsants help manage neuropathic pain.
  3. Palliative care focuses on improving quality of life in advanced cancer patients.
  4. Hospice care is provided when life expectancy is less than six months.

18. Miscellaneous Facts

  1. Cachexia is a complex syndrome causing weight loss, muscle wasting, and weakness in cancer patients.
  2. Survivorship care focuses on the long-term health of cancer survivors, addressing late effects of treatment.

Miscellaneous.

  1. Paraneoplastic syndromes are symptoms that occur due to cancer but are not directly related to tumor invasion or metastasis.
  2. Cancer cells evade the immune system through mechanisms like immune checkpoint inhibition.
  3. Angiogenesis is the process by which tumors develop their own blood supply to support growth.
  4. Neoadjuvant therapy is treatment given before the primary therapy (like surgery) to shrink tumors.
  5. Adjuvant therapy is additional treatment given after the primary treatment to reduce the risk of cancer recurrence.
  6. Oncogenes are mutated genes that promote uncontrolled cell growth, contributing to cancer development.
  7. Tumor suppressor genes like p53 help prevent cancer by controlling cell division and promoting apoptosis.
  8. BRCA mutations increase the risk of breast, ovarian, and other cancers.
  9. Liquid biopsy is a non-invasive test that detects cancer cells or DNA in the blood.
  10. Immunohistochemistry (IHC) helps identify specific markers in cancer cells to guide targeted therapy.
  11. Checkpoint inhibitors like nivolumab and pembrolizumab enhance the immune response against cancer.
  12. Targeted therapies work by interfering with specific molecules involved in cancer growth and progression.
  13. Oncologic hypercalcemia is treated with IV fluids, bisphosphonates, and sometimes calcitonin.
  14. Prophylactic mastectomy may be considered for women at very high risk of breast cancer (e.g., BRCA mutation carriers).
  15. Cancer cachexia cannot be fully reversed by nutritional support alone due to metabolic changes.
  16. Kaposi’s sarcoma is a cancer associated with Human Herpesvirus 8 (HHV-8), common in AIDS patients.
  17. Helicobacter pylori infection is a known risk factor for gastric cancer and MALT lymphoma.
  18. The Warburg effect refers to the tendency of cancer cells to prefer glycolysis for energy production, even in the presence of oxygen.
  19. Vascular endothelial growth factor (VEGF) inhibitors like bevacizumab are used in cancer therapy to inhibit angiogenesis.
  20. Cancer-related fatigue is one of the most common side effects experienced by cancer patients during and after treatment.

Important One-Liner Points on Respiratory Disorders.


1. Basic Anatomy and Physiology

  1. The respiratory system includes the nose, pharynx, larynx, trachea, bronchi, and lungs.
  2. The alveoli are the primary site of gas exchange in the lungs.
  3. Surfactant reduces surface tension in the alveoli, preventing lung collapse.
  4. The diaphragm is the main muscle of respiration.
  5. Oxygen saturation (SpO₂) measures the percentage of hemoglobin bound with oxygen.
  6. The normal respiratory rate for adults is 12–20 breaths per minute.

2. Obstructive Lung Diseases

  1. Chronic obstructive pulmonary disease (COPD) includes chronic bronchitis and emphysema.
  2. Chronic bronchitis is defined as a productive cough for at least 3 months in 2 consecutive years.
  3. Emphysema involves the destruction of alveolar walls, leading to air trapping.
  4. The primary risk factor for COPD is smoking.
  5. Asthma is a reversible airway obstruction characterized by wheezing, shortness of breath, and chest tightness.
  6. Status asthmaticus is a life-threatening asthma attack unresponsive to standard treatment.
  7. Peak expiratory flow rate (PEFR) helps monitor asthma control.
  8. Beta-agonists (e.g., salbutamol) are first-line drugs for acute asthma attacks.
  9. Inhaled corticosteroids are the most effective long-term control medication for asthma.

3. Restrictive Lung Diseases

  1. Pulmonary fibrosis causes scarring of lung tissue, leading to stiff lungs and reduced gas exchange.
  2. Sarcoidosis is a granulomatous disease affecting multiple organs, commonly the lungs.
  3. Pneumoconiosis refers to lung diseases caused by inhalation of dust particles, like coal worker’s pneumoconiosis.
  4. Asbestosis increases the risk of mesothelioma, a type of lung cancer.

4. Infections of the Respiratory System

  1. Pneumonia is an infection of the lung parenchyma, causing fever, cough, and chest pain.
  2. Community-acquired pneumonia is commonly caused by Streptococcus pneumoniae.
  3. Hospital-acquired pneumonia is often caused by multidrug-resistant organisms.
  4. Atypical pneumonia presents with a dry cough and is caused by organisms like Mycoplasma pneumoniae.
  5. Tuberculosis (TB) is caused by Mycobacterium tuberculosis and primarily affects the lungs.
  6. The Mantoux test (PPD skin test) is used for TB screening.
  7. Rifampicin, Isoniazid, Pyrazinamide, Ethambutol (RIPE) is the standard first-line treatment for TB.
  8. Latent TB infection means the person is infected but asymptomatic and not contagious.
  9. Miliary TB is disseminated TB that affects multiple organs.

5. Pleural Diseases

  1. Pneumothorax is the presence of air in the pleural space, causing lung collapse.
  2. Tension pneumothorax is a medical emergency requiring immediate needle decompression.
  3. Pleural effusion is the accumulation of fluid in the pleural space.
  4. Transudative pleural effusions are caused by conditions like heart failure, while exudative effusions are due to infections or malignancies.
  5. Thoracentesis is the procedure used to remove pleural fluid for diagnostic or therapeutic purposes.

6. Vascular Disorders

  1. Pulmonary embolism (PE) is a blockage of the pulmonary artery, often due to a blood clot.
  2. Sudden onset of chest pain and shortness of breath is classic for PE.
  3. D-dimer is elevated in PE but not specific; a CT pulmonary angiogram confirms the diagnosis.
  4. Deep vein thrombosis (DVT) is the most common source of pulmonary emboli.
  5. Anticoagulation therapy is the mainstay of treatment for PE and DVT.

7. Respiratory Failure

  1. Acute respiratory distress syndrome (ARDS) is characterized by severe hypoxemia and non-cardiogenic pulmonary edema.
  2. Type I respiratory failure is hypoxemic, while Type II respiratory failure is hypercapnic.
  3. Mechanical ventilation is often required in severe respiratory failure.
  4. CPAP (Continuous Positive Airway Pressure) is used for conditions like obstructive sleep apnea and some cases of respiratory failure.

8. Lung Cancer

  1. Lung cancer is the leading cause of cancer-related deaths worldwide.
  2. Small cell lung cancer (SCLC) is aggressive and strongly associated with smoking.
  3. Non-small cell lung cancer (NSCLC) includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
  4. Pancoast tumor is a lung cancer at the apex of the lung, causing shoulder pain and Horner’s syndrome.
  5. Horner’s syndrome includes ptosis, miosis, and anhidrosis due to sympathetic nerve involvement.

9. Miscellaneous Respiratory Conditions

  1. Cystic fibrosis is a genetic disorder causing thick mucus buildup in the lungs and other organs.
  2. Obstructive sleep apnea (OSA) causes repeated episodes of airway obstruction during sleep.
  3. Snoring, daytime sleepiness, and morning headaches are signs of OSA.
  4. Epiglottitis is a life-threatening condition causing airway obstruction, especially in children.
  5. Bronchiolitis is a common viral infection in infants, often caused by RSV (Respiratory Syncytial Virus).
  6. Whooping cough (pertussis) is a highly contagious respiratory disease caused by Bordetella pertussis.
  7. Legionnaires’ disease is a severe pneumonia caused by Legionella pneumophila.

10. Diagnostic Tools in Respiratory Diseases

  1. Spirometry measures lung function, especially useful in diagnosing obstructive and restrictive lung diseases.
  2. Pulse oximetry measures oxygen saturation non-invasively.
  3. Arterial blood gas (ABG) analysis provides information on oxygenation, ventilation, and acid-base balance.
  4. Chest X-ray is the first imaging study for most respiratory complaints.
  5. CT scan of the chest provides detailed images of lung structures.
  6. Bronchoscopy allows direct visualization of the airways for diagnostic and therapeutic purposes.

Important One-Liner Points on Gastrointestinal (GI) Disorders.


1. Anatomy & Physiology

  1. The gastrointestinal tract extends from the mouth to the anus.
  2. The small intestine is the primary site for nutrient absorption.
  3. The liver produces bile, essential for fat digestion.
  4. The pancreas produces digestive enzymes and insulin.
  5. The large intestine absorbs water and electrolytes.
  6. Peristalsis is the wave-like contraction that moves food through the GI tract.
  7. The stomach’s acidic environment helps in protein digestion and killing pathogens.
  8. The esophageal sphincter prevents acid reflux into the esophagus.
  9. The gallbladder stores and concentrates bile.
  10. The appendix is a vestigial organ, often inflamed in appendicitis.

2. Esophageal Disorders

  1. Gastroesophageal reflux disease (GERD) is caused by the backflow of stomach acid into the esophagus.
  2. Heartburn is the most common symptom of GERD.
  3. Barrett’s esophagus is a precancerous condition caused by chronic GERD.
  4. Esophageal varices are dilated veins in the esophagus, often due to liver cirrhosis.
  5. Achalasia is a motility disorder where the lower esophageal sphincter fails to relax.
  6. Dysphagia refers to difficulty swallowing, a common symptom of esophageal disorders.
  7. Esophageal cancer is commonly squamous cell carcinoma or adenocarcinoma.
  8. Mallory-Weiss tear is a mucosal tear at the gastroesophageal junction due to severe vomiting.
  9. Boerhaave syndrome is esophageal rupture, a life-threatening emergency.
  10. Barium swallow study is a diagnostic test for evaluating esophageal motility disorders.

3. Gastric Disorders

  1. Gastritis is the inflammation of the stomach lining, often caused by H. pylori or NSAIDs.
  2. Peptic ulcer disease (PUD) includes gastric and duodenal ulcers.
  3. H. pylori infection is a major cause of peptic ulcers.
  4. Epigastric pain relieved by eating suggests duodenal ulcers.
  5. Epigastric pain worsened by eating suggests gastric ulcers.
  6. Perforated ulcer presents with sudden, severe abdominal pain and requires emergency surgery.
  7. Melena (black, tarry stools) indicates upper GI bleeding.
  8. Zollinger-Ellison syndrome involves gastrin-secreting tumors causing refractory ulcers.
  9. Proton pump inhibitors (PPIs) are first-line treatment for acid-related disorders.
  10. Gastrectomy can lead to dumping syndrome, causing rapid gastric emptying.

4. Small Intestine Disorders

  1. Celiac disease is an autoimmune disorder triggered by gluten.
  2. Diarrhea is defined as the passage of three or more loose stools per day.
  3. Malabsorption syndromes cause steatorrhea (fatty stools) and nutrient deficiencies.
  4. Crohn’s disease can affect any part of the GI tract from mouth to anus.
  5. Skip lesions are characteristic of Crohn’s disease.
  6. Ulcerative colitis affects the colon and rectum with continuous inflammation.
  7. Bloody diarrhea is more common in ulcerative colitis than in Crohn’s disease.
  8. Fistulas are abnormal connections between organs, common in Crohn’s disease.
  9. Ileus is the absence of intestinal peristalsis without mechanical obstruction.
  10. Intussusception is the telescoping of one part of the intestine into another, causing obstruction.

5. Large Intestine Disorders

  1. Appendicitis presents with right lower quadrant pain, fever, and nausea.
  2. McBurney’s point tenderness is a classic sign of appendicitis.
  3. Diverticulosis involves the formation of pouches in the colon wall.
  4. Diverticulitis is inflammation or infection of diverticula.
  5. Irritable bowel syndrome (IBS) is a functional disorder causing abdominal pain and altered bowel habits.
  6. Colorectal cancer often develops from precancerous polyps.
  7. Change in bowel habits and blood in stools are warning signs of colorectal cancer.
  8. Hemorrhoids are swollen veins in the rectum or anus causing bleeding and discomfort.
  9. Fecal occult blood test (FOBT) is used to screen for colorectal cancer.
  10. Sigmoidoscopy and colonoscopy are diagnostic tools for colon diseases.

6. Hepatobiliary Disorders

  1. Hepatitis is inflammation of the liver, commonly caused by viruses (A, B, C, D, E).
  2. Hepatitis B and C can lead to chronic liver disease and hepatocellular carcinoma.
  3. Jaundice is yellowing of the skin and eyes due to elevated bilirubin.
  4. Cirrhosis is irreversible scarring of the liver, often due to alcohol or chronic hepatitis.
  5. Ascites is the accumulation of fluid in the abdominal cavity due to liver disease.
  6. Portal hypertension leads to complications like varices and splenomegaly.
  7. Hepatic encephalopathy is brain dysfunction due to liver failure.
  8. Gallstones (cholelithiasis) can cause biliary colic and cholecystitis.
  9. Murphy’s sign is a clinical indicator of cholecystitis (pain on deep inspiration with RUQ palpation).
  10. ERCP (Endoscopic Retrograde Cholangiopancreatography) is used to diagnose and treat biliary disorders.

7. Pancreatic Disorders

  1. Acute pancreatitis presents with severe epigastric pain radiating to the back.
  2. Gallstones and alcohol are the most common causes of acute pancreatitis.
  3. Amylase and lipase levels are elevated in acute pancreatitis.
  4. Chronic pancreatitis leads to pancreatic insufficiency, causing malabsorption and diabetes.
  5. Pancreatic cancer often presents with painless jaundice and weight loss.
  6. Courvoisier’s sign indicates a palpable, non-tender gallbladder in pancreatic cancer.
  7. Pancreatic pseudocyst is a complication of pancreatitis requiring drainage if symptomatic.
  8. Steatorrhea (fatty stools) is common in chronic pancreatitis due to fat malabsorption.

8. Gastrointestinal Bleeding

  1. Upper GI bleeding presents with hematemesis (vomiting blood) or melena.
  2. Lower GI bleeding presents with hematochezia (bright red blood per rectum).
  3. Esophageal varices are a common cause of upper GI bleeding in cirrhosis patients.
  4. Octreotide is used to control bleeding from esophageal varices.
  5. Angiodysplasia is a common cause of GI bleeding in the elderly.
  6. Nasogastric tube aspiration helps differentiate upper from lower GI bleeding.
  7. Endoscopy is the first-line diagnostic tool for GI bleeding.
  8. Hemodynamic stabilization with IV fluids and blood transfusion is the priority in active GI bleeding.

9. Infections & Parasitic Diseases

  1. Gastroenteritis is inflammation of the stomach and intestines, causing diarrhea and vomiting.
  2. Rotavirus is a leading cause of severe diarrhea in children.
  3. Norovirus is a common cause of foodborne outbreaks of gastroenteritis.
  4. Clostridioides difficile (C. diff) causes antibiotic-associated colitis.
  5. Giardiasis is a parasitic infection causing greasy, foul-smelling diarrhea.
  6. Amoebiasis causes bloody diarrhea, often linked to contaminated food or water.
  7. Typhoid fever is caused by Salmonella typhi, presenting with high fever and abdominal pain.
  8. Traveler’s diarrhea is often caused by E. coli and treated with hydration.

10. Hernias and Obstructions

  1. Inguinal hernias are the most common type of hernia.
  2. Strangulated hernia is a surgical emergency due to compromised blood flow.
  3. Hiatal hernia occurs when part of the stomach herniates through the diaphragm.
  4. Bowel obstruction presents with abdominal distension, vomiting, and absence of bowel movements.
  5. Air-fluid levels on X-ray are indicative of intestinal obstruction.
  6. Volvulus is the twisting of the intestine, leading to obstruction and ischemia.

11. Anorectal Disorders

  1. Anal fissures are small tears in the anal mucosa causing painful defecation.
  2. Perianal abscess is a collection of pus near the anus, often requiring drainage.
  3. Anal fistula is an abnormal connection between the anal canal and the skin.
  4. Pilonidal cyst occurs near the tailbone and can become infected.
  5. Rectal prolapse is the protrusion of the rectal wall through the anus.

12. Nutritional and Metabolic Disorders

  1. Vitamin B12 deficiency can cause macrocytic anemia and neurological symptoms.
  2. Iron deficiency anemia often results from chronic GI blood loss.
  3. Short bowel syndrome occurs after significant resection of the small intestine, leading to malabsorption.
  4. Lactose intolerance causes bloating, diarrhea, and gas after dairy consumption.
  5. Refeeding syndrome is a potentially fatal shift in fluids and electrolytes after reintroducing nutrition in malnourished patients.

Important One-Liner Points on Fluid and Electrolyte Imbalance.


1. Basic Concepts of Fluid Balance

  1. Total body water constitutes about 60% of body weight in adults.
  2. Intracellular fluid (ICF) makes up about two-thirds of total body water.
  3. Extracellular fluid (ECF) includes interstitial fluid, plasma, and transcellular fluid.
  4. Osmosis is the movement of water across a semipermeable membrane from low to high solute concentration.
  5. Osmolality measures the concentration of solutes per kilogram of water.
  6. ADH (antidiuretic hormone) regulates water balance by promoting water reabsorption in the kidneys.
  7. Aldosterone promotes sodium retention and potassium excretion in the kidneys.
  8. Thirst mechanism is regulated by the hypothalamus in response to increased osmolality.
  9. Oncotic pressure is the pulling force exerted by proteins like albumin to retain fluid in blood vessels.
  10. Hypovolemia refers to decreased blood volume, often due to fluid loss.

2. Types of IV Fluids

  1. Isotonic fluids (e.g., normal saline, lactated Ringer’s) have the same osmolality as blood.
  2. Hypotonic fluids (e.g., 0.45% saline) cause water to move into cells.
  3. Hypertonic fluids (e.g., 3% saline) pull water out of cells into the extracellular space.
  4. Dextrose solutions provide both fluid and calories.
  5. Colloid solutions (e.g., albumin) expand plasma volume by increasing oncotic pressure.

3. Dehydration and Overhydration

  1. Dehydration occurs when fluid output exceeds intake.
  2. Signs of dehydration include dry mucous membranes, hypotension, and tachycardia.
  3. Severe dehydration can lead to hypovolemic shock.
  4. Water intoxication results from excessive water intake, causing hyponatremia.
  5. Edema is fluid accumulation in the interstitial space, often due to heart, liver, or kidney failure.

4. Sodium Imbalance (Na⁺)

  1. Normal sodium level: 135–145 mEq/L.
  2. Hyponatremia is defined as sodium <135 mEq/L.
  3. Symptoms of hyponatremia include confusion, seizures, and headache.
  4. SIADH causes hyponatremia due to excess ADH secretion.
  5. Hypernatremia is sodium >145 mEq/L, leading to thirst, agitation, and coma.
  6. Diabetes insipidus causes hypernatremia due to water loss from lack of ADH.
  7. Rapid correction of hyponatremia can cause central pontine myelinolysis (osmotic demyelination syndrome).
  8. Hypertonic saline (3% NaCl) is used for severe symptomatic hyponatremia.

5. Potassium Imbalance (K⁺)

  1. Normal potassium level: 3.5–5.0 mEq/L.
  2. Hypokalemia is potassium <3.5 mEq/L.
  3. Symptoms of hypokalemia include muscle weakness, cramps, and cardiac arrhythmias.
  4. ECG changes in hypokalemia: flattened T waves, U waves, and ST depression.
  5. Potassium chloride is used to treat hypokalemia, administered cautiously to avoid arrhythmias.
  6. Hyperkalemia is potassium >5.0 mEq/L.
  7. Symptoms of hyperkalemia include muscle weakness, paresthesia, and life-threatening arrhythmias.
  8. ECG changes in hyperkalemia: peaked T waves, widened QRS complexes.
  9. Calcium gluconate stabilizes the heart in hyperkalemia but doesn’t lower potassium.
  10. Insulin with glucose shifts potassium into cells during hyperkalemia.
  11. Kayexalate (sodium polystyrene sulfonate) removes excess potassium via the GI tract.

6. Calcium Imbalance (Ca²⁺)

  1. Normal calcium level: 8.5–10.5 mg/dL.
  2. Hypocalcemia is calcium <8.5 mg/dL.
  3. Symptoms of hypocalcemia: tetany, muscle cramps, and seizures.
  4. Chvostek’s sign (facial twitching) and Trousseau’s sign (carpal spasm) indicate hypocalcemia.
  5. Hypoparathyroidism is a common cause of hypocalcemia.
  6. Hypercalcemia is calcium >10.5 mg/dL.
  7. Symptoms of hypercalcemia: “bones, stones, groans, and psychic overtones” (bone pain, kidney stones, GI symptoms, confusion).
  8. Malignancy and hyperparathyroidism are common causes of hypercalcemia.
  9. IV fluids and bisphosphonates are used to manage severe hypercalcemia.

7. Magnesium Imbalance (Mg²⁺)

  1. Normal magnesium level: 1.5–2.5 mEq/L.
  2. Hypomagnesemia causes muscle cramps, tremors, and arrhythmias.
  3. Hypomagnesemia is often associated with hypokalemia and hypocalcemia.
  4. Magnesium sulfate is given IV for severe hypomagnesemia and preeclampsia.
  5. Hypermagnesemia is magnesium >2.5 mEq/L, leading to hypotension, bradycardia, and respiratory depression.
  6. Calcium gluconate is the antidote for magnesium toxicity.

8. Phosphate Imbalance (PO₄³⁻)

  1. Normal phosphate level: 2.5–4.5 mg/dL.
  2. Hypophosphatemia causes muscle weakness, respiratory failure, and rhabdomyolysis.
  3. Refeeding syndrome often leads to hypophosphatemia.
  4. Hyperphosphatemia is common in chronic kidney disease.
  5. Phosphate binders (e.g., sevelamer) are used to treat hyperphosphatemia.

9. Acid-Base Imbalance

  1. Normal pH: 7.35–7.45.
  2. Acidosis refers to pH <7.35, while alkalosis is pH >7.45.
  3. Metabolic acidosis is caused by conditions like DKA, sepsis, or renal failure.
  4. Kussmaul respiration (deep, rapid breathing) occurs in metabolic acidosis.
  5. Anion gap helps differentiate causes of metabolic acidosis: AG = Na – (Cl + HCO₃).
  6. Metabolic alkalosis is often due to vomiting or diuretic use.
  7. Respiratory acidosis occurs with hypoventilation, leading to CO₂ retention.
  8. Respiratory alkalosis occurs with hyperventilation, reducing CO₂ levels.
  9. ABG analysis is the gold standard for diagnosing acid-base disorders.

10. Fluid Volume Disorders

  1. Isotonic dehydration is the most common type, caused by equal loss of water and electrolytes.
  2. Hypotonic dehydration occurs with more sodium loss than water, leading to hyponatremia.
  3. Hypertonic dehydration occurs with more water loss than sodium, causing hypernatremia.
  4. Third-spacing refers to fluid shifting from the intravascular space to the interstitial space.
  5. Hypovolemic shock results from severe fluid loss, leading to low BP and poor perfusion.
  6. Orthostatic hypotension can indicate volume depletion.
  7. Central venous pressure (CVP) measures fluid status in critically ill patients.

11. Hormonal Regulation of Fluids & Electrolytes

  1. Renin-angiotensin-aldosterone system (RAAS) regulates sodium, fluid balance, and blood pressure.
  2. Atrial natriuretic peptide (ANP) promotes sodium excretion to lower blood volume.
  3. Cortisol affects sodium and water retention during stress.

12. Dehydration in Pediatrics and Elderly

  1. Infants and elderly are at higher risk of dehydration due to impaired thirst and fluid regulation.
  2. Sunken fontanelle is a sign of dehydration in infants.
  3. Dehydration in the elderly may present as confusion or dizziness instead of thirst.

13. Electrolyte Replacement Guidelines

  1. IV potassium should never exceed 10–20 mEq/hr to avoid cardiac arrhythmias.
  2. Oral rehydration solutions (ORS) are effective for mild to moderate dehydration.
  3. Rapid correction of chronic hypernatremia can cause cerebral edema.
  4. Slow correction of chronic hyponatremia is essential to prevent osmotic demyelination.

14. Common Electrolyte Disturbances in Diseases

  1. Addison’s disease causes hyponatremia and hyperkalemia due to aldosterone deficiency.
  2. Cushing’s syndrome leads to hypernatremia and hypokalemia due to excess cortisol.
  3. Diabetic ketoacidosis (DKA) often presents with hyperkalemia despite total body potassium depletion.
  4. Hyperaldosteronism (Conn’s syndrome) causes hypokalemia and hypertension.
  5. Chronic kidney disease leads to hyperkalemia, hyperphosphatemia, and hypocalcemia.

15. Clinical Signs of Imbalances

  1. Dry mucous membranes and poor skin turgor indicate dehydration.
  2. Jugular venous distension (JVD) suggests fluid overload.
  3. Bounding pulse and crackles in the lungs are signs of fluid overload.
  4. Tingling, numbness, and tetany suggest calcium or magnesium imbalances.
  5. Muscle cramps and weakness are common in sodium, potassium, or magnesium disturbances.

16. Monitoring and Assessment

  1. Daily weight measurement is the most accurate indicator of fluid balance.
  2. Urine output <0.5 mL/kg/hr indicates possible dehydration or renal failure.
  3. Serum osmolality helps differentiate causes of hyponatremia and hypernatremia.
  4. Urine specific gravity indicates hydration status; high in dehydration, low in overhydration.
  5. Electrolyte panels (BMP/CMP) are essential for monitoring fluid and electrolyte status.

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Categorized as COH-MSN, Uncategorised