pg notes 5.doc

7/28/2019 PG notes 5.doc

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PHYSIOLOGY

ATP is high energy compound.

Glutamate - Excitatory neurotransmitter.

Glycine is inhibitory neurotransmitter in spinal cord. GABA is in CNS.

C-cell in thyroid secretes calcitonin. Calcitonin is increased in medullary

carcinoma of thyroid.

Renin secretion is increased in the following conditions- Low sodium level,

low blood pressure, upright position, hemorrhages, dehydration, diuretics

and CCF.

Renshaw cell inhibition recurrent inhibition.

Sperms acquire motility in epididymis.

Capacitance of sperms occurs in female genital tract after coitus.

After vasectomy antibodies are formed against sperms.

Increased basal body temperature by 0.3 to 0.5 degree centigrade is due to

progesterone.Estrone is the estrogen form in old age.

Tongue tip- sweet taste.

Tongue margin- sour taste.

Tongue centre- salt taste.

Tongue back- bitter taste.

Vibration sensation by Pacinian corpuscles.

Stroke volume = 80 ml = C.O/ Heart rate

M cell = Macrofold cell in small intestine and presents antigen.

Tetradoxin blocks sodium channel during action potential.

Gall bladder bile salt is more concentrated than the hepatic bile salt.

Growth hormone and prolactin are produced from the acidophilic cells.


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Thermo-regulation Anterior hypothalamus- cools the body when it is too

hot. (A/C). Posterior hypothalamus keeps the body warm when it is cold.

Transport maximum for glucose in male is 350 mg, and in female is 300mg.

Intercalated disc is present in cardiac muscles.

Melatonin is produced in pineal gland mainly at night, and helps is sleep-

waking cycle.

Melanin is produced by melanocytes.

Brown- Sequards syndrome- Hemisection of spinal cord. Causes ipsilateral

loss of touch and vibration sensation and contralateral loss of pain and

temperature sensation.

Zona glomerulosa(G) Aldosterone

Zona fascicualta (F) Glucocorticoid

Zona reticularis(R) Androgen

Note that GFR- deeper you go sweeter it is.

Bainbridge reflex Rapid infusion of fluid increases the heart rate.

K+ and bicarbonate concentration is more in saliva than in plasma.

Porcine insulin differs from human insulin by one amino acid.

Bovine insulin differs from human insulin by three amino acids.

ADH acts in collecting duct.

Damage to auditory cortex leads to deficiency in interpretation of sound.

Arousal response is due to reticular activation system (RAS)

Across the cell membrane glucose is transported along with sodium, this iscalled as sodium- glucose SYMPORT.

Urine/plasma sodium ratio = 0.6

Pulmonary wedge pressure equals left atrial pressure.

Arterioles are resistance vessels. They cause maximum peripheral pressure.


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Maximum blood is present in systemic veins = 54%

Maximum resistance = arterioles

Maximum surface area = capillaries and contains only 5% of total blood.

Acid secretion is increased in stomach by vagal stimulation, gastrin and food

in the stomach. And it is decreased by somatostatin.

Anion gap is mainly due to proteins.

Surfactant in fetal lungs is formed in 28 to 28 weeks of intrauterine life.

Hypoxia causes rise in erythropoietin formation.

TRH stimulates the release of TSH as well as prolactin.

Osmo-receptor is in hypothalamus.

PTH Increases calcium level in blood by increasing the intestinal

absorption and renal re-absorption and decreases phosphate level by

increased excretion and decreased re-absorption, increases bone re-

absorption.

BMR depends upon the body surface.

Normal functional residual capacity is 2.3 liters (2.2 in female and 2.6 in

male).

CSF pressure = 50 to 180 mm of water or 6 to 12 mm of mercury.

In PCOD LH to FSH ratio is increased.

pH of saliva = 7

pH of gastric juice = 1

pH of hepatic bile is 7.8 to 8.6

pH of gall bladder bile 7.0 to 7.4

pH of pancreatic juice is 8.0

Maximum triglyceride is present in chylomicrons

Prothrombin needs factor Xa and factor V to form thrombin.

Renal plasma flow is measured by para-amino hippuric acid (PAH)

Renal glomerular filtration rate is measured by inulin.


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Ficks principle is used for measurement of cardiac output.

Dura-mater is pain sensitive.

CSF glucose is 2/3 of blood glucose. CSF glucose to blood glucose ratio is

0.64

Collagen has triple helix.

Endothelial derived relaxing factor (EDRF) is nitric oxide (NO). Released

from endothelium.

Antidromic conduction is seen in axon.

CNS phagocytosis is by microglia which originates from mesoderm.

Liver macrophages = Kuppfers cell

Lungs Alveolar macrophages

Anti-peristalsis is normal in ascending colon.

FSH stimulates Sertori cells which secrete inhibin which has negative

feedback on FSH secretion. Sertori cells also act as blood testis barrier.

Renovascular hypertension is due to rennin

Gastric juice has no calcium content.

Most abundant ion in blood is chloride. And the second most common is

bicarbonate.

Stomach - Parietal cell (Oxyntic cell) - Intrinsic factor and hydrochloric acid

-Chief cell (Zymogen or peptic cell) Pepsinogen.

Amacrine cells are present in retina.

Archicerebellum develops to flocculus.

When from supine position to upright the following changes are seen in

CVS- increased heart rate, decreased cardiac output, and decreased stroke

volume.

Tight junction or desmosome keeps the cells together


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Gap junction from where molecules are transferred.

Atrial natriuretic peptide (ANP) - secreted from the left atrium, causes

natriuresis and renin secretion.

Action potential is due to sodium influx also called as depolarization.

Bernaullis principle- sum of kinetic energy of flow and pressure inside a

tube is always constant.

Axon hillock has lower threshold for action potential than axon.

Type I respiratory failure Oxygen is decreased (Hypoxia)- e.g. pneumonia,

pulmonary edema, pulmonary hemorrhage.

Type II respiratory failure Carbondioxide is increased (Hypercapnia) e.g inneuromuscular diseases, respiratory fatigue in COPD, asthma, restrictive

lung diseases.

Resting membrane potential -90mv

Action potential -65mv (threshold)

Lateral spinothalamic tract contralateral pain and temperature.

Anterior spinothalamic tract contralateral crude touch.

Dorsal column fine touch, vibration and position sense of the same side.

Because the proteolytic enzymes are secreted in inactive form auto digestion

is prevented.

Non-shivering thermo-genesis in adult is by nor-adrenaline, and in infant is

by brown fat.

Total alveolar ventilation = 4.2 liters.

Extrinsic pathway- factor VII

Intrinsic pathway factor XII, XI, IX, X and VIIIExtra-cellular hyper-osmolarity causes thirst.

Henderson- Hasselbach equation is used for measuring acid base balance.


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BIOCHEMISTRY

Irreversible step in glycolysis is phosphor-fructo-kinase.

4 kinases are used in glycolysis

Familial melanoma- p-16 gene

Li-Fraumeni syndrome- p- 53 gene

Haptoglobulin binds with hemoglobulin thus in hemolytic disordes

haptoglobulin is reduced

Simplest amino acid is glycine

Sucrose = glucose + fructose

Chylomicrons have highest amount of TG.

LDL has highest cholesterol.

Maple syrup urine disease is also called as branched chain amino aciduria

and is it due to deficient keto-decarbixylase. Leucine is excreted in urine.

Polymerase chain reaction enzymatic DNA amplification

DNA

transcription

mRNA

translation

protein

Anti- oxidants Vitamin A, C, E, beta carotene, butylated hydroxyl toluene,

butylated hydroxyl anisole.

Androstenedione dehydrogenation testosterone

Phenyl ketonuria Mousy urine oduor due to phenyl acetate accumulation

and screening by Guthares test.

Carcinoid syndrome- 5HIAA in urine is raised which is formed fromtryptophan.

Pheochromocytoma VMA, meta-nephrines and catacholamines are

increased in urine.

Tryptophan give rises to niacin, serotonin, and also melatonin.


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Sickle cell anaemia- at 6th position of amino acid chain glutamic acid is

replaced by valine. ( glutamic acid goes and valine visits)

Pectin, cellulose and hemicellulose are dietary fibres.

Von Gierkes disease glucose -6-phosphatase deficiency occurs and

manifests as hepatomegaly, hypoglycemia, hyperuricemia, hyperlipidemia

and lactic acidosis.

Glucogenic/ ketogenic amino acids are phenylalanine, lysine, isoluecine,

tryptophan and tyrosine. (PLITT)

Ketogenic amino acid Leucine

Essential amino acids are Methionine, isoleucine, leucine, lysine,

phenylalanine, tryptophan, threonine, valine and histidine. ( MILL PTT VH)

In G6PD deficiency hemolysis is due to decrease in NADPH.

Beta carotene is pro- vitamin A

Iron absorption is reduced by phytates, oxalates and phosphates. Absorption

is increased by vitamin C.

Steroid is synthesized in smooth ER.

Function of mitochondria- cell respiration, ATP synthesis, beta-oxidation of

fatty acid.

Malonate inhibits succinate dehydrogenase.

Glycophorin is a major integral membrane glycoprotein in human RBC

Cell motility is due to tubulin.

Bence Jones protein light chain protein in excreted in urine in multiple

myeloma.

Glucose Lactate 2 ATP produced

Collagen has triple helix structure and is made up of glycine and praline and

vitamin C is required.


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Beta form of DNA is predominant.

Renal threshold of glucose is 180 mg.

Restriction endonuclease breaks double stranded DNA.

Carboxylation needs biotin.

Bile salt is synthesized in liver from cholesterol and enzyme is 7-alpha-

hydroxylase.

Cobalt is component of vitamin B 12 (cynocobalamin)

Complete enzyme complex is holozyme.

Richest source of cholesterol is egg.

Micro tubules are responsible for the shape and motility.

Fluoride inhibits enolase.

Pentothenic acid is essential for Co-enzyme A synthesis.

Most common source of gluconeogenesis is alanine.

Golgi bodies marker is galactosyl transferase.

Benedict- Roths apparatus is for BMR calculation.

B12 is absorbed in ileum.

Xeroderma pigmentosa defect in thiamine diamers.

Surperoxide dismutase protects brain from free radicals.

Selenium deficiency leads to Keshans disease. Selenium is needed for

glutathione peroxidase.

Okazaki fragments helps in DNA replication.

B-48 Chylomicrons.

B-100 LDL, VLDL, IDL

To find out the thiamine deficiency, do transketolase activity in RBC.

Cancer cell gets energy from glycolysis.

FIGLU in urine helps to find out the folic acid deficiency


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Kallikrein is most commonly found in collecting duct.

In brain NH3 is detoxified to glutamine

Nitric oxide is synthesized from argentine and needs oxygen, FAD, FMN,

NADHP, BH4, heme and RSH.

Adrenaline synthesis- Rate limiting enzyme is tyrosine hydroxylase.

True essential fatty acid is linoleic acid.

Homocystine is a risk factor for ischemic heart disease.

Dietary fibers decrease the intestinal transit time

AUG is start codon and is also methionine. AUG augments the protein

synthesis.

Homeobox gene Normal development during morphogenesis.

Fenton reaction is conversion of ferrous to ferric ion and free radical.

Fe2+ +H2O2 Fe3+ + HO+ HO-

Transketolase is needed for the thiamine metabolism.

Glycolysis/ Krebs cycle does not occur in RBC.

Liver cells do not need insulin for the glucose uptake.

Ketone bodies are detected by Rotheras test.

Vitamin D3 = Steroid super family.

Chaperons help in protein folding.

Histone is basic amino acid and helps in protein folding.

PATHOLOGY

Caseous necrosis that occurs in tuberculosis- Coagultive necrosis +

liquifactive necrosis.


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Most common primary brain tumor is glioblastoma. Otherwise most

common tumor in brain is secondaries.

Wiskott Aldrich syndrome- X- linked, eczema, thrombocytopenia.

Obstructive jaundice- there is vitamin K deficiency.

Gitter cells- phagocytes in CNS.

Mc Callums patch- in rheumatic carditis is usually present in left atrium.

Wound margin has myofibroblast.

Most common thyroid carcinoma is papillary carcinoma, also has best

prognosis and has Orphan Annie nucleus and psammoma bodies. Worst

prognosis (worst prognosis) is in follicular carcinoma of thyroid.

Cytokeratin is tumor marker of carcinoma.

HMB45/S-100 = tumor marker of melanoma

Factor VIII is marker of Kaposis sarcoma and angiosarcoma.

Mallory bodies - intermediate filaments present in liver in alcoholic

hepatitis.

Councilmans bodies is present in liver in viral hepatitis

Pale infarct is present in firm organs like heart, spleen and kidney

Red infarct is present lungs.

Earliest change in atherosclerosis is fatty streak.

MI- after 3 to 7 days macrophages are seen. Complete healing occurs in 7 to

8 weeks.

Pneumocystis carnii is stained by methenamine silver.

Livercentrilobular necrosis caused by carbon tetrachloride.

Liverperipheral necrosis is caused by phosphorus, and also in eclampsia.Mid zonal necrosis is seen in yellow fever.


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Rh incompatibility = type II reaction (cytotoxic)

Type I (anaphylaxis and atophy) A

Type II reaction (cytotoxic) thrombocytopenia, hemolytic anaemia, type I

lepra reaction, agranulocytosis. C

Type III reaction (immunocomplex) Arthrus reaction and serum sickness.

I

Type IV reaction (delayed hypersensitivity) -Tuberculin reaction and contact

dermatitis. D

1/2/3/4 ACID.

Most common cause of lung abscess is aspiration.

Flea bitten appearance of kidney is due to malignant hypertension.

Splenectomy causes anisocytosis, poikilocytosis, Howell Jolly bodies, Heinz

bodies, and basophilic stippling.

SLE - Anti ds, wireloop glomerulonephritis, Libman Sach endocarditis,

onion skin spleen.

Focal segmental glomerulosclerosis IgA nephropathy,heroin abuse, AIDS,

reflux oesophagitis, analgesic, unilateral agenesis.

MPGN- lipodystrophy.

Hypernephroma renal cell carcinoma- clinical features are hematuria,

polycythemia, renal venous thrombosis.

Macrophage develops from monocytes.

Malignant hypertension- flea bitten appearance, fibrinoid necrosis,

hyperplastic arteiolitis.

Epulis = granulomatous lesion of gingiva

Normocytic normochromic anaemia in chronic diseases like CRF, aplastic

anaemia, pure red cell aplasia.

Aneurysm true- all layers of arterial wall is involved.

-Berrys most common congenital

- Sacular - one side of wall is involved


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- fusiform circumferencial dilatation

- Mycotic inflammatory

Aspirin inhibits cyclo-oxygenase pathway.

Acute cor- pulmonale is due to pulmonary embolism.

Alpha feto-protein is raised in hepatocellular carcinoma, yolk sac tumor and

endodermal sinus tumor.

Dystrophic calfication occurs in inflamed region e.g. atheroma, TB lymph

node and cardiac valve.

Metastatic calcification occurs in normal tissue due to hypercalcemia

Atherosclerosis is the most common cause of aneurysm. Berry aneurysm is

the most common congenital aneurysm.

Renal amyloidosis presenting feature is proteinuria.

Muscular dystrophy is heterogenicity of muscular fibers.

Liver change in Reyes syndrome is diffuse steatosis.

Pleomorphic adenoma is the commonest parotid gland tumor.

Idiopathic adenoma myelofibrosis tear drop cell

Amyloid staining is with congo red and visualized with polarized light.

Chronic disease anaemia- low serum iron, low total iron binding capacity

and high ferritin level.

Rodent ulcer is basal cell cancer and is most common in inner canthus of

eye and has rolled edge.

Psamomma bodies seen in papillary carcinoma of thyroid, meningioma, and

ovarian carcinoma.

Marfans syndrome- lens dislocation, aortic aneurysm at ascending aorta.

Peutz Jeghers syndrome hamartomatous polyp in small intestine.

Type A gastritis Auto immune, antibodies form against intrinsic factor and

parietal cell, pH increases.


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Tybe B gastritis is due to bacteria-Helicobacter pylori

Line of Zahn seen in primary platelet clot and mural thrombus.

Alzheimers disease shows senile plaques, neurofibrillary triange, and loss

of neurons in cerebral cortex.

Hepatocytes are not labile cells.

Proteoglycans has lamnin, collgen type IV, fibronectin, entacin.

Hemangioma is the most common tumor in liver.

Most common site for the brain abscess is temporal lobe.

Non caseating granuloma with hilar lymphadenopathy is in sarcoidosis.

Glanzmanns thrombosthenia defective platelet aggregation.

Benign hypertension hyaline arteriosclerosis, benign nephrosclerosis.

Diabetes mellitus Nodular glomerulosclerosis ( Kimmelsteil Wilson

disease).

Major basic protein comes from eosinophils.

Chronic bronchitis and syphilis show no amyloidosis.

MI completely heals in 7 to 8 weeks.

Rupture of ventricles in MI occurs in 4 to 10 days.

Non smokers carcinoma lungs is adenocarcinoma. It is also the cause for

Horners syndrome.

Toxic megacolon is a complication of ulcerative colitis.

Minimal change glomerulonephritis no change is seen in light microscopy

and loss of podocytes are seen in electron microscopy.


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CLL most common cell type is B cell.

Homer Wright rosette is seen in medulloblastoma.

Fitz Hugh Curtis syndrome is peri-hepatitis due to PID caused by

Chlamydia. There is violin string sign

Neutrophil T1/2 is 6 hours.

Pheochromocytoma arises from chromaffin cell.

Mycosis fungoides is cutaneous T cell lymphoma, Sezary syndrome.

Lacunar infarct is due to hypertension induced lipohylinolysis.

Most sensitive and vulnerable tissue to hypoxia is brain (3 to 5 minutes).

Cloudy swelling of cell is due to intracellular water and sodium retention.

Leukotriene lipoxygenase pathway.

Primary biliary cirrhosis lipoprotein X is increased.

Earliest change to iron therapy is reticulocytosis.

Primary amyloidosis major fibril protein is AL type.

Secondary amyloidosis AA protein

PCKD cyst in kidney, lungs, liver but not in brain.

Tram track appearance is seen in membranous glomerulonephritis.

Egg cell calcification is seen in silicosis.

Head and neck carcinoma is associated with p53 gene.

Aschoff bodies have antischkow cells, giant cells, and fibrinoid necrosis.

Rheumatic fever exudate is sero-fibrinous.

Spingomyelin Niemann Pick disease.

Celiac sprue is gluten sensitive enteropathy associated with HLA DR3


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Myotonic dystrophy is inherited as autosomal dominant.

Late manifestation of multiple myeloma is renal failure.

Pseudopolyps are seen in ulcerative colitis.

Casonis test is immediate hypersensitivity reaction.

Most common breast carcinoma is infiltrating ductal carcinoma.

In PSGN cresent is formed by mesengial cell, epithelial cell and

macrophages.

Small cell carcinoma is ectopic source of ACTH.

FORENSIC MEDICINE

Dying deposition is more important than the dying declaration

Ophotoxemia is poisoning due to snake bite.

Sex determination is by barr bodies in epithelial cell, RBC or buccal

epithelium.

Transvestism is also called as Eonism

Paltauffs hemorrhage is subpleural hemorrhage that occurs in drowning.

Suspended animation is seen in electrocaution, heat stroke, hypothermia,

cerebral concussion and anaesthesia

Crocodile skin appaearance is due to high voltage burn

Rigor mortis is stiffening and shortening and simulates with cadaveric

spasm.

In death due to arsenic poisoning rigor mortis is delayed.

Suggligation = Vibices = Livor mortis = Lividity.

Joule burn = electrical necrosis.


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Emphysema aquosum is wet drowning. Wet drowning death is due to

laryngospasm.

Contre-coup injury is seen in brain

Galton method is identification by finger print. Loops = 60% . Whorls =

35%

Gustafsons method of identification by teeth.

Sexual asphyxia is in masochism

Mummification occurs due to desiccation of dead body and needs high

temperature, dry air, and windy.

Hydrostatic test if to find out infanticide. Lungs float is death is after birth

and drowns if the death is intrauterine.

EDTA and BAL antidote for lead poisoning.

EDTA, BAL, penicillamine for copper poisoning.

Desferoxamine Iron antidote.

Phossy jaw is due to phosphorus.

Yellow phosphorus is the most poisonous form phosphorus.

Red velvety gastric mucosa is in arsenic poisoning. It shows symptoms as

that of cholera.

Nux vomica = Strychnine seeds, fatal dose is 15 to 30 gm, and presents as

convulsion, opthisthotonus and all the muscle are involved simultaneously.

Colour of post staining in various poisoning-Carbon monoxide- Bright cherry red

Cyanide- Pink

Chlorates- Chocolate brown

Phosphorus- Dark brown

Nitrates- Red brown

Hydrogen sulphide- Bluish green


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Yellow fever = Ades, flavi virus, vaccine works for 10 years.

Scrub typhus = Mite

Japanese encephalitis = Culex

Wucheria bancrofti = Culex

West Nile fever = Culex

Sand fly- Kalazar

Culex is vector for JE, West Nile fever, and Wucheria bancrofti.

Ades is vector for Dengue and yellow fever.

Rose spots are seen in typhoid fever.

All stages of rashes (pleomorphic rashes) are seen in Chicken pox

Epidemic typhus Louse, Rickettsia prowazekii

Endemic typhus Flea, Rickettsia typhiTrench fever- Louse

Koplik spots are seen in buccal mucosa in measles.

Blindness is when visual acuity is less than 3/60

Phosphate test is to check the milk pasteurization

Mumps acquire life long immunity.

Sentinel surveillance helps to find out the missing cases.

Vitamin D requirement in adult is 100 IU per day, in children it is 200 IU,

and in pregnant and breast feeding ladies it is 400 IU per day.

Epidemiological triad - Environment, Agent and Host.

Rabies is not transmitted by ingestion.

Corpulence index of obesity is actual weight/ desirable weight.

Lathyrism Beta oxalyl amino alanine (BOAA)

Peri-natal death = death in the period of 28 weeks of gestation to 7 days after

birth


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Still birth after 28 weeks

Rabies vaccine- Pre-exposure 0/7/21(or 28) days

- Post-exposure 0/3/14/30/90 days

Chandlers index - number of eggs per gram of stool, test done in hook

worm infestation.

Medical termination of pregnancy can be done till 20th week of period of

gestation.

Echinococcus granulosus - intermediate host is man and definitive host is

dog.

Best way to remove cyclops from water is filtration, and Cyclops have life

cycle of 3 weeks.

IQ = MA/CA100

Mild retardation- 50 to 70

Moderate retardation- 35 to 49

Severe retardation- 20 to 34

Profound retardation- < 20

Influenza vaccine is given intra-nasally

BCG is given intradermal

OPV orally

Measles subcutaneously

Hepatitis B intramuscular

Brostal certified school where boys over 16 years of age who are difficult

to be handled are confined.

Live vaccines- BCG, Yellow fever, OPV (Sabin), MMR

UNICEF- 1946

WHO- 1948WHO day is on 7th April.

UNESCO head quarter is in Paris.

FOA head quarter is in Rome.

Red Cross established by Jean Henry Dunant.

Erythema infectiosum- Fifth disease, and shows slapped chick appearance.


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Paris green is stomach poison for anopheles mosquitoes.

Infective stage of malarial parasite is sporozoite.

Total fertility rate = Complete family size.

General fertility rate = Live birth in an area during one year/ mid year

female population of age 15 to 441000.

Pearl index = number of accidental pregnancy/ total number of exposure per

hundred woman years1200

Diphtheria commonly affects the age group of 2 to 5 years.

Fluorine level in water is desired between 0.5 to 0.8mg/L

Ortho toludine test measures the chlorine level in water.

Multi load device is second generation IUCD

Progertasert Third generationIUCD.

MMR vaccine is contra indicated during pregnancy.

Benzidine is associated with bladder carcinoma

Oral rehydration solution (ORS)

Glucose 111 M Mol/L

Sodium 90 m Mol/L

Chloride 80 m Mol/L

Bicarbonate 30 m Mol/L

Potassium 20 m Mol/L

Citrate 10 m Mol/l

Lepromin test Fernandez reaction = early reaction, occurs in 48 hours

-Mitsuda reaction is late reaction, occurs in 3 to 4 weeks.

Case fatality = ratio of death due to disease and the total number of diseased

Mid day meal consists of 1/3 calories and 2/3 proteins


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Rat flea transmits plague, hymenolepis dimunita, maurine typhus

Burden of tuberculosis in a community is found by tuberculin conversion

rate.

Abate is organophosphorus poison.

Barkesonian bias is bias due to different admission rate in hospital.

Ragi is rich in calcium.

Daily requirement of iron during pregnancy is 0.8mg in the first half of

pregnancy and 3.5gm in the second half of pregnancy.

Protein requirement = 1gm/kg body weight.

Cereals are deficient in lysine.

Incubation perid of pertussis is 7 to 10 days.

Latent period is interval between initiation of disease to detection of disease.

Primary case = the first case of epidemic

Index case = the first case to come in attention of investigator of an

epidemic.

Duration of malnutrition is tested by height for the age.

Severity of malnutrition is tested by weight for the height.

Alpha wave = 8 to 12/ sec

Beta wave = 13 to 45/ sec

Theta wave = 5 to 7 /sec

Babies are considered to be at risk if

birth weight is less than 2.5 kg

twins

birth order is more than 5

artificial feeding

weight less than 70%

failure to gain weight in three successive months

PEM/ diarrhea


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Population growth

stationary = no growth

slow growth 2.0

Nuclear family/ Elementary family = husband, wife and their dependent

children

Ancylostoma duodenale = infective form is rhabditiform larva.

Antigenic drift (point mutation) - Influenza virus.

Iodised salt = production level 35ppm

= consumers level 15 ppm

Pit latrine = depth is 10 to 12 feet

Sandfly transmits Kalazar, oriental sore, Oraya fever, and sandfly fever.

MICROBIOLOGY

Ova those float in saturated salt solution are of

Ancylostoma duodenale

Hymenolepis nana

Ascaris lumbricoides (Fertilized) Fertilized floatsTrichuris trichuria

Enterobius vermicularis

Ova those do not float in saturated salt solution are of

Tinea solium

Tinea saginata

TrematodesAscaris lumbricoides (Unfertilized) Unfertilized does not float

Thayer Martin medium Gonococcus (GNDC)

Loeffler serum slope = Diphtheria


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Erythema gangrenosum Pseudomonas

HIV affects T helper cells

EBV affects B cells

Positivity of tuberculin test depends upon the induration

Prion diseases

Creutzufeldt Jacob disease

Kuru

Fatal familial insomnia

Gerstmann Straussler syndrome

Medusa head colony = Bacillus anthracis

String of pearls sign is seen in colonies of Bacillus anthracisSwarming = Proteus

Japanese encephalitis vector is culex and pig is amplifier of the organism

Peripheral blood smear in suspected malaria thick film to detect the

parasite and thin film is to differentiate the type of malarial parasite/ species

Primary antibody response is by IgM

Toxocara canis = Cutaneous larva migransLGV caused by Chlamydia

Granuloma inguinale = Calymmatobacter granulomatosis, diagnosed by

Donovan bodies.

Listeria monocytogen

Gram +ve rods

Causes neonatal meningitis

Causes abortion in pregnancy

Transmitted by contaminated cheese

Rat urine- Leptospirosis

CD4 less than 50 = CMV retinitis

Epstein Barr virus

Infectious mononucleosis


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Nasopharyngeal carcinoma

Burkitts lymphoma

Interleukin 1= fever

Interleukin 2 = T cell proliferationInterleukin 3 = Bone marrow proliferation

Interleukin 4 = IgE activation

Interleukin 5 = IgA activation

( Hot Tea Bone stEAk)

Legionella growth = Buffered yeast charcoal extract (BYCE)

Invasive ameobiasis diagnosed by ELISA

Yersina petis

Gram ve rods

Non motile

Bipolar staining

Vibrio cholerae transport medium is Venkat Ramakrishnan and Clairy

Blair medium

IgA = mucosal epithelium

IgG crosses placenta.

Monotrichate organisms = Vibrio/ pseudomonas/ Spirillum

Peritrichate = Escherchia coli, Salmonella

Amphitrichate = Alkaligens facealis.

Lophotrichate = Pseudomonas

Negri bodies in hippocampus and cerebellum in case of rabies. There

occurs brain stem encephalitis in rabies.

Purine are adenine and guanine

Pyramidine are cytosine and thymine. A=T, G=C is Chargaffs rule

Wasserman reaction= Complement fixation test

Appearance of RBC

Falciparum = MAURERS dot (FM)

Vivax = SCHUFFNERS dot (VS)


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Malariae = ZIEMANNS dot (MZ)

Ovale = JAMES dot (OJ)

Lysogenic or phage conversion Corynebacterium diphtheria

Clostridium perfringes causative agent of gas gangrene

Dimorphic fungus

Histoplasma

Blastomyces

Coccodiodomycosis

Spirotrichum

Vibrio has darting motility

Rabies virus sensitive to ethanol, phenol, ultraviolet rays, formalin

M protein is responsible for the virulence in Streptococcus pyogenes

Dipththeria toxin acts by inactivating elongation factor.

Buruli ulcer Mycobacterium ulcerans

Nagler reaction is due to Clostridium welchi

Casonis test for hydatid cystKevims test for sarcoidosis

Interferon is

glycoprotein

host specific

useful in various malignancies as well as viral infection treatment

In virus DNA is covered by capsid

IgM

Maximum complement fixation

Maximum molecular weight

Staphylococcus aureus coagulase +ve

Native valve endocarditis = Streptococcus viridans


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IV drugs abusers endocarditis is common in tricuspid valve and organism is

Staphylococcu aureus

Prosthetic valve endocarditis

Early onset = Staphylococcus epidermidis Late onset = Streptococcus viridans

Acute endocarditis Staph. aureus

Chronic endocarditis Sterptococcus viridans

Human papova virus causes progressive multifocal leucoencephalopathy

Hepatitis E virus is calcivirus

Histoplasma present in RES

Cryptococcus

affects bone, brain, lungs but no kidney

capsulated, oval, 5 to 10 micrometer size

has predilection for meningitis

diagnosed by India ink stain

Myxovirus = segmented RNA

Natural killer cells are known as large granular lymphocytes

Isoniazid resistant mycobacterium has mutation for catalase peroxidase

enzyme

Salmonella multiplies in intestine before causing symptoms and also

releases preformed toxins

Carcinoma cervix HPV 16/18/31/35/39/45/51/51/56/58


27/28


28/28

pg notes 5.doc

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