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SURGERY, OPHTHA &

PHARMACOLOGY
 Diuretic that does not act on tubular lumen?
Spirinolactone, Loop diuretics, Carbonic
anhydrase inhibitor, Mannitol?
 Nitrates: extensive first pass metabolism (90%)
 DOC for Alzheimer’s Disease: Tacrine – Super
“Old School”… @ Present Ach inhibitors such as
Donepezil are used 1st line
 S/E cataract: Allopurinol
 MOA Cimetidine: H2 receptor blocker
 DOC for nematodes: Mebendazole
 Lactulose: decease blood ammonia levels in
hepatic encephalopathy (Target 4-5 x BM per
day)
 Ondansetron: CA chemotherapy induced emesis
 S/E bismuth containing compounds: Melena
ENT
Why is the sigmoid colon the mc site of
volvulus
-redundancy of length
-increased mobility
cdb note: The most common site of
intussusception of the large intestine is in
the ileocecal region with the lower portion of
the ... Instead the pathogenesis appears to
be (1) abnormal mobility of the sigmoid
colon due to its long mesentery,
 liver abscess? E. histolytica (Anchovy
MEDICINE
 GCS computation
 MOA of Morphine in MI
 Cardiac Enzymes: Troponin I
 Associated with chronic hepatitis? Hep B
 Hypokalemia: T wave flattening
 Potassium deficit
 Hypokalemia: Ileus
 Jones criteria of Rheumatic Fever
Disease
 Cushings Syndrome: MCC Iatrogenic
(excess steroid intake)
 Acute vs. Chronic Pancreatitis
 Definition of Azotemia
 Case: dehydration  pre-renal azotemia
 Stages of Pneumonia  Congestion =
 Methotrexate: dihydrofolate reductase inhibitor;
Leucoverin/Folinic acid – rescue dose
 Clomiphene: Increase FSH & LH  ovulation 
pregnancy
 Case: (+) endometrial implant. Tx? Danazol
 Leuprolide- GnRH analog
 Minoxidil – vasodilator, can be used for male
pattern baldness
 Beta-blockers: anti-HPN C/I in px with Asthma
 MOPP
 Bromocriptine: Dopamine agonists
 MOA Quinolones: inhibits DNA
gyrase/topoisomerase II
 S/E Methicilin – Interstitial nephritis
 MOA Vancomycin – binds to D-alanyl-D-alanine
portion of cell wall precursors  inhibits
peptidoglycan polymerization
 Sulfonamide: PABA analog competitive
inhibitor of dihydropteroate synthetase
 Peripheral neuritis: S/E INH, Tx: Vitamin B6
 Quinine: DOC for chloroquine resistant Malaria
 Antidotes:
 Benzodiazepine – Flumazenil
 Organophosphate poisoning – Atrophine/
Pralidoxime
 Mercury – Dimercaprol
 Opiod – Naloxone
 Phenylephrine – alpha-1 agonist used as nasal
decongestant
 Pilocarpine – management of glaucoma
 Edrophonium – diagnosis of Myasthenia gravis ;
Tensilon Test
 Montelukast – leukotriene antagonist
 Aminophylline- S/E Increases HR
 MOA Aspirin: inhibits cyclooxygenase &
thromboxane A2
 Phenobarbital – induction of glucoronyl
transferase activity, enhances hepatic uptake
 HPN with renal problem: Protective – ACE
inhibitor
 DOC Herpes: Acyclovir
Paste)
 Pseudomonas- Severe burns
 In renal transplantation, where is it
commonly placed? – Iliac Fossa
 Keloid: extend beyond border of
original wound
 Palpable olive shape- Hypertrophic
Pyloric Stenosis
 Myofibroblasts: responsible for wound
contraction
 Case: 30 minutes after blood
transfusion, px had fever and chills?
Management? Stop BT
 Case: Px under general anesthesia,
what is the sign of transfusion
reaction? Hypotension/spontaneous
bleeding
 Viral conjunctivitis - adenovirus
 Toxic dose of Lidocaine
 Burn Parkland Formula (4 x weight in
kg x TBSA)
 Suture removal
 How many kilocalories in 3L of D5LR?
600kcal (3-4 kcal/gram of Dextrose)
 Where is the location of stone within
the biliary tree? CBD
 Cancer of Gingiva? SCC
 Common complication of Otitis media?
Meningitis
 Tension pneumothorax
 Thyroid
 Cleft palate
 AAA with 6cm diameter needs close
observation
 Common in boxers? Subdural
Hematoma
 Manangement of multinodular non-
toxic goiter? Subtotal
thyroidectomy/ablation/PTU??
 Breast CA Stage I – 90% 5 years
survival rate
Crackles
 COPD (Emphysema and chronic
bronchitis)
 Peutz-Jegher’s Syndrome:
hamartomatos polyps +
hyperpigmentation on buccal mucosa
 Risk factor: high fat & low fiber diet
 IV fluids for Dengue patient: PLR
 Aspirin: Increased anion gap acidosis
 Gram-negative septicemia: shock
 Immediate Effective Management of
increased ICP? Hyperventilation
 ARS: ground glass appearance on chest
X-ray
 Duration of treatment for extra-
pulmonary TB?
 Most organ commonly involved in
Sarcoidosis
 Perihilar LAD: Sarcoidosis
 Neuro cases: Hx & PE showing localized
manifestation to one side with speech
impairment?
 Most important risk factor in
Osteoarthritis? Trauma, age, weight???
 Blood test in patients with G6PD
Deficiency? Increased reticulocyte count
 14 hours of GI bleeding? Melena
 Malignant hepatitis –hepa C
 Membrane bleb: Apoptosis
 Kaposi sarcoma- lesions on lower
extremeties related to AIDS
 Polyarteritis Nodosa – small-medium
vasculitis
 Takayasu – pulseless disease
 Malignant Hypertension- renal related:
Onion skin lesion, fibrinoid necrosis
 Kernicterus/ Bilirubin Encephalopathy
 Hereditary sperocytosis – Spectrin;
Osmotic fragility test
 Hemophilia A – Increased PTT
 ABO incompatility – Type II
 DOC CMV: Gancyclovir
 DOC Syphilis: Penicillin
 DOC for amebic abscess: Metronidazole
 For carrier: Iodoquinol
 RAI C/I in pregnancy
 Primaquine – used for relapsing Malaria
 Pseudomembranous colitis –
Metronidazole/Vancomycin
 Malignant Hyperthermia – Succinylcholine, Tx:
Dantrolene
 Aminoglycoside – both bactericidal &
bacteriostatic; S/E Ototoxic & nephrotoxic
 DOC Hypertensive Emergency: Na Nitroprusside,
S/E Cyanide toxicity (blocks complex
IV/cythochrome oxidase); Antidote: Na
Thiosulfate
 Pheochromocytoma – Phenoxybenzamine
 Thiazide: S/E Hyperuricemia
 MOA of charcoal in poisoning
Why is the sigmoid colon the mc site
of volvulus
-redundancy of length
-increased mobility
cdb note: The most common site
of intussusception of the large
intestine is in the ileocecal region
with the lower portion of the ...
Instead the pathogenesis appears to
be (1) abnormal mobility of the
sigmoid colon due to its long
mesentery,
 MOA of histamine
 Pleomorphic adenoma of the thyroid
 Anatomic site of melanoma with bad
prognosis ( scalp, hands, feet, mucous
membrane) vs good prognosis
(forearm, leg)
 Most common location of Pseudocyst?
 Case: (+) urinary incontinence? Spinal
cord injury
 Needle thoracotomy; 2nd ICS MCL
 Pericardiocentesis
 INF-gamma : activates macrophage
 Potent stimulator of inflammation?
Cytokines
 Endocrine response to injury:
Decreased TSH/T3, Gonadotrophins &
LH, Insulin
 Ideal time in changing urinary
catheter? 3, 5, 7 or 30 days???
 Organism causing fatal burn wound
infection: Pseudomonas sp.
 Papillary carcinoma commonly arises
from a thyroglossal duct cyst
 Sebaceous cyst: umbilicated center
 Glomus tumor
 Lipoma: with capsule
 Management of middle/3rd fracture of
clavicle? Pinning???
 Cleft palate: closed before 12 months
of age
 Ectopic parathyroid gland:
Paraesophageal
 MC site of gallstone ileus: terminal
ileum
 Courvoisier sign? Distended, palpable
gallbladder; suggests periampullary
CA
 Vaccines should be given before
elective splenectomy/case of asplenia:
H. influenza, Meningococcus, S.
pneumoniae
 Organ removed in resecting pancreatic
Hypersensitivity
 PUD gross morphology
 Hepatitis B - 20-30% risk of developing
carcinoma
 Papillary Thyroid CA – orphan annie,
neck irradiation
 Post-gastrectomy/Pernicious anemia –
Megaloblastic anemia - decreased
absorption of Vitamin B12 due to
absence of Intrinsic Factor
 Villous adenoma – premalignant
 Left sided colon CA – anemia in elderly
individuals
 Centroacinar emphysema – associated
with smoking vs. Panacinar (alpha-1-
antitrypsin deficiency)
 Angiosarcoma – vinyl chloride
 Mesothelioma – asbestos
 Webel-palade bodies – demonstration of
new formed lymphatic vessels within
the bulk of tumor
 Crohn’s vs. Ulcerative colitis
 Valvular Heart Diseases: location and
radiation of murmurs
 Chovstek sign – facial muscle twitching
 Trouseau sign – carpal spasm
 Spontaneous pneumothorax: rupture of
pulmonary bleb (Paraseptal
emphysema)
 Ischemia interventricular septum, left
ventricle? LAD occlusion
 Case: Diarrhea described as watery, non-
bloody, non-foul smelling with whitish
membranous endoscopic finding?
Giardia, Candida, Shigella, E.coli???
 Myasthenia gravis
 Hereditary spherocytosis: red cell
membrane defect (Spectrin)
 Systemic Lupus Erythematosus
 PTB morphology after 3 weeks?
Granuloma formation, fibrosis, scar,
 head CA? pancreas, duodenum, gall non-specific???
bladder except stomach???  History of chronic steroid use: Steroid
 Management of a 3cm stone in the induced Osteoporosis
ureter? Drink plenty of water  Hx of neck irradiation: Papillary thyroid
 Contents of spermatic cord except: CA (orphan annie, psammoma bodies)
ilioinguinal nerve 
 Drainage of tumor near the nipple-  Patient with MI elevated cardiac enzyme
internal mammary nodes after 1wk- lactate dehydrogenase
 Drainage of tumor at the upper outer (elevates in 3-4 days and remains
quadrant of the breast- axillary lymph elevated up to 10 days
node
 Cholesterol gallstone –MC form of
gallstone
 Stone lodge in ampulla of vater-
choices: cirrhosis, biliary CA,
constipation Ans. Vitamin K deficiency
 Buerger’s Disease- related to
smoking lesion at distal phalanges
 Prognostication for breast ca- axillary
lymph nodes, grades, stage, histology
 Vascular disease that spares the renal
artery: Churg-strauss
 Most common location of injury of
phrenic nerve- scalene anterior,
pericardium
 S5 dermatomal level of anus
 L5-S1 affects sensation of lateral and
posterior aspect of the leg
 Most common CA in Cardioesophageal
junction –adenocarcinoma
 Origin of cyst in the popliteal are?
Semitendinosus,
semimembranosus???
 Thoracentesis: superior border of the
rib
 Injury when thoracotomy: lower
bored upward
 Nerve block: inferior border
 How to excise ganglion cyst?
 Injection of epidural anesthesia:
between dura and ligamentum flavum
  Site of Paracentesis: 2.5 cm below the
umbilicus
 Mallory-Weiss Syndrome: linear
laceration, location of laceration
 Mc lobe that ruptures during
atelectasis post- op? lower lobe
 Pringle maneuver
 Why does prostate CA metastasize to
the bone? – Batson’s plexus
 Elbow swelling? Where to insert
needle for aspiration? Arthrocentesis
Lateral
 Dermatome level to be anesthesized in
appendectomy?
 Sensitive part of the urinary bladder-
trigone
 Drainage of Nasopharyngeal CA-
Posterior Cervical node
 Varicocoele is bigger in the left testicle
because the left testicular vein drains
in the left renal vein

OBSTETRICS & PEDIATRICS & PREVENTIVE MEDICINE & PUBLIC

GYNECOLOGY NUTRITION HEALTH

 Benefit for re-anastomosis: Vasectomy
 Mayer-Rokitansky Kuster-Hauser Syndrome –
absent vagina and uterus
 Abnormal uterine bleeding associated with
Hyperthyroidism?
 Androgenic steroid: Danazol
 Polycystic Ovarian Syndrome (Stein Leventhal
Syndrome)
 Testicular Feminization
 Case: 40 y/o G4P4 (4-0-04) with symmetrical
abdominal enlargement?
 Dx: Adenomyosis
 Vertically transmitted infection: rubella, CMV,
Varicella zoster, b19, HIV, all of the above
 Definition of Proteinuria
 MCC of neonatal meningitis in the
Philippines? GABHS- S. agalactiae
 Reason why supplemental iron is given in
three divided doses? Decreased gastric
irritation??
 Rubella (German Measles) : rash + post-
auricular lymphadenopathy
 Harlequin rash
 Physiologic vs. Pathologic Jaundice
 Breastmilk vs. Breastfeeding Jaundice
 Necrotizing Enterocolitis
 Iron Deficiency Anemia – in exclusively
breastfed infants
7th Edition #s: 1,7, 11, 52, 57, 67-70 (1
Pre-test QUESTION), 72, 79, 81, 82,
83,88-89 (1 QUESTION ONLY),
143, 148, 151, 153, 166, 168,
172, 199, , 214, 230, 261, 281,
282, 291, 336, 343, 345, 347,
358, 359, 372, 386, 387, 392,
396, 410, 492, 493
9th Edition #s: 4, 20, 30, 131, 137, 141,
Pre-test 143, 168, 251, 263, 293, 294,
299, 300, 324, 341, 344, 3363,
364, 379, 398, 399, 400, 493,
  GERD 494, 500
 Initial test: UTZ  HSP- purpuric lesion, non migratory
 Mgt: hysterectomy +/- salphingooophorectomy arthralgia, abdominal pain  Most obvious indicator of obesity? Simple
 Adjunct tx: Estrogen  Cerebral Palsy – delayed motor inspection? BMI? Family Hx?
 Biopsy finding: Endometrial glands within the development  Which among the following will cause
myometrium  1st to pneumotized at birth? Frontal sinus inheritable disease? Alcohol, Smoking,
 “finger-like projections” and vesicles on the vulva Central vs. Nephrogenic Diabetes Insipidus Cocaine
– anogenital warts, molluscus, herpes??  PTB  Years of accreditation of physicians in
 Clue cells: Bacterial vaginosis  Cri du chat – with characteristic cry Philhealth?
 Yellow green frothy vaginal discharge:  Congenital Adrenal Hyperplasia: 21-  Brand name: protect drug companies
Trichomoniasis hydroxylase deficiency; MCC of ambiguous  Most rewarding & challenging part of family
 Management of Tuberous TB? Microsurgical?? genitalia illness trajectory? Major therapeutic
 Tx of painful vesicular papule (chancroid) ? H.  Glucose-6-Phosphatase Deficiency – test  Behavioral psychodynamic: Personality
ducreyi for haemolytic anemia disorder
Tx:Azithromycin/Ceftriaxone/Ciprofloxacin/Eryt  Maculopapular rash after fever lysis:  Most sincere gesture: eye contact, touch,
hromycin Roseola hand shake?
 Multiple painful vesicle: Herpes, Tx: Acyclovir  VACTERL  How to start conversation? Open ended
 Hypertrophic pyloric stenosis question
 Volvulus  SCREEM
 Shortest AP diameter: Obstetric conjugate  Hirschsprungs Disease  Px with DM comply with meds? High
 DM screening: 24-28 weeks  Choanal Atresia cohesion?
 Variable Deceleration – Cord compression  Biliary Atresia  Case on TB exposure? Diagnostics? Dose of
 Late Deceleration – Utero-placental insufficiency  Duodenal atresia? Hyperechoic shadow in INH?
 Earl Deceleration – Head compression UTZ  Computations: mean, median, mode, crude
 Most important according to Friedeman?  Meckel’s Diverticulum mortality rate, maternal mortality rate,
Station?? (Descent -1st requisite for birth of  Aplastic anemia infant mortality rate, case fatality rate of
newborn)  Abdominal mass? Wilms vs. Pneumoia and CVD (in the case given)
 Abnormal Labor – management Neuroblastoma
 Indications for CS  Post-strep glomerulonephritis
 Forceps Delivery (Pipers – used for after coming  ASO vs. DNAse  Sensitivity: a+c
head)  How many days after pyoderma? 10 days  Family genogram
 Hypertension in Pregnancy  DOC: Penicillin  Family life cycle
 Risk factor for Pre-eclampsia? Multiple gestation?  Rheumatic Fever  Stage with growing children? Family with
 Cause of postpartum haemorrhage after 10 days?  Vesicoureteral Reflux Disease adolescents
Retained placenta?  UTI  How to approach defensive patient?
 Puerperal Infections  Absence Seizure/ Petit Mal – blank stare,  Process of repeating questions to patient?
 Most common aneuploidy? Monosomy, Trisomy EEG (3/sec spike) “paraphrasing”
13, 18, 21?  Read Phil. Pediatric Society PTB  Characteristic of primary health care vs.
 Abortions Concensus traditional health system? Community
 Anti-HPN C/I in pregnancy: ACE inhibitor (S/E  Read CARI/EPI/CDD participation in the stage of planning
Renal agenesis)  Hospice care? Available for 24 hours
 Antepartum Hemorrhage: Placenta previa vs.  Asymptomatic patient with typhoid? Carrier
Abruptio placenta  Situation wherein too many patients in the
 Mittelsmerz – onset of ovulation ER what are you going to do? Assess and
 Responsible for menstruation? Prostaglandin prioritize the more serious cases
 Menopause? Increased FSH  60% of primary health care? Preventive,
 TB in pregnancy – DOC: INH curative??
 Case: Eclampsia; Mgt- Give MgSO4  Core list of drugs approved by DOH in Phil
 Magnesium Sulfate Toxicity – Decreased DTR, RR, health: Essential drug list
urine output  Exposure to active PTB in children- 9mo INH
 MMR vaccination should be avoided 1 month
before or during pregnancy
 Varicella vaccination: susceptible pregnant
women with varicella exposure should be given
VZIG within 96 hours
 Rubella – congenital cataract
 Toxoplasmosis – intracranial calcification
 Chandelier sign – PID
 Chocolate cyst of the ovary – endometrioma
 Shoulder Dystocia – management
 Reason why UTI is common in pregnancy?
Decreased urinary peristalsis/urinary retention
 Preterm birth/delivery – Management
 Most common site of laceration in forceps
delivery? Middle 1/3 Posterior??
 High Grade Squamous Intraepithelial Neoplasia –
colposcopy?
 Ovarian mass in pregnancy? Prone to torsion
 Test to differentiate Cushings vs. PCOS? ACTH,
dexamethasone challenge, 24 hour urine
 APAS: recurrent abortions
 SLE in pregnancy
 Case: Missed abortion for 1 month prone to
develop? Septic abortion? DIC?
 Management for accreta for young patients-
subtotal hysterectomy
 Benign ovarian cyst- torsion
 Serious ovarian cyst- rupture
 Estrogen cream- labial adhesion with UTI
 Mg of Folic Acid- 4mg or 400 mcg
 On ultrasound hyperechoic
 With creases, lanugo – 36-38wks
 OGTT to requested at- 24-28 wks
 GBS- 35-37
 Best time to give measles vaccine –post partum
 Best time to give tetanus vaccine
 Abdominal pregnancy- terminate or wait
 Clomiphene citrate induced fertility