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SURGERY, OPHTHA &

PHARMACOLOGY MEDICINE
ENT
 Diuretic that does not act on tubular lumen? Why is the sigmoid colon the mc site of  GCS computation
Spirinolactone, Loop diuretics, Carbonic volvulus  MOA of Morphine in MI
anhydrase inhibitor, Mannitol?  Cardiac Enzymes: Troponin I
 Nitrates: extensive first pass metabolism (90%) -redundancy of length  Associated with chronic hepatitis? Hep B
 DOC for Alzheimer’s Disease: Tacrine – Super  Hypokalemia: T wave flattening
-increased mobility
“Old School”… @ Present Ach inhibitors such as  Potassium deficit
Donepezil are used 1st line cdb note: The most common site of
 Hypokalemia: Ileus
 S/E cataract: Allopurinol  Jones criteria of Rheumatic Fever
intussusception of the large intestine is in
 MOA Cimetidine: H2 receptor blocker Disease
the ileocecal region with the lower portion of
 DOC for nematodes: Mebendazole  Cushings Syndrome: MCC Iatrogenic
the ... Instead the pathogenesis appears to
 Lactulose: decease blood ammonia levels in (excess steroid intake)
be (1) abnormal mobility of the sigmoid
hepatic encephalopathy (Target 4-5 x BM per  Acute vs. Chronic Pancreatitis
day) colon due to its long mesentery,  Definition of Azotemia
 Ondansetron: CA chemotherapy induced emesis  Case: dehydration  pre-renal azotemia
 liver abscess? E. histolytica (Anchovy
 S/E bismuth containing compounds: Melena  Stages of Pneumonia  Congestion =
 Methotrexate: dihydrofolate reductase inhibitor; Paste) Crackles
Leucoverin/Folinic acid – rescue dose  Pseudomonas- Severe burns  COPD (Emphysema and chronic
 Clomiphene: Increase FSH & LH  ovulation   In renal transplantation, where is it bronchitis)
pregnancy commonly placed? – Iliac Fossa  Peutz-Jegher’s Syndrome:
 Case: (+) endometrial implant. Tx? Danazol  Keloid: extend beyond border of hamartomatos polyps +
 Leuprolide- GnRH analog original wound hyperpigmentation on buccal mucosa
 Minoxidil – vasodilator, can be used for male  Palpable olive shape- Hypertrophic  Risk factor: high fat & low fiber diet
pattern baldness Pyloric Stenosis  IV fluids for Dengue patient: PLR
 Beta-blockers: anti-HPN C/I in px with Asthma  Myofibroblasts: responsible for wound  Aspirin: Increased anion gap acidosis
 MOPP contraction  Gram-negative septicemia: shock
 Bromocriptine: Dopamine agonists  Case: 30 minutes after blood  Immediate Effective Management of
 MOA Quinolones: inhibits DNA transfusion, px had fever and chills? increased ICP? Hyperventilation
gyrase/topoisomerase II Management? Stop BT  ARS: ground glass appearance on chest
 S/E Methicilin – Interstitial nephritis  Case: Px under general anesthesia, X-ray
 MOA Vancomycin – binds to D-alanyl-D-alanine what is the sign of transfusion  Duration of treatment for extra-
portion of cell wall precursors  inhibits reaction? Hypotension/spontaneous pulmonary TB?
peptidoglycan polymerization bleeding  Most organ commonly involved in
 Sulfonamide: PABA analog competitive  Viral conjunctivitis - adenovirus Sarcoidosis
inhibitor of dihydropteroate synthetase  Toxic dose of Lidocaine  Perihilar LAD: Sarcoidosis
 Peripheral neuritis: S/E INH, Tx: Vitamin B6  Burn Parkland Formula (4 x weight in  Neuro cases: Hx & PE showing localized
 Quinine: DOC for chloroquine resistant Malaria kg x TBSA) manifestation to one side with speech
 Antidotes:  Suture removal impairment?
 Benzodiazepine – Flumazenil  How many kilocalories in 3L of D5LR?  Most important risk factor in
 Organophosphate poisoning – Atrophine/ 600kcal (3-4 kcal/gram of Dextrose) Osteoarthritis? Trauma, age, weight???
Pralidoxime  Where is the location of stone within  Blood test in patients with G6PD
 Mercury – Dimercaprol the biliary tree? CBD Deficiency? Increased reticulocyte count
 Opiod – Naloxone  Cancer of Gingiva? SCC  14 hours of GI bleeding? Melena
 Phenylephrine – alpha-1 agonist used as nasal  Common complication of Otitis media?  Malignant hepatitis –hepa C
decongestant Meningitis  Membrane bleb: Apoptosis
 Pilocarpine – management of glaucoma  Tension pneumothorax  Kaposi sarcoma- lesions on lower
 Edrophonium – diagnosis of Myasthenia gravis ;  Thyroid extremeties related to AIDS
Tensilon Test  Cleft palate  Polyarteritis Nodosa – small-medium
 Montelukast – leukotriene antagonist  AAA with 6cm diameter needs close vasculitis
 Aminophylline- S/E Increases HR observation  Takayasu – pulseless disease
 MOA Aspirin: inhibits cyclooxygenase &  Common in boxers? Subdural  Malignant Hypertension- renal related:
thromboxane A2 Hematoma Onion skin lesion, fibrinoid necrosis
 Phenobarbital – induction of glucoronyl  Manangement of multinodular non-  Kernicterus/ Bilirubin Encephalopathy
transferase activity, enhances hepatic uptake toxic goiter? Subtotal  Hereditary sperocytosis – Spectrin;
 HPN with renal problem: Protective – ACE thyroidectomy/ablation/PTU?? Osmotic fragility test
inhibitor  Breast CA Stage I – 90% 5 years  Hemophilia A – Increased PTT
 DOC Herpes: Acyclovir survival rate  ABO incompatility – Type II
 DOC CMV: Gancyclovir  Pleomorphic adenoma of the thyroid Hypersensitivity
 DOC Syphilis: Penicillin  Anatomic site of melanoma with bad  PUD gross morphology
 DOC for amebic abscess: Metronidazole prognosis ( scalp, hands, feet, mucous  Hepatitis B - 20-30% risk of developing
 For carrier: Iodoquinol membrane) vs good prognosis carcinoma
 RAI C/I in pregnancy (forearm, leg)  Papillary Thyroid CA – orphan annie,
 Primaquine – used for relapsing Malaria  Most common location of Pseudocyst? neck irradiation
 Pseudomembranous colitis –  Case: (+) urinary incontinence? Spinal  Post-gastrectomy/Pernicious anemia –
Metronidazole/Vancomycin cord injury Megaloblastic anemia - decreased
 Malignant Hyperthermia – Succinylcholine, Tx:  Needle thoracotomy; 2nd ICS MCL absorption of Vitamin B12 due to
Dantrolene  Pericardiocentesis absence of Intrinsic Factor
 Aminoglycoside – both bactericidal &  INF-gamma : activates macrophage  Villous adenoma – premalignant
bacteriostatic; S/E Ototoxic & nephrotoxic  Potent stimulator of inflammation?  Left sided colon CA – anemia in elderly
 DOC Hypertensive Emergency: Na Nitroprusside, Cytokines individuals
S/E Cyanide toxicity (blocks complex  Endocrine response to injury:  Centroacinar emphysema – associated
IV/cythochrome oxidase); Antidote: Na Decreased TSH/T3, Gonadotrophins & with smoking vs. Panacinar (alpha-1-
Thiosulfate LH, Insulin antitrypsin deficiency)
 Pheochromocytoma – Phenoxybenzamine  Ideal time in changing urinary  Angiosarcoma – vinyl chloride
 Thiazide: S/E Hyperuricemia catheter? 3, 5, 7 or 30 days???  Mesothelioma – asbestos
 MOA of charcoal in poisoning  Organism causing fatal burn wound  Webel-palade bodies – demonstration of
Why is the sigmoid colon the mc site infection: Pseudomonas sp. new formed lymphatic vessels within
 Papillary carcinoma commonly arises the bulk of tumor
of volvulus from a thyroglossal duct cyst  Crohn’s vs. Ulcerative colitis
 Sebaceous cyst: umbilicated center  Valvular Heart Diseases: location and
-redundancy of length  Glomus tumor radiation of murmurs
 Lipoma: with capsule  Chovstek sign – facial muscle twitching
-increased mobility  Management of middle/3rd fracture of  Trouseau sign – carpal spasm
clavicle? Pinning???  Spontaneous pneumothorax: rupture of
cdb note: The most common site  Cleft palate: closed before 12 months pulmonary bleb (Paraseptal
of age emphysema)
of intussusception of the large  Ectopic parathyroid gland:  Ischemia interventricular septum, left
intestine is in the ileocecal region Paraesophageal ventricle? LAD occlusion
 MC site of gallstone ileus: terminal  Case: Diarrhea described as watery, non-
with the lower portion of the ... ileum bloody, non-foul smelling with whitish
Instead the pathogenesis appears to  Courvoisier sign? Distended, palpable membranous endoscopic finding?
gallbladder; suggests periampullary Giardia, Candida, Shigella, E.coli???
be (1) abnormal mobility of the CA  Myasthenia gravis
sigmoid colon due to its long  Vaccines should be given before  Hereditary spherocytosis: red cell
elective splenectomy/case of asplenia: membrane defect (Spectrin)
mesentery, H. influenza, Meningococcus, S.  Systemic Lupus Erythematosus
pneumoniae  PTB morphology after 3 weeks?
 MOA of histamine  Organ removed in resecting pancreatic 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  Definition of Proteinuria 7th Edition #s: 1,7, 11, 52, 57, 67-70 (1
 Mayer-Rokitansky Kuster-Hauser Syndrome –  MCC of neonatal meningitis in the Pre-test QUESTION), 72, 79, 81, 82,
absent vagina and uterus Philippines? GABHS- S. agalactiae 83,88-89 (1 QUESTION ONLY),
 Abnormal uterine bleeding associated with  Reason why supplemental iron is given in
143, 148, 151, 153, 166, 168,
Hyperthyroidism? three divided doses? Decreased gastric
 Androgenic steroid: Danazol irritation?? 172, 199, , 214, 230, 261, 281,
 Polycystic Ovarian Syndrome (Stein Leventhal  Rubella (German Measles) : rash + post- 282, 291, 336, 343, 345, 347,
Syndrome) auricular lymphadenopathy 358, 359, 372, 386, 387, 392,
 Testicular Feminization  Harlequin rash 396, 410, 492, 493
 Case: 40 y/o G4P4 (4-0-04) with symmetrical  Physiologic vs. Pathologic Jaundice
abdominal enlargement?  Breastmilk vs. Breastfeeding Jaundice 9th Edition #s: 4, 20, 30, 131, 137, 141,
 Dx: Adenomyosis  Necrotizing Enterocolitis Pre-test 143, 168, 251, 263, 293, 294,
 Vertically transmitted infection: rubella, CMV,  Iron Deficiency Anemia – in exclusively 299, 300, 324, 341, 344, 3363,
Varicella zoster, b19, HIV, all of the above breastfed infants
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