Midnight Express Revision Lecture Notes - Dr. Nidhi S Patil

A comprehensive set of practice flashcards covering medical, surgical, and radiology concepts based on the Midnight Express Revision lecture.

What are the specific parameters (flow rate and color) for a 14G, 18G, and 24G intravenous cannula?

14G is Orange at $270\,ml/min$; 18G is Green at $80\,ml/min$; 24G is Yellow at $28\,ml/min$.

In the clinical progression of viral exanthems, which diseases appear on the first, third, and fifth days?

First day: Measles (Paramyxoviridae); Third day: Rubella (Togaviridae); Fifth day: Erythema infectiosum (Parvovirus B19).

What are the pathognomonic findings and characteristic giant cells associated with Measles?

Koplik's spots (found near upper 2nd and 3rd molars) and Warthin Finkeldey Giant cells.

What is the diagnostic criteria mnemonic for Kawasaki Disease?

CRASH & Burn: Conjunctivitis (non-exudative), Rash (desquamating), Adenopathy (unilateral cervical), Strawberry tongue, Hands (palmar erythema/swelling), and Burn (Fever $> 5$ days).

What define Heteroplasmy in mitochondrial disorders?

The presence of both normal and abnormal genes.

What are the specific features of Kearney-Sayre Syndrome and MERRF?

Kearn-Sayre Syndrome: Triad of CPEO, Retinitis pigmentosa, and conduction defects. MERRF: Myoclonic Epilepsy with Red Ragged fibres.

Which tumor marker is associated with Endodermal Sinus (Yolk Sac) tumors and Ataxia Telengectasia?

AFP (Alpha Fetoprotein).

What is the recommended age for prophylactic thyroid surgery in MEN2A and MEN2B?

MEN2A: 5 years; MEN2B: 1 year.

Name the specific X-ray views used for the Acetabulum, Hill Sach's lesion, and DDH.

Acetabulum: Judet view; Hill Sach's lesion: Stryker view; DDH: Von Rosen view.

In CAH, how do the deficiencies of 21-Hydroxylase and 11-Hydroxylase differ regarding blood pressure?

21-Hydroxylase deficiency leads to low BP (salt wasting), while 11-Hydroxylase deficiency leads to high BP (due to increased deoxycorticosterone).

What is the conversion for Foley's catheter size from French (Fr) to millimeters?

$1\,Fr = 0.33\,mm$ (representing the outer diameter).

Contrast the cellular locations and IHC markers for Squamous Cell Ca and Adenocarcinoma of the lung.

Squamous Cell Ca: Central location, markers $p40$ and $p63$; Adenocarcinoma: Peripheral location, markers $TTF-1$ and Napsin A.

Which paraneoplastic syndrome is specifically associated with Small Cell Ca of the lung?

SIADH, Cushing's Syndrome, and Lambert Eaton Myasthenic Syndrome.

What is the preferred technique for central line insertion and the most comfortable site for a conscious patient?

Seldinger technique; Subclavian vein.

List the trinucleotide repeats for Huntington's Disease, Fragile X Syndrome, and Friedreich's Ataxia.

Huntington's: CAG; Fragile X: CGG; Friedreich's Ataxia: GAA.

What are the specific color-coded markings on an NG tube for the GE junction, body of stomach, and pylorus?

$40\,cm$: GE junction; $50\,cm$: Body of stomach; $60\,cm$: Pylorus.

Define Westermark sign and Hampton's hump in the context of Pulmonary Embolism.

Westermark sign: Regional oligemia (blackness); Hampton's hump: Peripheral wedge-shaped opacities.

In Biomedical Waste management, which waste goes into the Red bag and how is it treated?

Recyclable waste (tubings, bottles, catheters, urine bags, syringes without needles); treated via Autoclaving/Microwaving followed by Shredding/mutilation.

Identify the additives and uses for Light Blue, Lavender, and Grey vacutainers.

Light Blue: $3.2\%\,Na$ Citrate (Coagulation/D-dimer); Lavender: K2 EDTA (Hematology/CBC); Grey: Sodium Fluoride/Potassium Oxalate (Glucose/Lactate).

What are the clinical components of MEN 1 (Wermer Syndrome)?

The 3 Ps: Pituitary (Prolactinoma), PTH Adenoma (Parathyroid), and Pancreatic Neuroendocrine tumors (most commonly Gastrinoma).

What is the significance of the Miller Fischer Test and Froin Syndrome in CSF analysis?

Miller Fischer Test: CSF tap of $40\,ml$ relieves symptoms in NPH; Froin Syndrome: CSF becomes exudative and coagulates on tap due to spinal obstruction.

Differentiate the flow volume curve findings for Obstructive vs. Fixed Airway obstruction.

Obstructive: Scooped out appearance; Fixed Airway: Flattening of both inspiratory and expiratory loops.

Which personality disorder is characterized by 'Ego syntonic' perfectionism and rigidity?

OCPD (Obsessive-Compulsive Personality Disorder).

What are the pathognomonic biopsy features and IHC markers for Langerhans Cell Histiocytosis (LCH)?

Biopsy: Birbeck granules (Tennis Racquet shape) and Coffee Bean nuclei; IHC markers: $S100$, $CD1a$, and $CD207$ (Langerin).

Name the pathognomonic sign for Burst Abdomen and the preferred suture material for rectus repair.

Salmon sign (serosanguinous pink discharge); Prolene is preferred over Nylon.

Identify the hallmark CT findings for Usual Interstitial Pneumonitis (UIP).

Honeycombing in the basal dependent regions, subpleural distribution, and traction bronchiectasis.

What is the rate-limiting enzyme in Heme synthesis and the most common inherited porphyria?

ALA Synthase (requires Vitamin $B_6$); Porphyria Cutanea Tarda (PCT).

Contrast the clinical features of Silicosis and Asbestosis on imaging.

Silicosis: Egg shell calcification and progressive massive fibrosis; Asbestosis: Calcified pleural plaques (Holly leaf sign) and Comet tail sign.

Define the RADS scores for COVID-19 (CORADS) and Breast Cancer (BIRADS) indicating high suspicion.

CORADS 5: Typical findings (GGO, Multifocal, Peripheral); BIRADS 5: Highly suspicious of malignancy ($>95\%$).

In the CEAP classification for varicose veins, what do C2 and C6 represent?

C2: Varicose veins ($>3\,mm$); C6: Active venous ulcer.

Which trauma score is calculated using the formula Mangled Extremity Severity Score (MESS) and what is the cutoff for a salvageable limb?

MESS includes Energy, Limb Ischemia, Shock, and Age; a score $< 6$ indicates a salvageable limb.

Differentiate Conus Medullaris from Cauda Equina syndrome regarding onset and sphincter involvement.

Conus: Sudden/bilateral onset with early sphincter incontinence; Cauda: Gradual/unilateral onset with late sphincter involvement.

Which cranial nerve columns are associated with the General Somatic Efferent (GSE) and Special Visceral Efferent (SVE)?

GSE: CN 3, 4, 6, 12; SVE: CN 5, 7, 9, 10, 11.

List the derivatives of the 1st pharyngeal arch (Mesoderm/Neural Crest).

Muscles of mastication, Mandibular Nerve, Maxilla, Mandible, Malleus, Incus, and the Sphenomandibular ligament.

What are the germ layer origins for the Adrenal Cortex and Adrenal Medulla?

Adrenal Cortex: Mesoderm; Adrenal Medulla: Neural Crest (Ectoderm).

Describe the clinical triad for JOB Syndrome (Hyper IgE syndrome).

Eczema, recurrent cold abscesses (Staphylococcal), and retained primary teeth (increased $IgE$ and Eosinophilia).

In manometry, what defines Achalasia Cardia and Jackhammer Esophagus?

Achalasia: $IRP > 15\,mmHg$ and no peristalsis; Jackhammer: $DCI > 8000\,mmHg/cm/s$.

What are the diagnostic signs for Cardiac Tamponade vs. Constrictive Pericarditis regarding JVP?

Tamponade: Blunted/absent y-descent and absent Kussmaul sign; Constrictive Pericarditis: Rapid y-descent (Friedreich sign) and positive Kussmaul sign.

List the developmental milestones for a 6-month-old infant.

Mirror play, monosyllables, transfers objects, sits with support, and listens to 'no'.

What are the legal limits for MTP (2021 Act) regarding contraceptive failure and significant fetal anomalies?

Contraceptive failure: up to 20 weeks; Significant fetal anomalies: allowed beyond 24 weeks if decided by the State Medical Board.