Comprehensive Exam Review Notes

Arterial vs venous intracranial bleeds
- Epidural hemorrhage = arterial origin (classically middle meningeal artery).
- Presents with possible “lucid interval”.
Stroke sub-types
- Ischemic stroke = cerebral artery blocked by thrombus/emboli → brain-cell death.
- Hemorrhagic stroke = vessel rupture (noted briefly).
- NSTEMI/STEMI are cardiac events but appear later under Cardiac.
Increased Intracranial Pressure (ICP)
- Posturing, fixed/dilated pupils, ↓ BP.
- Cushing triad = ↑ SBP (widened pulse pressure), bradycardia, irregular respirations (implicitly referenced).
Autonomic Dysreflexia (post–spinal injury)
- Hypertension, bradycardia, flushed face, bladder distention trigger.
Multiple Sclerosis (MS)
- Autoimmune demyelination → vision problems, fatigue, bladder issues.
Parkinson Disease
- Loss of dopamine‐producing neurons in substantia nigra.
Other neuro keywords
- Neurogenic shock (mentioned but corrected to autonomic dysreflexia).

Rheumatic Heart Disease
- Post-streptococcal infection damages valves.
Cardiac Tamponade / Beck Triad
- Muffled heart sounds, hypotension, JVD.
Heart-failure clinical sets
- Right-sided: hepatomegaly, splenomegaly, JVD, peripheral oedema.
Uncontrolled Hypertension complications
- HF, CKD, CAD, LV hypertrophy.
Myocardial Infarction categories
- \text{STEMI} and \text{NSTEMI} both elevate troponin (cardiac cell death).
Deep-Vein Thrombosis (DVT) risk factors
- Fracture/immobilisation, smoking, obesity, estrogen therapy, post-op.

Diverticulitis
- LLQ pain, fever, N/V.
Crohn Disease
- Transmural inflammation “through entire GI tract” → malabsorption.
Ulcerative Colitis
- Limited to colon/rectum (contrast to Crohn).
Celiac Disease
- Autoimmune → flattened intestinal villi; malabsorption.
Acute Pancreatitis patho
- Auto-digestion from premature enzyme activation.
BPH (elderly male; frequency, nocturia, dribbling).
Kidney-stone flank scenario
- Severe flank pain, hematuria ± hypercalcaemia (calcium-oxalate stones).
GI/ABG tie-in
- Panic attack hyperventilation → respiratory alkalosis (↓ PCO₂).

Pyelonephritis
- Fever + flank pain vs cystitis (local dysuria/frequency).
Chronic Kidney Disease labs
- ↓ GFR, ↑ BUN/Creatinine, hyper-K⁺, hypo-Ca²⁺.
Hypocalcaemia
- Muscle twitching, high phosphate (inverse Ca–P relationship).
Nephrotic Syndrome (briefly named)
- Heavy proteinuria >3.5 g/day, oedema, hypoalbuminaemia, hyperlipidaemia (context: peripheral oedema cue).

Obstructive diseases
- COPD/emphysema: chronic cough, barrel chest, hypercapnia.
- Asthma: expiratory wheeze, nocturnal cough, bronchospasm + mucus.
- OSA = ventilation issue.
Restrictive/other
- Atelectasis: post-op collapse of alveolar sections → hypoxia.
Pneumonia
- Fever, productive cough, crackles, CXR infiltrate.
Tuberculosis (active)
- Pulmonary infiltrates + cavitation, fever/night-sweats/hemoptysis.
Pneumothorax
- Collapsed lung; tension variant → tracheal deviation, JVD, hypotension.
Pulmonary Embolism
- Perfusion defect.
Ventilation vs Perfusion examples
- Ventilation disorders: asthma, OSA.
- Perfusion disorders: PE.
V/Q slide trivia
- PE = perfusion; pneumonia, pneumothorax can be mixed.

Diabetes
- Type 1 = autoimmune β-cell destruction; presents with polyuria, polydipsia, polyphagia, weight loss.
- DKA: ketonuria, fruity breath, Kussmaul respirations.
- Type 2 risk factors: age, obesity, gestational DM, poor diet, HTN.
Pituitary/Growth
- Acromegaly (post-epiphyseal GH excess): bone deformity, cardiomyopathy.
Thyroid
- Hyperthyroidism/Graves: tachycardia, heat intolerance, exophthalmos.
- Hypothyroidism/Hashimoto: fatigue, weight gain, cold intolerance.
Adrenal
- Cushing syndrome: cortisol excess → weight gain, hyperglycaemia, HTN, osteoporosis.
- Addisonian crisis = severe cortisol deficiency → hypotension, hyponatraemia, hyperkalaemia.
ACTH link
- Pituitary adenoma ↓ ACTH → adrenal cortex ↓ cortisol (secondary adrenal insufficiency).

Aplastic Anaemia
- Pancytopenia: ↓ RBC, ↓ WBC, ↓ platelets.
Transfusion Reactions
- Acute haemolytic: fever/chills, haemoglobinuria, renal failure, DIC.
- Febrile non-haemolytic = leukocyte incompatibility (fever only).
Post-haemorrhage compensation
- ↑ HR, RAAS activation, ↓ urine output (vasoconstriction & water retention).
Coagulation trivia: Roth spots & splinter haemorrhages referenced (IE), but main testable focus = DIC/clotting with mismatch.

Inheritance patterns
- Autosomal Dominant: one mutant allele causes disease (e.g., Marfan, Huntington).
- Autosomal Recessive: need two mutant alleles (e.g., sickle-cell, cystic fibrosis).
- X-linked recessive: males affected if single mutant X; females usually carriers (e.g., colour blindness, haemophilia A/B).
Nondisjunction
- Meiotic error → trisomy or monosomy; missing/extra chromosomes.
Terminology
- Homozygous recessive = aa, heterozygous dominant = Aa.

Types of immunity
- Active natural: infection.
- Active artificial: vaccination.
- Passive natural: maternal IgG/IgA.
- Passive artificial: IVIG, antitoxin.

Final exam: 100 MCQs; ~20 Qs from Weeks 13–14 (GI, repro), 80 cumulative.
“Select-all-that-apply” (SATA) strategy: usually ≥ 2 correct; avoid over-clicking (+1 error most common). Partial credit awarded.
IT issues: email Help-Desk & CC instructor immediately; do not continue if system glitch occurs (easier to reset if Qs unseen).