• Diabetes mellitus
• Tabes dorsalis
• Leprosy
• Amyloidosis
• Syringomyelia
• Meningomyelocele
• Peroneal muscular atrophy

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• Neoplasms
• Pulmonary embolism
• Infections
• Collagen vascular disorders
• GIT disorders – Perforation of esophagus, pancreatitis
• Others – Yellow nail syndrome, Uremia, Meig’s syndrome, After cardiac surgery / injury, Pericardial disease, Asbestos exposure, Radiation exposure, Chylothorax

1. Pleural effusion – left
2. Pathology – MCQ 37 – Development of inerstitiul lung disease
3. Massive pleural effusion

• Peaking of T waves
• Increase in PR interval (AV conduction delay)
• Wide QRS complex
• Loss of P waves

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• ST elevation with concavity upward
• T inversion occurs after some days (once ST segment returns to baseline)
• No change in QRS complexes (decrease in QRS voltage may occur in massive pericardial effusions)
• PR segment depression (due to atrial involvement)
• Atrial premature beats, atrial fibrillation

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• Chronic myeloid leukaemia
• Chronic lymphocytic leukemia
• Hairy cell leukemia
• Myelofibrosis
• Polycythemia vera
• Autoimmune hemolytic anemia
• Sarcoidosis
• Gaucher’s disease
• Diffuse splenic hemangiomatosis

1. AIIMS November 2011 – MCQ 11
2. Medicine – MCQ 78 – 21 year old male presents with anemia and mild hepatosplenomegaly
3. Medicine – MCQ 2

1. Otitic hydrocephalus
2. Complications of CSOM
3. Pseudotumor cerebri (Benign intracranial hypertension)

Other drugs which block the hepatic synthetic function (eg: warfarin which blocks hepatic synthesis of clotting factors) are also best given at night time.

1. Why is warfarin given at night?
2. Night Blindness – Causes
3. Surgery – MCQ 80 – Dacron vascular graft

1. Why are statins given at night?
2. Night Blindness – Causes
3. Anticoagulants, Antiplatelet drugs and Thrombolytic agents – Powerpoint presentation (ppt)

1. Pharmacology – MCQ 96 – Drug interactions of digoxin
2. Pharmacology – MCQ 42 – Precipitation of Digoxin toxicity
3. Medicine – MCQ 105 – A 30 year old man with history of jaundice for 10 days

1. Pharmacology – MCQ 123 – Side effects of amiodarone
2. Medicine – MCQ 49 – Pituitary apoplexy
3. Titbits on hypothyroidism

There are 3 stages:

1. Anatomy – MCQ 60 – Chorda tympani nerve
2. Pupillary signs in a comatose patient
3. Anatomy – MCQ 64 – Injury to the long thoracic nerve

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eCcr =
(140-age) * Weight (in kilograms) * 0.85 (if patient is female)
—————————————————————
72 * Serum creatine (in mg/dl)

Hence, the creatine clearance will be less in elderly individuals and females.

1. Paediatrics – MCQ 23 – Schwartz formula for calculation of creatinine clearance
2. Biochemistry – MCQ 42 – Estimation of blood creatinine level
3. Pharmacology – MCQ 49 – Drug dose reduction in renal failure

1. Winter bronchitis
2. Paroxysmal nocturnal dyspnoea
3. Pulmonary oedema
4. Pulmonary apoplexy
5. Pulmonary infarction
6. After anticoagulant therapy.

1. Radiological signs in mitral stenosis
2. AIIMS November 2011 – MCQ 14
3. Air bronchogram – Mechanism, Causes

Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.

1. Priscilla White classification of Diabetes complicating pregnancy
2. Classification of atrial fibrillation based on duration
3. Runyon’s Classification of non tuberculous mycobacteria

• Clostridium perfringens – most common
• Clostridium bifermentans
• Clostridium septicum
• Clostridium sporogenes
• Clostridium novyi
• Clostridium fallax
• Clostridium histolyticum
• Clostridium tertium

• Bacteroides
• Anaerobic streptococci
• Klebsiella pneumoniae in the context of diabetes

1. Surgery – MCQ 98 – Chronic burrowing ulcer
2. Pathology – MCQ 76 – Causes of atypical pneumonia
3. Microbiology – MCQ 50 – Organisms responsible for nosocomial pneumonias

• Cystic fibrosis
• Lung cysts
• Emphysematous bulla / apical subpleural bleb
• Rupture of bronchogenic carcinoma / esophageal carcinoma
• Honeycomb lung
• Catamenial pneumothorax (associated with menstruation)
• AIDS

1. Light index of pneumothorax
2. Ophthalmology – MCQ 16 – Malignancy in a recurrent chalazion
3. Mass lesion – Left lungs – X-ray

• Impetigo
• Herpes simplex
• Epidermolysis bullosa
• Bullous icthyosis
• Incontinentia pigmenti

1. VINDICATE – Mnemonic for differential diagnosis
2. Orthopaedics – MCQ 22 – Differential diagnosis of lesion, histologically resembling giant cell tumour
3. Differential diagnosis of low set ears – Medical mnemonic

• Vascular (Multi infarct dementia)
• Motor neuron disease

• Guillain Barre syndrome
• Sarcoidosis – uveoparotid fever
• Leprosy
• Lymphoma / leukemia

1. NEET PG / USMLE – MCQ 34
2. Microbiology – MCQ 75 – Epstein Barr (EB) virus associated conditions
3. Medicine – MCQ 172 – Isolated 3rd nerve palsy

• By inducing a stress response which increases the sympathetic tone
• Increased sympathetic tone can precipitate atrial fibrillation (AF)
• Hypoxia leading to increased pulmonary resistance
• This results in pulmonary hypertension and atrial dilatation
• Atrial dilatation can lead to AF
• Direct involvement of the atria

1. Mechanism of development of atrial fibrillation in valvular heart disease
2. Atrial fibrillation with bigeminal rhythm
3. Pharmacology – MCQ 122 – 60 year old man with atrial fibrillation

• Smoking
• Alcohol
• Upper respiratory tract infections
• Recent influenza infection
• Corticosteroid therapy
• Old age
• Pre existing lung disease

1. Reye syndrome
2. Pathology – MCQ 37 – Development of inerstitiul lung disease
3. Pathology – MCQ 75 – Viral pneumonia

1. Radiology – MCQ 31 – Most preferred route for cerebral angiography
2. Anatomy – MCQ 57 – Branches of external carotid artery
3. Anatomy – MCQ 12 – Posterior communicating artery a branch of

Ref : Pediatric neurology: a case-based review By Tena Rosser

1. Ophthalmology – MCQ 11 – Persistent hyperplastic primary vitreous
2. Pathology – MCQ 88 – Prognosis in neuroblastoma
3. Medicine – MCQ 164 – Drugs for prophylaxis of migraine

Very – Varicella (day 1)
Sick – Scarlet fever (day 2)
Person – Pox – small pox (day 3)
Must – Measles (day 4)
Take – Typhus (day 5)
Double – Dengue (day 6)
Tablets – Typhoid (day 7)

1. Fever with rash – based on day of appearance of rash
2. Mechanism of febrile seizures
3. Rickettsial diseases

1. Paediatrics – MCQ 33 – A 15 year old female with history of recurrent epistaxis
2. Paediatrics – MCQ 8 – Baby with profuse bleeding from umbilical stump
3. AIIMS November 2011 – MCQ 55

1. Paediatrics – MCQ 32 – Juvenile myoclonic epilepsy
2. Rhinitis caseosa – Epidemiology, Pathology, Clinical features, Treatment
3. Medicine – MCQ 90 – Drug of choice for absence seizures

• Barium carbonate is a whitish powder
• It is used as a rodenticide
• Symptoms develop within half an hour of poison ingestion
• Fatal dose is 0.8g

Symptoms of barium carbonate poisoning:

• Gastrointestinal
  • Diarrhoea
  • Vomiting
  • Abdominal pain
• Cardiac
  • Arrhythmia
  • Hypertension
  • Heart failure
• Areflexia, tetraplegia, flaccid paralysis

1. Medicine – MCQ 114 – A hoursewife ingests a rodenticide white powder accidentally
2. Medicine – MCQ 165 – Features of lower motor lesions
3. Forensic medicine – MCQ 5 – The drug of choice for mushroom poisoning is?

1. Mechanism of wide fixed split in Atrial septal defect (ASD)
2. Mechanism of wide fixed split in severe right heart failure
3. Mechanism of physiological split in second heart sound

• First you can review the Mechanism of normal split in second heart sound
• In severe right heart failure, the right ventricle takes a longer time to eject the blood – hence the wide split
• Also since it cannot accomodate the increased blood flow during inspiration, there is no increase in the split during inspiration

If you couldn’t grasp the rationale behind it, here’s an example:

• Imagine the right ventricle to be a plane with 100 seats (seats referring to the capacity)
• Lets first take the case of a normal right ventricle
• Imagine that during the weekdays (expiration) about 50 people travel in it
• But during the weekends (inspiration) about 60 people travel in it (due to increased venous return)
• Its easy to understand that during the weekends, it takes a longer time for the people to get out of the plane
• But in the holiday season (right heart failure), the plane (right ventricle) is full during both weekdays and weekends
• Even though there is more demand for the plane during the weekends, (due to increased venous return) the plane (right ventricle) cannot accommodate any more people (blood)
• Hence there is no difference in time taken for people to exit from the plane (the time taken to eject the blood is the same)
• This explains the fixed split
• Hope I didn’t confuse you with the explanation! If you find any difficulty in understanding this concept, please leave a comment below.

1. Mechanism of wide fixed split in Atrial septal defect (ASD)
2. Mechanism of physiological split in second heart sound
3. Split of second heart sound in Ventricular Septal Defect (VSD)

So, why does it cause a wide fixed split instead of a wide variable split?

• During inspiration, the blood flow through the vena cava increases, whereas that from the left atrium decreases
• Whereas during expiration, blood flow through the vena cava decreases, and that from the left atrium increases
• During the respiratory cycle, the blood flow through the vena cava and left atrium vary reciprocally
• Hence the wide fixed split

You can also read about : Split of second heart sound in Ventricular Septal Defect (VSD)

1. Mechanism of wide fixed split in severe right heart failure
2. Split of second heart sound in Ventricular Septal Defect (VSD)
3. Mechanism of physiological split in second heart sound