Imp points
*determinant of blood flow is cardiac output
*determinant of cardiac output z venous return
*fastest conduction in purkinje fibers
*fastest heart rate z in SA node
*most sensitive n early enzyme in 1 hr myoglobin
*within first 6 hours gold standard z Ecg
*most sensitive n specific marker z trop T
*for Re infraction ckmb
*if duration given 1 hour prefer myoglobin
*if 6 hours or 3-4 hrs prefer ckmb
* if say marker trop T
*if enzyme than ckmb
*dextrocardia in kartagener syndrome
*vsd commonly occurs in membraneous septum
*anti hypertensive drug ehich raise indirect billirubin is methyldopa due to hypersensitivity hemolysis
*mother to fetus trabsport z by facilitated diffusion
*erythropoiesis from yolksac upto 8 week, from liver 6 weks upto birth than from bonemarow
*blood leavng placenta have po2 30mmhg but if askng 02 saturation than its 80%
*o2 saturation in umblical artrey 20%
*R border of heart formed by R atrium n svc but if askng on xray than prefer svc
*most post part of heart z left atrium
*cardiac cycle 0.8 sec total duration
*atrial systole o.1 sec
*ventr systole 0.3 sec
* quiscent period(all 4 chambers in diastole) o.4 sec
*x wave absent in tricuspid regurgitation
*period of highest 02 consumption z isovolumetric contraction
*Mvp shows myxomatous degeneration
*most frequent valvular lesion z mvp
*machine like murmur pDA
* most common cause for pda z prematurity
*continuous chest pain unrelated to respiration z myocarditis
* chest pain on lying down z pericarditis
*atrial depol by P wave
*atrial Repolariz masked by QRS complex
*ventr dep by QRs
*ventr repolarization by T wave
*ventr depol+vent repolariztion by Qt interval
*sort pR intervak with wide Qrs complex z wolf parkinson n p wave present
*narrow Qrs complex n l wave absent z svt
*irregularly irregular baseline without p wave is atrial fibrullation
* saw tooth appearanve z in atrial flutter
*fatal arrythmia z ventriculr fibrillation
*lengthning of pR interval with drop beat z mobitz type 1
*lengthning of pR intervsk wth 2:1 z mobitz type 2
*lyme disease results in 3° block
*complete heart block in newborns associated with maternal sle
*aortic arch respond only to inc in bp
*carotid sinus respond to both inc n dec in bp
*most common cause of early childhood cyanosis z TOF
*pda causes differential cyanosis
*preductal coarctation of aorta associated with turners but congenital heart diseases asociated with downs>>turners
*most common cause of essential hypertension z idiopathic 90%
*mvp associated with marfan syndrome
*common site for atherosclerosis z abd aorta
*patient with severe chest pain with st elevation dissecting aorta
*ant wall mi v1-v4
*anteroseptal v1-v2
*inf wall mi by R marginal artry(cpsp key)
*lv pseudoaneurysum acts lyk. Time bomb
*most common cause after mi z arrythmia
*most common cardiomyopahy z dilated n least common z restrictive
*in atheletes hypertrophic cardiomyopathy
* systolic dysfunction in dilated cardiomyopathy n distolic dysfunction in hypertrophic n restrestrictive
*myofibrillar disarray in hypertrophic cardiomyopathy
*heart failure cells contain màcophages
*RhF cause cardiac cirrhosis
*acute IE by staph n subacu5e by viridians streptococci,prosthrtic valves by s.epidermidus,in colon cancer by s.bovis
*common valve involved in IE z mitral but in iv abusers common z tricudpid
* beck triad occurs in cardiac tamponade
*tree bark appearance ocvurs in 3°syphillus
*most common heart tumor z metastasis but if askng 1• cardiac tumor in adults myxoma n in children rhabdomyomas
*PAN shows fibrinoid necrosis
*doc for svt adenosine
*doc for vT amidron

Name two cells that can not utilize ketone bodies?
Rbc and liver cells

Lysosomal storage diseases are autosomal recessive,except?
fabry and hunter (need to double check)

1-ovulation---14 day before menstruation
2-implantation----- at 6 day post fertilization
3-embryo---- less than 10 week
4-fetus----more than 10 week
5-EDD---- +9month +7day or (-3month +7 day)
6-viability-----20 week
7-fetal HR----7-8 week
8-Quicking----primigravida 18 week , multigravida 14-16 week
9-reccurent abortion ----- 3 or more than 3 time
10-length of cervix 3-5 cm less than 2 cm lead to cervical incompitance

11-cervical cercalage done at 12-14 week and remove stitch at 36-38 week
12-placenta previa diagnosis after 28 week
13-anti-D give during 72 h after delivery
14-normal B-HCG doubling every 48 h
15-gestetional sac at 6-7 week
16- if NO fetal HR less than 20 week this missed abortion , more than 20 week this
IUFD
17-normal delivery uterine contraction at least 2/10 mint last 30 sec
18-dose of MgSo4---2g/h , antidote is calcium gluconate dose 1g
19-pre-eclampsia (HTN more 140/90,proteinuria more 3g/h ,edema) after 20 week
20-progesterone secret from corpus letum till 12 week after that secret from placenta

21-pregnancy test positive in blood after 5-9 day, in urine 14 day
22--Uterus become abdominal organ at 12week
-become at umbilical level at 20 week
-return to umbilical level immediate after delivery
-return to pelvic after 6 week post delivery
23-neonatal ---- 0-28 day
24-colstrum milk 2 day postpartum, mature milk 3-6 day postpartum
25-puerperium 6 week pospartum
26-uterus weight 50 g
27-PPH-----500cc in vaginal delivery , 1000cc in CS
28-PHH-----1ry PHH less than 24 h , 2ry more than 24 h
29-Weight of the placenta ---500g or 1/6 fetal weight
30-screening for gestational DM at 24-28 week

31-oligohydromnias AFI less than 5 , polyhydromnias AFI more than 20-25
32-macrosomia fetal weight more than 4.5 kg
33-aminotic fluid maximum 800 cc at 28 week
34- Nuchal translucency done at 1st trimester
35-triple scewn at 2nd trimester
36-amniocentesis done after 15 week
37-chorionic villous sampling (CVS) done 9-12 week
38- L/S ratio 2 or more than ------mature lung
39-average wight gain during pregnancy 12 kg
40-daily requirement of minerals and vitm during pregnancy
iron----1000mg/day (1g/day)
folic acid -----0.4 mg/d
ca+2----increase need during pregnancy
vitm c---- increase 20%
50-crowning at station +5

51- 1st stage of delivery -----pain and cervical dilatation
52-2nd stage of delivery------full dilatation of cervix to delivery fetus
53- 3rd stage of delivery-----delivery of placenta
54- incidince of breach NOT SURE 1% OR 3%
55-NORMAL fetal HR ----120-160
56-thelarche 1st sign of puberty at 10y ,menarche last sign at 12-13 y
57-in polycystic ovary LH:FSH ratio 3:1

So Important
★ Ovulation---14 day before menstruation
★ Implantation----- at 6 day post fertilization
★ Embryo---- less than 10 week
★-Fetus----more than 10 week
★EDD---- +9month +7day or (-3month +7 day)
★-Viability-----20 week
★-fetal HR----7-8 week
★Quicking----primigravida 18 week ,
multigravida 14-16 week
★-Reccurent abortion ----- 3 or more than 3
time
★-Length of cervix 3-5 cm less than 2 cm lead
to cervical incompitance
★-Cervical cercalage done at 12-14 week and
remove stitch at 36-38 week
★-Placenta previa diagnosis after 28 week
★-Anti-D give during 72 h after delivery
★-Normal B-HCG doubling every 48 h
★-Gestational sac at 6-7 week
★- If NO fetal HR less than 20 week this missed
abortion , more than 20 week this
IUFD
★-Normal delivery uterine contraction at least
2/10 mint last 30 sec
★Dose of MgSo4---2g/h , antidote is calcium
gluconate dose 1g
★ Pre-eclampsia (HTN more 140/90,proteinuria
more 3g/h ,edema) after 20 week
★-Progesterone secret from corpus letum till 12
week after that secret from placenta
★-Pregnancy test positive in blood after 5-9
day, in urine 14 day
★--Uterus become abdominal organ at 12week
-become at umbilical level at 20 week
-return to umbilical level immediate after
delivery
-return to pelvic after 6 week post delivery
★-Neonatal ---- 0-28 day
★-Colstrum milk 2 day postpartum, mature milk
3-6 day postpartum
★-puerperium 6 week pospartum
★-uterus weight 50 g
★-PPH-----500cc in vaginal delivery , 1000cc in
CS
★-PHH-----1ry PHH less than 24 h , 2ry more
than 24 h
★-Weight of the placenta ---500g or 1/6 fetal
weight
★-screening for gestational DM at 24-28 week
★-oligohydromnias AFI less than 5 ,
polyhydromnias AFI more than 20-25
★-macrosomia fetal weight more than 4.5 kg
★-aminotic fluid maximum 800 cc at 28 week
★- Nuchal translucency done at 1st trimester
★-triple scewn at 2nd trimester
★-amniocentesis done after 15 week
★-chorionic villous sampling (CVS) done 9-12
week