Distinction between an Ordinary Physician and a Medical a.

Mental memory Body of pubis narrow Body of pubis wider

Jurist b. Speech/manner of talking Iliopectineal line sharp Ileopectineal line rounded
1. An ordinary physician sees an injury or disease c. Gait/manner of walking Obturator foramen egg- Obturator foramen
on the point of view of treatment while a d. Mannerisms/peculiar habit shaped triangular
medico-jurist sees injury or disease on the point e. Hands and feet (size and shape) Sacrum short and narrow Sacrum long and wide
of cause f. Complexion
2. The purpose of an ordinary physician examining g. Changes in the eyes Kinds of rape
a patient is to arrive at a definite diagnosis so h. Facies 1. By using force or intimidation
that appropriate treatment can be instituted i. Left-or-right handedness 2. When a woman is deprived of reason or
while the purpose of the medical jurist is to j. Degree of nutrition otherwise unconscious
include those bodily lesions in his report and a. Deprived of reason
testify before the court or before an Applicable to both living and Dead before decomposition 1. On insane or mentally deficient
investigative body 1. Occupational marks woman
3. Minor or trivial injuries are usually ignored by an 2. Race (color, feature of the face, skull shape, 2. While the woman is under the
ordinary clinician in as much as they do not apparel) influence of alcohol or other
require usual treatment. A medical jurist must 3. Stature depressant drugs
record all bodily injuries even if they are small or 4. Tattoo marks 3. Under the influence of sex-stimulating
minor because they may be proofs to qualify the 5. Weight drugs
crime. 6. Deformities b. Woman is unconscious
7. Birth marks 1. Woman is on her natural sleep
Types of Medical Evidence 8. Injuries leaving permanent results 2. Woman suffering from sleep sickness
1. Physical evidence 9. Moles 3. Woman unconscious because she is
2. Autoptic or real evidence 10. Scar knocked out
3. Testimonial evidence 11. Tribal marks 4. After administration of narcotics
4. Experimental evidence 12. Sexual organ 3. When the woman is under 12 years of age
5. Documentary evidence 13. Blood examination (statutory)

Physiological and Psychological signs and symptoms of Scientific methods of identification Distinctions between rigor mortis and cadaveric spasm
guilt 1. Fingerprinting 1. Time of appearance: RM 3-6 hrs, CS appears
1. Sweating 2. Dental identification immediately
2. Color change 3. Handwriting 2. Muscles involved: RM all muscles of the body, CS
3. Dryness of the mouth 4. Identification of skeleton only a certain group of muscles and are
4. Excessive activity of the adam’s apple 5. Determination of sex and age asymmetrical
5. Fidgeting 6. Identification of blood and blood stains 3. Occurrence: RM natural phenomena after death,
6. Peculiar feeling inside 7. Identification of hair and fibers CS may or may not appear at time of death
7. Swearing to the truthfulness of his assertion 4. Medicolegal significance: RM used to
8. Spotless past record (religious man) Differences between a male and a female pelvis approximate time of death, CS useful to
9. Inability to look at the investigator straight in the Male Female determine nature of crime
eye Heavier construction wall Lighter construction wall
10. “Not that I remember” expression more pronounced less pronounced Distinctions between ante-mortem and post-mortem clot
Height greater Height lesser Ante-mortem Post-mortem
Points of identification applicable to living persons Pubic arch narrow and less Pubic arch wider and Firm in consistency Soft in consistency
1. Characteristics which may easily be changed round rounder Surface of blood vessel raw Smooth and healthy after
a. Growth of hair, beard, or mustache Diameter of true pelvis less Diameter of true pelvis after clots are removed clots are removed
b. Clothing greater Clots are homogenous in Clots can be stripped off in
c. Frequent place of visit Curve of iliac crest higher Curve of iliac crest lower construction, cannot be layers
d. Grade of profession Narrow greater sciatic Wider greater sciatic notch stripped off into layers
e. Body ornamentations notch Uniform in color Distinct layers
2. Characteristics that may not be easily changed
 2. Hanging 3. Bullets entering common entrance making
3. Firearm individual exits
Distinctions between contusion (bruise) & post-mortem 4. Jumping from a height 4. Near shot with a shotgun, pellets dispersed
hypostasis 5. Drowning
Contusion (Bruise) Post-mortem Hypostasis 6. Cutting and stabbing Instances when GSW Entrance > Exit
Below the epidermis in In the epidermis or cutis as 7. Suffocation by plastic bag 1. Bullets not through and through, instead lodged
small bruises or a simple stain (underlying 8. Electrocution 2. Exit through natural orifices
extravasations engorged capillaries 3. Different entrance sites but common exit wound
Cuticle abraded by violence Cuticle unabraded Distinctions between Ante-mortem from post-mortem
May or may not be in a Always appears in a wounds Classification of Burns
dependent part dependent part where Ante-Mortem Post-Mortem 1. Thermal
gravity ordains it Hemorrhage conspicuous Hemorrhage slight or none 2. Chemical
Incision shows blood Incision shows the blood is and arterial and always venous 3. Electrical
outside the vessels still in its vessels Spouting of blood No spouting of blood 4. Radiation
Variegated color Color uniform Clotted blood Soft clot, blood not clotted 5. Friction
Deep staining of edges not Edges not deeply stained
Methods of Judicial Death removed by washing and are removed by Classification of burns by degree (Dupuytren’s
1. Death by electrocution (>1500 volts) washing Classification)
2. Death by hanging Edges gape Edges do not gape but are 1. First degree: erythema or simple redness of the
3. Death by musketry (firing squad) closely approximated skin with superficial inflammation and slight
4. Death by gas chamber Inflammation and None swelling
5. Others: beheading, crucifixion (by asphyxia), reparative process 2. Second degree: vesicle formation with acute
beating, cutting asunder, precipitation from inflammation, superficial epithelium not
height, destruction by wild beast, Types of small firearms destroyed
flaying/skinning alive, impaling, stoning, 1. Revolver 3. Third degree: destruction of the cuticle, area is
strangling, smothering, drowning 2. Automatic pistol very painful due to exposure of nerve endings
3. Rifle 4. Fourth degree: whole skin destroyed with
Types of euthanasia 4. Shotgun formation of slough, not very painful, nerve
1. Active/intentional or deliberate endings are destroyed
2. Passive (Orthothanasia: incurably ill person is Distinction between gunshot wound of entrance and 5. Fifth degree: involvement of deep fascia and
allowed to die a natural death and Dysthanasia: wound of exit muscles
attempt to extend the life span of a person by 6. Sixth degree: charring
Entrance wound Exit wound
use of extraordinary treatments) Smaller owing to tissue Bigger than the missile
Distinctions between burns and scalds
elasticity
Classification of Suicide Burns Scald
Inverted edges Everted edges
1. First degree: deliberate, planned, pre- Caused by dry heat Caused by moist heat
Oval or round No shape
mediatated Occurs at or above the site Occurs below the site of
(+) contusion collar/contact none
2. Second degree: impulsive, unplanned, under of contact of flame application/contact with
ring
provocation liquid
(+) tattooing/smudging none
3. Third degree: accidental suicide (+) Hair singeing none
Underlying tissues not Underlying tissues may be
4. Suicide under circumstances which suggest a Unclear boundaries Distinct boundaries
protruding seen protruding
lack of capacity for intention as when the person Severe injury Limited
Always present May be absent
is psychotic or intoxicated from alcohol Clothings involved none
(+) Paraffin test (-) Paraffin test
5. Self-destruction due to self-negligence
6. Justifiable suicide Classifications of Asphyxia
Instances when GSW Entrance < Exit
1. Hanging
1. A bullet split into several fragments making
Common methods of committing suicide 2. Strangulations manually or by ligature
separate exits
1. Drugs and poisons: sedative 3. Suffocation (smothering or choking)
2. Natural orifice entrance
 4. Submersion or drowning 1. Heterosexual Classification of Alcoholic Beverages
5. Pressure on the chest 2. Homosexual: overt and latent 1. Wine: natural alcoholic fermentation + fruit
6. Irrespirable gases 3. Infantosexual: pedophilia juices
4. Bestosexual/animals - Red, white, dry, sweet, still, sparkling, fortified,
5. Autosexual Chinese medicinal, basi, lambanog
Death by crucifixion 6. Gerontophilia 2. Distilled liquor: from distillate of wines, grains, or
- When a person is nailed on a cross, the weight is 7. Necrophilia starch
supported by the nailed feet. In order to 8. Incest - Whiskey, gin, rum, alcoholic cordials and liquors,
breathe, the person had to raise his body then vodka
throw his weight on his feet. When on the cross, Mode of sexual expression or way of sexual satisfaction 3. Malt liquors: brewed from malt
the intercostal muscles are stretched and the 1. Oralism: fellatio, cunnilingus, anilism - Ale, beer, stout, porter
chest cage is fixed. The alternative raising and 2. Sado-masochism: flagellation (being whipped)
lowering of the body lead to exhaustion, - Sadism/active algolagnia: cannibalism, love bites Blood Alcohol Levels
unconsciousness and death from asphyxia. - Masochism/passive 1. 10 mg %: pleasant clearing of head
Because of the difficulty of the chest movement, 3. Fetishism 2. 20 mg %: physical feeling of well-being
this type of death may be classified as traumatic a. Anatomic 3. 50 mg %: individual feels on top of the world,
asphyxia. b. Clothing increased self-confidence and decreased
c. Necrophilic inhibitions
Classification of Child Abuser d. Odor: urolagnia, corpolagnia, mysophila 4. 100 mg %: individual intoxicated and under the
1. Intermittent e. Pygmalionism (statues) influence
2. One-time f. Mannikinism 5. 150 mg %: deterioration in performance and
3. Constant g. Narcissism judgment
4. Ignorant h. Negative fetish: eyeglasses, beard 6. 150 – 300 mg %: lose some degree of muscular
i. Saboteur fetish: cutting clothes or hair coordination, inability to walk properly
Kinds of Virginity j. Incendiarism: setting fire 7. 300 mg %: stuporous, uncoordinated, lose
1. Moral virginity: not knowing nature of sexual life k. Vampirism: sight of blood sphincter control
and not having experienced sexual relation 8. 400 mg %: anesthetic level
2. Physical virginity: conscious of nature of sexual Classification of Mental Deficiency 9. Above 400 mg %: death, coma, depressed
life but has not experienced sexual intercourse 1. Idiot: IQ 0-20 reflexes
3. Demi-virginity: permits any form of sexual 2. Imbecile: 20-40
liberties as long as they abstain from rupturing 3. Feeble-minded (moron): 40-70 Degree of Intoxication
the hymen by sexual act 4. Moral defective: careless, pleasure loving 1. Slight inebriation: flushing of face, exaggerated
4. Virgo intacta: truly virgin, no structural changes mood
in her organ and that she is a virtuous woman Classification of Mental Retardation 2. Moderate inebriation: talkative, argumentative,
1. Profound: under 20 over-confident, impairment of mental faculties
Crimes against chastity 2. Severe: 20-35 3. Drunk: confusion, irregular behavior,
1. Seduction: qualified and simple seduction 3. Moderate: 36-51 uncontrolled mov’t
2. Acts of lasciviousness 4. Mild: 52-67 4. Very drunk/dead drunk: difficulty in speech,
3. Abduction: forcible and consented 5. Borderline retardation: 68-83 unable to walk, disoriented
4. Adultery and concubinage 5. Coma: stuporous, comatose
5. Prostitution Pharmacologic classification of Dangerous drugs
1. Hypnotics: opiates, morphine Stages of Execution of a crime
Types of a prostitute 2. Sedatives: barbiturates, methaqualone 1. Attempted crime
1. Call girl 3. Hallucinogens/psychomimetic: marijuana, 2. Frustrated crime
2. Hustler: pick up girl or streetwalker lysergic acid diethylamide/LSD, morning glory, 3. Consummated crime
3. Door knocker datura
4. Factory house 4. Stimulants: amphetamines, cocaine Persons Criminally liable
5. Deliriants: methanol, ethanol 1. Principals: direct participation, inducement,
Sexual abnormalities As to choice of sexual partner cooperation
 2. Accomplices 8. Social humiliation 6. Schwann cells: myelinates axons of neurons in
3. Accessories 9. Similar injury the PNS increasing conduction velocity via
salutatory conduction
Circumstances affecting criminal liability Types of Injuries
1. Justifying circumstances 1. Head and neck injuries Micro: Describe as to shape and stain. E. coli, N.
2. Exempting circumstances 1. Direct or coup injuries gonorrhea, V. cholera, S. aureus
3. Mitigating circumstances 2. Indirect injuries: contre coup, remote, locus
4. Aggravating circumstances minoris Resistencia Physio: Cells not needing insulin.
5. Alternative circumstances 3. Coup contre coup
2. Injuries in the chest: chest wall, lungs, heart Split vs full thickness graft, compare
Duration of penalties 3. Abdominal injuries
1. Reclusion perpetua: 30 years 4. Pelvic injuries Three Theories in endometriosis
2. Reclusion temporal: 12-20 years 5. Extremities
3. Prison mayor and temporary disqualification: 6- Why is a gunshot to the ventricles not rapidly fatal?
12 years Complications of Peptic Ulcer disease needing surgery - Gunshot wound of the heart as a general rule
4. Prison correccional, suspension, destierro: 6m-6 1. Bleeding does not prevent the victim from running,
years 2. Perforation walking, climbing stairs, or do other forms of
5. Arresto mayor: 1 month – 6 months 3. Obstruction volitional acts for death is not usually
6. Arrestomenor: 1 day to 30 days 4. Intractability or non-healing instantaneous. Wound of the auricle is more
7. Bond to keep the peace: court determined rapidly fatal as compared with the wound of the
Classify as to Mechanism of Action ventricle on account of the thickness of the
A PHYSICIAN is a person who after completing his 1. Misoprostol: a PGE1 analog which increased the musculature of the latter which produces
secondary education follows a prescribed course of production and secretion of gastric mucous temporary closure of the wound. Bullet may
medicine at a recognized university or medical school, at barrier thereby decreasing acid production lodge in the musculature of the ventricle and
the successful completion of which, is legally licensed to 2. Ranitidine: H2 blocker, reversible block of becomes encapsulated by fibrous tissue. Death
practice medicine by the responsible authorities and is histamine H2 receptors decreasing H+ secretion in firearm wound of the heart may be due to loss
capable of undertaking the prevention, diagnosis, and by parietal cells of blood or tamponade.
treatment of human illness by exercising independent 3. Omeprazole: PPI, irreversible inhibit H+/K+
judgment and without supervision (WHO) ATPase in stomach parietal cells Name five muscles associated with the intercostal spaces
4. Sucralfate: binds to ulcer base providing physical (Thoracic Area): external oblique, internal oblique,
Kinds of Medical fees protection and allowing HCO3- secretion to intercostals muscles (external and internal), rectus
1. Simple contractual fee reestablish pH gradient in mucous layer abdominis, transverses thoracis, subcostalis, etc
2. Retainer fee: by space of time not by services
rendered Enumerate and define the following: Explain the importance of the pulmonary surfactant.
3. Contingent fee: depends upon success or failure 1. Neurons: signal transmitting cells of the NS, Elaborate on the mechanism of action of surfactants
of treatment signal relaying cells with dendrites, cell bodies, - Type II pneumocytes which is responsible for the
4. Dichotomous fee (fee splitting): agents to solicit and axons production and secretion of surfactant
patients 2. Astrocyte: physical support and repair, K+ (dipalmitoylphosphatidylcholine) which reduces the
5. Straight fee/pakyaw system (package deal metabolism, removal of excess alveolar surface tension
agreement) neurotransmitter, component of BBB
3. Microglia: CNS phagocytes, scavenger cells of the Identify the effects of sympathetic stimulation on the:
Conditions Involved in moral damages CNS pupil of the eye, heart muscle, bronhci, gut lumen
1. Physical suffering 4. Myelin: wraps and insulates axons, increases
2. Mental anguish conduction velocity of signals transmitted down Identify the major divisions and subdivisions of
3. Fright axons pharmacology
4. Serious anxiety 5. Oligodendroglia myelinates axons of neurons in
5. Besmirched reputation the CNS Give the four routes of metastasis of malignant tumors
6. Wounded feelings (Pathology)
7. Moral shock - Hematogenous
 - Lymphatic - Asian <4 y/o
- Direct Seeding - Fever 5 benign lesions in PEDIATRICS
- Distant Metastasis - Cervical LAD
Differentiate: - Conjunctival Injection/ Conjunctivitis 4 Presenting parts in cephalic
1. Diffusion- means of passive transport, results - Strawberry tongue 1. Occiput
from thermal random movement - Hand-foot erythema 2. Sinciput
3 Types: - Desquamating rash 3. Brow
- Simple Diffusion – small non polar molecule 4. Face
poses through a lipid bilayer Rule of 2 of Meckel’s Diverticulum
Does not involve a protein  2 inches long Criteria for Pathologic jaundice
- Channel Diffusion – involves channel proteins,  2 ft. From ileocecal valve
material moves thourgh an open aqueous pore  2% of population Gold standard for bacterial infections, explain
- Facilitated Diffusion – dependent on single  2 years old
transport protein carrier  2 types of epithelia (gastric, pancreatic) Three types of Cardiomyopathy
2. Osmosis – Spontaneous net movement of 1. Dilated: dilated ventricle, normal wall thickness,
solvent molecules through a semi permeable Common names of left and right ventricular failure
membrane into a region of higher concentration 1. Strongyloides stercoralis- threadworm 2. Restrictive: low ventricular compliance restricts
in the direction that tends to equalize the solute 2. Entameoba histolytica- diastolic filling, amyloidosis, sarcoidosis,
concentration on 2 sides. 3. Enterovius vermicularis- pinworm hemochromatosis
3. Active transport – movement of molecules 3. Hypertrophic: ventricular hypertrophy, small
across a cell membrane in the direction against Bacillary dysentery vs. Amoebic dysentery cavity septum may obstruct outflow, often
their concentration gradient (i.e moving from an Bacillary Amoebic genetic
area of lower concentration to higher Maybe Epidemic Seldom Epidemic
concentration) Acute Onset Gradual onset Patient presented with polyuria, polydepsia with weight
4. Co-transport- 2 subs, are simultaneously Prodromal fever & malaise No prodromal features loss and frothy breath
transported across a membrane by one protein common 1. Type 1 DM
complex which does not have ATPase activity 2. Action of insulin
Vomitting common No vomiting
when both substances are transported in the 3. Triggers of insulin release
Pt. Prostate (flat, face Pt. Usually ambulant
same direction, the transport protein is known
down, powerless)
as symport NYHA classification:
Watery, bloody diarrhea Bloody diarrhea
1. I: negative symptoms with ordinary activity
Odorless stool Fish odor stool
Sensitivity vs. Specificity 2. II: positive symptoms with ordinary activity
Sensitivity- proportion of all people with disease who test Micro: Numerous bacilli, Few bacilli, RBC, 3. III: positive symptoms with less than ordinary
positive macrophage, RBC, no trophozoites with RBC. activity
- True positive Charcot-leyden crystals Charcot Leyden Crystals 4. IV: positive symptoms at rest
- Used for screening in disease with low Abdominal Cramps Mild Abdominal Cramps
prevalence Tenesmus common Tenesmus Uncommon Magnus vs. Diaphanous
- Highly sensitive test, when negative-RULES OUT Spontaneous recovery in Lasts for weeks 10. Magnus test: a ligature is applied around the
disease few days base of the finger with moderate tightness. In a
Specificity- Proportion of all people without disease who No relapse Returns after remission living person, there appears a bloodless zone at
test negative the site of the application and a livid area distal
- True Negative Zollinger Ellison triad to the ligature which is absent on a dead man
- Probability that a test indicates non-disease 11. Diaphanous Test: the fingers are spread wide
when disease is absent HIV drugs classification and the finger webs are viewed through a strong
- Highly specificity test used for confirmation after 5. Fusion inhibitors light. In the living, the finger webs appear red
a positive screening test 6. Integrase inhibitors but yellow in the dead
- 100% is desirable for RULING IN disease 7. Protease inhibitors 12. Icard’s test: injection of a solution of fluorescein
8. Nucleoside reverse transcriptase inhibitors subcutaneously. If circulation is still present, the
Kawasaki disease features: 9. Non-nucleoside reverse transcriptase inhibitors dye will spread all over the body
 Human functions on road accident Virus with vaccine
Ranson’s Criteria for Pancreatitis: Factors responsible to an automotive crash - Smallpox
Upon admission: After 48hours 13. Human factor/driver - Yellow fiver
Glucose > 200 Calcium <8 a. Mental attitude - Chicken pox
AST > 250 Hct drop >10% b. Perceptive defect: vision and hearing - Sabin Polio
LDH > 350 Oxygenation < c. Delayed or sluggish reaction time - MMR
60mm d. Disease - Influenza
Age > 55 BUN >5 e. Chemical factor: alcohol most common - Rota virud
WBC > 16,000 Base def>4 14. Environmental factors: roads, visibility, - Pneumococcal
Sequestration of fluid >6L intersections - Varicella
15. Mechanical factors: brake, steering wheel - Hepatitis A
Mechanism of Edema and Ascites 16. Social factor: speed
1. EDEMA: soft tissue swelling due to ABNORMAL 17. Pedestrian Types of wound
expansion of interstitial fluid volume; plasma 1. As to severity
transudate that accumulates when movement of Phases of muscle contractions a. Mortal wound: capable of causing death
fluid from vascular to interstitial space is b. Non-mortal wound
favoured; >3L, renal retention of salt and water Risks of CAD 2. As to the kind of instrument
is necessary for edema to occur Modifiable: a. Wound brought by blunt instrument:
2. ASCITES: accumulation of fluid within the - Smoking contusion hematoma, lacerated wound
peritoneal cavity; the primary abnormality is - Hypertension b. Wound by sharp instrument:
inappropriate renal retention of sodium and - Hyperlipidemia - sharp edged (incised wound)
water in the absence of volume depletion; - Diabetes - sharp pointed (punctured wound)
inappropriate sequestration of fluid within the Non-modifiable: - both (stab wound)
splanchnic vascular bed due to portal - Age c. Wound brought by tearing force: lacerated
hypertension and a consequent decrease in - Sex: increase in men and postmenopausal wound
effective circulating blood volume-> activates women d. Wound by changes in atmospheric
the plasma rennin, aldosterone, and sympathetic - Family history pressure: barotrauma
nervous system -> resulting in renal sodium and e. Wound by heat or cold: frost bite, scald or
water retention Anterior and Posterior triangle of the neck burns
- Posterior triangle f. Wound by chemical explosion: GSW,
Types of Breech presentation o Occipital triangle shrapnel
1. Complete o Supraclavicular triangle g. Wound brought by infection
o Indian squat - Anterior Triangle 3. As to manner of infliction: Hit, thrust, stab,
o Thighs are flexed and legs are flexed upon o Submental triangle gunpowder explosion, sliding, rubbing, or
the thighs o Diagastric triangle abrasion
2. Incomplete o Carotid triangle 4. As to regards of depth of wound
o One or both legs are extended o Muscular Triangle a. Superficial
o Single or double footling b. Deep: penetrating and perforating
o Risk for cord prolapse How glucose is converted to ATP? 5. As regards to relation of site and application of
a. Single footling force and the location of injury
b. Double footling Pathologic findings in ATHEROMA a. Coup: located at site of application of force
3. Frank: b. Contre coup: opposite site of force
o Thighs flexed at hips but legs are extended Gynecologic patients: Ectopic pregnancy vs. Ovarian c. Coup contre coup: at site and also opposite
in front of the thorax torsion d. Locus minoris Resistencia: areas offering
o Arms flexed least resistance to the force applied
o Most favourable for vaginal delivery Upper/Major Respiratory airway e. Extensive
6. As to regions or organs of the body involved
Typhoid fever Risk factor for DVT 7. Special types of wounds
a. Defense wound
 b. Patterned wound  dx: APTT  Hypoalbuminemia
c. Self-inflicted wound  Hyperlipidemia, >3.5g/day
Warfarin:
Food pyramid  inhibit clotting factors 2,7,9,10 Collagen synthesis
 clinical use: out patient INSIDE Fibroblasts:
Fates of pyruvate  antidote for toxicity: Vit. K and FFP 1. Synthesis
- Converted to ethanol  dx: PTPA 2. Hydroxylation
- Glycolysis 3. Glycosylation
- TCA Paroxysmal Nocturnal Hemoglobinuria 4. Exocytosis
- Decarboxylated Acetyl-Coa TCA
- Carbvoxylated Oxaloacetate TCA Menopause: OUTSIDE Fibroblasts:
Definition: 5. Proteolytic processing
Signs and Symptoms 6. Cross-linking
Hepatitis Antigen and Antibody
Anti-HAV (IgM)- best test to detect active hep A Steps in THYROID hormone synthesis Types of collagen
Anti HAV (IgG) indicates prior HAV 1. Iodine trapping I- bONE
infection/vaccination; protects from reinfection 2. Oxidation and iodination II- carTWOlage
HBsAg- Hep B infection 3. Coupling process III- 3ticulin (reticulin)
Anti-HBs- immunity to hep B 4. Hydrolysis IV- FLOOR (basement membrane)
HBcAg- core of HBV
Anti- HBc- positive during WINDOW PERIOD Opportunistic fungal infections Hepatic Segments
Anti-HBe- LOW transmissibility 1. Candida 1. I: dorsal
HBeAg-active viral replication-HIGH transmissibility 2. Aspergillus 2. II: left lobe posterior
3. Pneumocystis 3. III: left lobe anterior
4. Cryptococcus 4. IV: quadrate/ median lobe
Rigor mortis vs. Algor mortis 5. V: right lobe anterior inferior
1. Algor mortis: cooling of the body, progressive fall Glucose transporter 6. VI: right lobe posterior inferior
of body temperature which is rapid during the Glut 1: RBC, Brain 7. VII: right lobe posterior superior
first 2 hours of death and eventually becomes Glut 2: pancreas, liver, kidney, small intestine 8. VIII: right lobe anterior superior
slower Glut 4: adipose tissue, skeletal muscle
2. Rigor mortis: state of post-mortem rigidity due Cardiac cycle:
to the contraction of the muscles which develops BMI: wt in kg/ ht in m2 1. Isovolumetric contraction
3-6 hours after death and may last from 24 – 36 2. Systolic ejection
hours Parts of parietal pleura 3. Isovolumertic relaxation
1. Costal 4. Rapid filling
Sperm pathway 2. Mediastinal 5. Reduced filling
Seminal vesicle 3. Diaphragmatic
Epididymis 4. Cervical Right to left shunts: cyanotic heart disease
Vas Deferens 1. Tetralogy of fallot
Ejaculatory Duct Nephritic vs. Nephrotic 2. Transposition of aorta
Nothing Nephritic: inflammatory process 3. Truncus arteriosus
Urethra  Oliguria 4. Tricuspid atresia
Penis  Hematuria 5. TAPVR
 Hypertension
Heparin vs. Warfarin MOA  Azotemia, <3.5g/day Left to Right shunts
Heparin: Nephrotic: massive proteinuria a. VSD: pansystolic murmur
 decrease thromboxane and Xa  Edema b. ASD: fixed split S2
 clinical use: in patient  Proteinuria c. PDA: continuous machinery like murmur
 antidote for toxicity: protamine sulfate
Tetralogy of fallot retention Alvarado score: MANRRELS: Migration of pain, Anorexia,
1. RVH Nausea, RLQ, Rebound tenderness, Elevated temperature,
2. Pulmonary stenosis Increase ESR: SLE, infections, cancer, inflammation, Leukocytosis
3. VSD pregnancy
4. Coarctation of aorta Decreased ESR: Sickle cell, polycythemia, CHF Bacteria associated with mesenteric adenitis: Yersenia
enterolytica
Protein synthesis: Pneumoperitoneum
Initiation -> Elongation -> Termination 1. 3 step ladder appearance Layers of abdomen during appendectomy:
2. 3 mm serosal thickness 1. Skin
AUG- Start of codon 3. 3 cm small bowel calibre 2. Subcutaneous fascia (Camper’s)
Stop codon: UAA, UAG, UGA DUOdenal atresia: DoUble bubble sign on xray 3. Scarpas
4. External oblique
Carcinoid syndrome: rule of 1/3 BILE components: Absorption-> Terminal ileum 5. Internal oblique
1/3 metastasize  Lecithin 6. Transversus muscle
1/3 present with 2nd malignancy  Bile acid/ Bilirubin 7. Transversalis fascia
1/3 multiple  Cholesterol 8. Peritoneal fat
9. Peritoneum
Hyperplastic progression Parasites:
NORMAL -> HYPERPLASIA -> CIS -> invasion ->mets Nematode-> round PHARMACOKINETICS
Cestode-> tape/flat 1. Bioavailability
Hesselbach’s triangle: Trematode-> flukes 2. Volume of Distribution
1. epigastric vessels 3. Half life
2. inguinal ligament  HERPESVIRUSES: HSV1, HSV2, VZV, EBV, CMV, HHV-6 4. Clearance
3. lateral borders of rectus abdominis Roseola, HHV-8 Kaposi
 Gram negative organism: Klebsiella, Enterobacter, TUMOR Markers
Triangle of callot: Escherichia, Proteus, Pseudomonas, Serratia 1. PSA- Prostate CA-125- ovarian
1. cystic duct  Organism isolated in Cholangitis except: E. Coli (KEPS) 2. CEA- Colon S-100- neuro
2. common hepatic duct  Colorectal cancer Pathogenesis: Normal colon -> (loss 3. AFP- Liver ALP- bone
3. cystic artery of APC gene) -> colon at risk -> (k-ras mutation) -> 4. B-HCG- GTD’s Calcitonin- PTH
adenoma -> (loss of p53) -> carcinoma 5. CA-15-3- Breast
Types of necrosis  Plummer Vinson disease (DAG): Dysphagia, Anemia,
1. Coagulative: occurs in tissues supplied by end- Glossitis Epidural Subdural
arteries -lenticular - crescent
2. Liquefactive: occurs in CNS due to high fat Stage of Appendicitis -arteries -bridging veins
content 1. Congestive: mucosa is susceptible to impairment
3. Caseous: seen in tuberculosis of blood supply becoming compromised early in Subarachnoid: star of david, severe headache
4. Fatty: enzymatic and non-enzymatic the process
5. Fibrinoid: vasculitides 2. Suppurative: bacterial invasion HYPERSENSITIVITY Reaction
6. Gangrenous: common in limbs and GI tract 3. Gangrenous: progressive distention first of the I- Anaphylactic (alleric reactions)
venous return and subsequently the arteriolar II- Immune mediated (goodpasture, ITP)
EXUDATE TRANSUDATE inflow, area with poorest blood supply is III- Cell mediated (SLE, Serum sickness, GVHD)
Hypercellular Hypocellular compromised IV- Delayed (GB, Contact derm, TB)
Protein rich Protein poor 4. Rupture: distention, bacterial inivasion,
SpG: >1.020 SpG: <1.012 compromise of vascular supply and infarction Transplant rejection
Due to lymphatic Due to increased progress 1. HYPERACUTE: within minutes
obstruction, hydrostatic pressure. Causes: fecalith, lymphoid hyperplasia 2. ACUTE: within weeks
inflammation/infection, Decreased oncotic Classical presentation: periumbilical pain, n/v, anorexia, 3. CHRONIC: within months
malignancy pressure, and sodium pain migrating to RLQ 4. GVHD: varies
SPIROCHETES: Borelia, Treponema, Leptospira 5. Social Mobilizer 10 MEDICINAL PLANTS:
1. Sambong: diuretic and anti-urolithiasis
Types of Placenta Previa: 5 TYPES OF IMMUNOGLOBULIN: IgM vs. IgG vs. IgA vs. IgD 2. Akapulko: fungal dermatitis; scabies
6. Placenta accreta vs. IgE 3. Niyug-niyogan: ascariasis
7. Placenta increta 4. Tsaanggubat: abdominal pain
8. Placenta percreta SHIFT TO THE LEFT: 5. Ampalaya: DM
1. Decreased temperature 6. Lagundi: cough and asthma
Causes of Non-cardiogenic chest pain 2. Decreased altitude 7. Ulasimangbato: anti-gout
- Costocondritis 3. Decreased pCO2 8. Bayabas: wound cleaning; mouth sore
- Pleuritis 4. Decreased 2,3 DPG 9. Bawang: lowers cholesterol
- 5. FetalHemoglobin 10. Yerba Buena: body ache; pain
ASA action and classification: type of NSAID that 6. INCREASED pH
irreversibly inhibits cyclooxygenase both COX 1 and 2, 5 PILLARS of the PHILIPPINE MEDICINE POLICY OF 2011
both Thromboxane A2 and Prostaglandin resulting to SHIFT TO THE RIGHT: 1. Safety, efficacy and quality
increase bleeding time 1. Increased temperature 2. Availability and affordability
2. Increased altitude 3. Rational use of medicine
Causes of acute pelvic pain 3. Increased pCO2 4. Accountability and transparency
4. Increased 2,3 DPG 5. Health system, support
Stages of Lobar Pneumonia 5. DECREASED pH
PHILIPPINE NATIONAL DRUG POLICY: 4 PILLARS
CSF Flow: Choroid plexus  foramen of Monroe  2 Gastric Cells and their Secretions: 1. Quality assurance
lateral ventricles  aqueduct of Sylvius  3rd ventricle  Mucus cells- Mucus 2. Rational drug use
Foramen of Monroe  4th ventricle  subarachnoid G cells- Gastrin 3. Self reliance
granulations Chief cells- pepsinogen 4. Targeted procurement
Parietal cells- HCl and IF
EUTHANISIA or MERCY KILLING
 Largest protozoan: Balantidium coli 1. Active Euthanasia
KREB’S CYCLE: (Can I Kiss Sexy Sean For My Orgasm)  Taeniasolium: PORK TAPEWORM 2. Passive Euthanasia
 Citrate  Isocitrate  Ketoglutarate  Succinyl  primary lateral uterine branches: 7-13 3. Voluntary Euthanasia
CoA  Succinate  Fumarate  Malate   matureproglotids: <13 4. Involuntary Euthanasia
Oxaloacetate  Taeniasaginata: BEEF TAPEWOM
 primary lateral uterine branches: 12-20 HYPERSENSITIVITY REACTION:
Cell Types:  matureproglotids: >13 1. Type I: Anaphylactic and Atopic (anaphylaxic or
1. Permanent Cells atopic d/o)
2. Stable (Quiescent) Cells SPECIAL BULLETS: 2. Type II: Antibody Mediated (haemolytic anemia)
3. Labile cells 1. Armor-piercing bullets 3. Type III: Immune complexes (SLE, RA)
2. Phosphorus plate bullets 4. Type IV: Delayed type (Contact dermatitis;
Stages of Hepatic Encephalopathy 3. Plastic bullets GVHD)
1. Trivial lack of awareness 4. Soft point bullets
2. Lethargy or euphoria apathy 5. Bullets with secondary explosion IMMUNOHISTOCHEMICAL STAINS:
3. Somnolence to semistupor but responsive to 1. Vimentin: Connective tissue
verbal stimuli; Confusion; Gross disorientation FAMILY AS A UNIT: 2. Desmin: Muscle
4. Coma 1. Genetic influence 3. Cytokeratin: epithelial cells
2. Family is crucial in child development 4. GFAP: neuroglia
5 STAR PHYSICIAN: 3. Infectious disease spreads in the family 5. Neurofilament: neurons
1. Medical Researcher 4. Family factors affect morbidity and mortality in
2. Health Educator adults Five differential diagnosis of NIPPLE DISCHARGE:
3. Health Leader 5. Family is important in the recovering from illness 1. Pregnancy uterine
4. Health Care Provider 2. Galactorrhea
 3. Infection/ Mastitis 2. LEVEL II: deep, central, interpectoral groups - Spironolactone, Spironolactone+Butizide, Furosemide,
4. Intraductal carcinoma 3. LEVEL III: lateral to the pectoralis minor, HCTZ
5. Fibrocystic change subclavicular group 7. Vasodilators:
6. Carcinoma - Hydralazine HCl, Terazosin HCl
LYMPH NODE GRIUPS:
SOURCES OF INFECTION IN SURGICAL PATIENTS: 1. Axillary Vein Group (Lateral) LIGAMENTS OF THE REPRODUCTIVE SYSTEM:
1. Indwelling catheter/IV 2. Subclavicular group (apical) 1. Suspensory Ligament- contain ovarian
2. UTI, SSS 3. Interpectoral group (Roller’s) vessels
3. Sinusitis 2. Cardinal Ligament- uterine vessels
4. Clostroidiumdifficile enteritis 5 TYPES OF CHOLEDOCHAL CYST BY TODANI 3. Round ligament
5. Diverticulitis 1. 1.Type I 4. Broad Ligament: mesosalpinx,meso ovarian
6. Perforated PUD 2. Type II 5. Ligaments of the ovary
3. Type III or Choledochocele
PRIMITIVE REFLEXES: 4. Type Va CRITERIA OF CONGESTIVE HEART FAILURE (Framinghams)
1. Moro reflex 5. Type V or Caroli’s Disease MAJOR:
2. Rooting reflex 1. Paroxysmal Nocturnal Hemoglobinuria
3. Sucking reflex 2. Neck vein distention
4. Palmar and plantar reflex MENSTRUAL CYCLE: 3. Rales
5. Babinski reflex 4. Proliferative Phase: Estrogen Phase 4. Cardiomegaly
6. Gallant reflex 5. Secretory Phase: Progesterone Phase 5. Acute Pulmonary edema
6. Menstruation 6. S gallop
Causes of Metabolic acidosis: 7. Increase venous pressure
- Methanol, uremia, DKA, Infection, Lactic CHRONIC KIDNEY DISEASE 8. (+) hepatojugular reflex
acidosis, Ethylene glycol, Salicylates, Cockroft-GaultFormular:
Formaldehyde 140-age in years x wt in kg. MINOR:
72 if female or 85 if male x serum crea in mg/dl 1. Extremity edema
STRAP MUSCLES: 2. night cough
- Sternohyoid, Sternothyroid, thyrohyoid, superior 1. Stage I: kidney damage with normal or increase 3. dyspnea on exertion
body of omohyoid GFR 4. hepatomegaly
2. Stage II: kidney damage with milk decrease GFR 5. pleural effusion
MALE AND FEMALE GENITAL HOMOLOGUE 3. Stage III: Moderate decrease GFR 6. vital capacity decrease 1/3 from normal
Glans penis- Glans clitoris 4. Stage IV: Severe decrease GFR 7. tachycardia
Corpus cavernosum and spongiosum- vestibular bulbs 5. Stage V: Kidney failure
Bulbourethral glands of Cowper- Greater vestibular glands PHASES OF MENSTRUAL CYCLE:
of Bartholin ANTI-HYPERTENSIVE AND CARDIAC DRUGS 1. Menstruation
Prostate gland- Urethral and Paraurethral glands of Skene 1. ACEi – “pril” 2. Follicular Phase
Ventral shaft of penis- Labia minora  Captopril, Cilazapril, Enalapril 3. Ovulation
Scrotum- Labia majora 2. Angiotensin II Antagonist (and Diuretic combination): - 4. Luteal Phase
“sartan” Losartan, Losartan + Hydrochlorthiazide,
TOP 5 CAUSES OF ATRIAL FIBRILLATION: Telmisartan STAGES OF LABOR:
1. Ethanol ingestion: Holiday heart syndrome 3. Beta blockers”olol” 1. Stage I: onset of regular contractions and ends
2. Valvular heart disease - Atenolol, Bisoprololfumarate, Carvedilol, Metoprolol with complete cervical dilatation (a. Latent, b.
3. Ischemic heart disease succinate Active)
4. Cardiomyopathy 4. Calcium channel antagonist: “dipine” 2. Stage II: Complete CD and ends with delivery of
5. Thyrotoxicosis - Amlodipine, Nifedipine, Felodipine, Diltiazem, Verapamil neonate
5. Centrally acting drugs: 3. Stage III: delivery of neonate and end with the
LYMPH NODES LEVELS - Clonidine HCl, Methyldopa delivery of placenta
1. LEVEL I: medial to pectoralis minor, scapular 6. Diuretics: 4. Stage IV: primary after delivery of placenta
group, external mammary, axillary vein
ABNORMAL UTERINE BLEEDING: 4. Grade 4: prolonged haemorrhoid 1. Metabolic Acidosis: decreased pH, decreased
1. Oligomenorrhea: infrequent UB with interval PCO2, decreased HCO3; Compensation:
from 35dayss to 6months BENIGN THYROID DISEASES: Hyperventilation (immediate)
2. Amenorrhea: no menses for at least 6months a. Grave’s disease 2. Metabolic Alkalosis: increased pH, increased
3. Menorrhagia: prolonged >7days or excessive UB b. Plummer’s disease PCO2, increased HCO3; Compensation:
at irregular intervals c. Chronic lymphocytic thyroiditis Hypoventilation
4. Metrorrhagia: irregular bleeding but frequent d. Giant cell thyroiditis 3. Respiratory Acidosis: decreased pH, increased
intervals, amount is variable PCO2, decreased HCO3; Compensation:
5. Menometrorrhagia: prolonged and irregular MALIGNANT THYROID DISEASES: increased renal (HCO3) reabsorption
uterine bleedings 1. Papillary carcinoma: 80% best prognosis 4. Respiratory Alkalosis: increased pH, decreased,
6. Intermenstrual bleeding: bleeding of variable 2. Follicular carcinoma: 10% unicentric PCO2, decreased HCO3; Compensation:
amounts occurring between regular menstrual 3. Medullary carcinoma: 5% decreased renal (HCO3) reabsorption
period 4. Anaplastic carcinoma: poor prognosis
ACUTE MYOCARDIAL INFARCTION: Diagnostics:
ANTIBIOTICS: JONES Criteria for Acute Rheumatic Fever 1. Troponin T
1. Penicillin, Methicillin, Ampicillin, Piperacillen, Major manifestation: 2. Troponin I
Cephalosporin, Aztreonam: block the cell wall 1. Carditis 3. CK-MB
synthesis by inhibition of peptidoglycan cross 2. Polyarthritis 4. ECG
linking 3. Chorea
2. Bacitracin, Vancomycin: block peptidoglycan 4. Erythema marginatum ECG changes in MI:
synthesis 5. Subcutaneous nodules 1. ST elevation: transmural infarct
3. Sulfonamides,TMP: blocks the nucleotide 2. ST depression: subendocardial infarct
synthesis Minor manifestation: 3. Pathologic Q waves: transmural infarct
4. Fluoroquinolones: block the DNA topoisomerase 1. Clinical findings: arthralgia and fever
5. Rifampin: block mRNA synthesis 2. Lab findings: increased Acute phase reactants, ORALS II
6. Metronidazole: damage DNA prolonged PR interval PEDIA OPD: Most Common Diseases
7. Chloramphenicol, Macrolides, Clindamycin, 1. URTI
Linezolid,, Streptomycin: blocks the CHON DUKES Criteria for Infective Endocarditis 2. PCAP
synthesis at 50S ribosomal unit Major Criteria: 3. Rhinitis
8. Aminoglycosides, Tetracycline: 30s unit 1. Positive blood culture results for IE 4. AGE
2. Positive echocardiographic study 5. ATP
CHARCOT’S TRIAD: MINOR criteria: 6. Acute Bronchitis
1. Fever 1. Predisposing heart condition 7. SVI
2. RUQ pain 2. Fever >38.0C 8. UTI
3. Jaundice 3. Vascular phenomena 9. VED
10. HSV
Reynaud’s Pentad: ECG:
1. Fever 1. P wave: atrial depolarization MEDICINE OPD: Most Common Diseases
2. RUQ pain 2. PR interval: conduction delay through AV node 1. ARD
3. Jaundice 3. QRS complex: ventricular depolarization 2. Low Back Pain
4. Change in sensorium 4. QT interval: mechanical contraction of the 3. URTI
5. Hypotension (shock) ventricle 4. Hypertension
5. T wave: ventricular repolarization 5. AGE
GRADING OF INTERNAL HEMORRHOIDS: 6. ST segment: isoelectric, ventricles depolarized 6. Nape pain
1. Grade 1: no prolapsed 7. U wave: hypokalemia, bradycardia 7. UTI
2. Grade 2: prolapsed during defecation 8. ATP
spontaneously reduces ACID-BASE PHYSIOLOGY: 9. Rashes
3. Grade 3: prolapsed during defecation, minimally 10. Dizziness/ Headache
reduces
SURGERY OPD: 4. night sweats Malarial Species
1. Anterior neck mass 5. headaches 1. P. Falciparum: MC, fatal, assoc. with cerebral malaria,
2. Soft tissue mass 6. anxiety recrudescence
3. RLQ pain 7. mood swings 2. P. malariae- recrudescence, quartan
4. Breast mass 8. weight gain 3. P. Ovale-relapse
5. Animal bite 4. P. Vivax- relapse
6. RUQ pain SEGMENTS OF FALLOPIAN TUBE FROM UTERUS TO
7. Paronychia FIMBRIAL END
8. Inguinoscrotal mass 1. interstitium
9. Soft tissue injury/trauma 2. isthmus
10. Abscess 3. ampulla
4. infundibulum
ABNORMAL UTERINE BLEEDING
1. Structural: PALM (Polyp, Adenomyosis, RISK FACTORS FOR ENDOMETRIAL CANCER
Leiomyoma, Malignancy and Hyperplasia) 1. menopause after 52 y
2. Non-structural: COEIN (Coagulopathy, Ovulatory 2. unopposed estrogen stimulation
dysfunction, endometrial, iatrogenic, not yet 3. unopposed estrogen replacement therapy
classified) after menopause
4. obesity
Natural methods of contraception: 5. nulliparity
1. Billing’s method/cervical mucus method 6. diabetes
2. Sympto-thermal method 7. feminizing tumors of the ovary
3. Calendar/Rhythm method 8. polycystic ovarian syndrome
4. Basal body temperature method (BBT) 9. tamoxifen therapy for breast cancer
5. Lactation-Amenorrhea method(LAM)
6. Coitus interruptus Genesis of RBC
1. Proerythroblast- most immature and
Female homologue of the following male structures recognizable
1. scrotum: labia majora 2. Basophil erythroblast-smaller nucleus, more
2. penis: clitoris cytoplasm
3. prostate: Skene’s glands/paraurethral 3. Polychromatophil erythroblast-hemoglobin
glands function
4. Orthochromatic erythroblast- extrude nucleus
Pelvic Sites of endometriosis 5. Reticulocyte- RNA remnants
1. ovary 6. Erythrocyte
2. fallopian tube
3. broad ligament Genesis of Granulocyte
4. pelvic peritoneum over the uterus 1. Myeloblast
5. anterior and posterior cul-de-sac 2. Promyelocytes
6. uterosacral& round ligament 3. Myelocytes
7. pelvic lymph nodes 4. Metamyelocyte
8. cervix 5. Band
9. vagina 6. Mature Granulocyte
10. vulva
3 Steps of Phagocytosis
ACUTE SYMPTOMS OF ESTROGEN DEFICIENCY 1. Recognition and attachment
1. insomnia 2. Engulfment
2. hot flush 3. Killing and Degradation
3. depression