COMMUNITY HEALTH OFFICER (CHO) Golden Key Points Guide PDF

COMMUNITY HEALTH OFFICER CHO GOLDEN KEY POINTS GUIDE PREM MIRAL CHO BOOKLET A SHORT BOOKLET COMMUNITY HEALTH OFFICER EXAM ALL POSSIBLE ONE LINER MCQS BASED ON NEW CONCEPT  Important Points for CHO Rajasthan Some Important Health Programmes of India 1. National F...

COMMUNITY HEALTH OFFICER CHO GOLDEN KEY POINTS GUIDE PREM MIRAL CHO BOOKLET A SHORT BOOKLET COMMUNITY HEALTH OFFICER EXAM ALL POSSIBLE ONE LINER MCQS BASED ON NEW CONCEPT  Important Points for CHO Rajasthan Some Important Health Programmes of India 1. National Family Planning Programme: 1951 2. National Malaria Control Programme (NMCP): 1953 3. National Leprosy Control Programme: -1955 4. National Malaria Eradication Programme (NMEP): 1958 5. National Tuberculosis Programme (NTP): 1962 6. Integrated Child Development Services (ICDS) Scheme: 1975 7. National Programme for Control of Blindness (NPCB): 1976 8. Kala Azar Control Programme: 1977 9. Modified Plan of Operation (MPO): 1977 10. National Mental Health Programme: -1982 11. National Leprosy Eradication Programme (NLEP): 1983 12. National AIDS Control Programme (NACP): 1987 13 Baby Friendly Hospital Initiative (B FHI): 1991 14. Revised National Tuberculosis Control Programme (RNTCP): 1992 15. Child Survival and Safe Motherhood (CSSM) Programme: 1992 16. National AIDS Control Programme I (NACP I): 1992-97 17. Enhanced Malaria Control Project (EMCP): 1997 18 Reproductive and Child Health Programme I: 1997 19 National Anti Malaria Programme (NAMP): 1999 20. National AIDS Control Programme II (NACP II): 1999-2004 21. National Vector Borne Disease Control Programme (NVBDCP): 2003-04 22. Reproductive and Child Health Programme II: 2004-09 23. National Rural Health Mission (NRHM): 2005-12 2|Page 24. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): 2006 25.National AIDS Control Programme III (NACP III): 2006-11 26. National Tobacco Control Programme (NTCP): 2007-08 27. National Program for Health Care of the Elderly (NPHCE): 2011 28. National Health Mission (NHM): 2013 29. National AIDS Control Program IV (NACP IV): 2012-17 30. Pradhan Mantri Jan DhanYojana (PMJDY): 2014 31. Pradhan Mantri Suraksha BimaYojana: 2015 32. Pradhan Mantri Jeevan Jyoti BimaYojana: 2015 33. The national health policy(NHP): 1983 34. Universal immunization programme(UIP): 1985 35. Blood safety programme: 1989 36. National health policy: 2002 37. Reproductive and child health programme: 1997 38. National vectore borne disease control Programme: 2003 39. Revised programme of nutritional support: 2004 40. janani suraksha yojana launched: 2005 Important key points: 1. Chloramphenicol drug causes Gray Baby Syndrome in infant and children. 2. Amebiasis is transmitted by - fecoOral Route 3. Scotch tape swab is used to identify -Pinworm Infestation. 4. Baggassosis is caused by inhalation of Sugarcane Dust. 5. Streptomycine (Antituberculosis drug) absolutely -Contraindicated in pregnancy. 6.Kala azar is transmitted by- Sand Fly 3|Page 7.Universal Immunization program Was launched in -1985 8. Guthrie Test - is used to screen - Phenylketonuria. 9. The WHO DAY is Celebrated on- 7th April 10. The name of causative organism of AIDS is - Retro Virus (HIV). 11. The Route of BCG Vaccine is - Intradermal 12. Mid day Meal programme started in the year -1961 13.Koplik's spots is clinical manifestation of which disease -Measels (Rubeola) 14. Anthracosis is caused by -Inhalation of Coal Dust. 15. JSY stands for Janani Surksha yojna. 16. The full form of DOTS - Direct Observed treatment Short Course. 17. Primary post partum hemorrhage occurs within 24 hours. 18. Normal Birth Weight is 2.5-3.5 kg 19. Best Test - to detect iron deficiency in a client is Serum ferrithin 20. Exclusive Breast Feeding refers to feeding of infant only with breast milk for the period of 6 months. 21. DOTS used To treat T.B 22. Full form of ASHA - Accredited social health Activist. 23. Other Name of Health Survey and Development Committee -Bhore Committee (1943) 24. Most common side effect of Copper T is – Bleeding 25. Folic acid deficiency during first trimester of pregnancy can cause neural tube defect in fetus. 26. The another name of Leprosy is Hansen's Disease. 27. The Last natural case of small pox was reported in 1977. 28. Small Pox eradicated in 1980 by WHO. 4|Page 29. At institutional delivery BCG,OPV & Hepatitis B vaccines are administered at birth 30. National Malaria control program was launched in1953. 31. Baby Friendly hospital initiative was started in india in the year-1993. 32. DDT is a Contact Poision. 33. Rabies is caused by RNA virus called Lyssavirus type 1, it belongs to family rahbdoviridae serotype 1. 34. Frozen DPT vaccine should be discarded. 35. BCG Vaccines should dilute with normal saline, it is available along with the vaccine. 36. The another name of whooping cough is pertussis. 37. Sucking reflex in mother causes production of Milk. 38. Community health center is the first referral unit. 39. Cataract is leading Cause of blindness in india. 40. Niacin (Vitamin B3) deficiency causes pellagra which include (3D's symptoms diarrhoea,dementia,& dermatitis) 41. MID day Meal programme started in the year 1961. 42. Monday fever is also known as Byssinosis. 43. Byssinosis is caused by inhalation of cotton dust or other vegetable fibers 44. Father of Epidemiology is John Snow. 45. Brachial neuritis is the reaction occurring towards tetanus vaccine. 46. Polishing of rice can leads to loss of Vitamin B1 (Thiamime) 47. Schick's Test - is used to diagnose Diphtheria. 48. Tetracycline is drug of choice for cholera. 5|Page 49. Ongoing Measurement of performance of a health services is known as surveillance. 50. The terminal method of contraceptive in male is Vasectomy & in Female is tubectomy. 51. Cold chain is system of preserving Vaccine 52. The constant presence of a particular disease in a geographic area is called is - endemic. 53. Spread of disease among larger population is known as pandemic. 54. Epidemic refers to a widespread occurrence of an infectious disease in a community at a particular time. 55. Episodic refers to Occasional. 56. MALA N & MALA D both are Oral contraceptive pills. Both have same combination of hormone. 57. Mala N is distributed free of cost by govt. But Mala D sold under Consumer market. 58. Oral contraceptive pills contain total 58 pills in which 21 is hormonal pill and 7 is iron tabs. 59. Rotavirus vaccine is given by oral route. 60. The initial dose of Vitamin-A is 1 Lakh IU at 9-12 month, Thereafter 2 Lakh IU at an interval of 6 month till the age of five year. 61. Sabin Oral vaccine is Live Attenuated polio Vaccine and Given by Oral Route. 62. Salk is inactivated Polio vaccine given by IM/SC route. 63. Sentinel surveillance used to identify the hidden cases in the community. 64. Choroquine is drug of choice forfalciparum malaria. 65. Tetracycline is the drug of choice for Cholera. 6|Page 66. AlmaAta was conducted in the year of 1978. 67. Prevention of risk factors is known as primordial prevention. 68. Deficiency of Thiamine (vita B1) causes Wernicke’s encephalopathy. 69. Limit for registration of birth is 21days. 70. Census is conducted in every 10 years. 71. Nosocomial infection is termed used for hospital acquired infection which develop after 48 hours of hospitalization. 72. Recommended site for DPT vaccine in infant is lateral aspect of thigh. 73. First dose of measles vaccine is administered at 9 month. 74. Rubella vaccine contraindicated in pregnancy because it causes severe birth defect in fetus. 75. Reconstituted Measles vaccine should be used within 3 hours. 76. BCG vaccine given by intradermal route. 77. June month is antimalaria month. 78. Chikungunya is transmitted by Aedes mosquito. 79. OPV is most heat sensitive vaccine. 80. Hydrophoboia is clinical feature of rabies. 81. Chicken pox rashes first appear on trunk. 82. World AIDS DAY 1st December. 83. National tuberculosis programme launched in 1962. 84. Revised national tuberculosis programme was launched in 1997. 85. Lung cancer is most commonest cancer in the world. 86. Breast cancer in female is most commonest cancer in India. 87. Vitamin A also known as Retinol. 88. One gram fat contain 9 Kcal. 89. One gram Carbohydrate 4 Kcal. 7|Page 90. 100 ml of human milk provide 70 91. ASHA works at Village level. 92. One Anganwadi unit covers 1000 population. 93. Population covered by PHC 30000 in plain area & 20000 in hilly area. 94. Sub centre is at population of 5000-6000. 95. Coitus interruptus & Breast Feeding is natural method of contraception. 96. Eligible couple age is 1545 years. 97. Cu T 380 is most effective Cu T & need to replace once in 10 year. 98. Vasectomy is most cost effective family planning method. 99. The extra calorie requirement for lactating mother is 550 Kcal/day. 100. The Children Act was passed in1960.  Pulmonary Tuberculosis (PTB) -low grade after noon fever.  Pneumonia – rust colored sputum.  Asthma- wheezing on expiration.  Emphysema - barrel chest.  Kawasaki Syndrome - strawberry tongue.  Pernicious Anemia - red beefy tongue.  Down syndrome - protruding tongue.  Cholera - ricewatery stool and washer woman’s hands (wrinkled hands from dehydration).  Malaria - stepladder like fever with chills.  Typhoid - rose spots in the abdomen.  Dengue - fever, rash, and headache. Positive Herman’s sign.  Diphtheria - pseudomembrane formation.  Measles -Koplik’s spots (clustered white lesions on buccal mucosa).  Systemic Lupus Erythematosus -butterfly rash. 8|Page   Leprosy -leonine facies (thickened folded facial skin).  Bulimia -chipmunk facies (parotid gland swelling).  Appendicitis - rebound tenderness at McBurney’s point.  Rovsing’s sign (palpation of LLQ elicits pain in RLQ).  Psoas sign (pain from flexing the thigh to the hip).  Meningitis -Kernig’s sign (stiffness of hamstrings causing inability to straighten the leg when the hip is flexed to 90 degrees)  Brudzinski’s sign (forced flexion of the neck elicits a reflex flexion of the hips).  Tetany - hypocalcemia, [+] Trousseau’s sign; Chvostek sign.  Tetanus - Risus sardonicus or rictus grin.  Pancreatitis -Cullen’s sign (ecchymosis of the umbilicus), Grey Turner’s sign (bruising of the flank).  Pyloric Stenosis - olive like mass.  Patent Ductus Arteriosus -washing machinelike murmur.  Addison’s disease -bronzelike skin pigmentation.  Cushing’s syndrome - moon face appearance and buffalo hump.  Grave’s Disease (Hyperthyroidism) - Exophthalmos (bulging of the eye out of the orbit).  Intussusception – Sausage shaped mass.  Multiple Sclerosis - Charcot’s Triad: nystagmus, intention tremor, and dysarthria.  Myasthenia Gravis -descending muscle weakness, ptosis (drooping of eyelids).  Guillain Barre Syndrome -ascending muscles weakness.  Deep vein thrombosis (DVT) - Homan’s Sign. 9|Page   Angina -crushing, stabbing pain relieved by NTG.  Myocardial Infarction (MI) -crushing, stabbing pain radiating to left shoulder, neck, and arms. Unrelieved by NTG.  Parkinson’s disease – pillrolling tremors.  Cytomegalovirus (CMV) infection -Owl’seye appearance of cells (huge nucleus in cells).  Glaucoma - tunnel vision.  Retinal Detachment - flashes of light, shadow with curtain across vision.  Basilar Skull Fracture -Raccoon eyes (periorbital ecchymosis) and Battle’s sign (mastoid ecchymosis).  Buerger’s Disease -intermittent claudication (pain at buttocks or legs from poor circulation resulting in impaired walking).  Diabetic Ketoacidosis -acetone breathe.  Pregnancy Induced Hypertension (PIH) -proteinuria, hypertension, edema.  Diabetes Mellitus -polydipsia, polyphagia, polyuria.  Gastroesophageal Reflux Disease (GERD) -heartburn.  Hirschsprung’s Disease (Toxic Megacolon) - ribbonlike stool.  Sexual Transmitted Infections:  Herpes Simplex Type Il -painful vesicles on genitalia  Genital Warts -warts 12 mm in diameter.  Syphilis -painless chancres.  Chancroid -painful chancres.  Gonorrhea -green, creamy discharges and painful urination.  Chlamydia -milky discharge and painful urination. 10 | P a g e   Candidiasis -white cheesy odorless vaginal discharges.  Trichomoniasis - yellow, itchy, frothy, and foul smelling vaginal discharges Lab. Diagnostic Test - 1. Adom Test -Scoliosis 2. Allen Test - ABG Analysis 3. Aldehyde Test -Leprosy 4. Phosphate Test - Pasteurization 5. Patch Test -Allergic Reaction 6. Tourniquet Test -Dengue 7. Urea Breath Test -H.Pylori 8. Schick test -Diphtheria 9. Dick test - Scarlet Fever 10. Rothera Test –Acetone in Urine 11. Hey Test –Bile Salt Urine 12. Smith Test –Bile Pigment Urine 13. Benedict Test – Urine Glucose 14. Kveim Test - Sarcoidosis 15. Rinne & Webber Test -Hearing 16. Direct Coomb Test -HemolyticAnemia 17. Ischiara Test - ColorVision Test - 18. SnellenChart Test -DistanceVision 19. Confrontation Test -CentralandPeripheralVision 20. Jegar's type Card Test -NearVision 22. Schiling Test -VitaminB12Absorption 11 | P a g e 23. Histamine Test - Leprosy 24. Roller over Test - PreEclampsia 25. Fern Test Nitrizine Test -leakageofAmnioticfluidandA 27. VMA (VanellylMandelicAcid) - Pheochromocytoma 28. Glucose Tolerance Test - DiabetesMellitus 29. Glyco sylated Hemoglobin/Hb1AC Test - DiabetesMellitus 30. Water Deprivation Test -DiabetesInsipidus 31. Treadmill/Stress Test - HeartFunction 32. Triple Test - DownSyndrome 33. D-Dimer Test - measuring Clot formation. (DVT, PE, DIC) 34. TrendelenburgTest -Vericose Vein 35. Phallen/Tinnel Test -Carpal Tunnel Syndrome 36. Gold Quntiferon Test -Tuberculosis 37. Bangle Test – Protein Energy Malnutrition 38. Tensilon Test – Myasthenia Gravis 39. Romberg Test -Neurological Function 40. Knee Kiss Test - Meningitis in Children 41. T zank Test - Herpes Genital or Vericella 42. Frie Test - Lymphogranulomainguinale 43. Widal Test -Typhoid (on2ndweek) 44. Weil felix Test - Typhoid fever 45. Bonny/Marshall Test -Stress Incontinence 46. Binnet Test -Intelligence Quotient 47. Sweat Chloride Test -Cystic fibrosis 48. Hanging Drop Test - Cholera 49. Paul bunnel Test - EpstienBarrVirus 12 | P a g e 50. Shake /Bubble Test -Surfactant and fetal Lungs maturity 51. Rubin Test -Patency of Fallopian Tube 52. Tape Test - Pin Worm 53. Ortho Tolidin Test -Check Chlorine in Water 54. Dexa Scan Bone Metabolic Disease (eg. - Osteoporosis) 55. Heelto Shin Test - Body Coordination Test - 56. Halo Test - CSF Leakage 57. Dexamethasone Suppression Test - ACTH or Pituitary/Adrenal gland tumor 58. Arthrocentesis - Joint inflammation and Infection 59. Holter Monitoring - 24Hour ECG Monitoring in Dysrhythmia 60. Pulmonary Function Test -measure lung volume and Capacity (By Spirometer) 61. SGOT&SGPTAST/ALT Liver Function Test - 62. PAP’s Smear Cancer of Cervix 63. Creatinine Clearance Test - estimation of GFR 64. Wood's Light Examination Superficial Infection of Skin 65. Burrow Ink Test - Scabies/ the Itch 66. Braden Scaleto Measure integrity of Bed Sore COMMUNITY HEALTH NURSING GOLDEN KEY POINTS 1. JSSK launch 1st June 2011 2. NRHM start 5 April 2005 3. NUHM started 2008 4. 0.5 to 0.8 MG per liter fluoride is normal in drinking water 5. Under five clinic also known as well baby clinic 6. Salter scale used for low birth weight monitoring 13 | P a g e 7. VDRL Test - used for diagnosis of STD 8. Sick Test - used diphtheria 9. Classical dengue fever known as the break bone fever 10. Measles known as the rubella 11. Leprosy is another name is the Hansen disease 12. Diphtheria whooping cough transmitted by droplet infection 13. Tubectomy permanent contraceptive method in female 14. Vasectomy permanent contraceptive method of male 15. Red Cross Society founder - Henry Duralt in 1919 16. MMR maternal mortality rate, birth and death registration act passed 1969 Birth registration time 21 days 17. Death registration time 7 days 18. 8 may 1984 declared smallpox the world 19. Oral polio vaccine stored 20 degree temperature 20. In pregnancy pregnant mother given 2 TT dose 21. Pulse polio immunization programme start 1995 22. Trans placental vertical transmission ex AIDS, syphilis, torch 23. Hepatitis A diarrhoea, Typhoid fever is transmitted by contaminated food and water 24. Dengue malaria Chikungunya Filaria ji Kala Azhar is a Vector Borne Disease Epidemic usually effective large population 25. Koplik spot are seen in measles 26. Mums is an acute infectious disease caused by an RNA virus paramyxo virus. Poliomyelitis is caused by polio virus incubation 7 to 14 days 27. Qunien is the common treatment of Malaria 14 | P a g e 28. Slim disease also known as the HIV 29. Treatment of HIV giving anti retroviral drug Zidovudin 30. First case of HIV in Chennai 1986 31. Rabies is caused by Lassa virus Type 1 found warm blooded animals like dog. Census in done every 10 year 1st census in India 1881 32. tragi system used in in disaster and Management 33. Silicosis is occupational disease show XRay in snowstorm 34. ESI act passed 1948 35. first generation intrauterine contraceptive device is a lippes loop 36. Second generation intrauterine device copperT 200, prevent 5 year copper T 380 prevent 10 year pregnancy 37. 3rd Generation hormonal intrauterine device LNG (Marina) 38. Copper T instillation timing 7 to 10 days during menses, first week after delivery, Bleeding is a commonest complication 39. Combined pills oestrogen progesterone example Mala N and Mala D in Mala N levonorgestrel 40. MTP Act was passed 1971 duration 12 week pregnancy RMP doctor 41. Mishon indradhanush start 26 December 2014 42. 2005 eradicate Polio in India 43. STD Disease Control Programme 1946 44. National Malaria Control Programme 1953 45. National leprosy Control Programme 1955 46. mid day meal programme 1961 47. National Goiter Control Programme 1962 15 | P a g e 48. National Cancer Control Programme 1975 49. National blindness Control Programme 1976 50. National AIDS control programme 1987 51. Janani Suraksha Yojana 2005 52. Bhore committee – 1946 (health survey and development committee) 53. Mudaliar committee 1962 (health survey and planning committee) 54. Kartar singh committee1974 (multipurpose worker committee) 55. WHO - 7 April 1948 headquarter in Geneva 56. UNICEF 1946 Headquarter New York 57. UNDP 1966 Headquarter New York 58. Food and Agriculture Organization 1945 headquarter ROM 59. International Labor Organization 1919 headquarter Geneva 60. USAID 1961 headquarter Washington 61. International Red Cross Society 1919 headquarter Geneva 62. Indian Red Cross 1920 ( 700 branches in India work relief work milk and medical supply armed forces and services family planning blood bank and first aid) 63. Hind kusth Nivaran Sangh 1950 Headquarter New Delhi 64. Tuberculosis Association of India 1939 65. Kasturaba Memorial fund 1944 66. Family planning Association of India 1949 headquarter Mumbai 67. One sub Centre cover 3000 - 5000 population & total staff 3 68. One PHC cover 20000 -30000 population & total staff 15 69. One CHC cover 80000 -120000 population & total staff 25 70. Small pox causative agent of veriola virus 12 to 14 incubation period 71. Chicken pox cause varicella zoster 14 to 16 days incubation period 16 | P a g e 72. Diphtheria caused by cornibactirium dipthiriya 26 day incubation period 73. Dengue arbo virus group 4-7 incubation period 74. Tetanus causative agent clostridium tetani 6 to 10 day incubation period 75. Anti leprosy day 31 January 76. World cancer day 4 February 77. World glaucoma day 8 march 78. World tuberculosis day 24 March 79. World Autism awareness day 2 April 80. World immunization week 24 April 81. World Malaria Day 25 April 82. World asthma day 5 may 83. World Thalassemia day / World Red Cross day 8 may 84. World blood Donor day 14 June 85. World breastfeeding week 1 to 7 August 86. Day 21 September world heart day 87. World hand washing day 29 September 88. World polio day 15 October 89. World diabetes day 29 October 90. World rabies day 14 November 91. International yoga Day 21 June 92. International day 1 December 93. One oral pills package 28 tablet, 7 iron pills & 21 hormonal pills 94. DOTS treatment of tuberculosis 95. MDT – treatment of Leprosy 96. Complication of MUMPS (Orchitis) 97. ASHA, ANGANWADI WORKER cover 1000 population 17 | P a g e 98. Indirect transmission by – 5F - Flies, Fomits, Fingers, food & Fluid 99. TBA – Traditional birth attendant Local Dai tanning 30 day 100. Village health guide tanning 3 Month (100 Day MEDICAL SURGICAL GOLDEN KEY POINTS 1. Most common initial symptoms of pulmonary embolism in chest pain 2. Right lung have 3 lobe left lung 2 lobe 3. Sharp pain breathing symptoms of pleurisy 4. Pulse oximeter used to check oxygen saturation status 5. Common cause of COPD smoking 6. Commonest site of lungs tuberculosis in apex apex of lungs 7. Blood in urea is called haematuria 8. Removal of lungs Called Laryngotomy 9. Tracheostomy surgical procedure create opening throw neck into the trachea 10. Contaminated catheter most common cause of urinary bladder infection 11. E. Coli most common cause of UTI 12. Glomerulonephritis is an inflammation of renal pelvic inflammation of renal pelvic 13. Wilms tumor also known as Nephroblastoma 14. In myocardial infection ECG St segment elevated elevated segment elevated elevated 15. Aseptic technique used during catheterization 16. Normal serum creatinine level 0.6 to 1.2 mg/dl 17. Full form of BUN blood urea nitrogen 18. Vitamin A stored in in stored in in liver 18 | P a g e 19. Cataract is opacity of transparent lens 20. Hepatitis A transmitted by contaminated contaminated water and food 21. Leukoplakia is white thickness patches in mouth sign of Cancer 22. Calcitonin hormone secreted by C cell of thyroid gland 23. Major cause of cretinism is deficiency of thyroid hormone 24. Glucagon hormone secreted by Alpha cell of pancreas 25. Insulin hormone secreted by Beta cells of pancreas of pancreas 26. Somatostatin hormone secreted by Delta cells secreted by Delta cells of pancreas 27. Chronic complication of diabetes mellitus is retinopathy, neuropathy , coronary artery disease 28. Insulin should be administered subcutaneous route 29. Pernicious anemia deficiency of Vitamin B12 30. Fat embolism is most serious complication of fracture of bone 31. Heartburn is main clinical feature of hiatal hernia 32. Cholelithiasis means stone present in gallbladder 33. Nitroglycerin is vasodilator given by sublingual route 34. Miners diseases is a inner ear inner ear disease 35. Diplopia mean double vision 36. Hepatomegaly is a largest size of liver 37. Inflammation of oral cavity is called stomatitis 38. Annulation is the removal of eye 39. NO2 used in cryosurgery 40. Chemotherapy radiotherapy and surgery is a treatment of cancer 41. Internal radiotherapy is known as beachy therapy 42. Hydrocele means collection of fluid in scrotum 19 | P a g e 43. Fistula between general and bladder is called best vaginal fistula 44. Differentiation is used pulseless patients highest energy waste 360 jule 45. Rhinitis Inflammation of nasal mucosa 46. Collage of lungs is called atelectasis 47. Collection of pus in lungs abscess 48. DOTS therapy used treatment of Tuberculosis 49. John criteria used Diagnosed of Rheumatic fever 50. Accumulation fluid in in pericardium called cardiac tamponed 51. Chronic liver disease caused by Hepatitis C 52. Cushing syndrome disorder of endocrine system moon like face face thin Skin main sign 53. Rule of 9 used in burn TBSA 54. Aqueous humour is production and secreted by celery body 55. Bilirubin is end product of breakdown of RBC CSF pressure increase in meningitis 56. Inflammation of Test -es is called orchitis 57. Women is carrier of haemophilia scabies is a a skin disorder disorder 58. Kaposi sarcoma is a skin disorder 59. Glasgow Coma Scale used for diagnosis of neurological problem 60. Inflammation of the fallopian tube is the salpingitis 61. HydrocelocTommy is the treatment of hydrocele 62. Prostate gland present in around mail urethra 63. Gynecomastia is development of breast tissue in male 64. Breast self examination will be free 3-7 days after menses period end 65. Lithotomy position used vaginal examination 66. Heparin nature natural anticoagulant in body 20 | P a g e 67. Hospital acquired infection called nasocrominal infection 68. Scleroderma is chronic hardening any body part 69. Hodgkin's disease is most common type of lymphoma 70. Acquired active immunity developed by immunization 71. Natural acquired passive immunity passed in infant by mother breastfeeding 72. Glasgow Coma score range 3-15 73. Red blood cells formed in bone marrow found long bone and sternum 74. Rheumatoid arthritis pain reliever Aspirin used 75. Fungal infection on scalp is term Tinea Capitis 76. Parkland formula used fluid replacement of burn patient 77. Burn patient risk of hypovolemic shock 78. Injury of spinal cord risk of neurogenic shock 79. Hospital staff in common source of burn patient infection 80. RL solution administered burn patient prevent Hypernatremia 81. Tonometer use of intraocular pressure normal preshure 14 – 21 82. Confirming Test of diagnosis of meningitis is lumbar puncture procedure 83. Respiratory and Cardiac vasomotor regulating Centre is Medula oblegata 84. CAD coronary artery disease 85. CVP Central venous pressure range 5-10 cm and H 2O 2-8 mm/Hg 86. SA node is a pacemaker of heart 87. Helicobacter pylori is most common cause of the tea culture 88. Barium swallow used diagnosis in hiatal hernia 89. Ulcerative colitis is chronic inflammation of the rectum and colon 90. Bone marrow depression is most common side effect of chemotherapy 91. Constipation give high fibre diet and diabetes same as 21 | P a g e 92. Mastectomy is the removal of breast 93. Uterine and cervical cancer is most common site of cancer in female 94. Normal intra cranial pressure 715 mm/hg 95. Normal CSF pressure 100180 mm of h2o 815 mm/hg 96. Prostate cancer most common cancer ageing person (old age) 97. Oedema is last sign of heart failure 98. Alopecia – lose of hair 99. First part of duodenum most commonest site Peptic ulcer 100. Disease athletic foot caused by fungal infection MIDWIFERY & GYNECOLOGY GOLDEN KEY POINTS 1. Two bartholin gland present between hymen and labia majora 2. PH of vagina is acidic between 3.5 to 4.5 3. Size of uterus 7.5 x 5x2.5 Non pregnancy 4. Weight of uterus 52-80 gram (non pregnant) 5. Weight of uterus in pregnancy 800-900 gram 6. Cervix mucus secret per day 20-60 ml cervical mucosa 7. Fallopian tube also known as uterine tube & oviduct 8. Length of fallopian tube is 10 centimetre 9. Longest part of the fallopian tube is ampulla length 6 cm and wide 5mm 10. Fertilization in done Ampulla part of fallopian tube 11. Ovary is also known as the primary sex gland in female 12. Size of ovary 3 x 2 x 1.and colour is pink Grey 13. Main function of ovary development of ovum and secreted sex hormone estrogen and progesterone 22 | P a g e 14. Breast also known as the mammary gland and it extends from 2 nd – 6th Midclavicular line average weight of breast in child bearing 200 400 gm 15. Surrounding the nipples dark pigmented brownies area is called - Montgomery tubercles 16. Oogenesis is the process of mature ovum development 17. Mature ovum is the largest cell of our body its size 130 microns 18. Ovum is covered two layer outer layer zona pellucida and inner layer Corona radiata, inner layer provide nutrition 19. Female pelvis made 4 bone, 2 innominate bone, 1 sacrum, 1 coccyx 20. Gynecoid pelvis is true pelvis, oval shape, favourable for childbirth 21. Anthropoid pelvis oval shape 22. Android pelvis same male pelvis 23. Platypelloid pelvis kidney shape 24. Anterior posterior diameter is 11 cm, oblique diameter 12 cm, and Transverse diameter 13cm 25. Diameter of cavity anterior posterior 12 cm transvers 12cm oblic 12 cm 26. Weight of placenta 500gm 27. Umbilical cord another name funic 28. Short cord plecenta 20 cm Long cord Placenta 100 cm 29. Outer covering umbilical Code by Wharton s jelly 30. Umbilical cord containing 2 artery 1 vein 31. Umbilical vein carry oxygenated blood Placenta to fetal 32. And carry deoxygenated blood fetal to placenta 33. Sagittal suture between two parietal bone 34. Coronal suture between parietal and frontal bone 35. Frontal suture between two frontal 23 | P a g e 36. Lambdoid suture between parietal and occipital bone 37. Squamous suture between parietal and temporal bone 38. Anterior fontanels called bregma, shaped diamond, size 2.53cm, and closing time 18 month 39. Posterior fontanels called Lambda size 1.2-1.2cm 45 days Tringular shape 40. Highest diameter of fetal head mento vertical 14cm 41. Obstacle grip also known as leopold maneuvers 42. Fundal grip first Leopold maneuvers 43. Lateral for umbilical grip second Leopold maneuvers 44. Pawlic grip third Leopold maneuvers 45. Pelvic grip fourth Leopold maneuver 46. In breech presentation presenting part buttocks also say complete breech presentation 47. in fetus different part relationship one another part called attitude , flexion is the Universal attitude of fetus 48. Pree Free embryonic period 2 week after Conception 49. Embryonic period 3rd week 8 week after conception 50. Fetal period 9 weeks to birth 51. 12 week development kidney begin urine 52. Heartbeat detected by droplet transducer between 10 to 12 week 53. Quickening feel mother 16 week 54. Testes are the scrotum In 40 week 55. After fertilization zygote implanted 11th day in uterine cavity 56. Placenta and fetal membrane are development tropoblast 57. Pregnant uterus innermost layer endometrium called decidua 24 | P a g e 58. Feto placental circulation start 20-21 days after fertilization 59. Placental development start 6 week and completely 12 week 60. Placenta shape is circular disc diameter 15 to 20 centimetre 61. Weight of placenta 500 gram, waight ratio with fetus 1: 6 62. Maternal surface of placenta 1 / 5 63. Fetal surface of placenta 4 / 5 64. One mature placenta have a 500 ML blood 65. Umbilical artery have a a a 60 mm of HG pressure 66. Fetal outer layer is chorion, and inner layer is amnion 67. Amniotic fluid is also known as the liquor amnii and Nature is alkaline 68. Amniotic fluid volume 12 week 50 ml, 20 week 400 ml, 36&38 week 1 liter ,At term 600-800 ml 69. Polyhydramnios 2000 ml amniotic fluid, Oligohydramnios 200 ml fluid 70. Green colour amniotic fluid (meconium stained) fetal distress indicate 71. Golden colour amniotic fluid indicate RH incompatibility 72. Green colour amniotic fluid Saffron colour indicate post maturity 73. Dark brown colour amniotic fluid t0baco juice indicate intrauterine death 74. Dark colour amniotic fluid indicate hemorrhage 75. Normal umbilical cord length 50 cm, Short Cord less than 30 cm, long cord 100 76. Amniocentesis done 14 to 16 week, identify the chromosomal abnormality fetal lung maturity and sex detect 77. Alpha fetoprotein level increased open neural tube defect spine bifida and anencephaly 25 | P a g e 78. Inhibin a protein level incresed in dawn syndrome (glycoprotein made by Corpus luteum and placenta 79. Chorionic villus sampling for detection genetic abnormality after 10 week 80. Cordocentesis done 18 to 20 week intrauterine life 81.Click Test done after 28 week know the fetal movement 82. Triple Test aged combined biochemical Test - in the Test - low maternal serum alphafetoprotein human chorionic gonadotropin and unconjugated ostiole this Test - use detect the down syndrome 83. Nausea and vomiting in first trimester of pregnancy e main cause HCG and progesterone level increase and blood 84. According to who at last 4 vist in antenatal period, first 16 week, second 24 to 28 week, third 32 week and forth 36 weeks 85. Fundal height 22 week on umblicus level, lightning in 36-37 week Say welcome sign of pregnancy 86. Quickening between 16 to 18 week fetal movement feel by mother 87. Jacquemeir and Chadwick sign (6-10) week Blue and purple colour of vagina 88. Goodell's sign 6 to 10 week soft meaning of cervix 89. Osianders sign 6-10 week feel pulsation feel vagina 90. Hegar sign 6-10 week softening of isthmus of uterus 91. Normal duration of pregnancy 40 week (280 days LMP) 92. True gestrational period 266 day from ovulation 93. Expected date of delivery by neagles formula (LMP+9 month + 7 day =EDD) 94. HCG secreted by syncytiotrophoblast cell 26 | P a g e 95. Maximum level of HCG 100 200 iu/ml between 8 to 10 week, low level 10-20 iu/ml 14-20 week 96. Progesterone secreted by Corpus luteum 6 week of pregnancy 97. Normal labour called Eutocia abnormal labour called dystocia 98. Labour has been completed 4 stage 99. First stage of labour start to labour pen to full cervical dilation, full cervical dilation 10 centimetre 100. First stage of primigravida 12 hours multigravida 6 hours 101. Show present first stage of labour 102. Bishop score use cervical status of fetal position evaluation 103. Second stage of labour full cervical dilation to foetus delivery, primi gravid duration 2 hours multigravida 30 minutes 104. Event of second stage of labour = 1 engagement, 2 descent, 3 flexon, 4 internal rotation, 5 Crowning, 6 extension, 7 restitution, 8, external rotation 105. Partograph use graphical recording of cervical dilation and decent of head developed by RH pilporter 1972 106. Third stage of labour start fetal expulsion to Placenta separation, time 5- 30 minutes primi multigravida 107. Four stages of germination stage time 1- 4 hours 108. Lochia is the vaginal discharge (1-14) day start after delivery and present in puerperium, PH alkaline in start and end of acidic 109. Lochia rubra red colour duration 13 day content blood decidua cell foetal membrane Lanugo meconium 110. Lochia Serosa pink yellowish and brownish colour duration 4-9 days Content mucus leukocytes 27 | P a g e 111. Lochia Alba pale white colour duration 10 to 14 days content decidua cell mucus microorganism 112. RH negative mother prevent RH incompatibility giving anti D immunoglobulin after delivery in 72 hours 113. After delivery Blood loss in 24 hours called postpartum haemorrhage 114. Mammogenesis Corporation forest 115. CholestrumFirst mother milk, thick yellow, present in milk IgA and anti Bodied 116. Bromocriptine drug suppress lactation 2.56 mg 10-14 day OD 117. Improve electrician tablet Meta chlorpropamide, nasal oxytocin 118. Hyperemesis gravidarum main coach excessive secretion of HCG and Prostaglandin 120. End of pregnancy Before 20 week, weight 500 gram called abortion 121. Main cause of abortion chromosomal abnormality in 50% cases down Syndrome 122. D& C in pregnancy less than 20 weeks done 123. Missed abortion is called silent miscarriage 124. Incomplete abortion and illegal abortion is septic abortion 125. Recurrent abortion is the the more than three times abortion main cause cervical Incompetence second trimester abortion and Management shiorodkar and McDonald surgery e 14 weeks. 126. Ectopic pregnancy a type of pregnancy grow outside of uterine cavity, Most common tubal pregnancy e in ampulla region 55%. 127. Hydratedformol vesicular mole molar pregnancy is the the placental chorian disease, sonography the mol l seen snow storm 128. Antepartum haemorrhage is the bleeding from genital tract 28 week of 28 | P a g e Pregnancy and before birth of baby 500 ml blood loss main cause of, APH Placenta previa, abruptio placenta 129. Dizygotic twins 80% made by 2 ovem fertilization called binovular 130. Monozygotic twins 20%made by one ovum fertilization after twining Called umivular twin 131. Preeclampsia multisystem disorder increase blood pressure 140/ 90 mm of HG, generalized edema, protein urea, 132. Eclampsia sign- increased blood pressure, generalized edema, and protein Urea, and fitts 133. Eclamptic fits controlled by pregnancy Magnesium Sulphate MGSO4 , Magnesium sulphate antidote calcium gluconate 134. Gestational hypertension develop after 20 week of pregnancy 1450/90 Mm/hg, and normal 6 week after delivery 135. Preterm labour is the 20 week after before 37 weeks post term labour After 42 week, 290 days 136. Normal menstrual cycle is 28 days 4 phase completed, 1 proliferative Phase 5 to 14 days, 2 secretory phase 14 to 24 days, 3 pre menstrual phase 25 to 28 days, 4 menstrual phase 1 to 4 days 137. Dysmenorrhea is a painful menstruation 138. Menorrhagia is tha heavy menstrual bleeding 7 day 139. Polymenorrhea means less interval 21 days 140. Oligomenorrhea means menstrual bleeding grater then 35 days 141. Hypomenorrhea means menstrual blood flow 2 day 142. Cryptomenorrhea means blood not pass in genital beacuse imperforate Hymener 29 | P a g e  CHILD HEALTH NURSING GOLDEN KEY POINT 1. Increased in the size or mass of tissue called growth 2. Maturation of function or skill in the child call development 3. Normal birth of baby 2.5-3kg 4. Birth weight of baby double in 6 month, triple in 1 year 5. Birth time head circumference is 33 -35 cm 6. Birth time chest circumference 30-33 cm 7. Birth time length of baby 45 to 50 cm 8. Temporary teeth eruption 6-8 month 9. Permanent teeth eruption 6- 8 year 10. five month baby sit with support, 8 month baby sit without support 11. 18 month baby start to run 12. Toilet training start it in 18 month 13. 12 month baby speak to word 14. Sucking reflex when tuch the mouth one side child the child turn head 15. Rooting reflex hold the nipple neonate our mouth 16. Exclusive breastfeeding time 6 month 17. 6th to 7th month baby anxiety start stranger 18. Giveing CPR in children use 2 finger and thumb technique 19. Highest incidence rate marusmus in infant rate 20. Vitamin A deficiency conjunctival xerosis 21. 100000 unit given Vitamin a solution 9 month of baby 22. Umbilical cord cutting length 10 to 12 cm 23. Measles& DPT vaccine store 2- 8 degree Celsius 24. Tetanus is a bacterial disease commonly found in children 30 | P a g e 25. Suctioning after birth oropharynx then nosophernx pressure 80- 100mm/hg 26. NICU Incubator temperature 36-37 degree Celsius 50% humidity 27. Pertusis is a wooping caugh, in China hundred day cough 28. 24 month child walk in stair up 29. First stool of newborn is meconium pass 24 hours 30. Tetanus neonatorum is 8 day disease 31. Prolactin hormone responsible for milk secretion 32. Colostrum age of first mother milk colour is thik yellow, 1 day to 3 day Secreted 33. Breastfeeding start after normal delivery within 30 minute to 1 hours and caesarean 2 hours 34. Septicemia is a main cause of neonatal death Coli, staphylococcus aurous and klebsiella pneumonia common cause of septicaemia 35. Physiological jaundice in newborn after 24 hours start, pathological within 24 36. Writer tip position in Erb’s palsy cause 5th- 6th cranial nerve 37. Bell's palsy facial palsy cause 7th cranium nerve damage 38. Treatment of neonatal jaundice used phototherapy. Converted unconjugated bilirubin soluble bilirubin, used blue green light range 550 600 mm range flight, 45 cm distance 39. Bronze baby syndrome (symptoms brownish black colour skin, urine serum in retinal damage side effect of phototherapy 40. Enteric fever is a typhoid cause by Salmonella typhi 41. Shakir tap used assist protein energy malnutrition normal green 13.5, yellow borderline 12.5-13.5, red less then 12 cm 31 | P a g e 42. Polio is infaction of almentory canal, transmitted polio by fako oral route 43. Main cause of paralytic polio Type 1 poliovirus 44. OPV is a sabin type vaccine discover sabin 1957 45. 1 Infant play solitary, 2 toddler parallel play, 3 preschool associative /cooperative play, 4 school age competitive play with rule, 5 Adolescent Age game and athlete with strict rule 46. Rice Water stool found in cholera causative organism of Cholera ( vibrio cholerae) shape 47. Dengue fever is a break bone fever caused by adage aegypti mosquito 48. Main cause of death in diarrhoea dehydration 49. VVM- vaccine vial monitor. 50. Tracxn careers 16-20 bile carry 4 icepack, day carrer 6-8 bile 2 ice pack 51. BCG vaccine given at birth 0.5 ml ID left deltoid muscles, dilute use normal saline 52. Live bacterial vaccine BCG typhoid oral 53. Live viral vaccine OPV oral, Measles, rubella, mumps, influenza 54. Killed bacterial vaccine in activated Cholera, plague, pertussis, typhoid Injectable 55. Killed viral vaccine inactivated Polio (Salk ) rabies, hepatitis 56. Toxoid tetanus toxoid, diphtheria toxoid 57. Total lung capacity of newborn baby 150 ml 58. Clostridium tetani causative organism of tetanus, Mens sign lockjaw 59. Measles vaccine given 9 moth subcutaneous rute 60. Baby friendly Hospital start 1992 main function is the promote breastfeeding 32 | P a g e 61. Deep freezer 300 litre CHC , small deep freezer 140 liter PHC 62. Pentavalent vaccine protect. diphtheria pertussis, tetanus ,Hepatitis B, influenza 63. Universal immunization programme start at 1985 memory of Indira Gandhi 64. 100 ml breast milk provide 66 calorie, and cow milk provide 100 ml 67 calorie 65. Keratitis is a complication of Jaundice 66. Anterior Fontanels closing time 18 month called brigma 67. Posterior fontanels closing time 45 days called Lambda 68. Vitamin A 1 dose giving at 9 month 1 laks intra unit, and booster dose Given 16-24 month 2 lakh intra unit 69. DPT 1st booster dose givings 16- 24 Month 70. Eating non eating substance called Pica 71. Putting on hair children called tricotilomania 72. Hirschsprung disease is a congenital abnormality of megacolon (Ribbon like stool) 73. Iron deficiency anaemia is a nutritional anaemia 74. Vitamin B12 deficiency is a cause Pernicious anaemia (premature death of RBC) 75. Thalassemia is haemolytic anaemia Heriditical transfer 76. Haemophilia is a blood clotting disorder deficiency of Plasma coagulation factor 77. Type A haemophilia commonest, efficiency of clotting factor VIII, Called (classical haemophilia) 78. Treatment of nephritic syndrome given high protein diet diuretics 33 | P a g e 79. Kerning sign present meningitis 80. 47 chromosomes are present Down syndrome (Trisomy 21 number chromosome), short finger Round face, flat nasal 81. Edward syndrome Trisomy 21 number chromosome 82. Patau syndrome trysomy 13 nomber chromosome 83. 45 chromosome present turner syndrome 84. Greenstick fracture found in children 85. Grave disease (toxic diffuse goitre caused by Hyperthyroidism 86. Creatinism in children's caused by Hypothyroidism in adult Mexidema 87. IgG immunoglobulin cross the placenta 88. Wilm,s tumour most common tumour renal tumour found in children 89. Tetralogy of Follet heart like look boot shape 90. Umbilical cord Have a 2 artery 1 vein 91. Pus collection intrauterine cavity called pyometra 92. Haemoglobin in newborn 18% 93. Ophthalmic neonatorum infaction of eye 94. Kwashiorkor protein energy malnutrition called red hair boy 95. Cold chain use of storage of vaccine 96. 1 litter ORS content NACL 2.5 gm, KCL1.5 gm, suger 13.5 gm, sodium citret 2.9 gm Used 24 hours 97. Diarrhoea is loose watery stool passing more than 6 8 time in a day 98. Hydrocephalic is a large size of head imbalance of CSF production and Absorption 99. Haemophilia found in male female is a carrier 100. BCG is a live attend vaccine giving by Intra dermal, prevent tuberculosis 34 | P a g e 101. MMR, DPT is a combine or mix vaccine 102. Most common cause of rheumatic fever streptococcal 103. Well baby clinic is also known as under five clinic adult 104. anterior fontanelle diamond shape , posterior tringular shape 105. lumbar puncture site in children L4 L5 , in adult L3 L4 Position C shape 106. APGAR score giving by Dr Virginia apgar normal score 710 healthy child ,check after chek 1 and 5 minute after birth 107. Cleft lip surgery cheiloplasty Zshape suturing used repring , timing surgery 4 month after birth 108. Cleft palet surgery is paletoplasty surgery timing 18 month during language development 109. Lbw low birth weight baby weight less than 2.5 kg below 110. Treatment of phimosis is a circumcision 111. Posterior pituitary gland secreted 2 hormone oxytocin, ADH, anti diuretics hormone 112. Neonatal sepsis is a most common cause of death neonate 113. Measles vaccine Stored 2-8 degree celsius 114. Blood glucose level new natal below 40 mg/ dl called hypoglycemia 115. Macrosomia means large size of baby 116. Pulse rate of newborn 120-140, 117. Vitamin K injection giving prevention of hemorrhage new born 118. Treatment of undecent Test -es orchidopexy 119. Hypothermia is a silent killer of new born 120. Inflammation of Test -is called orchitis 121. World breastfeeding day 1 August 27 August 122. Lanugo is the hair of newborn baby 35 | P a g e 123. Temporary teeth 20 formulla 2102x4 124. Permanent teeth 32 formulla 2123 x4 Pediatric Golden points MCQ 1. At birth normal temp. - 36.5 to 37.5⁰C 2. At birth normal body weight -2.5 to 3.9 kg 3. At birth normal height- The average length of full-term babies at birth is 20 in. (50 cm), although the normal range is 18 in. (45.7 cm) to 22 in. (60 cm). 4. At birth head circumference -33 to 35 cm 5. At birth chest circumference -30 to 33 cm 6. At birth mid upper arm circumference -11 to 12 cm 7. At birth suction 8. Suction pressure in preterm baby- 40 to 60 mm of hg 9. Suction pressure in adult - 80 to 120 mm of Hg 10. Normal suctioning time duration- 5 to 10 sec. 11. Newborn baby provide O2 therapy by -Hood 12. Complication of O2 theory in Newborn baby -Retrolanterial fibroplasia 13. APGAR Score discover by - Virginia Apgar 14. APGAR Score assess 3 body system -A. Cardiac system B. Respiratory system C. Nervous system 15. APGAR Score should be assess after birth...................min. -1 and 5 min 16. Normal length of umbilical cord at birth? 50-60cm 17. Before 4 months of gestation umbilical cord blood vessels...............-(2 artery and 2 vein) 36 | P a g e 18. After 4 months of gestation umbilical cord blood vessels............? (2 artery and 1 vein) 19. after birth umbilical cord cutting? After stoppage of pulsation in umbilical blood vessels 20. During umbilical cord cutting 1st clump 5 cm away from baby 21. Newborn baby heat prodection by Nonshivering thermogenesis 22. Heat regulatory Center persent -Hypothalamus 23. Heat loss by radiation 60% 24. Kmc effective when body temperature more than More than 34⁰ C 25. Color of male baby identification band -Blue 26. Vit. K active clotting factor no. 2 ,7 ,9,10 27. Provide vit. K to prevent tha baby from -Bleeding tendency 28. Term baby does of vit. K- 1mg 29. Children most suitable side for IM injection -Vastuslateralis muscle 30. Causative agent of ophthalmia neonatorum -Neisseria gonorrhea 31. At birth most common use eye medicine -Erythromycin 32. Down syndrome - Trisomy of 21 no of chromosome 33. What is the klinefelter syndrome? Ans. Only male baby, one X chromosome extra 34. What is the Turner syndrome? Ans. Only female body, one X chromosome absent MICROBILOGOGY SPECIAL SINGAL LINE ☆ Robert Koch is known as father of bacteriology. ☆ Staining technique discover by Robert Koch. 37 | P a g e  ☆ Mantoux Test - is done for identifying exposure to tuberculosis.the PPD is ☆ Given by intra dermal route. ☆ Typhoid(enteric fever) fever caused by salmonella typhi &rose spots are in on the patient ☆ Ziehl neelsen stain is known as acid fast stain. It is used for diagnosis of tuberculosis and leprosy organism. ☆ Sterilization is process kill all pathogenic and nonpathogenic organism and their spore. ☆ Bactericidal means agent kill organism and bacteriostatic means inhibit growth of the organism. ☆ Robert Koch develop pure culture technique. ☆ In hot air oven 1600C ☆ Required for sterilization - 70% ethyl alcohol is most effective than 100% alcohol. ☆ Autoclave is effective sterilization.The 1210C temperature 15 IB pressure used for 15 minutes. it is discovered by Charles chambeland ☆ Nosocomial infection is hospital acquired infection & most common Infection is UTI. ☆ Anaphylaxis is a classical immediate hypersensitivity and type 1. ☆ Mycobacterium is gram positive acid fast bacilli spread through respiratory tract. ☆ Corynebacterium diphtheria is Chinese shaped gram positive bacteia.it also known as Loffler bacillus. ☆ Clostridium tetani is gram positive anaerobic spore forming motile bacteria. 38 | P a g e  MICROBILOGOGY SPECIAL SINGAL LINE POINTS ☆ Malaria parasite is plasmodium oval, plasmodium vivax, and plasmodium malariae & plasmodium falciferum. HIV virus belong retrovirus groups ☆ Type 2 dengue virus is most dangerous. Dengue virus spread by bitten of Aedes mosquito. Ade’s mosquito also known as tiger mosquito. ☆ Midstream urine collect for urine examination. ☆ Leucopenia is a feature of the enteric fever. ☆ Innate immunity is birth immunity. ☆ Active immunity is known as when immunity gain after stimulation of antigen (natural& artificial) ☆ Natural active immunity means immunity gain after infection & artificial active means immunity gain aftrer administration of vaccine e.g. BCG MICROBILOGOGY SPECIAL SINGAL LINE POINTS ☆ Vibrio cholera is gram negative, coma shaped organism. It spread through fecal oral route & contaminated water, milk, fruits etc. ☆ Widal test - use to diagnosis of the typhoid, The Test - widal agglutination appear at the end of week. ☆ Hepatitis A is RNA virus transmitted by fecal oral route & hepatitis B is DNA (double standard) transmitted by parenteral route. ☆ In the hot air oven we can sterilized of glass syringe, pipettes, cotton swab liquid paraffin dusting powered. 39 | P a g e  ☆ Pasteurization is use to sterilization of the milk. The temperature used 630 C for 30 minutes in holder method & 720 C for 15 to 20 minutes in the flash method. ☆ Tyndalization is process killing of spore of the organism 100C for 30 minutes each 3 days. ☆ Gama radiation rays are used to sterilization of disposable syringes, gloves, catgut surgical, bone tissue graft and adhesive dressing. ☆ H2O2, Potassium permanganate are antiseptic. ☆ Formaldehyde use to sterilization of the vaccine and fumigation. It Inactivating bacterial toxin. ☆ 2% glutaraldehyde is used to sterilization of cystoscope, endoscope and other anesthetic equipment. ☆ Culture media sterilization by Tyndaliztaion. ☆ UV radiation are used to sterilization of the operation theaters. ☆ Surgical dressing, surgical linen, surgical metallic instruments are sterilized by autoclaving. ☆ Asepsis means free from infection. ☆ Benedict Test - is used to identify presence of sugar in the urine. ☆ CA153–BreastCancer ☆ CA199–GIT(Pancreatic, Liver Cancer) ☆ CA125–OvarianCancer ☆ AIDS Diagnostic Test -: ELISA Test -Screening for HIV ☆ Western Blot Test -Confirmative Test -for HIV ☆ CD4Count – Predictor Of HIV ( 65 years Morbid obesity Laboratory diagnosis:  Most timely and sensitive detection: RT-PCR Test  Samples: Nasopharyngeal throat swabs [Tracheal/bronchial aspirates in lower respiratory tract infection cases]  Duration of isolation: for 7 days after onset of illness OR 24 hours after resolution of fever/respiratory  symptoms whichever is longer  Antiviral therapy: - Severe/progressive clinical illness: Oseltamivir (if not available or resistance, use Zanamavir) 68 | P a g e  - High risk of severe/complicated illness: Oseltamivir OR Zanamavir Dosage:  Oseltamivir 75 mg BD x 5 days  Zanamavir 2 inhalations (2 x 5 mg) BD x 5 days DIPHTHERIA-  Causative agent: Corynebacterium diphtheriae, a gram positive nonmotile organism  Diphtheria is an endemic disease in India  Source of infection: Case or carrier o Carriers are more important as source of infection: 95% of total disease transmission o Nasal carriers are more dangerous than throat carriers o Immunization does not prevent carrier state o Incubation Period: 2-6 days  Mode of transmission: droplet infection (main mode), directly from Cutaneous lesions and fomites  Period of Infectivity: 14-28 days from onset of disease; longer for carriers Schick test -  Schick Test -: An intradermal Test - of immunity status and hypersensitivity to Diphtheria toxin  Dose: 0.2 ml (1/ 50 MLD) of Schick Test - toxin in Test - arm and 0.2 ml of heat inactivated toxin in opposite 'control' arm  Interpretations of Schick Test -: (Red flush=Positive reaction)  Schick Test - has been replaced by: Hemagglutination Test  Hemagglutination Test - Measurement of serum antitoxin level 69 | P a g e  WHOOPING COUGH- Pertussis/ Whooping Cough  Causative agent: Bordetella pertussis  Also known as 'Whooping Cough' or '100 Day Cough'  -Paroxysms of cough are followed by an inspiratory whoop (high pitch) Incubation period: 7 -14 days  Source of Infection: Case o There is no subclinical or chronic carrier state o Neither vaccination nor infection confers longterm immunity  Secondary Attack rate: > 90%  Incidence and fatality: Females > Males  Leukocytosis does not correlates with the severity of cough  Chief complications: Bronchitis, bronchopneumonia, bronchiectasis, subconjunctival hemorrhages, epistaxis, hemoptysis, punctuate cerebral hemorrhages, convulsions and coma.  Laboratory diagnosis: Culturing of nasopharyngeal swabs , polymerase chain reaction (PCR), immunofluorescence , and serological methods  Drug of choice: Erythromycin (40 mg/kg QID x 10 days)  Vaccines: DPT Meningococcal Meningitis/ Cerebrospinal Fever  Causative agent: o N. meningitidis, a gram negative diplococci o Serotypes A, B, C, D, 29E, W135, X, Y  Meningococcal disease is endemic in India  Carriers are the more important source of infection than cases  Mean duration of Temporary carriers: 10 months 70 | P a g e   During epidemics, carrier rate may go up to 70-80%  Mode of Transmission: Droplet infection  Incubation Period: 2-10 days (average 3-4 days)  Case Fatality Rate (CFR) of Meningococcal meningitis: 80% With early diagnosis and treatment, CFR < 10%  Drugs of Choice: o Management Drug of Choice o Treatment of cases Penicillin o Treatment of carriers Rifampicin o Chemoprophylaxis of contacts Rifampicin (For chemoprophylaxis: Rifampicin 600 mg BD X 2 days) o Treatment with Penicillin does not eradicate carrier state Meningococcal Vaccine o Type of Vaccine: Killed vaccine, cellular fraction o Dose: 0.5 ml o Route: Subcutaneous o Site: Anterolateral thigh. Middle onethird o Booster every 3 years o Available for group A, C, W135 and Y meningococci  Contraindications: o Pregnancy o Infants and children < 2 years of age (due to development of immunologic tolerance) Acute Respiratory Tract Infections (ARIs)/ Pneumonia o If 2 months5 years age child with Wheezing with Fast breathing/Chest indrawing Rapidly acting inhaled 71 | P a g e  o bronchodilator trial up to 3 times 1520 minutes apart TUBERCULOSIS  Tuberculosis Situation in India  Country with highest TB burden in world: India  Infected with TB (Mantoux positive): Two out of five Indians (40%)  Indians developing TB everyday: 5000  TB deaths per year: 0.37 million Tuberculin/ PPD Tuberculin: Purified protein derivative (PPD) → Tuberculins have also been prepared from atypical mycobacterium: PPDY (M. Kansasii), PPDB (Battey mycobacterium), and Scrofula (M. scrofulaceum) Discovered by Von Pirquet (1907) → Standard PPD (PPDS) contains: 50,000 tuberculin units (TU) per mg [1TU= 0.00002 mg PPD] → WHO advocates 'PPD-RT-23 with Tween-80' Tuberculin Test - is the 'only way of estimating the prevalence of infection in a population' Mantoux Test - (Tool for detection of TB infection) (Pirquet Test)  Dose: 1 TU of PPD in 0.1m1 injected intradermally on forearm  WHO advocated preparation: PPDRT23 with Tween80  Is a Test - of prognostic significance  Has limited validity due to lack of specificity  Readings: Result read after 72 hrs (3d)  Only induration is measured: 72 | P a g e → Induration >9 mm: Positive (Past OR current infection with TB) → Induration 69 mm: Doubtful (M. tuberculosis or Atypical mycobacteria) → Induration 60 is necessary to sustain the vital organs Normal is 70- 105mm of Hg CVP  Central venous pressure (CVP): Is BP in Venacavae, near RA  Normal CVP: Can be measured from 2 points of reference:  Sternum: 0–14 cm H2O  Midaxillary line: 8–15 cm H2O.  Position: Supine, with head of bed at 45 degrees.  Manometer (Swan-Ganz catheter) is introduced to measure the CVP  Pulmonary capillary wedge pressure 6–12 mm of Hg Venous pressure  Venus Pressure are highest in extremities (5 to 14 cm H2O in the Arm)  lowest Venus Pressure closest to heart (6 to 8 cm H2O in the IVC)  Digoxin (Lanoxin) Inotropic agent (Increase Ventricle Contractility)  Normal digoxin level is 0.5 to 2 ng/mL.  Indiation: Atrial fibrillation, Atrial flutter & HF  Contraindication: VF, VT, hypersensitivity to digoxin  Assess apical pulse for 1 minute before administration  Hold digoxin if apical pulse 0.52 it indicates cervical insufficiency Sonography should be done prior to cerclage to confirm a live fetus Best method of abortion up till 7 week medical Best method of abortion between 7-12 week = suction and evacuation Mesoprost syndrome is Teratogenic when used in 1st trimester Moebius syndrome is caused by mesoprost Suction and evacuation –diameter of suction cannula should be equal to week of gestation Suction pressure= 60-70 cm of Hg (600 mm of Hg) 196 | P a g e  Karman’s cannula is used for suction evacuation M/C site of ectopic pregnancy = fallopian tube M/C non tubal site of ectopic pregnancy = ovary Least common site of ectopic pregnancy =ectopic in cesarean scar Least common site in fallopian tube is = interstitial Maximum chances of ectopic pregnancy with contraceptive agent = Tubectomy failure (1st ) , IUCD (2nd) Least chance of ectopic pregnancy with contraceptive agent= OCPs , vasectomy M/C site of tubal abortion –ampulla M/C site of tubal rupture –isthmus Salpingectomy is the gold standard treatment in rupture ectopic Gold standard for diagnosis is –laparoscopy Choriocarcinoma develops most commonly after – H.mole M/C gestational trophoblastic neoplasia to develop after full term pregnancy –choriocarcinoma M/C site of metastasis in choriocarcinoma is –lungs Stall worthy sign is decreased in fetal heart rate when fetal head is pushed down into pelvis. M/C fetal complication of placenta previa is low birth weight baby. M/C fetal complication of abruption placenta is prematurity. M/C of DIC in obstetrics –abruption First DIC is managed and then vaginal delivery should be done. Cesarean is not done in DIC 197 | P a g e  Singer’s alkali denaturation Test is done in vasa previa. All monochorionic pregnancies are monozygotic. Dichorionic pregnancy can monozygotic or dizygotic. Monozygotic twin can be monochorionic or Dichorionic. If the twins are of different sex then they are always dizygotic. Same sex twins can be monozygotic or dizygotic. Conjoined twins also called Siamese twins Thoracophagus is most common type of conjoined twins Rh antigen develops in fetus 30 – 40 days after fertilization Maximum chances of fetomaternal hemorrhage are beyond 28 weeks. Minimum fetal blood needed to stimulate maternal immune system 0.1 ml Indirect comb’s Test -used to check maternal Rhantigen Dose of antiD before 12 wks o f pregnancy 50mcg (200 IU) After 12 weeks of pregnancy 300mcg (1500 IU) Antepartum prophylaxis 300mcg Rosette Test is a qualitative screening Test for fetomaternal hemorrhage that detects fetal D +ve red cells in maternal Rh negative blood. Kleihauer betke Test - quantitative Test Reagent used – citric acid phosphate buffer M/C acquired valvular disease –mitral stenosis M/C congenital heart disease –atrial septal defect M/C cyanotic congenital heart disease –fallot’s tetrology Heart disease with max risk of maternal mortality– eisenmenger syndrome 198 | P a g e  M/C of maternal mortality in heart disease during pregnancymitral stenosis M/C type of heart failure during pregnancy: Immediately post partum (1st) 2nd stage of labor (2nd) 1st stage of labor (3rd) Heart disease where vaginal delivery is contraindicated: Aortic aneurysm Marfan syndrome Acute severe congestive heart failure Best time for cardiac surgery in mitral stenosis – 14-18 week M/C fetal complication in heart disease –IUGR Best Tocolytic agent in heart disease Atosiban In Septic abortion M/C valve affected is –tricuspid valve Hemoconcentration is hallmark of PIH. Main organ affected in PIH is placenta. M/C hematological finding in PIH is decreased platelet count. M/C type of eclampsia –Antepartum eclampsia M/C MRI finding in eclampsia –subcortical white matter edema. Disappearance of patellar reflexes is 1st sign of impending toxicity of MgSo4 REFLEXES TOXICITY LEVEL Patellar reflex 10mEq/L Respiratory depression >12 mEq/L 199 | P a g e Respiratory arrest >15 mEq/L Cardiac arrest >30mEq/L Best marker of MgSo4 toxicity is PULSE OXIMETRY. Criteria for HELLP syndrome: LDH >600 IU/L ASTH > 70 IU/L Platelet count < 100,000/mm3 Ga Pb+c+d+e method of GATPAL also known as (G PT+P+A+L) b –number of term pregnancy c –number of preterm deliveries d –number of abortion e –number of children at present Ovarian cycle is initiated by FSH. Dominant follicle selected at 5-7 day Peak level of Estradiol 200 pg/ml on day 10-11 Time between LH surge 32-36 hrs ovulation LH peak 10-12 hrs ovulation Time between estrogen peak and LH peak =14-24 hrs Mean duration of LH surge – 48 hrs Hormone responsible for resumption of meiosis 1st LH When meiosis 1st resume 36 hrs prior ovulation Corpus luteum in non pregnant state it is maintained by hormone LH Corpus luteum in pregnancy maintained by HCG. main hormone of Follicular phase–estrogen 200 | P a g e  main hormone of Luteal phase –progesterone Thickness of endometrium: THICKNESS Immediately after menstruation 0.5–2 mm, Proliferative phase 4–8 mm , Periovulatory phase 6–10 mm, secretory 7 – 14 mm Some disease and their incubation period 1 Chicken pox 14-16 days 2 Measles 10 -14 day 3 Rubella 14-21 day 4 Mumps 14 -21 day 5 Influnza 18- 72 hours 6 Syphillis 9-90day 7 Cholera hours to 5 day 8 Typhoid 10 -14 day 9 Rabies 3- 8 weeks 10 JE 5-15day 11 Diptheria 2 -6day 12 Whoping Cough 7 -14 day 13 TB 3 -6 weeks 14 Polio 7-14day 15 SARS 3 -5day 16 Meningococal 3 -4day 17 Trachoma 5-12day 18 Tetanus 6 -10 day 201 | P a g e 19 HIV months to 10 years 20 Staphylococcal food poisoning 1-6 hrs 21 Ascriasis about two months 22 Hook worm 5 weeks to 9 months 23 Filariasis 8-16 months 24 Leprosy 3-5 years 25 Hydated diseases months to years variable 26 Malaria Vivex 8-17 days 27 Falciparum 9-14 day 28 Scabies 3- 6 weeks 29 Kalazar 1-4months Important one liner points 1. The best family planning method for newly married couple is OCP. 2. The most popular method of FP in nepal is Depoprovera. 3. Depoprovera contains 150 mg depot medroxy progesterone. 4. Copper T acts for 12 year Norplant for 5 year. 5. CONDOM prevents from both STDs and pregnancy. 6. According to WHO & Nepal a minimum of 4 antenatal visits (ANC) are required in pregnancy. 7. A mother requires +350 kcal/day extra during pregnancy, +600kcal/day in laction (0-6 month) & +520kcal/day in lactation (6-12 month). 8. Birh weight