I (IVC) ate (T8) ten (T10) eggs (esophagus) at (aorta) 12 (T12) = diaphragm openings

3,4,5 keeps my diaphragm alive = diaphragm innervation C 3,4,5

RALS right anterior-left superior = middle lobe of lung

(Dipalmitoyl phosphatidylcholine) Lecithin:sphingomyelin ratio = > 2.0 = fetal lung maturity

METHhemoglobinuria treated with METHylene blue

Tx cyanide 1) nitrites 2) thiosulfate = nitrites > hgb > methhgb > bind cyanide. Thiosulfate > bind cyanide > thiocyanate > urine excretion

CADET face RIGHT (right shift) = CO2, ACID, ALTITUDE, DPG (2,3 DPG), EXERCISE, TEMP.

Normal pulmo arterial pressure = 10-14 mmHg

Pulmo HPN > BMPR2 gene mutation > smooth muscle proliferation

1 grm. Hgb bind to 1.34 mL O2/dL

hypoxemia = problem in oxygen diffusion/transport in lungs to blood
hypoxia = problem in oxygen transport from blood to tissue
ischemia = loss of blood flow

CO2 transport = bicarbonate, carbaminohemoglobin, dissolve CO2

Lungs = Haldane effect
Peripheral = bohr effect

small cell CA = kulchitsky cells
asthma = curschmann's spirals

Horner's syndrome MAPE
miosis (constriction of the pupils), anhidrosis (lack of sweating), ptosis (drooping of the eyelid) and enophthalmos (sunken eyeball).

psammoma bodies
-mesothelioma
-















normal
GFR 100 mL/min
osmolarity 290 mOsm

plasma glucose 160-200 mg/dL = glucosuria
>350 mg/dL all transporters are saturated

PTH inhibit Na/phosphate trans = phosphate excretion
AT 2 stimulate Na/H exhange = contraction alkalosis

egg shape - transposition of great arteries
aschoff bodies - rheumatic fever

high output states BATS
-beri beri
-anemia
-thyrotoxicosis
-systemic AV shunting

acute precipitant of heart failure PAINT My HAND
-Pregnancy
-anemia
-infection
-increase Na
-thyrotoxicosis
-Myocardial infarction
-HPN emeregency
-alcohol consumption
-non compliance to meds
-drugs (e.g. beta blocker, NSAID)

close first - aorta-----------------> S2
close last - pulmonary----------> S2
open first - pulmonary
open last - aorta
close first - mitral ---------------> S1
close last - tricuspid ------------> S1
* high pressure close first
* high pressure open last

opening snap > opening diastole in pressure > mitral, tricuspid stenosis
ejection click > opening systole in pressure > aortic , pulmonary stenosis

mid systolic click > mitral valve prolapse

soft S1 or S2 > not close properly > regurgitation/atresia
loud S1 or S2 > high pressure pushing valve to close forcefully or stenosis of valve

S2 spliting > increase 02 in lung > increase pulmonary compliance due to dilatory effect of O2 in lung vasculature > increase/more venous return > later closure of valve (pulmo) than aortic valve > P2>A2

increase splitting S2
- increase preload
- transfusion
- increased oxygen
- VSD
- ASD
- exercise
- deep breathing

narrow splitting S2
- pulmo stenosis
- decrease O2
- decrease pre load
- restrictive lung disease

louder in expiration > left side
louder in inspiration > right side

fixed wide S2 split > only ASD > most common CHD present in adult

S3 > non compliant ventricle, normal only in adolescent female (estrogen effect muscle relaxation)
- dilated ventricle
- viable reload
- decompensation

S4 > atrial kick > resistance due to stenosis or high pressure overload, hypertrophy, compensation

cushing disease > pituitary ACTH overproduction
cushing synfrome > adrenal over cortisol production due to drugs or adrenal hyperplasia
conn's syndrome > hyperaldosteronism

MEN 1 - T3P
- thyroid adenoma
- pituitary
- pancreas
- parathyroid

MEN II a 2PM
- pheocytochroma
- parathyroid
- medullary thyroid carcinoma

MEN II b 2PM MG
- pheocytochroma
- parathyroid
- medullary thyroid carcinoma
- marfanoid phenotype
- ganglioneuroma

low Km > high affinity > low v max
high Km > low affinity > high vmax