Can you give me a concised marrow notes for neet pg so that i could revise it the last 15 days

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Here are your high-yield Marrow-style NEET PG revision notes - covering the most frequently tested topics across all subjects in a mix of bullets, tables, and mnemonics. Designed for 15-day last-minute revision.

NEET PG LAST 15 DAYS - HIGH-YIELD MARROW NOTES

ANATOMY

High-Yield Points

Nerve to serratus anterior = Long thoracic nerve (C5,6,7) - "C5,6,7 keeps the wing off heaven"
Winging of scapula = Long thoracic nerve palsy
Axillary nerve injury (surgical neck humerus) = Loss of deltoid + small badge area of sensation
Radial nerve (spiral groove) = Wrist drop
Ulnar nerve (medial epicondyle) = Claw hand (ring + little)
Median nerve (carpal tunnel) = Ape thumb deformity, loss of LOAF muscles
Femoral nerve = Loss of knee jerk, quadriceps weakness
Common peroneal nerve = Foot drop (most commonly injured in fibular neck fracture)

Foramina Table

Foramen	Contents
Foramen ovale	V3, lesser petrosal nerve, accessory meningeal artery
Foramen spinosum	Middle meningeal artery
Foramen rotundum	V2
Jugular foramen	IX, X, XI + sigmoid sinus
Stylomastoid foramen	VII (facial nerve exits)

Mnemonic - Carpal Bones (lateral to medial, proximal row)

"She Looks Too Pretty, Try To Catch Her" Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate

PHYSIOLOGY

Action Potential - Key Facts

Resting membrane potential = -70 mV
Threshold = -55 mV
Depolarization = Na+ IN (voltage-gated Na+ channels)
Repolarization = K+ OUT
Absolute refractory period = Na+ channels inactivated (no stimulus works)

Lung Volumes (Standard)

Volume/Capacity	Value
Tidal Volume (TV)	500 mL
IRV	3000 mL
ERV	1100 mL
RV	1200 mL
FRC = ERV + RV	2300 mL
Vital Capacity	4600 mL
TLC	5800 mL

RV cannot be measured by spirometry (needs body plethysmography or helium dilution)

Renal - Starling Forces

Filtered load = GFR x Plasma concentration
GFR measured by inulin (gold standard), clinically by creatinine clearance
RBF measured by PAH

ECG Intervals

PR interval: 0.12-0.20 s (>0.20 = 1st degree AV block)
QRS: <0.12 s (>0.12 = bundle branch block)
QTc: <0.44 s in men, <0.46 in women

BIOCHEMISTRY

Enzyme Deficiencies - High Yield Table

Disease	Enzyme Deficient	Key Feature
PKU	Phenylalanine hydroxylase	Musty odor, fair skin
Alkaptonuria	Homogentisic acid oxidase	Black urine, ochronosis
Homocystinuria	Cystathionine beta synthase	Marfanoid, DVT, lens dislocation DOWN
Maple syrup urine	Branched chain keto acid dehydrogenase	Maple syrup odor
Gaucher	Glucocerebrosidase	Bone crises, Erlenmeyer flask
Niemann-Pick	Sphingomyelinase	Cherry red spot + hepatosplenomegaly
Tay-Sachs	Hex-A	Cherry red spot, NO hepatosplenomegaly
Fabry	Alpha-galactosidase A	Angiokeratomas, X-linked

Vitamins - Quick Reference

Vitamin	Deficiency	Key Fact
B1 (Thiamine)	Wernicke-Korsakoff, Beriberi	Alcoholics
B3 (Niacin)	Pellagra (3Ds: Dermatitis, Diarrhea, Dementia)	Hartnup disease also
B6 (Pyridoxine)	Sideroblastic anemia, peripheral neuropathy	INH side effect
B12	Megaloblastic anemia + subacute combined degeneration	Intrinsic factor needed
C	Scurvy (perifollicular hemorrhage, corkscrew hairs)	Hydroxylation of collagen
D	Rickets/Osteomalacia	1-alpha hydroxylase in kidney
K	Bleeding (increased PT)	Warfarin antagonist

PATHOLOGY

Amyloid - Must Know

AL amyloid = Multiple myeloma (most common systemic)
AA amyloid = Chronic inflammation (TB, RA, osteomyelitis)
AB amyloid = Alzheimer's (amyloid beta, chromosome 21)
Hemodialysis amyloid = Beta-2 microglobulin
Congo red stain + apple green birefringence under polarized light

Tumor Markers Table

Marker	Tumor
AFP	Hepatocellular carcinoma, Yolk sac tumor
b-hCG	Choriocarcinoma, gestational trophoblastic
CEA	Colorectal, pancreatic, gastric
CA-125	Ovarian carcinoma
CA-19-9	Pancreatic cancer
PSA	Prostate cancer
Calcitonin	Medullary thyroid carcinoma
S-100	Melanoma, Schwannoma
Chromogranin	Carcinoid, neuroendocrine tumors

Cell Injury - Key Points

Coagulative necrosis = most organs (ischemia) - preserved architecture
Liquefactive necrosis = brain infarct + bacterial abscess
Caseous necrosis = TB (cheese-like, no architecture)
Fat necrosis = pancreas (enzymatic) + breast (traumatic)
Fibrinoid necrosis = vasculitis, malignant hypertension

PHARMACOLOGY

Autonomic Drugs - Quick Table

Drug	Action	Key Use
Atropine	Muscarinic blocker	Bradycardia, organophosphate poisoning (with PAM)
Neostigmine	AChE inhibitor (reversible)	Myasthenia gravis, reverse NMB
Pralidoxime (PAM)	Reactivates AChE	Organophosphate poisoning (give early, within 24h)
Phenylephrine	Alpha-1 agonist	Nasal decongestant, reflex bradycardia
Clonidine	Alpha-2 agonist (central)	Hypertension, opioid/alcohol withdrawal
Propranolol	Non-selective beta blocker	Hypertension, angina, thyroid storm

Antibiotics - Mechanism Mnemonic

"Cell wall: PCV + Cepha" | "30S: Amino + Tetra" | "50S: MAC (Macro+Chlor+Clinda)" | "DNA: Fluoro + Metro + Rifampin"

Antibiotic	Mechanism
Penicillin/Cephalosporins	Inhibit cell wall synthesis (PBP binding)
Vancomycin	D-Ala-D-Ala binding (cell wall)
Aminoglycosides	30S ribosome (bactericidal)
Tetracyclines	30S ribosome (bacteriostatic)
Macrolides	50S ribosome (bacteriostatic)
Chloramphenicol	50S ribosome - Gray baby syndrome
Metronidazole	DNA strand breakage (anaerobes, protozoa)
Fluoroquinolones	DNA gyrase/topoisomerase IV
Rifampicin	RNA polymerase

Important Drug Side Effects

Drug	Side Effect
Chloramphenicol	Gray baby syndrome, aplastic anemia
Tetracycline	Teeth staining, photosensitivity
Isoniazid (INH)	Peripheral neuropathy (B6 deficiency), hepatitis
Rifampicin	Orange urine, enzyme inducer, hepatitis
Ethambutol	Optic neuritis (color vision loss first)
Streptomycin	Ototoxicity, nephrotoxicity
Methotrexate	Folate antagonist, hepatic fibrosis
Cyclophosphamide	Hemorrhagic cystitis (mesna prevents), SIADH
Amiodarone	Pulmonary fibrosis, thyroid dysfunction, photosensitivity
Lithium	Nephrogenic DI, hypothyroidism, tremor

MEDICINE

Murmurs - Summary Table

Condition	Murmur	Special Feature
Aortic stenosis	Ejection systolic (right 2nd ICS, radiates to neck)	Pulsus parvus et tardus
Aortic regurgitation	Early diastolic (right 2nd ICS)	Wide pulse pressure, Corrigan's pulse
Mitral stenosis	Mid-diastolic rumble (apex)	Opening snap, loud S1
Mitral regurgitation	Pansystolic (apex, radiates axilla)	Soft S1
VSD	Pansystolic (left lower sternal)	Harsh
ASD	Ejection systolic + fixed split S2
PDA	Continuous machine murmur
MVP	Mid-systolic click + late systolic murmur

JVP Waveforms

"a" wave = atrial contraction; absent in AF; giant in tricuspid stenosis, pulmonary hypertension
"v" wave = venous filling; giant in tricuspid regurgitation
Kussmaul's sign = JVP rises on inspiration (constrictive pericarditis, cardiac tamponade - paradox)

Diabetes Mellitus - Key Points

DM diagnosis: FPG ≥ 126, 2h OGTT ≥ 200, HbA1c ≥ 6.5%, random ≥ 200 + symptoms
HbA1c target = <7% (general), <8% in elderly/frail
Metformin = first line; contraindicated in eGFR <30, lactic acidosis risk
SGLT2 inhibitors = cardioprotective + renoprotective (empagliflozin, dapagliflozin)
GLP-1 agonists = weight loss, cardioprotective (liraglutide, semaglutide)

Thyroid - Quick Reference

Test	Hypothyroid	Hyperthyroid
TSH	HIGH	LOW
T4/T3	LOW	HIGH
Radioiodine uptake	Low (Hashimoto) / varies	High (Graves), low (thyroiditis)

Graves = TSH receptor antibody (TSI) - most common cause of hyperthyroidism
Hashimoto = Anti-TPO, Anti-thyroglobulin - most common cause of hypothyroidism
Thyroid storm = treat with PTU (first), propranolol, steroids, Lugol's iodine (SSKI)

SURGERY

Burns - Rule of Nines (Adult)

Area	% BSA
Head + Neck	9%
Each upper limb	9%
Anterior trunk	18%
Posterior trunk	18%
Each lower limb	18%
Perineum	1%

Parkland formula = 4 mL x kg x %BSA (Ringer's Lactate, first 8h = half, next 16h = half)
Lund-Browder chart = most accurate (for children)
Wallace's Rule of Nines = quick estimation

Fractures - High Yield

Fracture	Feature
Colles	Dinner fork deformity (FOOSH)
Smith's	Reverse Colles (Garden spade deformity)
Scaphoid	Anatomical snuffbox tenderness, AVN risk
Monteggia	Ulna fracture + radial head dislocation (MUD)
Galeazzi	Radius fracture + distal radioulnar dislocation (RUD)
Pott's	Bimalleolar fracture
March	Stress fracture of 2nd metatarsal

Mnemonic: "MUD RUD" - Monteggia=Ulna+Dislocation, Radius=Ulnar Dislocation (Galeazzi)

Colorectal Cancer

Most common site = rectosigmoid junction
Right-sided = iron deficiency anemia (occult bleed)
Left-sided = obstruction, pencil-thin stools
CEA = monitoring for recurrence (not screening)
Duke's staging replaced by TNM; Duke's A = confined to bowel wall

OBSTETRICS & GYNECOLOGY

Placenta Previa vs Abruption

Feature	Placenta Previa	Abruptio Placentae
Bleeding	Painless, bright red	Painful, dark
Uterus	Soft, non-tender	Board-like, tender
Fetal heart	Usually normal	Distress common
Shock	Proportionate to bleeding	Disproportionate
Dx	USG (don't do PV)	Clinical + USG

Pre-eclampsia

BP ≥ 140/90 after 20 weeks + proteinuria (≥300 mg/24h)
Severe features: BP ≥ 160/110, thrombocytopenia <100k, creatinine >1.1, visual symptoms
MgSO4 = prevention + treatment of eclampsia (Pritchard regimen)
Antidote to MgSO4 toxicity = Calcium gluconate
Definitive treatment = delivery

GTN / Molar Pregnancy

Complete mole: 46XX (both sets paternal), no fetal parts, snowstorm USG
Partial mole: 69XXY (triploid), fetal parts may be present
b-hCG marker for monitoring
Choriocarcinoma = most malignant, responds to methotrexate

Common Gynecological Tumors

Tumor	Feature
Serous cystadenocarcinoma	Most common malignant ovarian tumor
Serous cystadenoma	Most common benign ovarian tumor overall
Mucinous cystadenocarcinoma	Largest ovarian tumor
Dysgerminoma	Radiosensitive germ cell tumor
Granulosa cell tumor	Estrogen-secreting, Call-Exner bodies
Krukenberg tumor	Metastatic (gastric origin), signet ring cells

PEDIATRICS

Development Milestones - Key Ages

Milestone	Age
Social smile	6 weeks
Neck holding (prone)	3 months
Rolls over	5 months
Sits without support	8 months
Stands with support	9 months
Pincer grasp	9 months
Walks alone	13-15 months
2-word sentences	2 years
3-word sentences	3 years
Counts 10 objects	5 years

Vaccines Schedule - India (NIS) Key Points

BCG = At birth
OPV + HepB = At birth, 6, 10, 14 weeks, booster at 16-24 months
Pentavalent (DPT+HepB+Hib) = 6, 10, 14 weeks
IPV = 6, 14 weeks (2 fractional doses)
Rotavirus = 6, 10, 14 weeks
PCV = 6, 14 weeks, 9 months
Measles/MR = 9 months + 16-24 months
JE = 9 months + 16-24 months (endemic areas)
Typhoid = 2 years

Neonatal Values

Parameter	Normal
RR	40-60/min
HR	120-160/min
Normal wt loss after birth	up to 10% (regained by day 10)
Physiological jaundice starts	Day 2-3, peaks day 4-5, resolves day 7-10
Pathological jaundice	<24h of life = always pathological

ENT

Hearing Loss - Conductive vs Sensorineural

Test	Conductive	Sensorineural
Rinne	AC < BC (Rinne negative)	AC > BC (Rinne positive, but reduced)
Weber	Lateralizes to AFFECTED ear	Lateralizes to NORMAL ear

Important Syndromes

Syndrome	Feature
Gradenigo	Otitis media + VI nerve palsy + trigeminal pain
Bezold's abscess	Mastoid pus tracks under SCM
Cholesteatoma	Unsafe CSOM, foul discharge, marginal perforation, bone erosion
Otosclerosis	Conductive loss, Schwartze sign (flamingo pink blush), autosomal dominant
Meniere's	Low-frequency SNHL + episodic vertigo + tinnitus + aural fullness

OPHTHALMOLOGY

Glaucoma - Key Distinctions

Feature	POAG	PACG
Angle	Open	Closed
Onset	Insidious	Acute (haloes, pain)
IOP	Elevated (may fluctuate)	Very high (>40 mmHg)
Tx	Timolol, latanoprost	Pilocarpine, laser iridotomy

Retinal Conditions

Condition	Feature
CRVO	Disc edema, flame hemorrhages all quadrants, "blood and thunder" fundus
CRAO	Cherry red spot, cattle-trucking, sudden painless loss
Diabetic retinopathy	Microaneurysms (first sign), cotton wool spots, NVD/NVE
Hypertensive retinopathy	AV nipping, cotton wool, flame hemorrhages, papilledema (Grade 4)
Retinitis pigmentosa	Bone spicule pigmentation, night blindness, tunnel vision

PSYCHIATRY

DSM Criteria - Mnemonics

MDD (SIGECAPS) - ≥5 for 2 weeks including depressed mood or anhedonia: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation

Mania (DIG FAST): Distractibility, Impulsivity/Irresponsibility, Grandiosity, Flight of ideas, Activity, Sleep decreased, Talkativeness

Drug Doses - Key

Condition	Drug of Choice
Schizophrenia	Risperidone (atypical), Haloperidol (typical)
Bipolar disorder	Lithium (acute mania + prophylaxis)
OCD	Fluvoxamine, Fluoxetine (SSRIs)
Panic disorder	SSRIs (first line), Alprazolam (acute)
PTSD	Sertraline, Paroxetine
Enuresis	Imipramine (TCA), Desmopressin
ADHD	Methylphenidate (first line), Atomoxetine

DERMATOLOGY

Blistering Disorders

Disease	Level	Test	Feature
Pemphigus vulgaris	Intraepidermal (suprabasal)	Tzanck, IIF	Acantholysis, Nikolsky +ve
Bullous pemphigoid	Sub-epidermal	IIF	Tense bullae, elderly, Nikolsky -ve
Dermatitis herpetiformis	Sub-epidermal	DIF granular IgA	Celiac disease association
Epidermolysis bullosa	Sub-epidermal	-	Hereditary

Skin Cancers

Cancer	Feature
BCC	Pearly papule, rolled edge, telangiectasia, never metastasizes
SCC	Everted edge, arises from actinic keratosis, may metastasize
Melanoma	ABCDE criteria, worst prognosis, Clark's/Breslow staging
Merkel cell	Neuroendocrine, aggressive

COMMUNITY MEDICINE (PSM)

Epidemiology Formulas

Measure	Formula
Attack rate	(cases / population at risk) x 100
Case fatality rate	(deaths / cases) x 100
Sensitivity	TP / (TP + FN)
Specificity	TN / (TN + FP)
PPV	TP / (TP + FP)
NPV	TN / (TN + FN)
Relative risk	Incidence in exposed / Incidence in unexposed
Odds ratio	(a x d) / (b x c)

Nutritional Deficiencies - National Targets

Program	Objective
ICDS	6 months to 6 years (anganwadi)
NHM	Universal immunization
National Iron + program	Children 6-59 months, pregnant women
RNTCP/NTP	DOTS strategy

Study Designs - Quick Reference

Gold standard RCT = highest level of evidence for intervention
Cohort = prospective, calculates RR, for rare exposures
Case-control = retrospective, calculates OR, for rare diseases
Cross-sectional = prevalence studies, calculates prevalence ratio
Systematic review/meta-analysis = highest level overall

FORENSIC MEDICINE

Rigor Mortis

Starts: 2-6 hours after death
Complete: 12 hours
Passes off: 36-48 hours (in warm weather, faster)
Cadaveric spasm = instantaneous rigor (violent death)

Poisons - Antidote Table

Poison	Antidote
Organophosphate	Atropine + Pralidoxime (PAM)
Opioids	Naloxone
Benzodiazepines	Flumazenil
Warfarin	Vitamin K (chronic), FFP (acute)
Digoxin	Digoxin-specific antibody (Fab)
Iron	Deferoxamine
Lead	EDTA (inorganic), DMSA (dimercaptosuccinic acid)
Arsenic/Mercury	BAL (Dimercaprol)
Carbon monoxide	100% oxygen
Paracetamol	N-acetylcysteine
Cyanide	Sodium thiosulfate + hydroxocobalamin
Methanol	Ethanol / Fomepizole
Heparin	Protamine sulfate

RADIOLOGY

X-ray Signs - Must Know

Sign	Disease
Ground glass opacity	ARDS, PCP, pulmonary edema, COVID
Eggshell calcification	Silicosis, sarcoidosis, irradiated lymphoma
Bat-wing / Butterfly	Pulmonary edema
Honeycomb lung	UIP/IPF
Reverse bat-wing	COP (Cryptogenic organizing pneumonia)
Egg on side	TGA (transposition of great arteries)
Boot-shaped heart	Tetralogy of Fallot
Box-shaped heart	Ebstein's anomaly
Flask-shaped heart	Pericardial effusion

LAST 15-DAY REVISION STRATEGY

Week 1 (Days 1-7): High-density subjects - Pharmacology, Pathology, Medicine, PSM Week 2 (Days 8-13): Surgery, OBG, Pediatrics, Psychiatry + Rapid revision of Anatomy/Physiology/Biochemistry Day 14: ENT, Ophthalmology, Dermatology, Forensic Day 15: Revise mnemonics + previous year questions + weak areas only

These notes cover the most tested 20% of content that appears in 80% of questions in NEET PG. Focus on tables, exceptions, and "most common" facts - those are NEET PG's favorite question types. All the best!

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Reading File

Running Command

ls -la /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace && echo "workspace ready"

Running Command

mkdir -p /tmp/workspace/marrow-notes && cat > /tmp/workspace/marrow-notes/generate_pdf.py << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm, mm from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable, PageBreak, KeepTogether) from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY from reportlab.platypus import ListFlowable, ListItem # ── Output file ────────────────────────────────────────────────────────────── OUTPUT = "/tmp/workspace/marrow-notes/NEET_PG_Marrow_Notes.pdf" doc = SimpleDocTemplate( OUTPUT, pagesize=A4, rightMargin=1.8*cm, leftMargin=1.8*cm, topMargin=2*cm, bottomMargin=2*cm, title="NEET PG High-Yield Marrow Notes", author="Orris AI" ) W, H = A4 # ── Colour palette ──────────────────────────────────────────────────────────── C_NAVY = colors.HexColor("#1a237e") C_TEAL = colors.HexColor("#00838f") C_AMBER = colors.HexColor("#e65100") C_GREEN = colors.HexColor("#2e7d32") C_PINK = colors.HexColor("#ad1457") C_LGREY = colors.HexColor("#f5f5f5") C_DGREY = colors.HexColor("#424242") C_THEAD = colors.HexColor("#0d47a1") C_TROW1 = colors.HexColor("#e3f2fd") C_TROW2 = colors.white C_MNEMROW = colors.HexColor("#fff8e1") C_WARN = colors.HexColor("#fff3e0") C_BORDER = colors.HexColor("#bbdefb") # ── Styles ──────────────────────────────────────────────────────────────────── base = getSampleStyleSheet() def S(name, **kw): s = ParagraphStyle(name, **kw) return s title_style = S("Title", fontSize=22, fontName="Helvetica-Bold", textColor=C_NAVY, alignment=TA_CENTER, spaceAfter=4) subtitle_style = S("Subtitle", fontSize=11, fontName="Helvetica", textColor=C_TEAL, alignment=TA_CENTER, spaceAfter=18) h1_style = S("H1", fontSize=14, fontName="Helvetica-Bold", textColor=colors.white, backColor=C_NAVY, leading=20, spaceBefore=14, spaceAfter=4, leftIndent=-5, rightIndent=-5, borderPadding=(4,6,4,6)) h2_style = S("H2", fontSize=11, fontName="Helvetica-Bold", textColor=C_TEAL, spaceBefore=10, spaceAfter=3, borderPadding=(2,0,2,0)) h3_style = S("H3", fontSize=10, fontName="Helvetica-Bold", textColor=C_AMBER, spaceBefore=6, spaceAfter=2) body_style = S("Body", fontSize=8.5, fontName="Helvetica", textColor=C_DGREY, leading=13, spaceBefore=1, spaceAfter=1) bullet_style = S("Bullet", fontSize=8.5, fontName="Helvetica", textColor=C_DGREY, leading=12, leftIndent=14, firstLineIndent=-10, spaceBefore=1, spaceAfter=1) mnemonic_style = S("Mnemonic", fontSize=8.5, fontName="Helvetica-BoldOblique", textColor=C_AMBER, backColor=C_MNEMROW, leading=13, leftIndent=8, rightIndent=8, borderPadding=6, spaceBefore=4, spaceAfter=4) footer_style = S("Footer", fontSize=7, fontName="Helvetica", textColor=colors.grey, alignment=TA_CENTER) def strat_style_fn(col): styles = [S(f"Strat{col}", fontSize=8.5, fontName="Helvetica-Bold" if col==0 else "Helvetica", textColor=C_NAVY if col==0 else C_DGREY, leading=12, alignment=TA_LEFT)] return styles[0] # ── Helper functions ─────────────────────────────────────────────────────────── def section_header(title): """Returns a styled section header paragraph.""" return Paragraph(f" {title}", h1_style) def sub_header(title): return Paragraph(title, h2_style) def sub3_header(title): return Paragraph(title, h3_style) def bp(text): """Bullet point.""" return Paragraph(f"<bullet>•</bullet> {text}", bullet_style) def mn(text): """Mnemonic box.""" return Paragraph(f"Mnemonic: {text}", mnemonic_style) def body(text): return Paragraph(text, body_style) def spacer(h=4): return Spacer(1, h*mm) def hr(color=C_BORDER): return HRFlowable(width="100%", thickness=0.5, color=color, spaceAfter=2, spaceBefore=2) def make_table(header_row, data_rows, col_widths=None, zebra=True): """Creates a styled table.""" all_rows = [header_row] + data_rows if col_widths is None: n = len(header_row) avail = W - 3.6*cm col_widths = [avail/n]*n # Build cell styles style = [ # Header ('BACKGROUND', (0,0), (-1,0), C_THEAD), ('TEXTCOLOR', (0,0), (-1,0), colors.white), ('FONTNAME', (0,0), (-1,0), 'Helvetica-Bold'), ('FONTSIZE', (0,0), (-1,0), 8), ('ALIGN', (0,0), (-1,0), 'CENTER'), ('BOTTOMPADDING', (0,0), (-1,0), 5), ('TOPPADDING', (0,0), (-1,0), 5), # Body ('FONTNAME', (0,1), (-1,-1), 'Helvetica'), ('FONTSIZE', (0,1), (-1,-1), 7.5), ('TOPPADDING', (0,1), (-1,-1), 3), ('BOTTOMPADDING', (0,1), (-1,-1), 3), ('LEFTPADDING', (0,0), (-1,-1), 5), ('RIGHTPADDING', (0,0), (-1,-1), 5), ('VALIGN', (0,0), (-1,-1), 'MIDDLE'), ('GRID', (0,0), (-1,-1), 0.3, C_BORDER), ] if zebra: for i in range(1, len(all_rows)): bg = C_TROW1 if i % 2 == 1 else C_TROW2 style.append(('BACKGROUND', (0,i), (-1,i), bg)) # Wrap strings in Paragraphs for word-wrap wrapped = [] for ri, row in enumerate(all_rows): new_row = [] for ci, cell in enumerate(row): if ri == 0: p = Paragraph(str(cell), S(f"th{ri}{ci}", fontSize=8, fontName="Helvetica-Bold", textColor=colors.white, alignment=TA_CENTER, leading=10)) else: p = Paragraph(str(cell), S(f"td{ri}{ci}", fontSize=7.5, fontName="Helvetica", textColor=C_DGREY, leading=10)) new_row.append(p) wrapped.append(new_row) t = Table(wrapped, colWidths=col_widths, repeatRows=1) t.setStyle(TableStyle(style)) return t # ── Cover page ──────────────────────────────────────────────────────────────── story = [] story.append(spacer(20)) story.append(Paragraph("NEET PG LAST 15 DAYS", title_style)) story.append(Paragraph("HIGH-YIELD MARROW REVISION NOTES", title_style)) story.append(spacer(4)) story.append(Paragraph("All Subjects | Mix of Bullets + Tables + Mnemonics", subtitle_style)) story.append(HRFlowable(width="60%", thickness=2, color=C_TEAL, spaceAfter=6, hAlign='CENTER')) story.append(spacer(6)) cover_data = [ ["Coverage", "All major subjects"], ["Format", "Bullets, Tables & Mnemonics"], ["Exam Focus", "NEET PG / INI-CET"], ["Purpose", "Last 15-day rapid revision"], ] cover_style = [ ('BACKGROUND', (0,0), (0,-1), C_NAVY), ('TEXTCOLOR', (0,0), (0,-1), colors.white), ('FONTNAME', (0,0), (0,-1), 'Helvetica-Bold'), ('FONTNAME', (1,0), (1,-1), 'Helvetica'), ('FONTSIZE', (0,0), (-1,-1), 9), ('ALIGN', (0,0), (-1,-1), 'LEFT'), ('TOPPADDING', (0,0), (-1,-1), 6), ('BOTTOMPADDING', (0,0), (-1,-1), 6), ('LEFTPADDING', (0,0), (-1,-1), 10), ('BACKGROUND', (1,0), (1,-1), C_LGREY), ('GRID', (0,0), (-1,-1), 0.5, C_BORDER), ] avail = W - 3.6*cm ct = Table([[Paragraph(r[0], S("cv0", fontSize=9, fontName="Helvetica-Bold", textColor=colors.white, leading=12)), Paragraph(r[1], S("cv1", fontSize=9, fontName="Helvetica", textColor=C_DGREY, leading=12))] for r in cover_data], colWidths=[avail*0.3, avail*0.7]) ct.setStyle(TableStyle(cover_style)) story.append(ct) story.append(spacer(8)) story.append(Paragraph("Generated by Orris AI | July 2026", footer_style)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 1. ANATOMY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("1. ANATOMY")) story.append(spacer(3)) story.append(sub_header("High-Yield Nerve Injuries")) nerves = [ ["Nerve", "Lesion Site", "Deformity / Loss"], ["Long thoracic (C5,6,7)", "Serratus anterior", "Winging of scapula"], ["Axillary nerve", "Surgical neck of humerus", "Deltoid loss + badge area sensory loss"], ["Radial nerve", "Spiral groove", "Wrist drop"], ["Ulnar nerve", "Medial epicondyle", "Claw hand (ring + little fingers)"], ["Median nerve", "Carpal tunnel", "Ape thumb deformity; LOAF muscles lost"], ["Common peroneal", "Fibular neck", "Foot drop"], ["Femoral nerve", "Inguinal region", "Loss of knee jerk, quad weakness"], ] story.append(make_table(nerves[0], nerves[1:], col_widths=[avail*0.28, avail*0.32, avail*0.40])) story.append(spacer(4)) story.append(mn("C5,6,7 keeps the wing off heaven (Long thoracic nerve)")) story.append(spacer(4)) story.append(sub_header("Skull Foramina")) foramina = [ ["Foramen", "Contents"], ["Foramen ovale", "V3, lesser petrosal nerve, accessory meningeal artery"], ["Foramen spinosum", "Middle meningeal artery"], ["Foramen rotundum", "V2 (maxillary)"], ["Jugular foramen", "CN IX, X, XI + sigmoid sinus"], ["Stylomastoid foramen", "CN VII (facial nerve exits)"], ] story.append(make_table(foramina[0], foramina[1:])) story.append(spacer(4)) story.append(mn("Carpal bones: She Looks Too Pretty, Try To Catch Her (Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate)")) story.append(spacer(8)) # ═══════════════════════════════════════════════════════════════════════════════ # 2. PHYSIOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("2. PHYSIOLOGY")) story.append(spacer(3)) story.append(sub_header("Action Potential Key Values")) for txt in [ "Resting membrane potential = -70 mV", "Threshold = -55 mV", "Depolarization = Na+ IN (voltage-gated Na+ channels open)", "Repolarization = K+ OUT", "Absolute refractory period = Na+ channels inactivated (no stimulus works)", ]: story.append(bp(txt)) story.append(spacer(4)) story.append(sub_header("Lung Volumes")) lungs = [ ["Volume / Capacity", "Value"], ["Tidal Volume (TV)", "500 mL"], ["IRV", "3000 mL"], ["ERV", "1100 mL"], ["RV", "1200 mL"], ["FRC = ERV + RV", "2300 mL"], ["Vital Capacity", "4600 mL"], ["TLC", "5800 mL"], ] story.append(make_table(lungs[0], lungs[1:])) story.append(bp("RV cannot be measured by spirometry (use body plethysmography or helium dilution)")) story.append(spacer(4)) story.append(sub_header("GFR & RBF")) for txt in [ "GFR gold standard = Inulin clearance; clinically = creatinine clearance", "RBF = measured by PAH (para-aminohippuric acid)", ]: story.append(bp(txt)) story.append(spacer(4)) story.append(sub_header("ECG Intervals")) ecg = [ ["Interval", "Normal", "Abnormal Meaning"], ["PR interval", "0.12 - 0.20 s", ">0.20 s = 1st degree AV block"], ["QRS", "< 0.12 s", ">0.12 s = Bundle branch block"], ["QTc", "<0.44 s (M), <0.46 s (F)", "Prolonged QT = TdP risk"], ] story.append(make_table(ecg[0], ecg[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 3. BIOCHEMISTRY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("3. BIOCHEMISTRY")) story.append(spacer(3)) story.append(sub_header("Enzyme Deficiency Diseases")) enzymes = [ ["Disease", "Enzyme Deficient", "Key Feature"], ["PKU", "Phenylalanine hydroxylase", "Musty odor, fair skin, intellectual disability"], ["Alkaptonuria", "Homogentisic acid oxidase", "Black urine, ochronosis"], ["Homocystinuria", "Cystathionine beta-synthase", "Marfanoid, DVT, lens dislocation DOWNWARD"], ["Maple Syrup Urine", "BCKAD complex", "Maple syrup odor"], ["Gaucher", "Glucocerebrosidase", "Bone crises, Erlenmeyer flask on X-ray"], ["Niemann-Pick", "Sphingomyelinase", "Cherry red spot + hepatosplenomegaly"], ["Tay-Sachs", "Hexosaminidase A", "Cherry red spot; NO hepatosplenomegaly"], ["Fabry", "Alpha-galactosidase A", "Angiokeratomas, X-linked recessive"], ] story.append(make_table(enzymes[0], enzymes[1:])) story.append(spacer(4)) story.append(sub_header("Vitamins - Deficiency Summary")) vits = [ ["Vitamin", "Deficiency / Toxicity", "Key Fact"], ["B1 (Thiamine)", "Wernicke-Korsakoff, Beriberi", "Alcoholics; cofactor for pyruvate dehydrogenase"], ["B3 (Niacin)", "Pellagra (3Ds)", "Dermatitis, Diarrhea, Dementia; Hartnup disease"], ["B6 (Pyridoxine)", "Sideroblastic anemia, neuropathy", "INH side effect - give B6 prophylactically"], ["B12", "Megaloblastic anemia + SACD", "Intrinsic factor needed; Schilling test"], ["C (Ascorbic acid)", "Scurvy", "Perifollicular hemorrhage, corkscrew hairs"], ["D", "Rickets / Osteomalacia", "1-alpha hydroxylase in kidney for active form"], ["K", "Bleeding (increased PT)", "Warfarin antagonist; neonatal hemorrhage"], ] story.append(make_table(vits[0], vits[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 4. PATHOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("4. PATHOLOGY")) story.append(spacer(3)) story.append(sub_header("Amyloidosis")) amyloid = [ ["Type", "Precursor", "Associated Condition"], ["AL", "Immunoglobulin light chains", "Multiple myeloma (most common systemic)"], ["AA", "Serum amyloid A", "Chronic inflammation (TB, RA, osteomyelitis)"], ["AB (Amyloid beta)", "APP protein", "Alzheimer's disease (chromosome 21)"], ["Beta-2 microglobulin", "B2M protein", "Long-term hemodialysis"], ] story.append(make_table(amyloid[0], amyloid[1:])) story.append(bp("Congo red stain + apple green birefringence under polarized light")) story.append(spacer(4)) story.append(sub_header("Necrosis Types")) necrosis = [ ["Type", "Example", "Feature"], ["Coagulative", "Cardiac/renal infarct", "Architecture preserved; most common"], ["Liquefactive", "Brain infarct, bacterial abscess", "Enzymatic digestion; no architecture"], ["Caseous", "Tuberculosis", "Cheese-like; granuloma center"], ["Fat", "Pancreas (enzymatic), Breast (trauma)", "Calcium soap deposits"], ["Fibrinoid", "Vasculitis, malignant HTN", "Immune complex deposition"], ["Gangrenous", "Diabetic foot", "Dry (coagulative) or Wet (+ liquefactive)"], ] story.append(make_table(necrosis[0], necrosis[1:])) story.append(spacer(4)) story.append(sub_header("Tumor Markers")) markers = [ ["Marker", "Tumor"], ["AFP", "HCC, Yolk sac tumor"], ["b-hCG", "Choriocarcinoma, GTD"], ["CEA", "Colorectal, pancreatic, gastric"], ["CA-125", "Ovarian carcinoma"], ["CA 19-9", "Pancreatic cancer"], ["PSA", "Prostate cancer"], ["Calcitonin", "Medullary thyroid carcinoma"], ["S-100", "Melanoma, Schwannoma"], ["Chromogranin A", "Carcinoid, neuroendocrine tumors"], ] story.append(make_table(markers[0], markers[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 5. PHARMACOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("5. PHARMACOLOGY")) story.append(spacer(3)) story.append(sub_header("Antibiotic Mechanisms")) abx = [ ["Antibiotic", "Mechanism", "Notes"], ["Penicillins / Cephalosporins", "Inhibit cell wall synthesis (PBP)", "Beta-lactams"], ["Vancomycin", "Binds D-Ala-D-Ala (cell wall)", "MRSA; Red Man Syndrome"], ["Aminoglycosides", "30S ribosome inhibitor", "Bactericidal; ototoxic, nephrotoxic"], ["Tetracyclines", "30S ribosome inhibitor", "Bacteriostatic; no children/pregnancy"], ["Macrolides", "50S ribosome inhibitor", "Bacteriostatic; QT prolongation"], ["Chloramphenicol", "50S ribosome inhibitor", "Gray baby syndrome; aplastic anemia"], ["Metronidazole", "DNA strand breakage", "Anaerobes + protozoa; metallic taste"], ["Fluoroquinolones", "DNA gyrase / topoisomerase IV", "Tendon rupture; no children"], ["Rifampicin", "RNA polymerase inhibitor", "Orange urine; enzyme inducer"], ] story.append(make_table(abx[0], abx[1:])) story.append(mn("30S: Amino + Tetra | 50S: MAC (Macro, Aminoglycosides-no, Chlor, Clinda) | DNA: Fluoro + Metro + Rifampin")) story.append(spacer(4)) story.append(sub_header("Important Drug Side Effects")) sideeff = [ ["Drug", "Side Effect"], ["Chloramphenicol", "Gray baby syndrome, aplastic anemia"], ["Tetracycline", "Teeth staining, photosensitivity, Fanconi syndrome"], ["Isoniazid (INH)", "Peripheral neuropathy (B6), hepatitis, SLE-like"], ["Rifampicin", "Orange urine, enzyme inducer, hepatitis"], ["Ethambutol", "Optic neuritis (color vision loss first)"], ["Streptomycin", "Ototoxicity, nephrotoxicity"], ["Methotrexate", "Folate antagonist, hepatic fibrosis, teratogenic"], ["Cyclophosphamide", "Hemorrhagic cystitis (Mesna prevents), SIADH"], ["Amiodarone", "Pulmonary fibrosis, thyroid dysfunction, photosensitivity"], ["Lithium", "Nephrogenic DI, hypothyroidism, tremor, Ebstein's (fetal)"], ] story.append(make_table(sideeff[0], sideeff[1:])) story.append(spacer(4)) story.append(sub_header("Antidotes - Must Know")) antidotes = [ ["Poison", "Antidote"], ["Organophosphate", "Atropine + Pralidoxime (PAM) - give PAM within 24h"], ["Opioids", "Naloxone"], ["Benzodiazepines", "Flumazenil"], ["Warfarin (chronic)", "Vitamin K"], ["Warfarin (acute)", "FFP (Fresh Frozen Plasma)"], ["Digoxin toxicity", "Digoxin-specific Fab antibodies"], ["Iron", "Deferoxamine"], ["Lead", "EDTA (inorganic), DMSA (dimercaptosuccinic acid)"], ["Arsenic / Mercury", "BAL (Dimercaprol)"], ["Carbon monoxide", "100% Oxygen"], ["Paracetamol", "N-acetylcysteine (NAC)"], ["Cyanide", "Sodium thiosulfate + Hydroxocobalamin"], ["Methanol / Ethylene glycol", "Fomepizole (or Ethanol)"], ["Heparin", "Protamine sulfate"], ] story.append(make_table(antidotes[0], antidotes[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 6. MEDICINE # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("6. MEDICINE")) story.append(spacer(3)) story.append(sub_header("Heart Murmurs")) murmurs = [ ["Condition", "Murmur Type", "Special Feature"], ["Aortic stenosis", "Ejection systolic (R 2nd ICS → neck)", "Pulsus parvus et tardus; plateau pulse"], ["Aortic regurgitation", "Early diastolic (R 2nd ICS)", "Wide pulse pressure; Corrigan's pulse"], ["Mitral stenosis", "Mid-diastolic rumble (apex)", "Opening snap; loud S1"], ["Mitral regurgitation", "Pansystolic (apex → axilla)", "Soft S1"], ["VSD", "Pansystolic (left lower sternal)", "Harsh; may close spontaneously"], ["ASD", "Ejection systolic + fixed split S2", "Ostium secundum most common"], ["PDA", "Continuous machine murmur", "Indomethacin closes it"], ["MVP", "Mid-systolic click + late systolic", "Females; click moves with maneuvers"], ] story.append(make_table(murmurs[0], murmurs[1:])) story.append(spacer(4)) story.append(sub_header("Diabetes Mellitus")) dm = [ ["Parameter", "Value"], ["FPG diagnosis", "≥ 126 mg/dL"], ["2h OGTT diagnosis", "≥ 200 mg/dL"], ["HbA1c diagnosis", "≥ 6.5%"], ["Random glucose (symptomatic)", "≥ 200 mg/dL"], ["HbA1c target (general)", "< 7%"], ["HbA1c target (elderly/frail)", "< 8%"], ] story.append(make_table(dm[0], dm[1:])) for txt in [ "Metformin = first-line; contraindicated if eGFR <30; lactic acidosis risk", "SGLT2 inhibitors (empagliflozin, dapagliflozin) = cardioprotective + renoprotective", "GLP-1 agonists (liraglutide, semaglutide) = weight loss + cardioprotective", ]: story.append(bp(txt)) story.append(spacer(4)) story.append(sub_header("Thyroid")) thyroid = [ ["Test", "Hypothyroid", "Hyperthyroid"], ["TSH", "HIGH", "LOW"], ["T4 / T3", "LOW", "HIGH"], ["Radioiodine uptake", "Low (Hashimoto)", "High (Graves), Low (thyroiditis)"], ["Antibodies", "Anti-TPO, Anti-Tg (Hashimoto)", "TSI / TSH-R Ab (Graves)"], ] story.append(make_table(thyroid[0], thyroid[1:])) story.append(bp("Thyroid storm treatment: PTU first → Propranolol → Steroids → Lugol's iodine")) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 7. SURGERY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("7. SURGERY")) story.append(spacer(3)) story.append(sub_header("Burns - Rule of Nines (Adult)")) burns = [ ["Area", "% BSA"], ["Head + Neck", "9%"], ["Each Upper Limb", "9%"], ["Anterior Trunk", "18%"], ["Posterior Trunk", "18%"], ["Each Lower Limb", "18%"], ["Perineum", "1%"], ] story.append(make_table(burns[0], burns[1:])) story.append(bp("Parkland formula: 4 mL x kg x %BSA burnt (Ringer's Lactate); first 8h = half, next 16h = half")) story.append(bp("Lund-Browder chart = most accurate (especially in children)")) story.append(spacer(4)) story.append(sub_header("Fractures - High Yield")) fxs = [ ["Fracture", "Feature / Deformity"], ["Colles", "Dinner fork deformity; FOOSH (fall on outstretched hand)"], ["Smith's", "Reverse Colles; Garden spade deformity; reverse FOOSH"], ["Scaphoid", "Anatomical snuffbox tenderness; AVN risk; X-ray may be normal"], ["Monteggia", "Ulna fracture + radial head dislocation"], ["Galeazzi", "Radius fracture + distal radio-ulnar dislocation"], ["Pott's", "Bimalleolar fracture of ankle"], ["March", "Stress fracture of 2nd metatarsal"], ] story.append(make_table(fxs[0], fxs[1:])) story.append(mn("MUD RUD: Monteggia = Ulna + Dislocation of radius head; Galeazzi = Radius fracture + Ulnar Dislocation")) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 8. OBG # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("8. OBSTETRICS & GYNECOLOGY")) story.append(spacer(3)) story.append(sub_header("Placenta Previa vs Abruptio Placentae")) pp = [ ["Feature", "Placenta Previa", "Abruptio Placentae"], ["Bleeding", "Painless, bright red", "Painful, dark red"], ["Uterus", "Soft, non-tender", "Board-like, tender"], ["Fetal heart", "Usually normal", "Distress common"], ["Shock", "Proportionate to loss", "Disproportionate to visible loss"], ["Diagnosis", "USG (never do PV)", "Clinical + USG"], ] story.append(make_table(pp[0], pp[1:])) story.append(spacer(4)) story.append(sub_header("Pre-eclampsia")) for txt in [ "BP ≥ 140/90 after 20 weeks + proteinuria ≥ 300 mg/24h", "Severe features: BP ≥ 160/110, platelets <100k, creatinine >1.1, visual/CNS symptoms", "MgSO4 = prevention + treatment of eclampsia (Pritchard regimen)", "Antidote to MgSO4 toxicity = Calcium gluconate IV", "Definitive treatment = Delivery", ]: story.append(bp(txt)) story.append(spacer(4)) story.append(sub_header("Gestational Trophoblastic Disease")) gtd = [ ["Type", "Karyotype", "Feature"], ["Complete mole", "46XX (both paternal)", "No fetal parts; snowstorm USG; very high b-hCG"], ["Partial mole", "69XXY (triploid)", "Fetal parts may be present"], ["Choriocarcinoma", "Variable", "Most malignant; responds to methotrexate"], ] story.append(make_table(gtd[0], gtd[1:])) story.append(spacer(4)) story.append(sub_header("Ovarian Tumors")) ovarian = [ ["Tumor", "Key Feature"], ["Serous cystadenocarcinoma", "Most common MALIGNANT ovarian tumor"], ["Serous cystadenoma", "Most common BENIGN ovarian tumor"], ["Mucinous cystadenocarcinoma", "Largest ovarian tumor"], ["Dysgerminoma", "Radiosensitive germ cell tumor; LDH marker"], ["Granulosa cell tumor", "Estrogen-secreting; Call-Exner bodies; feminizing"], ["Krukenberg tumor", "Metastatic (gastric origin); bilateral; signet ring cells"], ] story.append(make_table(ovarian[0], ovarian[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 9. PEDIATRICS # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("9. PEDIATRICS")) story.append(spacer(3)) story.append(sub_header("Developmental Milestones")) dev = [ ["Milestone", "Age"], ["Social smile", "6 weeks"], ["Neck holding (prone)", "3 months"], ["Rolls over", "5 months"], ["Sits without support", "8 months"], ["Stands with support", "9 months"], ["Pincer grasp", "9 months"], ["Walks alone", "13-15 months"], ["2-word sentences", "2 years"], ["3-word sentences / Counts to 3", "3 years"], ["Counts 10 objects", "5 years"], ] story.append(make_table(dev[0], dev[1:])) story.append(spacer(4)) story.append(sub_header("National Immunization Schedule (India) - Key Points")) vacc = [ ["Vaccine", "Age Given"], ["BCG", "At birth"], ["OPV + HepB", "Birth, 6, 10, 14 weeks; booster 16-24 months"], ["Pentavalent (DPT+HepB+Hib)", "6, 10, 14 weeks"], ["IPV (fractional)", "6 weeks + 14 weeks"], ["Rotavirus", "6, 10, 14 weeks"], ["PCV", "6, 14 weeks + 9 months"], ["Measles / MR", "9 months + 16-24 months"], ["JE (endemic areas)", "9 months + 16-24 months"], ["Typhoid", "2 years onwards"], ] story.append(make_table(vacc[0], vacc[1:])) story.append(spacer(4)) story.append(sub_header("Neonatal Quick Facts")) for txt in [ "Normal RR = 40-60/min | HR = 120-160/min", "Physiological weight loss: up to 10% (regained by day 10)", "Physiological jaundice: Starts day 2-3, peaks day 4-5, resolves by day 7-10", "Pathological jaundice: Jaundice in FIRST 24 hours is ALWAYS pathological", ]: story.append(bp(txt)) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 10. ENT # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("10. ENT")) story.append(spacer(3)) story.append(sub_header("Hearing Loss Tests")) hl = [ ["Test", "Conductive Loss", "Sensorineural Loss"], ["Rinne test", "AC < BC (Rinne NEGATIVE)", "AC > BC (Rinne POSITIVE but reduced)"], ["Weber test", "Lateralizes to AFFECTED ear", "Lateralizes to NORMAL ear"], ] story.append(make_table(hl[0], hl[1:])) story.append(spacer(4)) story.append(sub_header("Important ENT Syndromes")) ent = [ ["Condition", "Key Feature"], ["Gradenigo syndrome", "Otitis media + VI nerve palsy + trigeminal pain"], ["Bezold's abscess", "Mastoid pus tracks under sternocleidomastoid"], ["Cholesteatoma", "Unsafe CSOM; foul discharge; marginal perforation; bone erosion"], ["Otosclerosis", "Conductive loss; Schwartze sign (flamingo pink blush); AD inheritance"], ["Meniere's disease", "Low-frequency SNHL + episodic vertigo + tinnitus + aural fullness"], ] story.append(make_table(ent[0], ent[1:])) story.append(spacer(8)) # ═══════════════════════════════════════════════════════════════════════════════ # 11. OPHTHALMOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("11. OPHTHALMOLOGY")) story.append(spacer(3)) story.append(sub_header("Glaucoma")) glaucoma = [ ["Feature", "POAG", "PACG"], ["Angle", "Open", "Closed"], ["Onset", "Insidious, asymptomatic", "Acute: haloes, pain, red eye"], ["IOP", "Elevated (may fluctuate)", "Very high (often >40 mmHg)"], ["Treatment", "Timolol, latanoprost", "Pilocarpine, laser iridotomy"], ] story.append(make_table(glaucoma[0], glaucoma[1:])) story.append(spacer(4)) story.append(sub_header("Retinal Conditions")) retina = [ ["Condition", "Key Finding"], ["CRVO", "Disc edema, flame hemorrhages all quadrants; 'blood and thunder' fundus"], ["CRAO", "Cherry red spot, cattle-trucking; sudden painless loss"], ["Diabetic retinopathy", "Microaneurysms (FIRST sign); cotton wool spots; NVD/NVE"], ["Hypertensive retinopathy", "AV nipping; cotton wool spots; papilledema in Grade 4"], ["Retinitis pigmentosa", "Bone spicule pigmentation; night blindness; tunnel vision"], ] story.append(make_table(retina[0], retina[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 12. PSYCHIATRY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("12. PSYCHIATRY")) story.append(spacer(3)) story.append(mn("MDD (SIGECAPS): Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation (≥5 for 2 weeks)")) story.append(mn("Mania (DIG FAST): Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity, Sleep decreased, Talkativeness")) story.append(spacer(4)) story.append(sub_header("Drug of Choice - Psychiatry")) psych = [ ["Condition", "Drug of Choice"], ["Schizophrenia", "Risperidone (atypical); Haloperidol (typical)"], ["Bipolar disorder", "Lithium (acute mania + prophylaxis)"], ["OCD", "Fluvoxamine / Fluoxetine (SSRIs)"], ["Panic disorder", "SSRIs (first-line); Alprazolam (acute)"], ["PTSD", "Sertraline, Paroxetine"], ["Enuresis", "Imipramine (TCA); Desmopressin"], ["ADHD", "Methylphenidate (first-line); Atomoxetine"], ["Alzheimer's (mild-moderate)", "Donepezil (AChE inhibitor)"], ["Neuroleptic malignant syndrome", "Dantrolene + Bromocriptine; STOP antipsychotic"], ] story.append(make_table(psych[0], psych[1:])) story.append(spacer(8)) # ═══════════════════════════════════════════════════════════════════════════════ # 13. DERMATOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("13. DERMATOLOGY")) story.append(spacer(3)) story.append(sub_header("Blistering Disorders")) blister = [ ["Disease", "Level of Split", "Test", "Feature"], ["Pemphigus vulgaris", "Intraepidermal (suprabasal)", "Tzanck, IIF", "Acantholysis; Nikolsky +ve; flaccid bullae"], ["Bullous pemphigoid", "Sub-epidermal", "IIF", "Tense bullae; elderly; Nikolsky -ve"], ["Dermatitis herpetiformis", "Sub-epidermal", "DIF granular IgA", "Celiac disease association"], ] story.append(make_table(blister[0], blister[1:])) story.append(spacer(4)) story.append(sub_header("Skin Cancers")) skin = [ ["Cancer", "Key Feature"], ["BCC", "Pearly papule; rolled edge; telangiectasia; NEVER metastasizes"], ["SCC", "Everted edge; arises from actinic keratosis; may metastasize"], ["Melanoma", "ABCDE criteria; Breslow thickness; worst prognosis"], ["Merkel cell carcinoma", "Neuroendocrine origin; aggressive; sun-exposed areas"], ] story.append(make_table(skin[0], skin[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 14. COMMUNITY MEDICINE (PSM) # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("14. COMMUNITY MEDICINE (PSM)")) story.append(spacer(3)) story.append(sub_header("Epidemiology Formulas")) epi = [ ["Measure", "Formula"], ["Attack rate", "(Cases / Population at risk) x 100"], ["Case fatality rate", "(Deaths / Cases) x 100"], ["Sensitivity", "TP / (TP + FN)"], ["Specificity", "TN / (TN + FP)"], ["PPV", "TP / (TP + FP)"], ["NPV", "TN / (TN + FN)"], ["Relative Risk (RR)", "Incidence in exposed / Incidence in unexposed"], ["Odds Ratio (OR)", "(a x d) / (b x c)"], ] story.append(make_table(epi[0], epi[1:])) story.append(spacer(4)) story.append(sub_header("Study Designs")) study = [ ["Design", "Key Use", "Measure of Association"], ["RCT", "Gold standard for intervention", "Risk difference, NNT"], ["Cohort study", "Prospective; rare exposures", "Relative Risk (RR)"], ["Case-control", "Retrospective; rare diseases", "Odds Ratio (OR)"], ["Cross-sectional", "Prevalence studies", "Prevalence ratio"], ["Systematic review / Meta-analysis", "Highest evidence level", "Pooled effect size"], ] story.append(make_table(study[0], study[1:])) story.append(spacer(8)) # ═══════════════════════════════════════════════════════════════════════════════ # 15. FORENSIC MEDICINE # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("15. FORENSIC MEDICINE")) story.append(spacer(3)) story.append(sub_header("Post-mortem Changes")) pm = [ ["Change", "Onset", "Maximum / Passes Off"], ["Rigor mortis", "2-6 hours", "Complete 12h; passes off 36-48h"], ["Livor mortis (hypostasis)", "30 min - 2h", "Fixed after 6-8 hours"], ["Putrefaction", "Starts 24-48h (warm weather faster)", "Bloating at 3-5 days"], ["Cadaveric spasm", "Instantaneous", "Indicates violent/sudden death"], ] story.append(make_table(pm[0], pm[1:])) story.append(spacer(8)) # ═══════════════════════════════════════════════════════════════════════════════ # 16. RADIOLOGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("16. RADIOLOGY - X-ray Signs")) story.append(spacer(3)) rad = [ ["Sign", "Disease"], ["Ground glass opacity", "ARDS, PCP, pulmonary edema, COVID-19"], ["Eggshell calcification", "Silicosis, sarcoidosis, irradiated lymphoma"], ["Bat-wing / Butterfly", "Pulmonary edema"], ["Honeycomb lung", "UIP / IPF"], ["Reverse bat-wing", "COP (Cryptogenic organizing pneumonia)"], ["Egg on side", "TGA (Transposition of Great Arteries)"], ["Boot-shaped heart", "Tetralogy of Fallot"], ["Box-shaped heart", "Ebstein's anomaly"], ["Flask-shaped heart", "Pericardial effusion"], ["Snowstorm appearance", "Hydatidiform mole (USG)"], ] story.append(make_table(rad[0], rad[1:])) story.append(PageBreak()) # ═══════════════════════════════════════════════════════════════════════════════ # 17. LAST 15-DAY STRATEGY # ═══════════════════════════════════════════════════════════════════════════════ story.append(section_header("17. LAST 15-DAY REVISION STRATEGY")) story.append(spacer(3)) strat = [ ["Days", "Focus"], ["Days 1-7 (Week 1)", "High-density subjects: Pharmacology, Pathology, Medicine, PSM"], ["Days 8-13 (Week 2)", "Surgery, OBG, Pediatrics, Psychiatry + Rapid revision of Anatomy / Physiology / Biochemistry"], ["Day 14", "ENT, Ophthalmology, Dermatology, Forensic Medicine"], ["Day 15", "Revise mnemonics + PYQs (previous year questions) + weak areas only"], ] story.append(make_table(strat[0], strat[1:], col_widths=[avail*0.28, avail*0.72])) story.append(spacer(6)) for txt in [ "These notes cover the top 20% of content that appears in 80% of NEET PG questions.", "Focus on tables, exceptions, and 'most common' facts - these are NEET PG favorites.", "For PYQs: use Grand Tests and subject-wise tests in the last 5 days.", "Sleep 7-8 hours in the last week - retrieval consolidates during sleep.", ]: story.append(bp(txt)) story.append(spacer(10)) story.append(HRFlowable(width="100%", thickness=1, color=C_TEAL, spaceAfter=4)) story.append(Paragraph("Generated by Orris AI | NEET PG High-Yield Marrow Notes | July 2026", footer_style)) # ── Build PDF ───────────────────────────────────────────────────────────────── doc.build(story) print(f"PDF created: {OUTPUT}") PYEOF echo "Script written"

Running Command

cd /tmp/workspace/marrow-notes && python generate_pdf.py 2>&1

Running Command

ls -lh /tmp/workspace/marrow-notes/NEET_PG_Marrow_Notes.pdf

Your PDF is ready! Download it here:

NEET PG Marrow Notes

PDF Document · PDF

What's inside (17 sections):

Section	Content
1. Anatomy	Nerve injuries table, skull foramina, carpal bones mnemonic
2. Physiology	Action potential, lung volumes, ECG intervals
3. Biochemistry	Enzyme deficiencies, vitamin deficiencies
4. Pathology	Amyloid, necrosis types, tumor markers
5. Pharmacology	Antibiotic mechanisms, drug side effects, antidotes
6. Medicine	Heart murmurs, DM criteria, thyroid
7. Surgery	Burns (Rule of Nines + Parkland), fractures
8. OBG	Placenta previa vs abruption, pre-eclampsia, molar pregnancy, ovarian tumors
9. Pediatrics	Milestones, NIS vaccines, neonatal facts
10-11. ENT + Ophthalmology	Hearing tests, glaucoma, retinal conditions
12-13. Psychiatry + Dermatology	SIGECAPS/DIG FAST, drug choices, blistering disorders
14-15. PSM + Forensic	Epi formulas, study designs, post-mortem changes
16. Radiology	Key X-ray signs
17. Strategy	Day-by-day 15-day revision plan

The PDF is formatted with color-coded section headers, zebra-striped tables, and highlighted mnemonic boxes - optimized for quick scanning during revision. All the best for NEET PG!

Marrow rr notes in a concised manner pls

Here are your Marrow Rapid Revision (RR) Notes - the most exam-ready, one-liner style facts that Marrow RR is known for. These are the "last read before exam" style notes.

MARROW RR NOTES - NEET PG

Rapid Revision | One-Liners + Key Facts

ANATOMY RR

Nerve to serratus anterior = Long thoracic (C5,6,7) → winging of scapula
Surgical neck humerus → Axillary nerve → deltoid paralysis
Spiral groove → Radial nerve → wrist drop
Medial epicondyle → Ulnar nerve → claw hand (ring + little)
Carpal tunnel → Median nerve → ape thumb + LOAF muscles lost
Fibular neck → Common peroneal → foot drop
Posterior interosseous nerve = deep branch of radial = no sensory loss, no wrist drop
Injury to L4-L5 disc = L5 nerve root affected
Obturator nerve = medial thigh sensation + adductor weakness
Femoral triangle: NAVY lateral to medial = Nerve, Artery, Vein, Y-fronts (lymphatics)
Danger zone of scalp = subaponeurotic layer (emissary veins → spread infection intracranially)
Bare area of liver → Right suprarenal gland contact
McBurney's point = 1/3 from ASIS to umbilicus
Hesselbach's triangle = direct inguinal hernia area (inferior epigastric, rectus, inguinal lig)
Conjoint tendon = internal oblique + transversus abdominis
Most common site for ectopic pregnancy = Ampulla of fallopian tube
Arcuate line = below this, posterior rectus sheath absent
Porta hepatis = Portal vein (behind), Hepatic artery (left), Bile duct (right) → PBA
Foramen of Winslow boundaries: anteriorly = hepatoduodenal ligament

PHYSIOLOGY RR

RMP = -70 mV | Threshold = -55 mV
Absolute refractory period = Na+ channels inactivated (no AP possible)
Relative refractory period = K+ channels open (larger stimulus needed)
Starling's law = greater initial fiber length → greater force of contraction
Cardiac output = HR × SV | Normal = 5 L/min
Frank-Starling mechanism = increased preload → increased stroke volume
GFR = 125 mL/min | Renal blood flow = 1200 mL/min
Measured by inulin (GFR), PAH (ERPF), Creatinine clearance (clinical GFR)
Juxtaglomerular apparatus = renin secretion in response to low BP/Na
Aldosterone → Na+ reabsorption in collecting duct (principal cells)
ADH → water reabsorption via aquaporin 2 in collecting duct
Surfactant = dipalmitoyl phosphatidylcholine (DPPC); type II pneumocytes; reduces surface tension
Haldane effect = CO2 transport in deoxygenated blood enhanced → Bohr effect = O2 release in acidic tissue
2,3-DPG increases → right shift of O2 dissociation curve → more O2 released to tissues
Left shift = CAHOOTS: CO, Altitude (alkalosis), HbF, Hypothermia, Oxygen (high pO2), Temperature (low)
Compliance = change in volume / change in pressure; decreased in fibrosis
FEV1/FVC: obstructive < 70%, restrictive = normal or increased
Cushing reflex = raised ICP → HTN + bradycardia + irregular respiration
Wilson's central terminal = indifferent electrode in ECG; reference for unipolar leads

BIOCHEMISTRY RR

Km = substrate concentration at half Vmax; indicator of enzyme affinity (low Km = high affinity)
Competitive inhibitor → increases Km, Vmax unchanged
Non-competitive inhibitor → Km unchanged, Vmax decreases
Rate-limiting enzyme of glycolysis = Phosphofructokinase-1 (PFK-1)
Rate-limiting enzyme of gluconeogenesis = Fructose-1,6-bisphosphatase
Rate-limiting enzyme of TCA cycle = Isocitrate dehydrogenase
Rate-limiting enzyme of fatty acid synthesis = ACC (Acetyl CoA carboxylase)
Rate-limiting enzyme of cholesterol synthesis = HMG CoA reductase
Statins inhibit HMG CoA reductase
Urea cycle: Carbamoyl phosphate synthetase 1 = rate-limiting; mitochondria
Ornithine transcarbamylase deficiency = most common urea cycle defect; X-linked
Cori cycle = lactate from muscle → liver → glucose
Glucose-6-phosphate dehydrogenase (G6PD) deficiency → hemolytic anemia with oxidant stress
PKU = phenylalanine hydroxylase; musty odor; treat with low Phe diet + BH4 (sapropterin)
Alkaptonuria = homogentisic acid oxidase; black urine (oxidizes on standing); ochronosis; arthritis
Homocystinuria = cystathionine beta-synthase; lens DOWN, Marfanoid, DVT, atherosclerosis early
Marfan = fibrillin-1 mutation; lens UP (ectopia lentis superiorly)
Collagen Type I = bone, skin, tendon | Type II = cartilage | Type III = blood vessels | Type IV = basement membrane
Vitamin C needed for hydroxylation of proline + lysine in collagen → scurvy = defective collagen
Zellweger syndrome = peroxisome biogenesis defect; no peroxisomes; VLCFA accumulate
Lesch-Nyhan = HGPRT deficiency; gout + self-mutilation + choreoathetosis; X-linked

PATHOLOGY RR

Cell Injury

Reversible: cellular swelling, fatty change, membrane blebs
Irreversible: karyolysis, karyorrhexis, pyknosis → 3 Ks
Apoptosis = programmed, no inflammation; caspase-mediated; shrinkage + apoptotic bodies
Ischemia → cell swelling (Na+ pump fails) → Ca2+ influx → irreversible injury
Reperfusion injury = free radicals (ROS) on restoration of blood flow

Inflammation

Acute = neutrophils; vascular change + cellular events
Chronic = lymphocytes, plasma cells, macrophages
Granuloma = modified macrophages (epithelioid) + Langhans giant cells → TB, sarcoid, leprosy, Crohn's
IL-1, IL-6, TNF-alpha = fever, acute phase response
C5a = chemotaxis | C3b = opsonization | C1q = classical pathway activation

Neoplasia

Proto-oncogenes → gain of function mutations → oncogenes
Tumor suppressor genes → loss of function (2-hit hypothesis) → Rb, p53
p53 = guardian of genome; mutated in 50% cancers; Li-Fraumeni syndrome
BRCA1/BRCA2 = DNA repair; breast + ovarian cancer
Warburg effect = aerobic glycolysis in cancer cells → lactic acid even in presence of O2
Metastasis routes: Lymphatic (carcinomas), Hematogenous (sarcomas), Transcoelomic (ovarian)
Most common site of metastasis = liver (from GI via portal), lung (from systemic)

PHARMACOLOGY RR

Pharmacokinetics (Must Know)

Zero order kinetics = constant amount eliminated regardless of concentration (alcohol, phenytoin, aspirin at high dose)
First order kinetics = constant fraction eliminated (most drugs)
Bioavailability = F = AUC oral / AUC IV × 100
Volume of distribution (Vd) = Dose / Plasma concentration; high Vd = tissue distribution
t½ = 0.693 × Vd / Cl
Steady state reached in 4-5 half-lives
Loading dose = (Vd × Target Cp) / F

Receptor Types

Gq = phospholipase C → IP3 + DAG → Ca2+ release (H1, M1, M3, alpha-1)
Gs = adenylate cyclase → cAMP ↑ (beta-1, beta-2, D1, H2)
Gi = adenylate cyclase ↓ → cAMP ↓ (alpha-2, M2, D2, opioid)
Ligand-gated ion channel = nicotinic ACh, GABA-A, NMDA

Autonomic Key Drugs

Bethanechol = muscarinic agonist; urinary retention; no nicotinic effect
Pilocarpine = miosis + glaucoma (open angle)
Atropine = tachycardia (blocks M2) + mydriasis + dry mouth; SLUDGE reversal
Prazosin = alpha-1 blocker; first dose hypotension; BPH + HTN
Phentolamine = non-selective alpha blocker; pheochromocytoma diagnosis/preop
Propranolol = non-selective beta blocker; contraindicated in asthma
Neostigmine = reversible AChE inhibitor; post-op ileus, myasthenia; does NOT cross BBB
Physostigmine = reversible AChE inhibitor; DOES cross BBB; antidote for atropine poisoning

NSAIDs

Aspirin = irreversible COX inhibitor; antiplatelet 75-150 mg; Reye's syndrome in children
Paracetamol = central COX-3 inhibition; no GI side effects; liver toxicity in overdose
Indomethacin = most potent NSAID; closes PDA; drug of choice in gout attack (along with colchicine)
Celecoxib = COX-2 selective; less GI bleed but increased CVD risk

MEDICINE RR

Hypertension

Target BP: general = <130/80 | CKD + proteinuria = <130/80
1st line: thiazide, CCB, ACEI/ARB
ACEi = cough (bradykinin), angioedema (use ARB instead); contraindicated in bilateral RAS, pregnancy
Beta blockers = NOT first-line in uncomplicated HTN; preferred in angina, HF, post-MI
Hypertensive emergency = target BP reduction by 25% in first hour, then 160/100 in 2-6h

Heart Failure

HFrEF (EF <40%): ACEi/ARB/ARNI + beta blocker + MRA + SGLT2i
Sacubitril/valsartan (ARNI) = superior to ACEi in HFrEF (PARADIGM-HF trial)
SGLT2 inhibitors = reduce HF hospitalization in both HFrEF and HFpEF
BNP = best marker for HF; elevated in volume overload
S3 gallop = volume overload (HF) | S4 = stiff ventricle (LVH, hypertension)

ACS

STEMI = ST elevation + troponin rise; treat within 90 min (door-to-balloon)
NSTEMI = no ST elevation; troponin elevated
Unstable angina = troponin NORMAL; no ST elevation
Troponin rises at 3-4h, peaks 24-48h, returns to normal 7-10 days (cTnI)
Dressler's syndrome = post-MI pericarditis; 2-10 weeks after MI; autoimmune

Arrhythmias

AF = irregularly irregular; absent P waves; rate control (beta blocker/CCB) vs rhythm control
CHADS2-VASc score → anticoagulation in AF; score ≥2 in males = anticoagulate
WPW = delta wave, short PR, widened QRS; accessory pathway (Bundle of Kent)
AVNRT = most common SVT; P wave hidden in QRS; vagal maneuvers + adenosine
VT = monomorphic (amiodarone/lidocaine) vs polymorphic (TdP → MgSO4)
Torsades de Pointes = prolonged QT → MgSO4; stop offending drugs

Respiratory

COPD: spirometry = FEV1/FVC <70% post-bronchodilator
Gold staging: GOLD I (FEV1 ≥80%), II (50-79%), III (30-49%), IV (<30%)
COPD exacerbation = SABA + SAMA + oral prednisolone + antibiotics (amoxicillin/azithromycin)
Asthma = reversible airflow obstruction; diurnal variation; eosinophilia; elevated IgE
Pneumothorax: spontaneous = tall thin young male; tension = trachea deviation AWAY from affected side
Pleural effusion: transudate (Light's criteria) vs exudate; unilateral in malignancy
Mesothelioma = asbestos exposure; no smoking link; pleural plaques
IPF (UIP) = honeycombing; Velcro crackles; FVC reduces; pirfenidone/nintedanib

Gastroenterology

GERD: first-line = PPI; alarm features → upper GI endoscopy
Barrett's esophagus = columnar metaplasia; risk of adenocarcinoma; surveillance endoscopy
H. pylori = CLO test (rapid urease), urea breath test, stool antigen; triple therapy (PPI + clarithromycin + amoxicillin)
Achalasia = incomplete LES relaxation; bird's beak appearance on barium; manometry = gold standard
Crohn's = skip lesions, transmural, cobblestone, fistulas, any part of GIT; non-caseating granulomas
Ulcerative colitis = continuous, mucosal, rectum upward; crypt abscesses; pseudopolyps; toxic megacolon
Primary biliary cholangitis (PBC) = antimitochondrial Ab (AMA); middle-aged women; pruritus
Primary sclerosing cholangitis (PSC) = ANCA positive; UC association; beaded appearance MRCP

Nephrology

CKD stages: GFR ≥90 (Stage 1), 60-89 (2), 30-59 (3), 15-29 (4), <15 (5 = ESRD)
Nephrotic = proteinuria >3.5g/day + edema + hypoalbuminemia + hyperlipidemia
Nephritic = hematuria + oliguria + HTN + mild proteinuria
Most common cause nephrotic in adults = membranous (idiopathic) / focal segmental glomerulosclerosis
Most common cause nephrotic in children = minimal change disease (responds to steroids)
IgA nephropathy = most common glomerulonephritis worldwide; hematuria after URTI
Hyperkalemia = peaked T waves; treat with calcium gluconate (membrane stabilization), then insulin + glucose, then kayexalate/dialysis

SURGERY RR

GI Surgery

Appendicitis: Rovsing sign, Psoas sign, Obturator sign; alvarado score
Obstructed hernia = blood supply intact; Strangulated = blood supply cut
Richter's hernia = only part of circumference of bowel strangulated
Maydl's hernia = W hernia; 2 loops in sac; middle loop strangulates
Most common hernia overall = indirect inguinal | Most common in females = femoral
Femoral hernia = below and lateral to pubic tubercle; high risk of strangulation
Courvoisier's law = palpable painless GB in obstructive jaundice = NOT gallstones (likely malignancy)
Charcot's triad = fever + jaundice + RUQ pain → cholangitis
Reynold's pentad = Charcot's triad + shock + altered consciousness → suppurative cholangitis
Klatskin tumor = cholangiocarcinoma at hilum of liver (bifurcation of hepatic ducts)
Whipple's procedure = pancreaticoduodenectomy for head of pancreas cancer

Thyroid Surgery

Recurrent laryngeal nerve injured → hoarseness; Superior laryngeal nerve → loss of high-pitched voice
Post-thyroidectomy hypocalcemia = parathyroid damage → Chvostek + Trousseau signs
Trousseau = carpal spasm on BP cuff inflation (more sensitive); Chvostek = facial twitch on tapping

Orthopaedics

Osteosarcoma = most common primary malignant bone tumor in children; distal femur; Codman's triangle; sunburst pattern
Ewing's sarcoma = onion peel periosteal reaction; 5-15 years; EWSR1-FLI1 translocation t(11;22)
Osteoclastoma (GCT) = epiphysis + metaphysis; soap bubble appearance; locally aggressive
DEXA scan gold standard for osteoporosis; T-score ≤ -2.5 = osteoporosis

OBG RR

Obstetrics

Nagele's rule = LMP + 9 months + 7 days (or LMP - 3 months + 7 days)
Quickening = 18-20 weeks (primigravida), 16-18 weeks (multigravida)
Goodell's sign = softening of cervix (6 weeks)
Hegar's sign = softening of isthmus (6-10 weeks)
Leopold's maneuvers = 4 maneuvers to assess fetal lie, presentation, engagement
Bishop's score ≥8 = favorable cervix for induction
Normal CTG: baseline 110-160 bpm, variability 5-25, accelerations present, no late decelerations
Shoulder dystocia = McRobert's maneuver (first) + suprapubic pressure
PPH = blood loss >500mL (vaginal), >1000mL (CS); most common cause = uterine atony
AMTSL = active management of 3rd stage; oxytocin 10 IU IM within 1 min of delivery
Oxytocin = uterotonic of choice for PPH; Carboprost = contraindicated in asthma

Gynecology

PCOS = oligomenorrhea + hyperandrogenism + polycystic ovaries (Rotterdam 2/3); LH:FSH >2:1
PCOS management = weight loss → OCP → metformin → clomiphene (for ovulation induction)
Endometriosis = chocolate cysts; powder burn lesions; CA-125 elevated; laparoscopy gold standard
Adenomyosis = uterus bulky; dysmenorrhea; menorrhagia; Junctional zone >12mm on MRI
Fibroid uterus = most common benign gynecological tumor; estrogen-dependent; calcification (whorled pattern)
Cervical cancer = HPV 16, 18 (squamous cell carcinoma most common); Pap smear screening
FIGO staging = clinical for cervical cancer; surgical for endometrial + ovarian
Endometrial cancer = most common gynecological cancer in developed countries; postmenopausal bleeding
DUB/AUB = PALM-COEIN classification

PEDIATRICS RR

Neonatology

APGAR score = A (appearance), P (pulse), G (grimace), A (activity), R (respiration) at 1 and 5 min; 7-10 = normal
Surfactant deficiency = Hyaline membrane disease (RDS); premature infants; give antenatal steroids
NEC = necrotizing enterocolitis; premature + formula-fed; pneumatosis intestinalis on X-ray
Kernicterus = unconjugated bilirubin deposits in brain; basal ganglia; treat with phototherapy/exchange
Phototherapy = 420-470 nm (blue light); increases bili excretion via photoisomerization

Nutritional Disorders

Marasmus = severe calorie deficiency; wasting; "old man face"; weight <60% expected
Kwashiorkor = protein deficiency; edema + skin changes ("flag sign" hair) + fatty liver; weight 60-80% expected
Vit A deficiency = night blindness → Bitot spots → keratomalacia (corneal ulceration)
Rickets = Vit D deficiency; Rachitic rosary, Harrison's groove, Bow legs, widened wrists, Craniotabes

Infections

Koplik spots = measles (before rash); pathognomonic; buccal mucosa
Rash distribution: Measles (head→trunk→limbs); Chickenpox (trunk→periphery, centripetal)
Roseola infantum (HHV-6) = high fever → sudden defervescence → rash
Hand, foot, mouth disease = Coxsackie A16 (HFMD); painful oral ulcers + vesicles on hands/feet
Kawasaki = fever >5 days + 4/5 (rash, cracked lips, strawberry tongue, conjunctivitis, cervical LAP, hand changes); coronary aneurysm risk; treat with IVIG + aspirin

PSYCHIATRY RR

Loose associations = schizophrenia; Flight of ideas = mania
Thought insertion/withdrawal/broadcast = first-rank symptoms of schizophrenia (Schneider)
Clang associations = rhyming; mania
Tangentiality = never returns to point; Circumstantiality = returns eventually
Depersonalization = feels detached from self; Derealization = world feels unreal
Delirium = acute, fluctuating, disturbed consciousness; reversible; organic cause
Dementia = chronic, progressive, consciousness INTACT; irreversible
Pseudodementia = depression mimicking dementia; improves with antidepressants
Antipsychotic side effects: EPS (acute dystonia → akathisia → Parkinsonism → tardive dyskinesia)
Tardive dyskinesia = late onset; involuntary orobuccal movements; irreversible; clozapine low risk
NMS = rigidity + fever + autonomic instability + elevated CK; treat with dantrolene + bromocriptine
Serotonin syndrome = hyperthermia + clonus + agitation; treat with cyproheptadine
SSRI discontinuation = FINISH mnemonic (Flu-like, Insomnia, Nausea, Imbalance, Sensory disturbances, Hyperarousal)
Lithium toxicity = coarse tremor + vomiting + ataxia + confusion; narrow TI; monitor levels
Clozapine = most effective for refractory schizophrenia; agranulocytosis → weekly CBC

DERMATOLOGY RR

Auspitz sign = psoriasis (pinpoint bleeding on scale removal)
Koebner phenomenon = psoriasis, vitiligo, lichen planus, warts - new lesions at site of trauma
Wickham's striae = lichen planus (lacy white lines on papule surface)
Lichen planus = 6 Ps: Pruritic, Purple, Polygonal, Planar, Papules, Plaques
Nikolsky sign = positive in pemphigus vulgaris; negative in bullous pemphigoid
Tzanck smear = acantholytic cells (pemphigus), multinucleated giant cells (herpes/varicella)
Wood's lamp = coral red (erythrasma/C. minutissimum), yellow-green (tinea capitis/M. canis), blue-white (vitiligo)
Dermatophytes = ringworm; KOH mount; griseofulvin (tinea capitis in children)
Scabies = Sarcoptes scabiei; burrows; interdigital web spaces; treat with permethrin 5%
Hansen's disease (leprosy) = M. leprae; TT = single hypopigmented patch; LL = multiple lesions, leonine facies

ENT RR

Rinne +ve = AC>BC = normal or SNHL | Rinne -ve = BC>AC = conductive loss
Weber = lateralizes to worse ear (conductive) OR better ear (SNHL)
Unsafe CSOM = cholesteatoma; attic perforation; danger of intracranial complications
Safe CSOM = tubotympanic type; central perforation; mucopurulent discharge; treat medically
Otosclerosis = bilateral conductive loss; young adult female; carhart notch at 2kHz; stapedectomy
Presbycusis = age-related SNHL; bilateral; high frequency first
Acoustic neuroma = CN VIII; CPA; unilateral SNHL + tinnitus + vertigo; gadolinium MRI
Epley maneuver = BPPV treatment (posterior semicircular canal most common)
Quinsy (peritonsillar abscess) = uvula pushed to opposite side; treat with incision + drainage
Ludwig's angina = bilateral submandibular space infection; airway emergency

OPHTHALMOLOGY RR

Visual acuity = Snellen chart; 6/6 = normal
Relative Afferent Pupillary Defect (RAPD) = Marcus Gunn pupil; optic nerve lesion
Argyll Robertson pupil = accommodates but doesn't react (syphilis); "prostitute's pupil"
Horner's syndrome = ptosis + miosis + anhidrosis; sympathetic chain lesion
CN III palsy = down and out + complete ptosis + dilated pupil (surgical III = compression by PComA aneurysm)
Trachoma = C. trachomatis; follicular conjunctivitis → pannus → trichiasis → blindness; WHO leading infectious blindness
Onchocerciasis = "river blindness"; Simulium blackfly vector; ivermectin treatment
Cataract = most common cause of reversible blindness worldwide
Glaucoma = most common cause of irreversible blindness worldwide
Diabetic macular edema = most common cause of visual loss in diabetic retinopathy
Central serous chorioretinopathy (CSCR) = type A personality, young males; stress-related

PSM / COMMUNITY MEDICINE RR

Levels of Prevention

Primordial = prevent risk factors developing (e.g. ban trans fats)
Primary = prevent disease (vaccination, health education)
Secondary = early detection (screening, Pap smear)
Tertiary = reduce disability (rehabilitation)

Screening Criteria (Wilson & Jungner)

Disease should be important + detectable in latent stage + effective treatment available
Test should be sensitive, specific, acceptable, affordable

Key Epidemiology

Incidence = new cases / population at risk × time → used for acute diseases
Prevalence = all cases at a point / total population → used for chronic diseases
Prevalence = Incidence × Duration of disease
Sensitivity = ability to detect TRUE positives (rule OUT with high sensitivity = SnNout)
Specificity = ability to detect TRUE negatives (rule IN with high specificity = SpPin)
Increasing threshold → sensitivity ↓, specificity ↑ (false negatives increase, false positives decrease)
Gold standard for causation = Hill's criteria (9 criteria; strength, consistency, temporality, etc.)
Temporality is the ONLY essential criterion of Hill's criteria

Health Indices

IMR = best indicator of socioeconomic development + health status of community
MMR = best indicator of obstetric care
Life expectancy = most sensitive index of overall health
Fertility rate: TFR India ~2.0 (near replacement level 2.1)

FORENSIC MEDICINE RR

Brain = last organ to putrefy | Uterus (non-pregnant) = most resistant
Vitreous humor = best sample for postmortem drug/alcohol analysis (protected from decomposition)
Time of death (TSD) = body temperature (Henssge nomogram), rigor mortis, livor mortis
Lacerated wound = blunt force; wound edges irregular, crushed, bruised; hair bridges across wound
Incised wound = sharp force; clean edges; length > depth
Stab wound = sharp force; depth > length
Hesitation cuts = tentative cuts in suicidal cut throat
Contact range gunshot wound = muzzle contusion ring + blackening + tattooing + soot
Entrance wound = smaller + inverted edges; Exit wound = larger + everted edges
Subdural hematoma = bridging veins torn; crescent shape on CT; chronic in elderly
Extradural hematoma = middle meningeal artery; lucid interval; biconvex/lenticular on CT
Hanging = ligature mark ABOVE thyroid cartilage; oblique non-continuous
Strangulation = ligature mark BELOW thyroid cartilage; horizontal continuous

RADIOLOGY RR

Sign	Condition
Snowstorm	Hydatidiform mole
String sign of Kantor	Crohn's disease
Lead pipe colon	Ulcerative colitis
Ram's horn sign	Amyloid of stomach
Coffee bean sign	Sigmoid volvulus
Ground glass opacity	ARDS, PCP, COVID
Egg on side	TGA
Boot-shaped heart	TOF
Box-shaped heart	Ebstein's anomaly
Flask heart	Pericardial effusion
Codman's triangle	Osteosarcoma
Onion peel	Ewing's sarcoma
Soap bubble	GCT / aneurysmal bone cyst
Rugger jersey spine	Renal osteodystrophy
Bone within bone	Osteopetrosis
H-shaped vertebra	Sickle cell anemia
Bamboo spine	Ankylosing spondylitis
Apple core lesion	Carcinoma colon
Rat-tail narrowing	Carcinoma esophagus
Bird's beak	Achalasia cardia
Sunburst pattern	Osteosarcoma
Eggshell calcification	Silicosis, sarcoidosis
Honeycomb lung	IPF / UIP
Bat wing / Butterfly	Pulmonary edema

Pro tip for last 15 days: Read these RR notes every 2-3 days rotating subjects. Focus on the BOLDED facts - those are the ones that appear most frequently as single correct answers in NEET PG MCQs. All the best! 🎯

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