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Ans. is 'b' i.e., Astrocytoma o Most common glial tumor-Astrocytomao Most common meningeal tumor-Meningioma Conventional classification of CNS tumorso Conventionally, CNS tumors are classified into following three groups1) Glial tumors :- Primary tumors of the CNS that arise from the three glial cells present in the CNS, i.e., astrocytes, oligodendrocytes and ependymal cells. Examples are astrocytomas, oligodendrogliomas, ependymomas, mixed gliomas.2) Neuronal tumors :- Primary tumors of the CNS that contain mature appearing neurons or show neuronal lineage. Examples are neurocytomas, gangliocytomas andgangliogliomas.3) Embroyonal tumors (poorly differentiated tumors) :- Primary tumors of the CNS which thought of neuroectodermal origin express few if any phenotype features of mature cells of nervous system. Examples are medulloblastomas, neuroblastomas and ependymoblastomas.
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Ans. is 'a' i.e., Ceftriaxone Recommended Rx of Gonococcal infection (Penicillinase producing NG):* Gonococcal infection of cervix, urethra, pharynx, rectum# First line - Ceftriaxone, ciprofloxacin, ofloxacin.# Alternatives - Spectinomycin, ceftizoxime, cefotetan.* Gonococcal conjuctivitis and ophthalmia neonatorum - Ceftriaxone.* Disseminated gonoccal infection (Gonococcal arthritis)# Patient tolerant to b-lactam drugs - ceftriaxone, cefotaxime, ceftizoxim.# Patient allergic to b-lactam drugs - ciprofloxacin, ofloxacin, spectinomycin.# Continuation therapy - Ciprofloxacin, ofloxacin, levofloxacin.* Gonococcal epididymitis - ceftriaxone followed by doxycycline.DOC for gonorrhea is ceftriaxone
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Spores of Bacillus stearothermophilus are used as a control in an autoclave.
“Sterilization control of autoclave: For determining the efficacy of moist heat sterilization, spores of Bacillus stearothermophilus are used as the test organism.
This is a thermophilic organism with an optimum growth temperature of 55-60 degree and its spores require an exposure of 12 minutes at 121 degrees to be killed."
“Plasma sterilization is a safe method to sterilize instruments at low temperature under vacuum.
Vacuum is required to prevent large concentrations of species from absorbing the UV rays created by the plasma during the sterilization process.
The bacterial organism most resistant to the sterilization technique was Bacillus stearothermophilus.
The organism was then used in Survival Analysis Curve testing and was effectively sterilized to a level of <106 with 30 min of diffusion time using both survivor curve and fraction negative analysis. So that Bacillus stearothermophilus is used as a control in plasma sterilization.” “B. subtilis is used in Guthrie's test.” "Sterilization control of Hot air oven: The spores of a non-toxigenic strain of Clostridium tetani are used as a microbiological test of dry heat efficiency."
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(Refer: Rajesh Bardale - Principles of Forensic medicine & Toxicology, 1st edition, pg no: 504, 5505)
Clinical features of Aconite poisoning
Fatal dose – 1 to 2 gram of root and 3 to 5 mg of aconitine
Nausea, vomiting, and diarrhea
Salivation
Tingling and numbness in the mouth and face
Palpitation
Weakness
Hypotension
Ventricular ectopics
Arrhythmias
Vertigo
Blurring of vision, hippus, mydriasis, xanthopsia
Convulsions
The main causes of death are ventricular arrhythmias and asystole, paralysis of the heart or of the respiratory center
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It is one of the forms of "calcium pyrophosphate dihydrate" (CPPD) arthropathy.
Pseudogout commonly involves the larger joints.Knee joint is most commonly involved; other sites are wrist, elbow, shoulder, ankle. Involvement of small joints is uncommon.
The radiologic hallmark of CPPD is "chondrocalcinosis". Chondrocalcinosis is seen as punctate and/or linear radiodense deposits in fibrocartilaginous joint menisci or articular hyaline cartilage.
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Ans. is 'c' i.e., Nitrosoureas o Nitrosoureas are highly lipid soluble and can cross blood brain barrier --> used in brain tumors like gliomas.
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Ans. A: Acute anxietyPanic attack has been described as an episode of incredibly intense fear or apprehension that is of sudden onset. A panic attack is a discrete period of intense fear or discomfo in which symptoms developed abruptly and reached a peak within 10 minutes.The symptoms of a panic attack commonly last approximately thiy minutes. However, panic attacks can be as sho as 15 seconds, while sometimes panic attacks may form a cyclic series of episodes, lasting for an extended period, sometimes hours.Often those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred.The effects of a panic attack vary from person to person. Some, notably first-time sufferers, may call for emergency services. Many that experience a panic attack, mostly for the first time, fear they are having a hea attack or a nervous breakdown. Experiencing a panic attack has been said to be one of the most intensely frightening, upsetting and uncomfoable experiences of a person's life.
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MC site for contrecoup injury is the Frontal lobes (tips of the frontal poles/orbital surface) and may be symmetrical, if a person falls on the occiput. In temporal or parietal impacts, the contrecoup lesions are usually on the contralateral surface ofthe brain. It is rare for a fall on the frontal region to produce occipital contrecoup. This is thought to be due to theanatomical configuration of the floor of the cranium.
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Ernest Rutherford is known as the father of nuclear physics. He discovered the concept of radioactive half-life, proved that radioactivity involved the transmutation of one chemical element to another, and also differentiated and named alpha and beta radiation. Henri Becquerel - discoverer of radioactivity. Marie Curie discovered Radium and Polonium, Coined the term "radioactivity".
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The incidence of ovarian cancer is reduced by 40% and uterine malignancy by 50% if taken for 1 year, and this effect lasts as long as 10 years after stoppage. The risk decreases with duration of its use. Reference : Shaw's Texbook of Gynaecology 16th edition page no 274
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"The most common cause of superficial thrombophlebitis is iatrogenic, especially with intravenous cannulations and infusions."
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Answer- C. AIONThe most common ocular manifestation of giant cell aeritis is visual loss, most commonly secondary to anterior ischemicoptic neuropathy (AION) due to occlusion of sho posterior ciliary aerities.Ophthalmic aery involvement can lead to sudden blindness which is the most feared complication of temporal aeritis.
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Isocitrate dehydrogenase & Malate dehydrogenase
According to older calculations, 3 ATPs (via NADH) are formed at : (i) Isocitrate dehydrogenase, (iii) a-ketoglutarate dehydrogenase, and (iii) Malate dehydrogenase.
However, according to recent studies only 2.5 ATPs are produced (via NADH) at all these steps.
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Ans: a (Edward Jenner) Ref:Ananthanarayan, ed, p. 457Early live vaccine such as Jenner's pox vaccine, were developed emperically from natural viruses.Sabin's name is related to oral polio vaccine.Salk's name is related to killed polio vaccine.This is a question based on historic importance.
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Ans A TalusRef: Snell s Clinical Anatomy, pg. 354Ref states: "Numerous important ligaments are attached to talus, but no muscles are attached to this bone"Extra MileSUPERFICIAL GROUP OF MUSCLES IN THE POSTERIOR COMPARTMENT OF LEG (SPINAL SEGMENTS IN BOLD ARE THE MAJOR SEGMENTS INNERVATING THE MUSCLE)MuscleOriginInsertionInnervationFunctionGastrocnemiusMedial head-posterior surface of distal femur just superior to medial condyle; lateral head-upper posterolateral surface of lateral femoral condyleVia calcaneal tendon, to posterior surface of calcaneusTibial nerve Plantar flexes the foot and the kneePlantarisInferior part of lateral supracondylar line of femur and oblique popliteal ligament of kneeVia calcaneal tendon, to posterior surface of calcaneusTibial nerve Plantar flexes the foot and the kneeSoleusSoleal line and medial border of tibia; posterior aspect of fibular head and adjacent surfaces of neck and proximal shaft; tendinous arch between tibial and fibular attachmentsVia calcaneal tendon, to posterior surface of calcaneusTibial nerve Plantar flexes the foot
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Category 1 Incomplete assessment, need additional imaging evaluation Category 2 Negative, routine mammogram in 1yr is recommended Category 3 Benign findings, routine management in 1 year is recommended Category 3 Probably benign findings, sho term follow up suggested Category 4 Suspicious abnormality, biopsy should be considered Category 5 Highly suggestive of malignancy, appropriate action should be taken Category 6 Known biopsy - proven malignancy
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Ans. Allergic
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Muscae volitantes: These are physiological opacities and represent the residues of primitive hyaloid vasculature. Patient perceives them as fine dots and filaments, which often drift in and out of the visual field, against a bright background (e.g., clear blue sky). Ref:comprehensive ophthalmology AK Khurana page no 245 REF IMG
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MAMMARY GLAND:- Modified sweat gland in superficial fascia of pectoral region. Rudimentary in males. Located in superficial fascia. Extend: veically- 2nd to 6th rib Horizontally- lateral border of sternum to mid axillary line. LYMPHATIC DRAINAGE:- Lymph nodes:- 1. Axillary-anterior, posterior, central and lateral. 2. Internal mammary. 3. Supraclavicular. 4. Posterior intercostal 5. Cephalic. Lymphatics draining the breast:- 1. Superficial- drain skin of the breast except that of nipple and areola. 2. Deep-drain parenchyma of the breast , and skin of nipple and areola. 3. A plexus of lymph ceasefires deep to areola is called subareolar plexus of sappy.The subareolar plexus and most of the lymph from the breast drains into anterior group of axillary lymph nodes. Lymphatic drainage:- 1. Lateral quadrant of breast-drains into anterior axillary/ pectoral group of lymph nodes. 2. Medial quadrant- drains into Internal mammary 3. Lower and medial quadrant- communicates with subdiaphragmatic and subperitoneal lymph plexus. 4. Deep surface of breast-apical group . 5. A few lymph vessels from the breast follow the posterior intercostal aeries and drain into posterior intercostal nodes. About 75% -axillary 20%-internal mammary 5%-posterior intercostal lymph nodes. Among the axillary lymph nodes, most of lymph goes into anterior axillary and remaining into posterior and apical. The lymph from anterior and posterior groups first goes into central and lateral groups and then through them into supraclavicular nodes.Apical group of lymph nodes are terminal. Some lymph vessels from the inferomedial quadrant of breast communicates with the subperitoneal lymph plexus and carry cancer cells to it. From here cancer cells migrate transcoelomically and deposit over ovary- krukenberg&;s tumor. {Reference:vishram singh page no.48}
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Ans. is 'd' i.e., Vagina, anus, and mouth * The law defines rape as sexual intercourse with a female without the consent of the female.* "Intercourse" must involve some penetration, but not necessarily ejaculation, and anal or oral penetration by the penis is also regarded as rape, as is forcible intercourse by a husband on his wife.
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Ans. is 'c' i.e., Tegmen tympani Roof (superior wall) of middle ear is formed by tegmen tympani.
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Ans. is 'b' i.e., The total bilirubin concentration in the serum increases by 1 mg/dl per day
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Ans. (d) Suitable For Patients With Stricture Bowel(Ref: Bailey and Love 26th edition Page 205)* Capsule Endoscopy is not suitable for patients with strictures.
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H.influenzae, H.haemolyticus, and H.aegyptius: requires both factor X and VH.parainfluenzae, H.parahaemolyticus, and H.paraphrophilus: Requires only factor VH.aphrophilus: Doesn't require both factors(Ref: Ananthanarayan 9th edition, p328)
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Ans. is b, i.e. CINRef: Novak 14th/ed, p490; CGDT 10th/ed, p577-578; Jeffcoate 7th/ed, p614Postmenopausal bleeding is defined as bleeding which occurs after 12 months amenorrhea in a middle aged women.Causes of Post-Menopausal Bleeding:* Exogenous estrogen (HRT)* Vaginitis - tubercular, Candida, chlamydia, senile* Endometrial hyperplasia* Cervical cancer* Uterine sarcoma* DUB - ovulatory/anovulatory ulcer/Foreign body* Bleeding from urethra, bladder, rectum which is mistaken for vaginal bleeding.* Endometritis - tubercular, senile pyometra & hematometra* Endometrial/cervical polyp* Endometrial cancer (correct option)* Ovarian cancer (correct option)* Fallopian tube carcinoma* Injuries - direct trauma / DecubitusAs far as Fallopian tube carcinoma is concerned. Most common age group = 50-60 years.Most common symptom: Watery discharge which tracks from the tube through the uterus and vagina (hydrops tubal profluens).It is typically colourless, profuse in amount and escapes continuously or in gushes. The discharge ultimately becomes blood stained from ulceration of growth and female presents as post menopausal bleeding, (correct option).Cervical cancer is a cause of postmenopausal bleeding, but cervical carcinoma in situ which is seen at 25-35 years of age and CIN which is seen in women in their 20's is not a cause of post menopausal bleeding.Remember:"CIN is most commonly detected in women in their 20's, peak incidence of carcinoma in situ is in women aged 25 - 35, while incidence of cervical cancer rises after the age of 40." - Ref: CGDT 10th/ed, p833
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increase secretion of renin causes sodium retention, potassium excretion, increase ECF volume, magnesium retention ( Harrison 17 pg 2251)
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Wegener's granulomatosis involves small vessels
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Weil felix reaction
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Juxtamedullary nephron one whose proximal convoluted tubule is close to the coicomedullary border and whose loop of Henle extends deep into the renal medulla. Ref: Ganong's review of medical physiology; 24th edition; page no; 674 Ref of img:
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Relations of stomachAnteriorly: The anterior abdominal wall, the left costal margin, the left pleura and lung, the diaphragm, and the left lobe of the liverPosteriorly: The lesser sac, the diaphragm, the spleen, the left suprarenal gland, the upper pa of the left kidney, the splenic aery, the pancreas, the transverse mesocolon, and the transverse colon.Hepatic flexure of colon is related to the colic impression on the inferior surface of the right lobe of the liver
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Collagen cross-linking: Cross linking occurs when a protein linked to other protein,lipid or sugar which is necessary for normal collagen function. Abnormal cross linking causes wrinkles/ages skin which is due to glucose mediated advance glycation end products(AGE),UV mediated free radical damage. Collagenase: Defect in collagen leads to increased level of collagen Collagenase inhibitor are given to treat wrinkles Desmosine: Desmosine is formed by 3allsyl side chains and one unaltered lysyl side chain of elastin. Fibrillin: It is a glycoprotein secreted by fibroblasts. It forms a framework of elastin deposition Defect in fibrillin-1 results in Marfans syndrome Reference: Harpers illustrated biochemistry 30th edition
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Ans. is 'a' i.e Rt. Leg and perineum Paracentral lobule:On the medial surface of cerebral hemisphere, the U shaped gyrus around the end of the central sulcus is the paracentral lobule.Motor cortex is located in the precentral gyrus on the superolateral surface of the hemisphere and in the anterior part of the paracentral lobule.Stimulation in this area results in movements in the opposite half of the body.The body is represented upside down in this area.A look at the motor homunculus in Ganong will show that the leg and perineum are represented in the paracentral lobule.
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Ans. is 'd' i.e., Urea Renal handling of various plasma constrituents in a normal adult human on an average diet. Per 24 Hours SubstanceFitteredReabsorbedSecretedExcretedPercentage ReabsorbedNa+ (mEq)26,00025,850 15099.4K+(mEq)600560a5029093.3C1- (mEq)18,00017,850 15099.2HCO3-mEq)4,9004,900 0100Urea (mmol)870460 b 41053Creatinine (mmol)121clc12 Uric acid (mmol)50494598Glucose (mmol)800800 0100Total solute (mOsm)54,00053,40010070098.9Water (mL)180,000179,000 100099.4 SubstancePercentage ReabsorbedNa+(mEq)99.4K+(mEq)93.3CT (mEq)992HC03-(mEq)100Urea (mmol)53Uric acid (mmol)98Glucose ( mmol)100Total solute (mOsm)98.9Water (mL)99.4
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B i.e. Conus medullaris syndrome
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The basilar membraneis widest (0.42-0.65 mm) and least stiff at the apex of the cochlea, and narrowest (0.08-0.16 mm) and stiffest at the base (near the round and oval windows). High-frequency soundslocalize near the base of the cochlea, while low-frequency sounds localize near the apex. Ref otolaryngology dhingra 3/e p34
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Golden rice:
Variety of rice produced through genetic engineering to boisynthesize beta carotene, a precursor of vitamin A.
The distinct golden colour is due to the beta carotene content.
It is indented to produce a fortified food to be grown and consumed in areas with a shortage of dietary vitamin A.
Golden rice differs from its parenteral strain by the addition of three beta carotene biosynthesis gene.
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Ans. B: TyphoidIn typhoid fever there is at first a general swelling of the Peyer's patch; it is an inflammatory swelling accompanied by abundant infiltration of leucocytes which occupy both the closed follicles and the mucous membrane. As the time goes on the whole tissue gets more and more infiltrated with leucocytes, and the raised patch gets more solid and its surface more homogeneous.On this condition follows Necrosis. The infiltrated and altered patch or solitary follicles forms a slough, of larger or smaller size.Mucosal shedding creates oval ulcers, oriented along the long axis of the ileum, that may perforate. Serpentine, elongated ulcers, oriented along the long axis of bowel is seen in Crohn's disease.
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Even if you don't know about all the options and you just know about P body you can answer this question. The P body is a cytoplasmic organelle involved in mRNA metabolism. Here is where miRNA-mRNA complexes are temporarily stored. They can either undergo degradation or mRNA can be released back for translation. Nucleolus is the pa of nucleus and is the site of rRNA formation. Cajal bodies are regions within the nucleus that are enriched in proteins and RNAs involved in mRNA processing. They are the main sites for the assembly of small nuclear ribonucleoproteins (snRNPs). Nuclear speckles, also known as interchromatin granule clusters, are nuclear domains enriched in pre-mRNA splicing factors.
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Ans. Retinopathy of prematurity
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Ans. is 'a' i.e., Cognisible and bailable Stalking Unwanted or obsessive attention by a person or group towads other person. In 2013, Indian Parliament made amendments to the IPC, introducing stalking as a criminal offence. Stalking has been defined as a man following or contacting a woman, despite clear indication of disinterest by woman, or monitoring her use of Internet or electronic communication. First conviction - Bailable and Cognizable offence and has punishment in the form of imprisonment upto 3 years with fine. Second Conviction - Bailable and Non Cognizable offence and has punishment in the form of imprisonment upto 5 years with fine.
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A i.e. Maternal inheritance; B i.e. Mitochondrial disease is associated mostly with Mutation & some have deletion; C i.e. Not highly conserved & has high mutation rate;
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Ans. is 'b' i.e. Survival The Kaplan-Meier estimator (also known as the product limit estimator) estimates the survival function from lifetime data. In medical research, it is used to measure the fraction of patients living for a certain amount of time after treatment.
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Mode is the most frequently occurring value in the distribution.
However sometimes, there are two (instead of one) most frequently occurring values in the distribution. This is known as bimodal distribution.
For bimodal distribution:-
Mode = 3 median – 2 mean
In the question median is 3 and mean is 2. Thus, Mode = 3 (3) – 2 (2) = 5.
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Class 1 - Mild ankyloglossia - 12-15 mm
Class 2 - Moderate ankyloglossia - 8-11 mm
Class 3 - Severe ankyloglossia - 4-7 mm
Class 4 - Complete ankyloglossia - 0-3 mm.
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Ans. (a) HypogastrinemiaRef: Sabiston 20th edition, Page 1291* This is a case of Short Bowel syndrome:# Malabsorption# Steatorrhea# Vitamin B12 deficiency (Terminal ileal resection)# Vitamin A, D, E, K deficiency (Due to steatorrhea fat soluble vitamins lost)# Gall stones (Cholesterol type)# Renal stones (Calcium oxalate)# Hypergastrinemia (Due to loss of feedback inhibition)
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Maximum concentration delivered by ventimask (venturimask) is 60%.
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vaccine available for mumps is an highly efectuve live attenuated vaccine.the major strains include,jeryl lynn,leningrad3,L-zagrib etc.as with most other live attenuated viral vaccine it should not be adminitered during pregnancy due to immunocompromiseref;parks textbook,ed22,pg144
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- Given features suggests the diagnosis of Macroangiopathic hemolytic anemia Macroangiopathic hemolytic anemia most commonly results from direct erythrocyte trauma due to abnormal vascular surface (e.g., prosthetic hea valve, synthetic vascular graft). Anemia is mild to moderate & is accompanied by an appropriate reticulocyte response. Blood smear examination reveals fragmented red blood cells (schistocytes) and polychromasia. Although microangiopathic hemolytic anemia results in morphologically-similar red blood cells, it reflects changes in small blood vessels.
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Klinefelter syndrome is seen in 1:500 males. The patient with this rare disorder externally resembles a male in general body conformity, the penis is small or normal in size, the testes are small, but as a rule are normally placed. Sterility is common, gynaecomastia is frequently present the voice may be high pitched, and the appearance may be eunuchoid. The patient is often mentally defective or delinquent. Most of these individuals are sex chromatin positive like females because of the extra X chromosome. Genetic analysis reveals their karyotype to be 47 XXY. Testicular biopsy usually reveals hyaline degeneration of the seminiferous tubules and overgrowth of Leydig cells as a result of which sterility is so often the presenting symptom. Sole-to-pubic length is more than normal. The person should be bred as male and should not be told about chromosomal abnormality. Testosterone may help. The breasts may need surgical excision. Shaw's Textbook of Gynaecology 16th edition page no 147
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Ans. is 'a' i.e., Raised intraocular pressure The most common risk factor known is increased intraocular pressure (lOP)o Glaucoma is a group of eye diseases causing optic nerve damage i.e., glaucoma is a chronic, progressive optic neuropathy caused by a group of ocular conditions which lead to damage of optic nerveo Optic neuropathy in glaucoma results in a characteristic appearance of optic disc and a specific pattern of irreversible visual field defects, called glaucomatous changes. It is worth noting that raised IOP without optic neuropathy is not referred to as glaucoma, it is simply called ocular hypertension.So, glaucoma is a type of optic neuropathy, which is usually caused by increased IOP.
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Sphenopetrosal synchondrosis is cailagenous union b/w lateral half margin of great wing of sphenoid & petrous bone. On the under surface of sphenopetrosal synchondrosis, is a furrow, the sulcus of auditory tube for lodgement of cailagenous pa of auditory tubeQ
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Ans. is 'B' i.e., HOCM Congestive hea failureCardiac arrhythmiaso Atrial fibrillation
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Uterine aeries arise from internal iliac aery or hypogastric aery. It runs downwards and forwards along the lateral pelvic wall until the base of the broad ligament. Ref: Gray&;s anatomy text book of anatomy
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Ans. is c i.e. First trimester aboion
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Ans. is 'c' i.e.. Ribosomes o Although both ribosomes & RER are involved tn synthesis of protein, the cellular component on which all intractions take place to synthesize the protein is ribosome.Proteins synthesized by polyribosomesCytosolic (free) PolyribosomesBound (rough ER) Polyribosomeso Cytosolic proteins, e.g., Hemoglobino Cytoskeletal proteinso Mitochondrial proteinso Nuclear proteinso Peroxisomal proteinso Synthesize all membrane proteinsy Mitochondrial membraney ER membraney Golgi apparatus membraney Plasma membraneo Secretory proteinso Lysosomal enzymes
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PSA velocity Several refinements have been proposed to increase the sensitivity of the serum PSA for younger men more likely to die of prostate-cancer, while reducing the frequency of diagnosing cancers of low biologic potential in elderly men more likely to die of other causes. These modifications include age-specific reference ranges, using a lower "upper" limit of normal for younger males and higher "upper" limit for older individuals. Prostate specific antigen density (PSAD) is calculated by dividing the serum PSA level by the estimated prostate weight calculated from transrectal ultrasonography (TRUS). It was proposed to correct for the influence of benign prostatic hyperplasia (BPH) on the measured level of PSA. Values <0.10 are consistent with BPH, while values >0.15 suggest the presence of cancer. PSAD levels also increase with age. PSA velocity is derived from calculations of the rate of change in PSA before the diagnosis of cancer was established. Increases of>0.75 ng/mL per year are suggestive of cancer. For a 50-year-old male, an increase from 2.5 to 3.9 ng/mL in a I-year period would warrant fuher testing, even though the level is still in the "normal" range. Free and complexed PSA measurements are used to determine which men require a biopsy when the PSA level is in the range of 4 to 10 ng/mL. In cancer, the level of free PSA is lower. Using a 25% threshold of free PSA for patients with levels in the range of 4 to 10 ng/mL, specificity was improved by 20% while maintaining a sensitivity of95%. Fuher refinements to increase the specificity of distinguishing benign and malignant conditions involve the determination of the ratios of free to total, complexed to total, and free to complexed PSA. Using normal ranges for free/total PSA of>O .15, for complexed total PSA of <0.70, and for free/complexed PSA of>0.25 improved specificity in one study by 20%. These modifications are designed to reduce the frequency of biopsies in men without cancer.
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Ans. is 'c' i.e., Immunoglobulin transfer (Ref: Ananthanarayan, 9th/e, p. 82 - 83 and 8th/e, p. 86, 87)* Immunoglobulin transfer gives passive immunity.* Rest of the other options are examples of active immunity.
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Typhoid Labarotary Diagnosis : 'BASU' Mneumonic Test of diagnosis Time of diagnosis Remarks Blood culture 1st Week Mainstay of diagnosis Antibodies (Widal test) 2nd Week Moderate, sens, spec Stool culture 3rd Week Urine test 4th Week Newer tests IDL Tubex test Detects IgM antibodies TYPHI DOT Detects IgM and IgG Ab TYPHI DOT-M Detection IgM antibodies DIPSTICK TEST Detects IgM antibodies Isolation of Vi Ag Detects carriers In chronic cases of Typhoid, organisms persist in : Gall Bladder and Biliary Tract Typhoid Mary, who gave rise to 1300 cases, was a chronic carrier VI antibodies are in 80% Most successful approach to treatment : Cholecystectomy + Ampicillins therapy Immunization doesn't give 100% protection Ref: Park 25th edition Pgno : 251-252
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Fixation is concept introduced by Sigmund Freud, he explains this in his each stage of Psychosexual stages of development. Ref: Synopsis of Psychiatry, 11e, pg 157.
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Epidermolysis Bullosa simplex : defect in K5 and K14
Epidermolysis Bullosa Junctionalis : defect in Laminin
Epidermolysis Bullosa Dystrophica : defect in collagen 7
Epidermolysis Bullosa Acquisita : absence of collagen 7
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A i.e. GlucokinaseIn glycolysis insulin acts on hexokinase IV (i.e. glucokinase) and hexokinase IIQ but not on other (I & III) hexokinase
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The thymus, derived from the third pair of pharyngeal pouches and inconsistently from the fouh pair, is divided into an outer coex and an inner medulla and is composed of lymphocytes and epithelial cells. The lymphocytes are mainly T cells, which are immature (thymocytes) in the coex and are mature in the medulla, where they have phenotypic characteristics of peripheral blood T lymphocytes. The epithelial cells are mainly located in the medulla, forming Hassall's corpuscles. The thymus normally has a few neuroendocrine cells, which may give rise to carcinoid tumors or small cell carcinoma, and a few myoid cells, which are similar to striated muscle cells and may play a role in the autoimmune pathogenesis of myasthenia gravis. The appearance of lymphoid follicles with germinal centers is diagnostic of thymic hyperplasia Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
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c. Chromosome 13(Ref: Nelson's 20/e p 2476-2478, Ghai 8/e 614-615)Retinoblastoma (RB) geneIt is located on chr 13q14; its mutation or deletion is responsible for hereditary form of RetinoblastomaIt encodes the retinoblastoma protein, a tumor suppressor protein that controls cell-cycle phase transition and has roles in apoptosis and cell differentiation
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Antiplatelet drugs like asprin and clopidogrel prolong the bleeding time Anticoagulant drugs prolong the clotting time Drugs interfering with extrinsic pathway like Warfare in prolonged the PT Drugs interfering with intrinsic pathway like heparin prolong the aPTT. Thrombin time is prolonged in cases of afibrinoginemia and dysfibrinogenemia. Refer kDT 6/e p609
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Ans. (a) Factor H(Ref: Robbins 9th/pg 162-164)The alternative pathway, can be triggered by microbial surface molecules (e.g., endotoxin, or LPS), complex polysaccharides, cobra venom, and other substances, in the absence of antibodyFactor I and H inhits complement activation
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D i.e. None
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Pneumonic plague is spread by droplet infection. The bacilli spread through the lungs producing hemmorhagic pneumonia. Cyanosis is very prominent. The bloody mucoid sputum that is coughed out contains bacilli in numerous numbers. Pneumonic plague is highly infectious and in untreated patients almost invariably fatal. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 328
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Ans. is 'b' i.e., Pilocarpine Treatment of angle closure glaucomao Definitive treatment (treatment of choice) is surgery. However, intially drugs are used to decrease IOP during an acute attack. Approach of treatment is as follows:-Start i.v. mannitol or i.v. acetazolamideWhen IOT starts falling, start topical pilocarpine or (3-blocker (timolol).Apraclonidine/latanoprost may be added.Once IOT is reduced, surgery is done.o Topical pilocarpine 2% is the preferred antiglaucomatous drugo After control of IOP, Laser (Nd : YAG) peripheral irodotomy is the definitive management of choice. If laser is not available surgical peripheral iridectomy is the procedure of choice. Other surgical procedures used are Alteration surgeries (like trabeculectomy, deep sclerotomy, Viscoanulostomy).o Symptomatic treatment during an attack also includes analgesics, antiemetic and topical corticosteroids to reduce inflammation. Mydriatics (e.g. atropine) are contraindicated as they precipitate glaucomao PACG is a bilateral disease, the fellow eye is at risk of developing an acute attack in 50% cases in future. Therefore a prophylactic peripheral laser iridotomy should be performed in the fellow eye.
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According to casper's dictum, a body decomposes in air twice as rapidly as in water and 8 times as rapidly as on earth.
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Ans. is a i.e. Cystocoele Genital prolapse : refers to protusion of the pelvic organ into or out of the vaginal wall. Classification of prolapse Anterior vaginal wall : upper two thirds - cystocoele Cytourethrocoele lower one third - urethrocoele Posterior vaginal wall : upper one third - enterocoele (pouch of Douglas Hernia) Grade I = Descent halfway to the hymen Grade II = Descent to the hymen Grade IIt = Descent halfway past the hymen Grade IV = Maximum possible descent for site Bader walker Halfway system : 11, Grade 0 = Normal postion for each reproesentative site Uterine descent : Shaw's classification (old classification) : 1deg- descent of the cervix to the vagina 2deg - descent of the cervix to the introitus 3deg - descent of the cervix outside the introitus. Procidentia : all of the uterus outside the introitus. Utero vaginal Prolapse : It is the commonest type of prolapse. Cystocoele occurs first followed by traction on the cervix causing retroversion of the uterus and then uterus is pushed into the vagina. Vault prolapse : it follows vaginal or abdominal hysterectomy, symptoms are-coital difficulty and difficulty in walking. Congenital Prolapse : There is no cystocoele. "Data from Women's Health Initiative revealed anterior pelvic organ prolapse in 34.3%, posterior wall prolapse in 18.6% and uterine prolapse in 14.3% of women in the study." Therefore, from the above data it is clear that cystocele (anterior organ prolapse) is the most common type of prolapse. Friends, according to latest trends, prolapse is not classified as above, but compamental classification is done. (It might be asked in fohcoming PGME exams). Newer classification Prolapse Uterine Prolapse Vaginal prolapse 10 descent of the uterus but the cervix remains within the introitus. 2o degree Descent to the extent that the cervix projects through the vulva, when the woman is straining or standing 3o degree i.e. complete Procidentia. Anterior compamentdefectLeads to cystocoeleUrethrocele of vagina Middle compamentdefectLeads to Enterocele& massive eversion Posterior compamentdefectRectocoele and Perinealbody descent Note:Sometimes the term apical prolapse is used - It includes : Uterine prolapse Vaginal vault prolapse (post hysterectomy) Enterocele
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The cause of physiological edema is due to increased venous pressure of the inferior extremities by the gravid uterus pressing on the common iliac veins Edema disappears on rest with foot end elevation Salt restriction, diuretics and fluid restriction have no role in management of physiological edema Diuretics and fluid restriction may be offered to patients having edema secondary to hea disease to reduce preload.
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Clinical features of neonatal septicemia
The most common and characteristic manifestations is an alteration in the established feeding behaviour baby refuses to suck and becomes lethargic, inactive or unresponsive.
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Hypoglycemic attacks are part of Whipple's triad
Insulinoma is usually solitary (~90%)
Only 5 to 15% are malignant
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Once a malignancy is established, investigations are required to stage the disease and to know operability.USG has limited role in staging. CT is used for staging. Preoperative laparoscopy is done as small peritoneal metastasis might be missed in CT. Ca 19-9 is useful in pancreatic cancer, its more useful as a prognostic indicator than for diagnosis.Bailey and love 27e pg 1136
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Granulomatous inflammation It is a distinctive pattern of chronic inflammatory reaction characterized by focal accumulations of activated macrophages, which often develop an epithelial-like (epithelioid) appearance. Tuberculosis is the prototype of the granulomatous diseases, Other granulomatous diseases:- Sarcoidosis Crohn's disease Cat-scratch disease Lymphogranuloma inguinale Leprosy Brucellosis Syphilis Yersinia has also been mentioned to be associated with granulomatous inflammation. So, the answer to exclusion is Mycoplasma.
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Juvenile chronic myeloid leukemia is characterised by elevated fetal hemoglobin levels and low or normal leukocyte alkaline phosphatase score.Thrombocytopenia and anemia are common.Peripheral smear shows leukocytosis with the full spectrum of granulocytic precursors and increased normoblasts.Bone marrow aspirate shows an increased cellularity with predominance of granulocytic cells in all stages of maturation;megakaryocytes are normal or decreased.Philadelphia chromosome is negative,and monosomy 7 is found in 30% patients. Reference:Essential pediatrics-Ghai,8th edition,page no:608.
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C i.e. Supra condylar fracture of humerus The elbow is the second only to distal forearm for frequency of fractures in childrenQ. Most of these injuries are supra condylar fractureQ, the remainder being divided between condylar, epicondylar and proximal radial and ulnar fractures. So this question is based on this concept only. Now lets quickly go through the mechanisms of different fractures.
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TONSILLECTOMY CONTRAINDICATIONS :- 1. Haemoglobin level less than 10g%. 2. Presence of acute infection in upper respiratory tract, even acute tonsillitis. Bleeding is more in the presence of acute infection. 3. Children under 3 years of age. They are poor surgical risks. 4. Ove or submucous cleft palate. 5. Bleeding disorders, e.g. leukaemia, purpura, aplastic anaemia or haemophilia. 6. At the time of epidemic of polio. 7. Uncontrolled systemic disease, e.g. diabetes, cardiac disease, hypeension or asthma. 8. Tonsillectomy is avoided during the period of menses. Ref:- Dhingra; pg num:-428
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10th rib do not aiculate with sternum anteriorly (false rib). The first seven 'true' ribs connect to the sternum by costal cailages, whilst the remaining lower five 'false' ribs either join the suprajacent (upper) costal cailage (8-10) or 'float' free at their anterior ends as relatively small and delicate structures tipped with cailage. Fig. : Rib cage
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Epithelial basement membrane dystrophy is the most common anterior corneal dystrophy.
Lattice dystrophy is the most common stromal corneal dystrophy (Lattice Type I is the commonest
Macular dystrophy is the least common stromal dystrophy.
Fuch's endothelial dystrophy is the most common Posterior (endothelial) corneal dystrophy.
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(D) Leukaemia# Occupational exposure to coal tar or coal-tar pitch is associated with an increased risk of skin cancer.> Other types of cancer, including lung, bladder, kidney, and digestive tract cancer, have also been linked to occupational exposure to coal tar and coal-tar pitch.
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To hold a typing paper, the index finger is adducted by the palmar interosseous muscle, and the middle finger is abducted by the dorsal interosseous muscle. Both muscles are innervated by the ulnar nerve. Card test: Patient is asked to hold a card b/w two extended fingers while examiner tries to pull it. Power of palmar interossei (adductors) supplied by ulnar nerve can be judged.
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Ref: Nelson's Textbook of Pediatrics, 18th edition. Page 1749: Dhingra's Disease of ENT, Page 203 Explanation: Both the ethmoidal and maxillary sinuses are present at birth, but only the ethmoidal sinuses are pneumatized. The maxillary sinuses are not pneumatized until 4 years of age. The sphenoidal sinuses are present by 5 years of age, whereas the frontal sinuses begin development at age 7-8 years and are not completely developed until adolescence. DEVELOPMENT OF PARANASAL SINUSES Outpouchings from mucous membrane of lateral wall of nose. At birth, only maxillary and ethmoidal sinuses are present. Earliest sinus to appear radiological!} is Maxillary sinus - At 4 - 5 months. (See table in the next coloum) Sinus Status at birth Growth First radiological evidence Maxillary Present as birth * Rapid growth from birth to 3 years and from 7-12 years * Adult size-15 years 4-5 months after birth Ethmoid Present at birth Anterior group: 5 x2x2mm Posterior- group: 5x4x2 mm * Adult size by 12 years 1 year Frontal Not present * invades frontal bone at the age of 4 years. Size increases till teens 6 years Sphenoid Not present * Reaches sella tumea by the age of 7 years * Reaches dorsum seilae by late teens and basisphenoid by adult age * Reaches full size between 15-adult age 4 years
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Ans. is 'b' i.e., >2 o First you should know what does mass prophylaxis mean in malaria.o In areas with high malaria prevalence, presumptive treatment is given to all people. This is know as mass treatment,o Presumptive treatment is given when API is >2.o Under The modified plan of operation, the endemic areas were reclassified according to annual parasite incidence (API) with different strategy for control measures.o The report of the consultative committee of experts indicated that in order to stabilize the malaria situation in the country', areas with API 2 and above should be taken up for regular spray operations.Areas with API < 2Areas with API >2Focal spraying is undertaken (Not regular spraying)Regular insecticidal sprayingTwo Rounds of DDT (if sensitive to DDT)Three Rounds of HCH (if refractory to DDT)Three rounds of Malathion (if refractory to HCH & DDT)Active and passive surveillance to be carried out every fortnightActive and passive surveillance is carried out every fortnightAll detected cases should receive radical treatmentAlt detected cases should receive radical treatment. Presumptive treatment is also considered.Epidemiglojgical .i instigationAll malaria positive cases are to be investigated.# Mass surveys -# Follow up blood smears to be collected from all positive cases on completion of radical treatment and thereafter at monthly intervals for 12 monthsEntomological assessmentThis is done by entomological teams.# They carry' out susceptibility tests and suggest appropriate insecticides to be used in particular areaso The technical advisory committee on Malaria (2002 ) has prioritized the criteria for undertaking indoor residual spray (IRS). These criteria are as follows.To spray priority basis with suitable insecticide all areas with > 5 API where ABER is 10% or more, taking subcentre as a unit.To spray on priority' basis with suitable insecticide all areas reporting > 5% SPR, if the ABER < 10%.Due priority' be accorded for spray if Pf proportion is > 50%.To accord priority for IRS in areas with API < 5/SPR < 5% in case of drug resistant foci, project areas with population migration & aggregation or other vulnerable areas.To make provision for insecticidal spraying in epidemic situations.Other parameters (entomological, ecological etc) may also be considered while prioritizing areas for sparying.o The population living in areas with API > 5 is planned to be covered by Long lasting insecticidal nets (LLINs) and in endemic areas registering API 2 to 5 is covered with conventional net treated with insecticides (Isecticide treated bed nets-ITNs) and IRS.
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2 roots of the lesser wing of the sphenoid contains optic foramen. Optic canal is the continutaion from optic foramania Optic foramen transmits Optic nerve with all layer of meninges Ophthalmic aery
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Pasteurization doesn't kill thermoduric bacteria nor the bacterial spores. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 606
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Ans. b (Bandl's ring). (Ref. Williams, Obstetris 21st/pg.836, Dutta, Obstetrics 4th/pg.367)BANDL'S (PATHOLOGICAL RETRACTION) RING# A circular groove encircling the uterus, formed between active upper segment and distended lower segment.SCHROEDER'S (CONSTRICTION) RING# Situated at the junction of upper and lower segment.# Usually reversible and complete.# May appear in all stages of labour.# Ring is not felt per abdomen, round ligament also not felt.
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Introns enable alternative splicing, which enables a single gene to encode multiple proteins that perform different functions under different conditions. For example, a signal the cell receives could cause an exon that is normally included to be skipped, or an intron that is normally spliced out to be left this would not be possible, would not be possible, or at least would be much more difficult, without the presence of introns.
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The polycystic ovarian disease is a heterogeneous, multisystem endocrinopathy in women of reproductive age.Endocrinological changes are as follows:1. Oestrone/E2 level rises.2. LH level is raised over 10 IU/mL. FSH level remains normal, but FSH/LH ratio falls.3. SHBG level falls due to hyperandrogenism.4. Testosterone and epi-androstenedione levels rise.5. Fasting blood glucose/fasting insulin, 4.5 suggests insulin resistance.6. Triglyceride level >150 mg/dL-hyperlipidaemia HDL < 50 mg/dL. Testosterone > 2 ng/mL, free T > 2.2 pg/mL (Normal level 0.2-0.8 ng/mL). Normal androstenedione level is 1.3-1.5 ng/mL. DHEA > 700 ng/mL suggests an adrenal tumor.7. Prolactin is mildly raised in 15% cases.8. Fasting insulin is more than 10 mIU/L in PCOS in 50-70/cases.9. Thyroid function tests may be abnormal (hypothyroidism).10. 17-a-hydroxyprogesterone in the follicular phase > 300 ng/dL suggests adrenal hyperplasia due to 21-hydroxylase deficiency.11. Urinary coisol < 50 mg/24 h.Ref: Shaw&;s textbook of gynecology; 16th edition; Page no: 432
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Orchidopexy is usually performed after the age of 1 year to avoid the risks of operating on a tiny patient. Testes should be brought down into the scrotum before the boy stas school.Orchidopexy during the second year of life is currently recommended by paediatric surgeons. Orchidopexy before 2 years of age improves feility, may reduce the risk of malignancy and has psychological benefits. Reference : page1378 and 77 Bailey and Love's sho practice of surgery 25th edition
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Answer is A (Midline granuloma): Midline granuloma has no association with Sjogren Syndrome (Sicca Syndrome) As a result of its tendency to cause 'dryness' Sjogren's syndrome is often referred to as `Sicca' syndrome. Being an autoimmune disorder this disorder is associated with a number of other disorders of autoimmune origin. Rheumatoid ahritis, chronic active hepatitis and scleroderma are known autoimmune disorders that are often associated with Sjogren Syndrome. These include: Autoimmune disorders associated with Sjogren's syndrome: -Rheumatoid ahritis (most common)Q - Chronic active hepatitis - SLE Q -Polymyositis - SclerodermaQ -Hashimoto's thyToditis Mixed connective tissue disease Q -Interstitial pulmonary fibrosis. Primary biliary cirrhosis Q - Sarcoidosis. - Vasculitis What puzzles the question? Sjogren is syndrome occurs as two types. Primary form (Sicca syndrome)- when it occurs as an isolated disorder. Secondary form - when it occurs in association with other autoimmune disease. In the true sense it is not Sicca syndrome but the secondary form with which autoimmune disorders are associated. Neveheless Midline granuloma remains the single best answer of exclusion.
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Treatment of Pleomorphic adenoma (or any benign lession of Salivary gland)
in Parotid → Superficial protidectomy
in other salivary glands → Excision of the affected gland.
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Ans. is All Options 'a' o Head circumference is measured from the occipital protuberance to the supraorbital ridge on the forehead. Option `b' o If the head circumference growth exceeds 1 cm in 2 weeks during the first 3 months, hydrocephalus should be suspected. o In microcephally head circumference is two standard detion below the mean for age and sex. Option `c o Head circumference measurements that progressively drop to lower percentiles with increasing age are indicative of a process or condition that has impaired the brain's capacity to grow. o So, serial measurement helps to assess neurological development and pediatric intelligence.
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PSORIASIS Lesions are characterized by infiltration of skin with activated T cells, which have a role in the pathophysiology of psoriasis (cytokines stimulate keratinocyte hyperproliferation). Earlier it was considered that Th1 cells(CD8+) plays most imp. role in pathogenesis, but now Th17 is considered most imp. in pathogenesis, induced by IL-23. Is linked to HLA-Cw6 and, to a lesser extent, to HLA-DR7. Psoriatic ahritis is associated with HLA- B27
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Pseudocyesis or phantom pregnancy is usually seen in patients nearing menopause or in young women who intensely desire children. Most of them suffer from some forms of psychic or hormonal disorder. The abdomen may distend due to deposition of fat. The pregnancy may progress to full term and the labour pain may stop abruptly when informed that she is not pregnant. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 333
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Ans. is 'd' i.e., Straight sinuso Great cerebral vein of Galen is formed by the union of two internal cerebral veins.o It is 2 cm long.o It is drains into the straight sinus.o Its tributaries arei) Internal cerebral veinsii Basal veinsiii) Occipital veinsiv) Posterior callosal vein
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Ans. (c) +1.50Ref: Khurana optics 2/e, p. 101, Elkington optics 4/e, p. 237Rough estimate for presbyopic add45 years: +1.00 to +1.25 D50 years: +1.50 to +1.75 D55 years: +2.00 to +2.25 DIn order to focus on an object at a reading distance of 25 cm, the emmetropic eye must accommodate by 4 D. However, for comfortable near vision one-third of the available accommodation must be kept in reserve. Therefore, the patient will begin to experience difficulty or discomfort for near vision at 25 cm when his accommodation has decayed to 6 D. This usually occurs between 40 and 45 years of age. A person experiencing such difficulty and discomfort for near vision due to reduced amplitude of accommodation is said to be presbyopic.
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Ans: c (D cell) Ref: Robbins, 7th ed, p. 1189Alpha cell-GlucagonsBeta cell-insulinD cell-somatostatinF cell-pancreatic polypeptideSomatostatinomaVIPomaMost common site - Head of pancreasOther names - Vemer Morrison syndrome. Water diarrhea syndrome, WDHA syndromeClinical features - Diabetes mellitus - Gall bladder diseasePancreatic cholera- DiarrhoeaMost common site - Tail of pancreas- SteatorrhoeaClinical features - Watery diarrhea - Hypokalaemia- Hypochlorhydria- Metabolic acidosis- Hypercalcaemia- hyperglycaemiaInsulinomaIt is an endocrine tumour of beta cells. Only 5-15% are malignant.Most common site of Insulinoma -distributed equally all over pancreasWhipple's triad1) Symptoms consistent with hypoglycaemia2) A low plasma glucose concentration3) Relief of symptoms after the plasma glucose level is raisedThese features are typically seen in insulinoma.
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Physiological jaundice which represents physiological immaturity of the neonate to handle increased bilirubin production, usually appears between 24-72 hrs.
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d. May cause a machinery murmur by its patency.(Ref: Nelson's 20/e p 497, Ghai 8/e p 413)Closure of ductus arteriosusPhysiological closure: occurs almost immediately after birth by contraction of muscular wall, mediated by bradykininAnatomic closure: occurs by proliferation of intima in 10-21 days; After obliteration, it forms ligamentum arteriosum. Note: Murmur due to PDA is classically referred to as a continuous machinery murmur.
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