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Ans. is 'D' i.e.,S. Pneumoniae Epiglottitso It is the inflammation of epiglottis with inflammatory edema of hyopharynx. It is a true medical emergencyo H.influenzae was the most common causative organism prior to vaccination. However, S. Pnemoniae is now considered as the most common cause of Acute Epiglottitis.o Other organisms are - Pneumococci, Streptococcus pyogenes, N.meningitidis, StaphylococcusClinical manifestationso Onset is sudden. Symptoms are - fever, dysphagia, drooling, muffled voice, inspiratory retractions, cyanosis and soft stridor. Patients often sit in sniffing dog position. Respiratory arrest may occur."The risk of sudden death for persons is high due to sudden airway obstruction'.Plain lateral soft tissue radiograph of necko Thickening of the epiglottis - the thumb signo Absence of a deep well defined vallecula - the vallecula signTreatment of epiglottitiso Once the diagnosis of epiglottitis is made, endotracheal intubation must be performed immediately. After an airway is established, cultures of the blood and epiglottis should be obtained and patient started on appropriateintravenous antibiotics to cover H. influenzae (Ceftriaxone or equivalent cephalosporins)."Third generation cephalosporins are preferred as first line agents because of increasing resistance to ampicil- lin. Ceftriaxone is the treatment of choice for epiglottitis".
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Ans. is 'c' i.e., Sticks
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The most common nosocomial infection is a urinary tract infection. Treatment consists of removal of an indwelling catheter as soon as possible and antibiotic therapy for cultures with greater than 100,000 CFU/mL. Pneumonias, wound infections, intra-abdominal abscesses, and catheter-related bloodstream infections are also all causes of nosocomial infections, and a workup of a postoperative fever should also include careful examination of the patient and other diagnostic tests as appropriate (chest x-ray, blood cultures, abdominal/pelvic CT scan).
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Anti-mullerain hormone levels are two-to-three fold higher in women with PCOD.
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Ans. is 'a' i.e., C3a Opsonin o A Substance capable of enhancing phagocytosis. o Complement (C3a) and antibodies are the two main opsonins.
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Black bag
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Ans) a (Endoscopy)Ref: Sabiston's textbook of surgery 18th editionUpper GI bleeding refers to bleeding that arises from the GI tract proximal to the ligament of Treitz and accounts for nearly 80% of significant GI hemorrhage. The causes of upper GI bleeding are best categorized as either nonvariceal or bleeding related to portal hypertension. The nonvariceal causes account for about 80% of such bleeding, with peptic ulcer disease being the most .common.The foundation of diagnosis and management of patients with an upper GI bleed is an OGD scopy. Early OGD scopy (within 24 hours) results in reductions in blood transfusion requirements, a decrease in the need for surgery, and a shorter length of hospital stay. Endoscopic identification of the source of bleeding also permits an estimate of the risk for subsequent or persistent hemorrhage as well as facilitating operative planning.
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. Increased reticulocyte count
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Ans. is'd'i.e., All of the aboveDroperidol is D2 antagonist which is used as : -Typical antipsychotic (neuroleptic)AntiemeticNeuroleptanalgesia (along with fentanyl)
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Ans. B. MRIMammography* It is an imaging technique exclusive for the breast.* Mainly uses characteristic spectrum radiation originating from a molybdenum anode.* It is generally done in females above 35 years of age.MRI* Most commonly used magnet in MRI: Superconducting magnets.* Stronger the magnet better the image resolution.* MRI has no radiation exposure as X-rays are not involved.Angiography* With the advent of cross-sectional modalities it is not used often.* It can be used in some cases where vascular flow and other dynamic components are to be evaluated.CTComputed tomography is basically a fusion of two technologies:* Tomography: X-ray based imaging technique developed to acquire sectional image of the body.* Computers: Brought in to deal with the complex mathematical algorithms and iterations in the image reconstruction.As X-rays are used in this technique, there may be a chance of radiation.
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DNA replication is semi conservative. Thus 2 DNA molecules have one strand with radioactivity and other 2 DNA molecules have no radioactivity.
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Insulin should be considered as the initial therapy in type 2 DM, paicularly in lean individuals or those with severe weight loss, in individuals with underlying renal or hepatic dis- ease that precludes oral glucose-lowering agents, or in individuals who are hospitalized or acutely ill. Insulin therapy is ultimately required by a substantial number of individuals with type 2 DM because of the progressive nature of the disorder and the relative insulin deficiency that develops in patients with long-standing diabetes. Reference : page 2415 Harrison&;s Principles of Internal Medicine 19th edition
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Ans. is 'a' i.e., Safflower oil
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Staphylococcal infections are usually caused by Staphylococcus aureus. However, the incidence of infections due to Staphylococcus epidermidis and other coagulase-negative staphylococci has also been steadily rising. Pharmacotherapy Patients with serious staphylococcal infections should be initially staed on agents active against MRSA until susceptibility results are available. Many coagulase-negative staphylococci are oxacillin-resistant. The duration of treatment and the use of synergistic combinations depend on the type of infection encountered. The following antibiotics may be used in the management of staphylococcal infections (listed alphabetically, not necessarily in order of preference): Cefazolin Ceftaroline Cefuroxime Clindamycin Dalbavancin Daptomycin Dicloxacillin Doxycycline Linezolid Minocycline Nafcillin Oritavancin Quinupristin/dalfopristin Tedizolid Telavancin Tigecycline Trimethoprim-sulfamethoxazole Vancomycin REFERENCE: www.medscape.com
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Humans are not the only reservoirs in non typhoid salmonella. Option 1 - Non-typhoidal salmonella can be acquired from multiple animal reservoirs. Option 2 - Transmission is most commonly associated with animal food products especially eggs, poultry, undercooked meat and dairy products. Option 3 - These infections are quite common in immunocompromised individuals. Option 4 - Increased use of ceftriaxone (cephalosporins) and ciprofloxacin (1st generation fluoroquinolone) to treat MDR (multi drug resistant) strains leads to resistance against it.
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Mycophenolate mofetil and methotrexate should be avoided in pregnancy. Antimalarials help control skin disease. Although these agents cross the placenta, hydroxychloroquine has not been associated with congenital malformations. Severe disease is managed with coicosteroids such as prednisone. Immunosuppressive agents such as azathioprine are beneficial in controlling active disease. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 54. Connective-Tissue Disorders. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
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Genital wa treatments that can be applied directly to your skin include: Imiquimod (Aldara, Zyclara). This cream appears to boost the immune system's ability to fight genital was. Avoid sexual contact while the cream is on your skin. It may weaken condoms and diaphragms and may irritate. One possible side effect is redness of the skin. Other side effects may include blisters, body aches or pain, cough, rashes, and fatigue. Podophyllin and podofilox (Condylox). Podophyllin is a plant-based resin that destroys genital wa tissue. Podofilox contains the same active compound but can be safely applied. Trichloroacetic acid (TCA). This chemical treatment burns off genital was. TCA must always be applied by a doctor. Side effects can include mild skin irritation, sores or pain. REF KD Tripathi 8th ed
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Classification of aminoacids based on side chain and charges. Acidic amino acids (with negative charge) Basic amino acids (with positive charge) Neutal aminoacids (having non-polar side chains )(hydrophobic) Neutral amino acids (having polar side chains )(hydropilic) Tyrosine Lysine Alanine Aspaic acid Arginine Valine Serine Glutamic acid Histidine Leucine Threonine Isoleucine Cysteine Methionine Glutamine Phenylalanine Asparagine Tryptophan Proline REFERENCE: DM VASUDEVAN TEXTBOOK EIGHTH EDITION ;Page no:27 t
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A i.e. Continuous flow machine
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Doxycycline
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Half-life of carbimazole is around 8 hours whereas propylthiouracil has t1/2 of 2 hours.
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Fetal Rh D genotype assessment from maternal blood offers several potential benefits. Administration of anti-D immune globulin to an Rh D-negative pregnant woman carrying an Rh D-negative fetus can be eliminated.In the setting of Rh D alloimmunization, early identification of an Rh D-negative fetus can avoid unnecessary amniocentesis and/or serial fetal middle cerebral aery Doppler assessment. Rh D genotype evaluation using cell-free fetal DNA is done using real-time PCR to target multiple exons of the RHD gene(Ref: William's Obstetrics; 25th edition)
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Feedback Effect of Thyroid Hormone to Decrease Anterior Pituitary Secretion of TSH Increased thyroid hormone in the body fluids decreases secretion of TSH by the anterior pituitary. When the rate of thyroid hormone secretion rises to about 1.75 times normal, the rate of TSH secretion falls essentially to zero. Almost all this feedback depressant effect occurs even when the anterior pituitary has been separated from the hypothalamus. Therefore, as shown in Figure 76-7, it is probable that increased thyroid hormone inhibits ante- rior pituitary secretion of TSH mainly by a direct effect on the anterior pituitary gland itself. Regardless of the mech- anism of the feedback, its effect is to maintain an almost constant concentration of free thyroid hormones in the circulating body fluids. Antithyroid Substances Suppress Thyroid Secretion The best known antithyroid drugs are thiocyanate, propyl- thiouracil, and high concentrations of inorganic iodides. The mechanism by which each of these drugs blocks thyroid secretion is different from the others, and can be explained as follows. Thiocyanate Ions Decrease Iodide Trapping. The same active pump that transpos iodide ions into the thyroid cells can also pump thiocyanate ions, perchlorate ions, and nitrate ions. Therefore, the administration of thiocyanate (or one of the other ions as well) in high enough concentration can cause competitive inhibition of iodide transpo into the cell--that is, inhibition of the iodide-trapping mechanism. The decreased availability of iodide in the glandular cells does not stop the formation of thyroglobulin; it merely pre- vents the thyroglobulin that is formed from becoming iodi- nated and therefore from forming the thyroid hormones. This deficiency of the thyroid hormones in turn leads to increased secretion of TSH by the anterior pituitary gland, which causes overgrowth of the thyroid gland even though the gland still does not form adequate quantities of thyroid hormones. Therefore, the use of thiocyanates and some other ions to block thyroid secretion can lead to develop- ment of a greatly enlarged thyroid gland, which is called a goiter. Propylthiouracil Decreases Thyroid Hormone Formation. Propylthiouracil (and other, similar compounds, such as methimazole and carbimazole) prevents formation of thyroid hormone from iodides and tyrosine. The mechanism of this is paly to block the peroxidase enzyme that is required for iodination of tyrosine and paly to block the coupling of two iodinated tyrosines to form thyroxine or triiodothyronine. Propylthiouracil, like thiocyanate, does not prevent for- mation of thyroglobulin. The absence of thyroxine and tri- iodothyronine in the thyroglobulin can lead to tremendous feedback enhancement of TSH secretion by the anterior pituitary gland, thus promoting growth of the glandular tis- sue and forming a goiter. Iodides in High Concentrations Decrease Thyroid Activity and Thyroid Gland Size. When iodides are present in the blood in high concentration (100 times the normal plasma level), most activities of the thyroid gland are decreased, but often they remain decreased for only a few weeks. The effect is to reduce the rate of iodide trapping so that the rate of iodination of tyrosine to form thyroid hormones is also decreased. Even more impoant, the normal endocytosis of colloid from the follicles by the thyroid glandular cells is paralyzed by the high iodide concentrations. Because this is the first step in release of the thyroid hormones from the storage colloid, there is almost immediate shutdown of thyroid hormone secretion into the blood. Because iodides in high concentrations decrease all phases of thyroid activity, they slightly decrease the size of the thyroid gland and especially decrease its blood supply, in contradistinction to the opposite effects caused by most of the other antithyroid agents. For this reason, iodides are frequently administered to patients for 2 to 3 weeks before surgical removal of the thyroid gland to decrease the neces- sary amount of surgery, especially to decrease the amount of bleeding. Negative feedback is a regulatorymechanism in which a 'stimulus' causes an opposite 'output' in order to maintain an ideal level of whatever is being regulated. Negative feedback loops occur in a series of steps. You have a stimulus, in which a change occurs. Ref guyton and hall textbook of medical physiology edtion 12 Pg 915
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Ans. (A) Glutamate(Ref Katzung 11/e p595)Vitamin K causes gamma carboxylation of glumate residues in many clotting factors that result in their activation.
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Name Site of action Example Mechanism Loop diuretics Thick ascending limb of Loop of Henle Furosemide, Torsemide Na-K-2Cl sympoer inhibition Carbonic anhydrase inhibitors PCT Acetazolamide, Dorzolamide, Brinzolamide Carbonic anhydrase inhibition Thiazides DCT Hydrochlohiazide, Chlohalidone Na-Cl sympoer inhibition Osmotic diuretics Non-specific Mannitol By osmotic effect Epithelial sodium channel blockers Collecting duct Amiloride, Triamterene eNa channel blockade Aldosterone antagonists Collecting duct Spironolactone, Epleronone Antagonism of aldosterone receptors
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Ans. D i.e. Immunomodulation Thalidomide It is a synthetic derivative of glutamic acid (alpha-phthalimido-glutarimide) with teratogenic, immunomodulatory, anti-inflammatory and anti-angiogenic propeies. Thalidomide acts primarily by inhibiting both the production of tumor necrosis factor alpha (TNF-alpha) in stimulated peripheral monocytes and the activities of interleukins and interferons. This agent also inhibits polymorphonuclear chemotaxis and monocyte phagocytosis. In addition, thalidomide inhibits pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), thereby inhibiting angiogenesis.
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A i.e. Transplantation reaction; B i.e. Autommune disease; C i.e. Involved in T -Cell function
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Standard normal curve
It is also known as bell curve or Gaussian distribution.
The shape of the curve is like a bell → shaped curve.
The data is distributed symmetrically on either side of a central value.
Normal distribution curve looks symmetrical in the dispersion with the largest frequencies in the middle score and tapering down of frequencies towards the highest as well as the lowest score No tail.
Normal distribution curve is based on mean and standard deviation.
Mean, median and mode all coincide → No skew.
Mean = median = mode = 0
Total area of curve is 1.
Its standard deviation is 1.
Variance is
Variance
Variance is squared deviation from mean.
For example, if deviation in a curve is 2 standard (2 SD) then variance will be square of this deviation i.e. (2 SD)2.
So,
Variance = SD2
In normal curve SD is 1.
So variance = SD2 =12 =1
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Ans. is 'd' i.e., All Pericarditis may be of following types A. Acute pericarditis o Acute pericarditis is the most common pathological process involving the pericardium. o It is characterized by accumulation of fluid in the pericardial space, i.e. pericardial effusion. o It may be divided, depending on the type of exudate that accumulates in the pericardium. 1. Fibrinous and serofibrinous pericarditis o These two anatomic forms are the most frequent type of o There is serous fluid mixed with fibrinous exudate. o Common causes include acute MI, Dressler syndrome, uremia, radiation, SLE, RF and trauma. May resolve or organized. 2. Serous pericarditis o There is serous inflammatory exudate. It is characteristically produced by non-infectious inflammation, such as RF, SLE, scleroderma, tumors, and uremia. May resolve without any consequences. 3. Purulent pericarditis o This is due to infection with a pyogenic organism. o There is accumulation of purulent exudate (Pus). o Resolution is unusual, and the usual outcome is organization. Because of the great intensity of inflammatory response, the organization frequently produce chronic constrictive pericarditis. 4. Hemorrhagic pericarditis o An exudate composed of blood mixed with a fibrinous or suppurative effusion accumulate in the pericardial space. o Most common cause is neoplastic involvement of the pericardial space. o Other causes are T.B., Uremia (API medicine - 434), Cardiac surgery, patients with bleeding diathesis. 5. Caseous pericarditis o Accumulation of caseous material in pericardial space. Almost invariably due to TB. B. Chronic or Healed pericarditis o Chronic pericarditis is inflammation that begins gradually, is long lasting, and results in fluid accumulation in the pericardial space or thickening of pericardium. o Chronic pericarditis may also occur as a healed stage (organization) of acute pericarditis. o Chronic pericarditis may be of following types ? 1. Adhesive pericarditis It is the stage of organization and healing by formation of fibrous adhesions in the pericardium following fibrinous, suppurative or hemorrhagic pericarditis. o Chronic adhesive pericarditis differs from chronic constrictive pericarditis in not embarrasing the function of hea. 2. Chronic constrictive pericarditis o Characterized by dense fibrous or fibrocalcific thickening of the pericardium resulting in mechanical interference with the function of the hea and reduced cardiac output. o The condition usually results from a long standing preceding causes such as - (i) Tubercular pericarditis (ii) Purulent pericarditis (iii) Haemopericardium 3. Pericardial plaques (milk spots, soldier's spots) o These are opaque, white, shining and well circumscribed areas of arganization with fibrosis in the pericardium. o They are seen most frequently on the anterior surface of right ventricle. o They arise from healing of preceding pericarditis.
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Ans is 'a' i.e. Brown atrophy o Deposition of lipofuscin in the heart is referred as brown atrophy.
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Ans. is 'a' i.e., Pancuronium Propeies of NM Blockers Longest acting Neuromuscular blocker - Pancuronium (duration of action 120-180 minutes). (Goodman & Gilman 11 th/e p. 222) (Note: In some books pipecuronium or Doxacurium have given as the longer activity). Shoest and fastest acting neuromuscular blocker - Succinylcholine (suxamethonium) - duration of action 5-8 minutes. Shoest acting competitive (nondepolarizing) neuromuscular blocker - Mivacurium (duration of action 12-18 minutes). Fastest acting nondepolarizing blocker Rocuronium (can be used for endotracheal intubation as an alternative to Sch). Non-depolarizing neuro-muscular blockers can cause ganglion block, vagal block and Histamine release (different agents has different propensity). Histamine release is caused by - D-TC (maximum tendency), succinylcholine, mivacurium, doxacurium, atracurium, tubocurarine - can cause bronchoconstriction. Viually no histamine release - Pancuronium Vagal block is caused by Pancuronium, recuronium, Gallamine. Maximal vagal block and tachycardia is caused by - Pancuronium (Previously it was gallamine, but it is not used now). Vagal stimulation is caused by - succinylcholine (can cause bradycardia). Ganglion block is caused by - d-Tc, Metocurine, Alcuronium. Maximum ganglion blockade is caused by - d-TC. Ganglion stimulation is caused by - Succinylcholine.
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Thalidomide is indicated for the treatment of patients with erythema nodosum leprosum and multiple myeloma. In addition, it has orphan drug status for mycobacterial infections, Crohn's disease, HIV-associated wasting, Kaposi sarcoma, lupus, myelofibrosis, brain malignancies, leprosy, graft-versus-host disease, and aphthous ulcers. Also Know: Thalidomide should never be taken by women who are pregnant or who could become pregnant while taking the drug.It is best known for the severe, life-threatening bih defects it caused when administered to pregnant women.
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Virulent strains of tubercle bacilli form microscopic "serpentine cord" in which acid fast bacilli are arranged in parallel chains, cord formation is correlated with virulence. A "cord factor" has been extracted from virulent bacilli with petroleum ether. It inhibits migration of leukocytes, causes chronic granulomas, and can serve as an immunologic "adjuvant"
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Ans. is 'd' i.e., Ad fibers o Fastest conduction velocity - Aa fiber,o Slowest conduction velocity - C fiber.Classification of Mammalian Nerve fibresGroup Erlanger and GasserLloyd & Hunt*MyelinationDiameter (microns)Conduction velocity (m/s)FunctionAgent to which conduction is most susceptibleA alphaIHeavily myelinated13-2070-120 MaximumProprioceptionMotor supply to Skeletal muscle (extrafusal to muscle spindle)PressureA betaIIMyelinated4-1325-70Touch, kinesthetic sense, pressurePressureA gamma-Slightly myelinated3-615-30Motor supply to intrafusal muscle fibres (muscle spindle)PressureA deltaIIISome myelination1-55-30Pain temperature, pressure, touchPressureB-Some myelination1-33-14Preganglionic autonomic fibresHypoxiaCIVUnmyelinated0-2-100-2-2 MinimumPain, temperature, pressure, postganglionic autonomic fibresLocal anaesthetics
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The danger of needle stick injury is present in medical and paramedical personnel,though the chance of infection are much less than with hepatitis B infection. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-583
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(Refer: Nelson’s Textbook of Pediatrics, SAE, 1st edition, pg no. 2554)
Potter’s syndrome
Potter syndrome refers to the typical physical appearance and associated pulmonary hypoplasia of a neonate as a direct result of oligohydramnios and compression while in utero.
In Potter syndrome, the primary problem is kidney failure mostly due to renal agenesis. The kidneys fail to develop properly as the baby is growing in the womb.
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Ans. (d) HypocalcemiaRef: Bailey and Love 26th/e p. 1127* Hypercalcemia and Hypertriglyceridemia causes acute pancreatitis * Recall the mnemonic I mentioned in theory "GET SMASHED" for acute pancreatitis causes.
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Elimination of free radical occur multiple mechanism:- 1.Antioxidant: (Glutathione and vitamin A, C, E) 2.Enzymes:- (i) Superoxide dismutase(mitochondria) O2-H2O (ii) Glutathione peroxidase (mitochondria) (iii) Catalase (Peroxisome): H2O2-O2 and H2O (glutathione independent). 3. Metal Carrier protein (Transferrin/Ceruloplasmin). Destruction of phagocytose material:- Oxygen dependent killing is most effective mechanism.
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Ans. is 'a' i.e. X-ray crystallography
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Fractures of the navicular bone of the wrist should be suspected in anyone, particularly a young person, who falls on an outstretched hand. Although x-rays are mandatory, it is important to realize that the fracture may not be seen on the initial x-ray and that a presumptive diagnosis can and should be made on clinical grounds alone. Typically, there will be tenderness to palpation over the navicular tuberosity and limitation of wrist flexion and extension. Immobilization of the wrist for about 16 week and sometimes up to 6 month is required. Nonunion or avascular necrosis is not uncommon and may require bone grafting for correction.Dislocation of the radial head with a fracture of the proximal third of the ulna is known as Monteggia's deformity. Usually, the radial head is dislocated anteriorly. The injury is usually caused by forced pronation. The injury can be treated by reduction and stabilization of the ulna followed by reduction of the radial head via supination and direct pressure.Anterior shoulder dislocations occur more frequently than posterior dislocations. However, posterior dislocations are seen in special situations, such as during an epileptiform convulsion and during electroshock therapy. Closed reduction followed by immobilization is usually sufficient therapyA spiral fracture, frequently seen in the tibia in skiers, results from the application of torque to a long bone. Greenstick fractures are common in children. The bones of young children are able to bend to a greater degree than those of adults; the fracture may occur only at the site of maximal cortical stress but not at the opposite cortex, the site of maximal longitudinal compression.
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Dementia is a chronic organic mental disorder, characterized by the following main clinical features: 1. Impairment of intellectual functions, 2. Impairment of memory (predominantly of recent memory, especially in early stages), 3. Deterioration of personality with lack of personal care. Reference: A sho textbook of Psychiatry by Niraj Ahuja, page no.22.
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Malonyl CoA
Acetyl-CoA is the immediate substrate for fatty acid synthesis.
However, acetyl-CoA needs to be converted to the activated form, which will serve as the donor of carbon units to the growing fatty acid chain.
Malonyl-CoA is such activated form; acetyl-CoA is converted to malonyl-CoA by acetyl-CoA carboxylase.
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Ans. is 'b' i.e., Hypothyroidism Kartagener's syndrome is characterized bv triad ofo Situs inversuso Chronic sinusitiso BronchiestasisIt is a subset of primary ciJiarv dyskinesiaPrimary ciliary dyskinesiao Primary ciliary dyskinesia (PCD, also called the immotile-cilia syndrome) is characterized by congenital impairment of mucociliary clearance (MCC).o Clinical manifestations includeChronic coughChronic rhinitis andChronic sinusitisOtitis and otosalpingitis (common in childhood)Nasal polyposis and agenesis of ike frontal sinusesClinical features of primary ciliary dyskinesiaPulmonaryRhinosinusitisOtitisCentral nervous systemFertilityo Mild respiratory distresso Runny nose ando Chronic secretoryo Chronic sinusitiso Infertilityo Increased incidence ofround the yearotitis media withcauses fatigue and(immoiilerespiratory infectionsnasal congestionrecurrent episodesheadachespermatozoawith chronic cough ando Nasal polyposisof acute otitis mediao Hydrocephalus duemotileexpectoration of Sitns inversusto impairedspermatozoa),mucopurluent sputum o Complete reversalfunction of o Bronchiestasis of the circulatoryependymal cilia | system and viscera Associated abnormalities o No adverse health o A number of congenital consequence abnormalities are : * Transposition of great vessels * Pyloric stenosis * Epispadias
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Psychotic depression (psychotic features in depression) occurs later in life (old age) and is associated with severe depression. Psychotic symptoms may be mood congruent (e.g. nihilistic delusion) or mood incongruent (e.g. delusion of control).
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Chemical constituents and setting reaction
The chemical constituents and setting reaction of impression paste is essentially similar to the zinc oxide eugenol cement. The gum rosin is an important constituent of both pastes and acts as a binder, giving the paste body and reducing the risk of separation of the other components. It also has the property of being thermoplastic so that the impression can be softened in hot water. This aids removal from the plaster model which is subsequently poured.
The magnesium chloride and other metallic salts of acetic and hydrochloric acid act as accelerators, so that the material will set in a clinically acceptable time. As with zinc oxide eugenol cements, water catalyses the setting reaction of impression paste.
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Types of Viral Hepatitis:
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Ans. is 'c' i.e., Rotavirus "Rotaviruses are recognized as the most common cause of diarrhea! disease in infants and children" - Ananthnarayan Causes of acute diarrhea in children Virus Bacteria Parasites Rota virus Calcivirus ETEC Salmonella E. histolytica Norwalk virus Astrovirus EIEC Campylobacter Giardia Adenovirus Shigella Aeromonas hydrophilia Cryptosporidium
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Ans. is 'c' physiological jaundice Child presents with severe jaundice at 30 hrs. of life (or we can say 2nd day of life.) Yellowing of face, palms and soles indicate that bilirubin level is > 15 mg/dl (For explanation see O.P. Ghai 5th/e, P 143) Now we will have to look for conditions which can cause such an elevation in bilirubin level by 2nd days. Both septicemia and congenital obliteration of bile duct can present with severe jaundice on the 2nd day of life. The other 2 options Breast milk jaundice & physiological jaundice cannot cause such an elevation in bilirubin by 2nd day of life. Now let's see them one by one. Breast milk jaundice In breast milk jaundice significant elevation in bilirubin occurs by 7th day of life reaching maximum concentration of 10-30 mg/dl by 2nd-3rd week. Physiological jaundice For jaundice to be physiologic rather than pathologic following 4 criteria's should be satisfied (C.P.D.T. 15*/e, page 13). Clinical jaundice appears after 24 hrs. of age.* Total bilirubin rises by less than 5 mg/dl per day.* Now we can easily exclude this, if the jaundice appears on 2nd day and per day rise in bilirubin is 5 mg/dl, how can it reach 15 mg in the same day. Other two criteria's for physiological jaundice. Peak bilirubin occurs at 3-5 days of age*, with a total bilirubin of no more than 15 mg/dl.* Clinical jaundice is resolved by 1 week in the term infant and by 2 weeks in the preterm infant.
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Ans. is 'c' i.e., | Acetylcholinesterase
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Astrocytoma
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Rotors is conjugated hyperbilirubinemia. Others are unconjugated hyperbilirubinemia. Reference: davidson, 23rd edition, page 860
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Answer is B (Air Bronchogram Absent): Air Bronchogram sign is a characteristic feature of Pneumococcal Pneumonia. Air Bronchogram is typically absent in Lobular Pneumonias (Bronchopneumonia) and Interstitial Pneumonias Pneumococcal Pneumonia is the most common pulmonary infection that produces lobar pattern of pneumonia. It is regarded as the typical prototype for Lobar Pneumonia. This type of Pneumonia is typically characterized by Homogenous (Non-Segmental) Consolidation involving an entire lobe. Because the airways are usually spared, air bronchograms (seen within the opacification) are common and characteristic. Cavitation is rare and Pleural effusion is uncommon. Lobar Pneumonia Lobular (Bronchopneumonia) Interstitial Pneumonia (Typical of Pneumococcal (Typical of Staphylococcal (Typical of Viral / Mycoplasma Pneumonia) Pneumonia) Pneumonia) Lobar pneumonia is typical of Bronchopneumonia is most typical of Interstitial pneumonia is most typical of pneumococcal pulmonary infection. staphylococcal pneumonia. viral, mycoplasma and pneumocystis infection Consolidation is typically Homogenous and Consolidation is typically Segmental Consolidation is not a typical feature since Non-Segmental they tend to involve the airway walls and alveolar septa Air Bronchogram is common Air Bronchograms are absent Air Bronchograms are absent Because the airways are usually spared, air Exudate within the bronchi accounts for bronchograms are common and significant the absence of air bronchograms in volume loss is unusual bronchopneumonia. Note: Bronchopneumonia is the most common cause of multifocal patchy airspace opacities, Bronchopneumonia is the most common pattern of Pneumonia
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IgM is paicularly effective at complement activation by binding to C1 Ref: Ananthanarayan & Parker's textbook of microbiology 9th edition pf:98
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a. VMA(Ref: Nelson's 20/e p 2227-2729, Ghai 8/e p 525)Biochemical tests for Pheochromocytoma:Pheochromocytomas synthesize and store catecholamine, so elevated plasma and urinary levels of catecholamines methylated metabolites (VMA or vanillyl mandelic acid), metanephrines, are the cornerstone for the diagnosisAmong these tests, the fractionated metanephrines and catecholamines are the most sensitive.QIn contrast to adults with pheochromocytoma in whom both norepinephrine and epinephrine are elevated, children with pheochromocytoma predominantly excrete norepinephrine in the urine.
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Celiac sprue is due to hypersensitivity to gluten, a protein found in wheat products. The disease is associated with HLA-DQ2 and HLA-DQ8. Laboratory testing shows the presence of anti-gliadin, anti-tissue transglutaminase, and anti-endomysial antibodies in patients. Clinical presentation of celiac sprue include, bloating, chronic diarrhea, and malabsorption. Extraintestinal manifestations are common. Dermatitis herpetiformis, a pruritic papular and vesicular rash on the extensor surface of the forearms, elbows, back, and buttocks is classic. Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 14. Gastrointestinal Pathology. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.
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Ans. is 'd' i.e., Massive haematemesis Most common complication of peptic ulcer is gastro intestinal bleeding. It is seen with both chronic and acute type of ulcers. Infact, chronic peptic ulcers are the most common cause of haematemesis and malaena. Complications of peptic ulcer ? 1) Gastrointestinal bleeding Most common complication of peptic ulcer Bleeding is more common in duodenal ulcers It is commonly seen in posterior duodenal ulcers because of erosion of gastroduodenal aery. 2) Perforation It is the second most common complication of peptic ulcer disease. Perforation occurs commonly in the ulcers located in the anterior pa of duodenum. Duodenal ulcers tend to penetrate into pancreas causing pancreatitis. Gastric ulcers tend to penetrate into left hepatic lobe. 3) Gastric outlet obstruction It is the least common ulcer related complication. It is commonly associated with duodenal ulcers. Tea pot stomach is caused due to longitudinal shoening of the gastric ulcer at the lesser curvature of the stomach (It causes the stomach to look like tea pot). Hour glass stomach is caused due to cicatricial contraction of a saddle shaped ulcer at the lesser curvature.
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Section 23(3) PCPNDT ACT (Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT)Act, 1994) Punishment for a person seeking prenatal diagnostic facilities for purpose of sex selection is 3 - 5 years imprisonment and fine Rs.50000 - 1 lakh
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It is used in Kaposi’s sarcoma. Intraleisional danorubicin and vinblastine, radiation treatment, placitaxel, interferon alpha are also used.
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Levamisole is an immunomodulator acting as immunostimulant at low doses and immunodepressant at high doses.
It was used as anti-helminthic and causes depolarization by stimulating nicotinic receptors.
It is used for the treatment of colorectal carcinoma in combination with 5-FU.
It is slow to act in psoriasis and requires two-day therapy per week for prolonged periods.
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The enzyme ornithine decarboxylase (ODC) catalyzes the decarboxylation of ornithine (a product of the urea cycle) to form putrescine. This reaction is the committed step in polyamine synthesis. In humans, this protein has 461 amino acids and forms a homodimer.Ref: https://en.wikipedia.org/wiki/Ornithine_decarboxylase
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Ans. C. Performed when sperm count is <5million/mlICSI is not done routinely. It stands for Intracytoplasmic Sperm Injection: single sperm is introduced inside a single ovumIndications for ICSI:a. Previous failed IVFb. Sperm count <5million/ml or <5% progressive motility or <4% normal morphology as in a case obstructive azoospermia or primary testicular failure. In these cases, sperms are obtained from either the epididymis or testis itself.c. In case of severe oligospermia or azoospermia, the sperms are obtained by TESE (Testicular sperm Extraction) and sperm preparation is required as in conventional IVF.A higher congenital anomaly rate is there with ICSI (4.2%), as compared to conventional IVF (2-3%)
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Features of Aedes: Breeds in the aificial collection of water Eggs are laid singly, cigar-shaped and don't have lateral folds Larvae have a siphon tube Pupae with long and narrow siphon tube Adults have stripes on body and legs Fly up to 100 m Aka Tiger mosquitoes Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 831
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Ans: A (Adenylate cyclase) Ref: Textbook of Microbiology, 8th ed, Ananthanarayan and Paniker. pg: 307; Mandell, Bennett and Dolin: Principles and Practice of infectious Diseases, 6th ed., pg: 1221Explanation:Cholera Toxin (CT)Production of CT is determined by a filamentous phage integrated with the bacterial chromosome..It can also replicate as a plasmid.CT is regulated by ToxR protein.CT is a protein enterotoxin.CT is made up of:o 1 A (has 2 fragments-A1 and A2).o A1 is biologically active component.o A 2 fragment only finks the biologically active A1 to B subunit.o 5 B subunits (attaches to the GM 1 ganglioside receptors on jejunal cells).The A1 fragment causes prolonged activation of cellular adenylate cyclate and accumulation of cAMP leading to outpouring into the small intestinal lumen of large quantities of water and electrolytes and the consequent watery diarrhea.CT also increases intestinal secretion via prostaglandins and neural histamine receptors.Complications in cholera result from the massive water and electrolyte depletionThe labile toxin produced by ETEC (Enterotoxigenic E.coli) also acts by increased activity of adenylate cyclase.The Stable-toxin (ST) producing E. coli causes activation of intestinal guanyiate cyclase. Cholora Toxin || |A subunitB subunit||||A1(Active part;-A2Joins A1 and B)Binds to GM1.ganglioside receptor| ADP ribosylation of G protein|Activation of adenyl cylase|Increased cAMP|Inhibits absorption of Na+ & Cl- DiarrheaFig: Mechanism of action of cholera toxinAlso Note:Mechanism of Action of Some Important Bacterial ToxinsBacterial ToxinsMechanismHeat labile toxin of E. coliIncreased cAMPHeat stable toxin of E. coliIncreased cGMPBotulism toxinInhibit release of acetylcholine from peripheral nervesTetanus toxinInhibit release of glycine and GABA at presynaptic terminalsDiphtheriaInhibit protein synthesis by inactivating EF-2
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Ans. is 'd' i.e., Reasons to be Recorded Section 409 CrPC : Withdrawal of cases and appeals by Session Judge. Section 410 CrPC : Withdrawal of cases by Judicial Magistrate. Section 411 CrPC : Making over or withdrawal of cases by executive magistrates. Section 412 CrPC : Reasons to be recorded:- A Session judge or Magistrate making an order under section 408, 409, 410 or 411. Shall record his reasons for making it.
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Prognosis in eclampsia long interval between onset of fit and commencement of treatment antepaum eclampsia with long delivery interval number of fits more than 10 coma in between fits temperature over 102 degree F with pulse rate above 120/min BP >200mmHg systolic oliguria with proteinuria non response to treatment jaundice D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no;233,7th edition
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Muscles REF: Apley 8th edition page 77 Tophi are nodular deposition of crystals of mono sodium urate which get deposited in connective tissues like: Aicular cailage Tendon Synovium Aicular ends of bone Periaicular tissue Pinna Cailage Ligaments Kidney Subcutaneous tissue On X-ray: Tophi appears as punched out cysts with over hanging bony edges or G sign or mael's sign. Metatarsophalangeal joint is the most common and earliest joint affected by gout
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Ans. b. IsotretinoinIndicators of isotretinoinIsotretinoinTargets all pathogenic mechanisms of Acne IndicationsNodulocystic acne QSevere, refractory AcneAcne fulminansAcne conglobataContraindicationsWomen of reproductive age groupHypertriglyceridemiaDyslipidemiaDosage0.5-1 mg/kg/day up to a cumulative dose of 120- 150 mg/kgSevere nodulo cystic acneSevere acne variants like acne fulminans, pyoderma facialeFailure of conventional therapyModerate to severe acne frequently relapsingAcne severe enough to result in psychological distressInflammatory acne
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Rasburicase and Pegloticase metabolize insoluble uric acid to soluble allantoin and used in the treatment of chronic gout.
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SUBMENTOVERTEX PROJECTION
Structures Shown:
A full axial view of the base of the cranium showing a symmetrical projection of the petrosa, the mastoid process, foramen ovale, spinosum canals, carotid canals, sphenoidal sinuses, mandible, maxillary sinus, nasal septum, odontoid process of the atlas and the entire atlas, axial inclination of the mandibular condyles. Helps to study destructive/expansile lesions affecting the palate, pterygoid region or base of the skull, sphenoidal sinus.
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Black Gun Powder: Described as FG, FFG, FFFG, FFFFG depending on the fineness of the grain. The finer grains have more number of 'F'
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Ans. C i.e. PseudohypoparathyroidismPseudohypoparathyroidism presents with hypocalcemia, normal to raised PTH, normal 25-(OH)D, and decreased 1,25-(OH),D
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In general, gram-negative organisms are the most common causes of acute urinary tract infections in patients who do not have complicating abnormalities of the urinary tract, such as obstruction from calculi or other causes. Among the gram-negative organisms, Escherichia coli is the bacterium that is most frequently isolated from urine cultures in these patients. Different species of Pseudomonas, Proteus, Serratia, and Klebsiella may also be responsible for so-called uncomplicated urinary tract infections, including acute pyelonephritis, but are less commonly implicated than Escherichia coli. Ref: Lerma E.V. (2009). Chapter 37. Chronic Tubulointerstitial Nephritis. In E.V. Lerma, J.S. Berns, A.R. Nissenson (Eds), CURRENT Diagnosis & Treatment: Nephrology & Hypeension.
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Perivalvular abscess is a known and feared complication of left-sided endocarditis because it is associated with increased moality. There was a male preponderance, and 60% of the patients had prosthetic valve endocarditis addition to use by cardiologists in outpatient and inpatient settings, TEE can be performed by a cardiac anesthesiologist to evaluate, diagnose, and treat patients in the perioperative period. Most commonly used during open hea procedures, if the patient&;s status warrants it, TEE can be used in the setting of any operation. TEE is very useful during many cardiac surgical procedures (e.g., mitral valve repair). It is actually an essential monitoring tool during this procedure. It helps to detect and quantify the disease preoperatively as well as to assess the results of surgery immediately after the procedure. If the repair is found to be inadequate, showing significant residual regurgitation, the surgeon can decide whether to go back to cardiopulmonary bypass to try to correct the defect. Aoic dissections are another impoant condition where TEE is very helpful. TEE can also help the surgeon during the inseion of a catheter for retrograde cardioplegia. A TEE is done when your doctor needs a closer look at your hea or does not get the information needed from a regular echo. You may need a combination of a TEE, Doppler ultrasound and color Doppler to get information about how blood flows across your hea&;s valves Ref Harrison 20th edition pg 1456
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There is sensory loss on the medial 2 fingersThere is no sensory impairment in anterior interossous nerve (AIN) syndrome.
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Ans. is 'c' i.e., Cisplatin Platinum compound These are alkylating agents and act by similar mechanism. Drugs are - First generation -9 - Cisplatin Second generation - Carboplatin Third generation - Oxaliplatin Side effects of Cisplatin Vomiting Ototoxicity Hyperuricemia Nephrotoxicity Neuropathy Note ? Cisplatin is most nephrotoxic where as carboplatin is more hematotoxic (bone marrow suppression). Carboplatin has less nephrotoxic, neurotoxic and ototoxic effects. Dose limiting toxicity of oxaliplatin is neurotoxicity (Peripheral neuropathy). Drugs causing nephrotoxicity: Chemotherapy and Immunosuppressants drugs causing nephrotoxicity: - Cisplatin - Methotrexate - Mitomycin - Cyclosporine - Ifosphamide (Causes Fanconi's Syndrome) Antibiotics: - Aminoglycoside - Sulfonamides Amphotericin B - Foscarnet Quinolones (e.g. Ciprofloxacin, Levofloxacin) - Rifampin - Tetracycline - Acyclovir (only nephrotoxic in intravenous form) - Pentamidine - Vancomycin Heavy Metals: Mercury Poisoning - Lead Poisoning - Arsenic Poisoning Bismuth - Lithium related kidney disorders AntiHyperlipidemics: - Statin Drugs (Rhabdomyolysis) Gemfibrozil-Associated with Acute Renal Failure due to Rhabdomyolysis Miscellaneous Drugs: - Chronic Stimulant Laxative use-Resulting in chronic volume depletion and Hypokalemia causes nephropathy - Radiographic contrast - ACE Inhibitor- NSA ID - Aspirin - Mesalamine
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PneumocytesTwo types of pneumocytes contribute to the maintenance of the alveoli of the lungsType I pneumocytes and Type II pneumocytes.These cells function to aid in gas exchange, secretion of pulmonary surfactant, and self-regeneration
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Nodulocystic acne is a severe form of acne which is very disfiguring. Nodulocystic acne sufferers develop nodules as well as cysts. Extensive scaring may result from this condition. Oral or systemic Isotretinoin is used in treatment. Oral antibiotics and contraceptives are also used.
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In S. aureus pneumonia, lobar enlargement with bulging of interlobular fissures can be seen in severe cases. Air bronchograms are not seen Abscess, cavitations (with air-fluid levels) and pneumatoceles are commonly seen and 30-50% of patients develop pleural effusions, half of which are empyemas. Note :- Cavitation and associated pleural effusions are also observed in cases of anaerobic infections, gram-negative infections and tuberculosis.
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Hutchinson&; s triad seen in congenital syphilis, this include interstitial keratitis, deafness, and Hutchinson&;s teeth. Ref: Baveja textbook of microbiology; 4th edition.
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Test results that confirm or exclude pulmonary embolism (adapted from Kearon) Diagnostic for pulmonary embolism (>=85% probability of pulmonary embolism) Computed tomography (CT) pulmonary angiogram: Intraluminal filling defect in a lobar or main pulmonary aery Intraluminal filling defect in a segmental pulmonary aery and moderate or high CPTP (clinical pre-test probability.) Ventilation-perfusion scan: High probability scan and moderate or high CPTP Positive diagnostic test for deep vein thrombosis (with a non-diagnostic ventilation-perfusion scan or CT pulmonary angiogram) Excludes pulmonary embolism (<=2% probability of progressive venous thromboembolism during 3 months' follow-up+) CT pulmonary angiogram: Normal Perfusion scan: Normal D-dimer test: Negative test which has high sensitivity (>95%) and low or moderate CPTP Negative test which has moderately high sensitivity (>85%) and low CPTP Non-diagnostic ventilation-perfusion scan or suboptimal CT pulmonary angiogram and normal venous ultrasound of the proximal veins and Low CPTP or Negative D-dimer test which has moderately high sensitivity (>=85%) or Normal repeat venous ultrasound scans of the proximal veins after 7 and 14 days Ref: Kearon C. Diagnosis of pulmonary embolism. CMAJ2003;168:183-94; Diagnosis and management of pulmonary embolism ; BMJ 2013;346:f75.
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Piecemeal necrosis occurs in chronic active hepatitis.
Piecemal necrosis is also known as interface hepatitis.
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Impoant Radioisotopes Half Life RADIOISOTOPE HALF LIFE IODINE 131 8 DAYS IODINE 125 60 DAYS IODINE 124 4 DAYS IODINE 123 13 HOURS PHOSPHORUS -32 14 DAYS RADIUM (RA-226) 1622 years Cobalt -60 5.2 years Cesium - 137 30 years TC- 99m 6 hours Iridium (Ir-192) 74.5 Days 18F (18FDG) 110 min Strontium 89 50.5 days
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Explanation: Loss of sensation of lateral 3 and 1/2 fingers is due to lesion of median and radial nerve. Sensations on the palmar aspect of lateral 3 &1/2 fingers (including nail beds) are carried by median nerve. Lateral 3 & 1/2 fingers (excluding nail beds) on the dorsum of hand are supplied by radial nerve. Palmar and dorsal aspect of medial 1 &1/2 fingers (including nail beds) is supplied by ulnar nerve.
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Ans. is 'a' i.e. Tyrosine kinase Chronic myeloid leukemia is characterized by BCR-ABL translocationThe BCR-ABL translocation in chronic myeloid leukemia encodes a tyrosine kinase which is essential for cell proliferation and survivalImatinib (511-571) is a new molecularly targeted drug, which inhibits the tyrosine kinase activity, producing hematological and cytological remission in majority of patients.The treatment of CML has changed with the introduction of imatinib mesylate.The drug is a specifically designed inhibitor of the tyrosine kinase activity of the bcr/abl oncogene.It is well tolerated and results in nearly universal, 98% hematologic control of chronic phase disease.It has now replaced both interferon and hydroxyurea as standard therapy.The addition of either alpha interferon or low dose chemotherapy with cytarabine holds promise for even better results.Adverse effects of imatinibNauseaPeriorbital swellingRashMyalgia
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All the four statements are correct. The attainment of milestones varies from one child to another. It differs amongst the brothers and sisters. This is because of different rate of myelination and development of the nervous system amongst different children. Development always proceeds in a cephalocaudal sequence. In the beginning there is head control. After this the child sits up and walking occurs after this.
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The internal anal sphincter, IAS, (or sphincter ani internus) is a muscular ring that surrounds about 2.5-4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is about 5 mm thick and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Ref - BDC 6e vol2 pg413-416
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SPARE RECEPTORS they are NOT needed for binding drug to achieve the maximum effect they respond to agonists only they do not alter maximal efficacy can be detected by finding that EC 50 < Kd for the agonist REF : KD TRIPATHI 8TH ED
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Stereotactic radiosurgery means delivery of precise high dose radiation in a single fraction to intracranial targetsReference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition
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(Refer – M.Satpathy’s Clinical Diagnosis of Congenital Heart Disease, 1st edition, pg no: 38)
Features of increased pulmonary blood flow
Blood vessels become visible in the outer third of lung field (At least 6 vessels can be traced to theouter third). When hilar and intrapulmonary vessels are uniformly changed, it is very suggestive of shunt lesions.
Ratio of right descending pulmonary artery to trachea > 1
Right descending pulmonary artery diameter> 14 mm suggests increased blood flow and >17 mm is very strongly suggestive
Prominent end-on vessels seen at hilum
Enface vessels below 10th posterior rib
Prominent vessels seen below crest of diaphragm
Ratio of vessels to adjacent bronchus >2:1
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Right posterior intra-peritoneal space(Right subhepatic space/Rutherford Morison's kidney pouch) is bounded in front by the liver & gallbladder,above by the liver,behind by the right kidney & diaphragm,below by the transverse colon & hepatic flexure,to the left by foramen of Winslow & duodenum.It is the largest and deepest space of all.It is the most common site of subphrenic abscess.Causes include appendicitis,cholecystitis,post operative,perforated duodenal ulcer,intestinal obstruction. Reference:SRB' s manual of surgery,5th edition,page no:575.
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Ans. A: Transfemoral Route Transfemoral route is the preferred route for cerebral angiography.
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The Foleys Silicone Catheter is a sterile 100% silicone catheter for long-term use (up to 3 months).
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Ans. is 'b' i.e., Protein o The composition of breastmilk varies at different stages after bih to suit the needs of the baby. o According to the postnatal period the breast milk is divided into ? 1. Clostrum Is the milk secreted during the first three days after delivery. It is yellow and thick. It contains more antibodies and cells and high amounts of vitamins A, D, E, K, & "Protein". 2. Transitional milk Is secreted during the following two weeks (after clostrum). The immunoglobulin and protein content decreases while the fat and sugar content increases. 3. Mature milk Follows transitional milk. It is thin and watery but contains all the nutrients essential for optimal growth of the body. o According to feed the breast milk is divided into - 4. Fore milk It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby's thirst. 2. Hind milk Comes towards the end of feed Rich in fat content and provides more energy, and satisfies the baby's hunger. o The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term - Preterm milk Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby.
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Ans. is 'c' i.e., Posterior ethmoidal o Epistaxis area is Little's area,o Four arteries contribute to little 9s area :Anterior ethmoidal arterySeptal branch of superior labial artery (Branch of facial A).Septal branch of sphenopalatine artery (Branch of maxillary A).Greater palatine artery (Branch of maxillary A).
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Ans. is 'b' i.e., Pigmented bih marks
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Ref Robbins 8/e p238; 9/e p248 Neutrophils are not the target for HIV .cells with CD4 marker.only T helper cell ..are the target to HIV infection
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Ans. is 'a' i.e., Inhibiting prostaglandin synthetase Medical measures to relieve dysmenorrheao Analgesics paracetamol and piroxicam.o Antispasmodies hyoscine, camylofin, and drotaverineo Prostaglandin synthetase inhibitors inhibiting cyclo-oxygenaseMefenamic acid, indomethacin, naproxen, ibuprofen.o Smooth muscle relaxantGlyceryltrinitrateo Progestogen containing IUCDMirena and progestasert - reduce pain, provide contraception and reduce bleeding, o Cyclical oral contraceptive drugso Vitamin E
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Acetyl CoA is formed from glucose. Following are the fate of Acetyl CoA after its formation: Oxidation in TCA cycle to form CO2 AND H2O Cholesterol biosynthesis Ketogenesis Fatty acid synthesis Acetylation reactions (Detoxication) Formation of acetyl choline Melatonin synthesis Ref: Textbook of Medical Biochemistry By Chatterjea, 2011, Page 442.
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Ans. is 'c' i.e., 5th metacarpal fracture EponymFractures of Upper limbMontegia fracture dislocationFracture of the proximal third of ulna with radial head dislocation.Galeazzi fracture dislocationFracture of the distal third of the radius with dislocation of the distal radio-ulnar joint.Colie's fractureFracture at cortico-cancellous junction of the distal-end of radius with dorsal tilt.Bennet's fractureOblique intra-art icular fracture of the base of the 1st metacarpal.Night stick fractureIsolated fracture of the shaft of the ulna.Smith's fractureA fracture of distal end of radius at cortico-cancellous junction with ventral tilt and displacements (reverse Colle's fracture).Barton's fractureA vertical, marginal intra-articular fracture of the distal end of radius occurring with volar or dorsal displacement.Chauffeur fractureAn intra-articular oblique fracture of the styloid process of the radiusBoxer's fractureA fracture through the neck of the 5th metacarpal.
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