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In examining a 2-year-old child, sta the examination at the child&;s feet and work your way up toward the head. Children are much more tolerant of having their feet touched than their head. Because children at the age of 2 are fearful (separation from parents, having the parent in the room may help you handle the child...
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Ans-B6-phospho-D-gluconate + NADP+ = {\display style \rightleftharpoons } D -ribulose 5-phosphate + CO2 + NADPH
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Multiple pathological fractures, high calcium, low phosphate and high alkaline phosphatase suggest the diagnosis of hyperparathyroidism.
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Buphthalmos is not a feature of I- cell disease. It is an inherited lysosomal storage disorder Defect in N-acetylglucosaminyl-1-phosphotransferase. Failure of the Golgi to phosphorylate mannose residues on glycoproteins It is characterized by the following: coarse facial features Gingival hyperplasia clouded corneas Re...
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Uvula vesicae is a small elevation situated immediately behind the urethral orifice, which is produced by the underlying median lobe of the prostate. It enlarges with age due to enlargement of the underlying median lobe of the prostate and may inhibit complete bladder emptying. Ref: Clinical Anatomy by Regions By Richa...
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Putrefaction is mainly caused by the action of enzyme LECITHINASE produced by clostridium welchi ( from bowels), Lecithinase caused marked hemolysis, liquefaction in blood vessels & tissue spaces. Clostirudium welchi is termed as the chief destructive agent in decomposition
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Cancers associated with vitamin D deficiency: Colorectal cancer, Breast cancer, Prostate cancer, Pancreatic cancer and Colorectal adenoma(" Ref: Meta-analysis of observational studies of serum 25-hydroxyvitamin D levels and colorectal cancer, breast and prostate cancer and colorectal adenoma. International Journal of C...
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Timolol is a non selective β blocker (act on β1& β2 ). β2 blocking effect of Timolol cause blockage of dilator β2 receptor so it can precipitate asthma. Whereas Betaxolol is cardioselective beta blocker that acts only on β2  receptor.
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CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients * Side effects * Agranulocytosis * Myocarditis * Seizure * Constipation * Weight gain * Metabolic syndrome Sialorrhea ref. kaplon and sadock, synopsis of psychiatry, 11 th...
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Ans. is b, i.e. Stein-Leventhal syndromeRef: Shaw 15th/ed, p284-285The Stein-Leventhal Syndrome also known as Polycystic Ovarian Disease (PCOD) is an important cause of Secondary Amenorrhea in young women.Testicular Feminizing syndrome, Turners syndrome and Mayer Rokitansky Kuster Hauser syndrome are causes of Primary ...
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Disability ceificate for poor vision if 4/60, is impairment percentage of: 75% All with correction Category Better Eye Worse Eye % Age Impairment Category 0 6/9-6/18 6/24 to 6/36 20% Category I 6/18-6/36 6/60 to Nil 40% Category II 6/40-4/60 or field of vision 10-20 3/60 to Nil 75% Category III 3/60 to 1/60 or field of...
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Cystic fibrosis is also known as salty baby syndrome or mucoviscidious Autosomal recessive condition predominantly affecting lungs Characterized by abnormal transpo of chloride and sodium across epithelium, leading to thick vicious secretions Refer robbins 9/e 466
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Transfer RNA (tRNA) have modified bases. Ribothymidine is a modified base of tRNA in which methyl group is added to uracil to form thymine.
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Ans. is 'd' i.e., Klebsiella o After pneumonia, absess formation is paicularly common with klebsiella and type 3 pneumococci infection.
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Measurement of glycated hemoglobin (HbA1c) is the standard method for assessing long-term glycemic control. When plasma glucose is consistently elevated, there is an increase in nonenzymatic glycation of hemoglobin; this alteration reflects the glycemic history over the previous 2-3 months, because erythrocytes have an...
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The child has presented with spina bifida occulta. Vitamin B9 (folic acid) deficiency in pregnant female can cause neural tube defects (spina bifida, Anencephaly) in the baby.
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Action of Lumbricals is Flexion at Metacarpo - phalangeal joint and extension at Interphalangeal joint.
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Barium investigations:Barium swallow: the study of the pharynx and esophagus up to GE junction Barium meal: the study of stomach and duodenum up to DJ flexureBarium meal follow through the study of small intestine following barium meal up to ileocaecal junction Enteroclysis: the study of small intestine by directly ins...
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The socioeconomic status of an individual / family can change over time due to the change in their literacy, job and income An individual belonging to a low socioeconomic class can move to a higher class by means of better income Similarly, an individual in a higher class may move to a lower class due to loss of his jo...
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Dysgerminoma
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The Schirmer's I test Measures combined basal and reflex tear secretion Relatively specific, but poorly sensitive Eyes closed / blink normally for 5 minutes Not useful in non co-operative adults and children Amount of wetting >10mm -normal 5-10mm -borderline < 5 mm is abnormal 5-minute Schirmer test with and without an...
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Sequence of changes in bone infection (osteomyelitis) on X-ray are : Earliest finding of osteomyelitis on X ray within 8 days is soft tisse swelling and loss of soft tissue planes Bone destruction and formation of periosteal reaction seen at 10-14 days Invoucrum formation at 3 weeks Sequestrum formation at 4 weeks
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Autopsy Techniques: A) Letulle's method (En masse) 1) Thoracic, cervical, abdominal, and pelvic organs are removed "en masse," as one big organ block. 2) Best technique to see relations amongst organs. 3) Preferred in infants so that congenital abnormalities in different organs can be seen in relation to each other 4) ...
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Thiazide diuretics can cause erectile dysfunction.
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Fat necrosis occurs at mainly fat rich anatoanatomical location in the body. Eg: traumatic fat necrosis of the breast especially in heavy and pendulous breast and mesentric fat necrosis due to acute pancreatitis. Ref Robbins 9/e p 10 .
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The most common cardiac disease associated with HIV is coronary hea disease, it is associated with a CD4+ T cell count of <500/ L. Other cardiac manifestations include dilated cardiomyopathy associated with congestive hea failure (CHF) ( HIV-associated cardiomyopathy), pericardial effusions, cardiac tamponade and nonba...
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Ans. D. Hormone sensitive lipase(Ref: Harper 31/e page 244)Pancreatic lipase to hydrolyse dietary TGsLipoprotein lipase to hydrolyse TGs in lipoprotein in the bloodLysosomal hydrolase to act on TGs in lysosomes
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Ans. is 'b' i.e.. Potassium o Radiation is pa of man's environment.
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C i.e. Increased secretion of insulin- Glucose, mannose, aminoacids (such as leucine, arginine, others) and f3 ketoacids such as acetoacetate (derived fromfat catabolism) stimulate insulin secretin and have protein sparing effectQ.- Insulin has anabolic effect on metabolism. It decreases protein catabolism and fat cata...
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Tacrolimus (FK 506) is an immunosuppressant macrolide antibiotic produced by Streptomyces tsukubaensis. Tacrolimus binds to the immunophilin FK-binding protein (FKBP). This complexe inhibit calcineurin, which is necessary for the activation of the T-cell-specific transcription factor NF-AT. Its toxic effects are simila...
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The child in the clinical scenario has presented with fever and multiple tender erythematous skin lesions and the lesions show neutrophilic infiltration in the dermis on microscopy. All of these points towards the diagnosis of Sweet Syndrome. In Behcet's syndrome the lesions are ulcerative in nature with a predominance...
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(Fat -embolism) (855-56-CSDT 12th) (178-Anaesthesia- A. yadav 3rd)FAT-EMBOLISM - Fracture through a large marrow filled cavity almost inevitably results in small showers of fat emboli being swept to the lungs. This can usually be accommodated without serious consequences, but in some cases (and especially in those with...
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Ostium secundum-type ASD accounts for 90% of all ASDs. It reflects a true deficiency of the atrial septum and should not be confused with patent foramen ovale. Ostium secundum defects commonly occur in the middle portion of the septum and vary in size from a trivial opening to a large defect of the entire fossa ovalis....
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Iron deficiency anemia is a microcytic hypochromic anemia. At first, children with iron-deficiency anemia may not have any symptoms. When symptoms do happen, a child might: look pale seem moody be very tired get tired quickly from exercise feel dizzy or lightheaded have a fast heabeat have developmental delays and beha...
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Ans. is 'b' i.e., Nose
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Ans. (d) NitrocelluloseRef: The essentials of FSM by KS Narayan Reddy 31st ed. /197-98Gun powders can be of two types and is made of:Black gun powderSmokeless powderConsists of:* Potassium nitrate 75%* Sulphur 10%* Charcoal 15%Consists of:* Nitrocellulose (single base; gun cotton)* Nitroglycerine + Nitrocellulose* Nitr...
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Aromatase enzyme: In a normal ovary, LH acts on the theca interstitial stromal cells, whereas FSH acts on granulosa cells. In response to LH the thecal cells secretes androgen, and the produced androsendione is conveed in the granulosa cells to estrogen by the action of aromatase enzyme. Ref: Physiology By James N. Pas...
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Peroxisomal proteins are fully folded in the cytoplasm and enter the organelle in folded form. The most common signal sequence which directs proteins to peroxisomes is a C-terminal Ser-Lys-Leu tripeptide. Reference: Harper; 30th edition
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Pigmentes stones Black stones Black stones are composed of insoluble bilirubin pigment polymer mixed with calcium phosphate and calcium bicarbonate Predisposing factors Hemolytic disorders (Heriditary spherocytosis, sickle cell anemia) Mechanical prosthetic hea valves Cirrhosis Gilbe's syndrome Cystic fibrosis Ileal di...
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The leading cause of GHRH mediated acromegaly is chest or abdominal carcinoid tumour. It will present with elevated GH levels and pituitary enlargement on MRI leading to high probability of misdiagnosis as pituitary adenoma. GHRH levels can be used to differentiate a pituitary vs extra pituitary aetiology.
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Gall bladder polyp more than 10 mm in size needs surgical intervention as the risk for developing malignancy is greater.Other risk factors include age>60 yrs,association with gallstones,rapid increase in size of polyp,symptomatic,sessile polyp. Reference:SRB's manual of surgery,5th edition,page no:658.
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Ans. is 'b' i.e., Catatonic o Best prognosis-Catatonic schizophrenia.o Late onset & good prognosis-Paranoid schizophrenia (overall second best prognosis after catatonic type).o Worst prognosis and early onset-Hebephrenic (disorganized schizophrenia).
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When insulin therapy is instituted ketosis subsides and potassium ions are driven intracellularly. This lead to hypokalemia. 1st IV Fluids should be given then slow iv infusion of insulin should be staed if blood glucose levels reach below 300, dextrose has to be combined with the insulin to prevent hypoglycemia (REF.E...
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*Oncogenic RNA viruses: Human T-cell leukemia virus 1, Hepatitis C virus*Oncogenic DNA virus : Human papilloma virus, Hepatitis B virus, Ebstein Barr virus, Kaposi sarcoma herpes virus (HHV8) and Merkel cell polyoma virus.Ref: Robbins 8/e p312
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Step 1 Painful ulcer → Chancroid or HSV. Step 2 In the question, there is no information about step 2 → suppurative lymphadenopathy, U/L or B/L lymphadenopathy, presence or absence of vesicle. So go for step - 3. Step 3 Induration (+)nt → Chancroid Undermined sloughed edges → Chancroid
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Rates of post-procedure hypocalcemia are approximately 5%, and it resolves in 80% of cases in approximately 12 months Other complications include haemorrhage , damage to recurrent laryngeal nerve and superior laryngeal nerve. Respiratory obstruction due to laryngeal oedema or very rarely due to collapse or kinking of t...
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Ans: A (Craving) Ref: Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th editionExplanation:AddictionIt is a lay-man term no longer preferred in medical literature.There is a range in the use of any substance (here "substance" is the term denoting anything which has some effect on body, usually brain) viz., ...
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Ans: A (Cardiac output) Ref: Pal GK, Cardiac Output. In: Textbook of Medical Physiology, 2nd ed, Ahuja Publishing House 2011: 74: 608Explanation:In Fick's method, the following variables are measured:Oxygen consumption in ml of pure gaseous oxygen per minuteOxygen concentration of blood taken from the pulmonary arteryO...
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Ref: Samar K Basaks Clinical Opthalmology 2nd edition.ExplanationRetinal detachmentRetinal detachment is the separation of sensory retina from the retinal pigmentary epithelium by subretina] fluid (SRF)Retina] break is the full thickness defect in sensory retinaRetinal detachments are classified asRhegmatogenous (prima...
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Ans. (b) Cardia.Forceful vomiting may produce a mucosal tear at the cardia rather than a full perforation. In Mallory-Weiss syndrome, vigorous vomiting produces a vertical split in the gastric mucosa, immediately below the squamocolumnar junction. The condition presents with hematemesis. Usually, the bleeding is not se...
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Ans. is 'a' i.e.Heimlich's maneuver The best option here is Heimlich's maneuver."Heimlich man oeuvre: stand behind the person and place your arms around his lower chest and give four abdominal thrusts. The residual air in the lungs may dislodge the foreign body providing some airway. "Heimlich's maneuveris actually per...
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Ans. A: Alkaline urine Paradoxical aciduria occurs when a metabolic alkalosis caused by severe vomiting as seen in pyloric obstruction. Blood tests initially will reveal hypochloremic metabolic alkalosis due to loss of hydrochloric acid vomiting, but sodium and potassium levels are normal. However as dehydration progre...
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Ans. C i.e. Somatisatic 7 disorderSomati3ation disorderPatient presents with multiple physical complaints (referable to different organ systems),Formal diagnostic criteria require the recording of at least 4 pains:- 2 gastrointestinal,- 1 sexual and- 1 pseudo-neurologic symptom
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Left atrial enlargement presents radiologically with elevation of left main bronchus ( earliest feature ) ,splaying or widening of carina ,displacement of oesophagus posteriorly ,double Right hea border and prominent left atrial appendage
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The fascia of Waldeyer is a connective tissue by which the rectum( ampulla) is attached to the sacrum and coccyx.Fascia of Denonvilliers lies between the prostate and the ampulla of the rectum.Reference: Textbook of anatomy, Abdomen and lower limb, Vishram Singh, 2nd edition, page no.281
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In severe cases of copper poisoning, jaundice occurs due to both haemolysis as well as direct liver damage produced by copper sulphate. Renal failure may occur due to direct toxicity as well as intravascular haemolysis. Ref: Krishan Vij textbook of forensic medicine, 5th edition pg : 569,570
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This is a condition of Dupuytren's contracture Flexion deformity- because of abnormal fibrosis of palmar aponeurosis leading to cord or nodule formation. M/C cause is Idiopathic MCP>PIP>DIP involved most commonly Ring finger more common than little finger involved Treatment: Conservative by stretching and inj. collagen...
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Repeated vomiting after meals
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In complicated cataract 'polychromatic luster'ie., appearance of iridescent coloured paicles of reds, greens and blue is a very characteristic sign (Rainbow cataract). IMG REF
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The anterior cranial fossa is supplied by Anterior and posterior ethmoidal nerves (major supply); Nervus meninges medius (a branch of maxillary nerve); and nervus spinosus (a branch of mandibular nerve).
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PERSONS WITH HIGH RISK OF CMV INFECTION : organ transplantation with malignant tumors who are recieving chemotherapy with hiv/aids viral excreation is icreased and prolonged diffuse interstitial pneumonia is common complication ref : ananthanaryana 9th ed
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D i.e. Childhood depression
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Since this patient has developed gangrene of the toe ankle to brachial presure ratio should be less than 0.3. Ratio of ankle to brachial systolic pressure (ankle brachial index) is obtained to determine the presence and magnitude of occlusive disease. The ankle brachial index of 0.9 - 1.0 indicates normalcy or minimal ...
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Mala-N Mala-D Type of contraceptive Combined OCP Combined OCP Estrogen Ethinyl estradiol Ethinyl estradiol Progesterone Norgestrel Desogestrel Status in RCH Provide free of cost Provided at a subsidized cost (Rs. 3/ per packet)
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Ans. All of the above
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The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; Pg.no. 114 : The length of the wound is slightly less than the width of the weapon upto which it has been driven in ,because of the stretching of the skin . Therefore length of stab wound gives information of the width of the weapon ...
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Anterior wall of Inguinal canal is formed by External oblique aponeurosis Internal oblique muscle
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A i.e. Herpes simplex Decreased corneal sensations, dendritic and geographical ulcers are characteristic features of Herpes simplex ocular disease Q Sensory supply of cornea is through trigeminal nerve Q. Neurotrophic keratopathy occurs due to paralysis of sensory supply of cornea. Causes of neurotrophic keratopathy or...
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Ans. is 'a' i.e., Debridement & antibiotics o Gas gangrene is one of the most fulminant gram-positive bacterial infections of humans. Even with appropriate antibiotic therapy and management in an intensive care unit, tissue destruction can progress rapidly. Gas gangrene is accompanied by bacteremia, hypotension, and mu...
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Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes.The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. Often it is associated with hives, which are swelling within the upper skin.Onset is typically over minutes to hours Ref Harrison...
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Ans. is 'b' i.e., Malignant nephrosclerosiso Malignant nephrosclerosis is the one of the renal disease associated with malignant or accelerated phase hypeension. The main pathology is Fibrinoid necrosis of aerioles.o In kidney small pinpoint petechial hemorrhage may appear on the coical surface from the rupture of aeri...
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The weakness of voice is the earliest symptom followed by hoarseness of voice. Ulceration of larynx produces severe pain, which may radiate to ears. Pain during swallowing is seen in later stages. On examination, hyperemia of the vocal cord in its whole extent or confined to posterior pa with impairment of adduction is...
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All of the above * Erythema multiforme. a. Target lesions are characteristic b. Haemorrhagic crusts may form on lips c. Lesions resolve over 3 to 6 weeks d. Severe erythema multiform with extensive bullous eruption of skin and mucous membranes is called Stevens-Johnson syndrome e. Lesions are distributed symmetrically ...
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International Organization for Standards (ISO) has added refinements (ISO 3950) to the FDI system to designate areas of the oral cavity and to provide 'sextants' as with the CPITN.  00 whole oral cavity  01 maxillary area  02 mandibular area  03 upper right sextant  04 upper anterior sextant  05 upper left sextant  06 ...
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Warfarin prevents the recycling of vitamin K by blocking the activity of Vitamin K epoxide reductase, thus creating a functional vitamin K deficiency.
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Clozapine
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Ans. is 'c' i.e., Inhibiting Vitamin K dependent carboxylation o Warfarin inhibits vitamin K dependent carboxylation of clotting factors by inhibiting the enzyme Vitamin K epoxide reductase.Oral anticogulantso They act indirectly by interfering with the synthesis of vit K dependent clotting factors in liver,o They inte...
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Acidic protein, 100% Soluble in ammonium sulfate at neutral pH (derivation of name) S100 protein family is multigenic group of nonubiquitous cytoplasmic EF-hand Ca2+-binding proteins, sharing significant structural similarities at both genomic and protein levels; S100 protein family has 24 known human members each code...
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All of the above statements are false regarding Oligomenorrhoea. Oligomenorrhoea: It denotes infrequent, irregularly timed episodes of bleeding usually occuring at intervals of more than 35 days. A revised terminology system for abnormal uterine bleeding in nongravid reproductive-age women was introduced in 2011 by the...
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Coronary circulation: Sympathetic stimulation will not decrease blood flow to the hea. If it occurs, then during sympathetic stimulation there is a high chance of getting myocardial infarction.
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Ans. is 'b' IgM antibody of HBcAg (Ref. November 2001, Micro, Harrison 17/e p 1943-44,1933-34 & 16/e, p 1823-24).
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Ans. C. HLA B8a. Dermatitis herpetiformis is a disease characterized by erythematous vesicular or bullous lesions and severe itching. The disease most commonly occurs between 20-40 years of age and men are more commonly affected. IgA is deposited in the reticular dermis of the uninvolved skin suggesting an immune etiol...
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Ans: (d) ChalazionRef: A.K. Khurana's Comprehensive Ophthalmology, 6th edition, Page 367-370 Hordeolum externumHordeolum internumChalazionDefinition*. Acute suppurative inflammation of the glands of Zeis and Moll*. Zeis - modified sebaceous glands and Moll - modified sweat gland. Both open at the root of lash follicles...
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1971
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DEEP PERINEAL POUCH CONTAINS Muscles Deep transverse perineal muscle External sphincter muscle of urethra External sphincter muscle of urethra(male) Compressor Urethrae Muscle(female) Urethrovaginal Sphincter (female) Other Membranous poion of the urethra (males) / proximal poion of urethra (females) Bulbourethral glan...
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H. Ducreyi causes soft chancre/ chancroid. It doesn't cause urethritis in males. Infectious cause of urethritis- Neisseria gonorrhea Chlamydia trachomatis Trichomonas vaginalis Mycoplasma genitalum HSV Adenovirus Ureaplasma urealyticum
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Ans. is 'a' i.e., Tuberculosis; 'b' i.e., Irradiation & 'c' i.e., Infarct Scar Ca seen after --> Old infarcts, metallic foreign bodies, wounds, granulomatous infection such as T.B. These carcinomas are usually Adenocarcinomas
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Ans. (a) Angiotensin receptor blockersRef KDT 6th ed. 553* ACEs are the drugs which inhibit the conversion of angiotensin-I to angiotensin-II. They can cause severe fetal malformations when given in the second and third trimesters.* These include: Hypocalvaria and renal dysfunction and are also teratogenic and because ...
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Ans. is 'a' i.e., Amiodarone Drugs causing hypothyroidism -o Lithiumo Sulfonamideo Phenobarbitoneo Phenytoino Amiodaroneo Paraminosalycylie acid (PAS)o Rifampicino Carbamazepine
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Ans. (b) SLE(Ref: Dubois' Lupus Erythematosus pg 542)Lupus Band testA diagnostic procedure used to detect deposits of immunoglobulins and complement components along the dermo-epidermal junction in patients with SLE & cutaneous lupusIt is positive in about 70%-80% of sun-exposed & 55% of sun-protected non-lesional skin...
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Insulin receptor is a tyrosine kinase which is heterotetrameric glycoproteinRef: Essentials of Medical Pharmacology, 7th edition, KD Tripathi, page no: 261
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ANS. BMenkes disease, also known as Menkes syndrome, is an X-linked recessive disorder that affects copper levels in the body, leading to copper deficiency (ATB 7A gene on chromosome 13).Signs and symptoms of this disorder include:1. Weak muscle tone (hypotonia)2. Sagging facial features3. Seizures4. Intellectual disab...
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The 4 muscles which constitute the rotator cuff are supraspinatus, infraspinatus, teres minor and subscapularis. They form a musculotendinous cuff around the glenohumeral joint. It provides muscular suppo primarily to the anterior, posterior, and superior aspects of the joint.Supraspinatus muscle: Its primary action is...
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Step wells
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TUBERCULAR OTITIS MEDIA In most of the cases, infection is secondary to pulmonary tuberculosis; infection reaches the middle ear through eustachian tube. Disease is mostly seen in children and young adults. PATHOLOGY The process is slow and insidious. Tubercles appear in the submucosal layers of middle ear cleft and ca...
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Ans. is 'c' i.e., Cotranspo of amino-acids with Na+
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Patients are usually evaluated for possible sarcoidosis based on two scenarios .In the first scenario, a patient may undergo biopsy revealing a noncaseating granuloma in either a pulmonary or an extrapulmonary organ. In the second scenario, signs or symptoms suggesting sarcoidosis such as the presence of bilateral aden...
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5 days
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5% lignocaine is used for spinal anaesthesia. Also know: Percentage of lignocaine used for: IV regional anaesthesia - 0.5% Nerve block - 1% Epidural / Jelly - 2% Topical - 4% Spinal - 5% Ref: Morgan's 4th / pg. 270, KDT 6th / pg. 357.
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Stitches are removed on 5 post -op day
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