Question: Ideal bone for bone graft is

The fibula is an ideal spare bone for a bone graft.Ref: Chaurasia; Volume 2; 6th edition; Page no: 29


Question: Most common cause of bone malignancy

Metastatic bone disease is the most commonest malignancy of bones and is much more than primary bone tumors Metastatic Bone Diseases(MBD) Cancer that begins in an organ, such as the lungs. breast, or prostate, and then spreads to bone is called metastatic bone disease (MBD). More than 1.2 million new cancer cases are diagnosed each year. Approximately 50% of these tumours can spread (metastasize) to the skeleton. With improved medical treatment of many cancers --especially breast. lung, and prostate -- patients are living longer. However, the primary cancers in more of these patients are spreading to bone. The tumours that result are called bone metastases. Organs involved in MBD * The most common cancers that arise from organs and spread to bone include: * Breast * Lung * Thyroid * Kidney * Prostate Pathophysiology of MBD : MBD causes pain in the area of spread. damages and weakens bone, and puts the patient at a greater risk for broken bones. It can make it hard to paicipate in daily activities. The biggest concern for patients with MBD is the general loss in quality of life. How much of an effect MBD has on a patient will vary and is associated with how much the cancer has spread. which bones are affected, and how severe the bone damage is. There are a range of treatment options, however. that can help patients manage pain and maintain their independence and activity levels. After the lung and the liver, the skeleton is the most common site of spread of cancers that begin in organs. Metastases to the lung and liver are often not detected until late in the course of disease because patients experience no symptoms. In contrast. bone metastases are generally painful when they occur. Cancer most commonly spreads to these sites in the skeleton: Spine Pelvis Ribs Skull Upper arm Symptoms Pain. The most common symptom of MBD is pain. Patients may have pain in the spine, pelvis, or extremities because the bone has been weakened by the tumour. Fractures. Weakened bones break more easily. A fracture from a minor injury is another possible sign of MBD. Anaemia. The most common sites of spread -- spine, pelvis, ribs, skull, upper arm, and long bones of the leg --correspond to areas of bone marrow that produce high levels of red blood cells, the cells responsible for carrying oxygen to tissues in the body. Anaemia (decreased red blood cell production) is a common blood abnormality in patients with MBD. A cancer patient who experiences any pain, especially in the back, legs, and arms, should notify his or her doctor immediately. Pain that occurs without activity (i.e., walking or lifting an object) is paicularly concerning. Refer Apleys 9th/e p 216


Question: Frey's syndrome (gustatory sweating) is due to lesion of

Auriculotemporal nerve carries parasympathetic secreto-motor fibres to parotid gland. After parotidectomy, sometimes there may be regeneration of secretomotor fibres in Auriculotemporal N This regeneration is misdirected into sweat glands. Thus, whenever the patient thinks of food/smells /chews food there would be stimulation of sweat glands & hyperaemia resulting in redness & sweating in front of ear on cheek. This clinical entity is called 'FREY SYNDROME'/AURICULOTEMPORAL SYNDROME/GUSTATORY SWEATING. Image showing Starch-iodine test:


Question: Nerve supply of tip of nose

Nerve supply General sensory nerves derived from the branches of trigeminal nerve are distributed to whole of the lateral wall: Anterosuperior quadrant is supplied by the anterior ethmoidal nerve branch of ophthalmic nerve. Anteroinferior quadrant is suplied by the anterior superior alveolar nerve branch of infraorbital continuation of maxillary nerve. Posterosuperior quadrant is supplied by the lateral posterior superior nasal branches from the pterygopalatine ganglion. Posteroinferior quadrant is supplied by the anterior palatine branch from the pterygopalatine ganglion REF.BDC VOL.3,FIFTH EDITION

Ext nasal branch of ophthalmic division of


Question: "Dacryocystitis" is interruption in drainage of


Question: Formal thought disorder that is classical in mania is

In flight of ideas, the individual stas at a point, shifts the topic , subsequent thoughts will have some association but they will not reach goal. This is classical of MANIA In loosening of association, patient comes with random thoughts that is not connected to each other and the goal is not reached. This is classical of schizophrenia they will introduce new words that are not present in one's dictionary , seen in SCHIZOPHRENIA In circumstantial speech individual stas about a topic, adds minute irrelevant details , beats around the bush and finally reaches the goal. This is seen in ORGANIC BRAIN CONDITIONS Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg No.194


Question: Anterior spinal artery is a branch of


Question: Posterior communicating aery is branch of

Posterior communicating aery arises close to the termination of internal carotid aery. Other branches of cerebral pa internal carotid aery are: Ophthalmic aery Anterior cerebral aery Middle cerebral aery Anterior choroidal aery Posterior cerebral aery is a branch of basilar aery. (Ref: Vishram Singh textbook of clinical neuroanatomy 2nd edition, pg- 176)


Question: Sacrococcygeal teratoma is a derivative of

Sacrococcygeal teratoma: - Sometimes remnants of the primitive streak persist in the sacrococcygeal region. Then cluster of pluripotent cells proliferate & form tumor, known as sacrococcygeal teratomas Which commonly contain tissues derived from all three germ layers. Occurrence 1: 37,000 Most common tumor in a new born. Teratomas may also arise from abberent migration of primordial germ cells.


Question: Liver is divided into


Question: Coracoid process is an example for

-This kind of epiphysis is a pa of the bone which exist as a separate bone in lower animals;but in humans it has fused with the main bone-Coracoid bone is a separate bone in aies


Question: Middle superior alveolar nerve is a branch of

C i.e. Anterior nasal division of maxillary nerve


Question: Initial investigation for obstructive jaundice is

Obstructive jaundiceObstructive jaundice is a paicular type of jaundice and occurs when the essential flow of bile to the intestine is blocked and remains in the bloodstream.Causes of Obstructive jaundice Due to blocked bile ducts caused by gallstones, or tumors of the bile duct.Swelling of lymph glands, scar tissue (from previous infections or surgery), or a cyst, possibly of the pancreas.Clinical featuresDiagnosisTreatmentSymptoms of obstructive jaundice include yellowing of the skin and whites of the eyes; paler stools and darker urine; and intense itching. Other symptoms vary, depending on the underlying cause of the obstruction although you may also feel tired.Blood tests to examine the level of bilirubinUltrasound of the liver and bile ducts to find out the exact cause of the obstruction CT scans are also used to help examine what is causing the blockageSurgical resection ERCP or a procedure is known as Percutaneous Transhepatic Cholangiography (PTC) with percutaneous biliary drainage(Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1535-1544)


Question: A widely used the drug that suppresses cellular immunity,inhibits prostaglandin and leukotriene synthesis and increases the catabolism of IgG antibody is

Ref-KDT 6/e p828,838 Glucocoicoids are powerful immunosuppresants. These inhibit both cellular and humoral immunity by: Decreasing the recruitment of immune cells Catabolism of immunoglobulins. Inhibiting the enzyme phospholipase A, resulting in decreased production of PGs,LTs and TXs


Question: The narrowest pa of the ureter is at the

Ureterovesical junction is the anatomical position where the ureters join the urinary bladder. This is the narrowest of the ureter. Ureters are surrounded by the valves called as ureterovesical valve which will prevent the vesicoureteral reflux. Ref - urologyhealth.org


Question: Sensory supply for skin over angle of jaw is

Cervial plexus supplies Skin over the angle of the jaw and over the parotid gland. Lower margin of the lower jaw


Question: The most common congenital anomaly of the pancreas

Pancreas divisum is the most common clinically significant congenital pancreatic anomaly, with an incidence 3% to 10% in autopsy series.


Question: Ligamentum teres develops from

Umbilical vein "In anatomy, the round ligament of liver (AKA: ligamentum teres - or more specifically ligamentum teres hepatis as the human body has three round ligaments in total) is a degenerative string of tissue that exists in the free edge of the falciform ligament of the liver. The round ligamentrepresents the remnant of the fetal left umbilical vein"


Question: Factor present in final common terminal complement pathway

Ref Harrison 17/e p2030 _2032 C5a is a protein fragment released from cleavage of complement component C5 by protease C5-convease into C5a and C5b fragments. C5b is impoant in late events of the complement cascade, an orderly series of reactions which coordinates several basic defense mechanisms, including formation of the Membrane Attack Complex (MAC), one of the most basic weapons of the innate immune system, formed as an automatic response to intrusions from foreign paicles and microbial invaders. It essentially pokes microscopic pinholes in these foreign objects, causing loss of water and sometimes death. C5a, the other cleavage product of C5, acts as a highly inflammatory peptide, encouraging complement activation, formation of the MAC, attraction of innate immune cells, and histamine release involved in allergic responses


Question: Apical lung tumor causes

Apical lung cancer/ Pancoast tumor causes - 2deg neuron injury (Preganglionic sympathetic fibres) I/L horner syndrome (Cervical sympathetic chain and ganglion involved) Loss of sweating on same side of face 1deg sympathetic neuron injury occurs in Wallenberg syndrome 2deg sympathetic neuron (preganglionic fibers) injury occurs in Apical lung cancer 3deg sympathetic neuron (postganglionic fibers) injury occurs in Internal carotid aery disection


Question: Epidural space lies between


Question: Biceps Femoris, a hamstring muscle causes

Hamstring Muscles( Biceps femoris long head, semitendinous, semimembranous, and adductor magnus) causes flexion at knee joint and Extension at Hip Joint. Hip flexion and knee Extension by quadriceps femoris muscle Hip and knee Flexion by saorious


Question: Punishment for adultery is

Man who commits the offence of adultery shall be punished with imprisonment up to 5 years or with fine or both. Ref: FORENSIC MEDICINE AND TOXICOLOGY DR PC IGNATIUS THIRD EDITION PAGE 308


Question: AScoffs nodules are seen in

Refer Harrison 17/2095 Robbins 9/e p558 Aschoff bodies are nodulesfound in the heas of individuals with rheumatic fever. They result from inflammation in the hea muscle and are characteristic of rheumatic hea disease The cardiac manifestations of rheumatic fever are in the form of focal inflammatoryinvolvement of the interstitial tissue in all 3 layers of the hea, a pathological change named pancarditis. The pathognomonicfeature of pancarditis in the case of rheumatic hea disease is the presence of Aschoff nodules or Aschoff bodies


Question: The infratentorial dura is supplied by branches of the

The tentorium cerebelli is a tent-shaped fold of dura mater, forming the roof of the posterior cranial fossa.It separates the cerebellum from the occipital lobes of the cerebrum and broadly divides the cranial cavity into supratentorial and infratentorial compaments. The infratentorial compament, in other words, is the posterior cranial fossa containing the hindbrain and the lower pa of the midbrain. The posterior cranial fossa is supplied chiefly by recurrent branches from first, second and third cervical spinal nerves and paly by meningeal branches of the ninth and tenth cranial nerves. Ref: BD Chaurasia; Volume 3; 6th edition; Page no: 92

Upper cervical spinal nerves and the vagus nerve


Question: The minor surfactant in lung is

Phosphotidyl choline is major surfactant Sphyngomyelin is minor surfactant


Question: Muscle involved in the rotation and protrusion of the mandible


Question: C cells are present in

Cells of the ultimobranchial body give rise to the parafollicular or C cells of the thyroid gland. These cells secrete calcitonin, a hormone involved in regulation of the calcium level in the blood.Reference: Krishna Garg Histology; 5th edition; Page no: 230; 232


Question: NOT a content of Rectus sheath among the following is

Thorcoabdominal nerves (T7 - T11) and Subcostal nerve ( T12) are the nerves of Rectus sheath. T6 is not the content of Rectus sheath


Question: Not under flexor retinaculum

Structures deep to flexor retinaculum1) Lateral compament : Flexor carpi radialis tendon with its synol sheath lodged in the groove on the palmar surface of trapezium.2 Medial compament : (carpal tunnel proper).Structures superficially to flexor retinaculum 1) Palmaris longus tendon continuous with apex of palmar aponeurosis.2) Palmar cutaneous branch of median nerve.3) Palmar cutaneous branch of ulnar nerve.4) Ulnar nerve.5) Ulnar vessels protected superficially by volar carpal ligament (superficial pa of the flexor retinaculum).


Question: In agranuloma , epthiloid cells and giant cells are derived from

ref Robbins 9/e p97 All granulomas, regardless of cause, may contain additional cells and matrix. These include lymphocytes, neutrophils, eosinophils, multinucleated giant cells, fibroblasts and collagen (fibrosis). The additional cells are sometimes a clue to the cause of thegranuloma. Macrophage and monocytes are also present


Question: Total bones in the skull are

The skull consists of the 22 bonesCalvaria or brain case Facial skeleton Unpaired1.Frontal2.Occipital3.Sphenoid4.EthmoidUnpaired1.Mandible2.VomerPaired1.Parietal2.TemporalPaired1.Maxilla 2.Zygomatic 3.Nasal 4.Lacrimal 5.Palatine 6.Inferior nasal conchaReference: Chaurasia; 6th edition; Chapter 1; Osteology of head and neck


Question: Paradoxical splitting of second hea sound Heard in

Ref Harrison 19 th ed pg 1447 Reversed or paradoxical splitting refers to a pathologic delay in aoic valve closure, such as that which occurs in patients with left bundle branch block, right ventricular pac- ing, severe AS, HOCM, and acute myocardial ischemia. With reversed or paradoxical splitting, the individual components of S2 are audible at end expiration, and their interval narrows with inspiration, the oppo- site of what would be expected under normal physiologic conditions.


Question: Jansen disease is


Question: The neuroleptic malignant syndrome is characterized by

Ref: Kaplan and Sadock&;s Synopsis of Psychiatry, 10th edition, pg no: 995Features of the Neuroleptic malignant syndrome:Increased body temperature >38degC (>100.4degF), orConfused or altered consciousnessDiaphoresis "sweat shock"Rigid musclesAutonomic imbalanceLabile hypeension Metabolic acidosis


Question: Cilioretinal A is a branch of

The posterior ciliary aery (PCA) circulation is the main source of blood supply to the optic nerve head (ONH), and it also supplies the choroid up to the equator, the retinal pigment epithelium (RPE), the outer 130 mm of retina (and, when a cilioretinal aery is present, the entire thickness of the retina in that region), and the medial and lateral segments of the ciliary body and iris. That makes the PCA circulation the most impoant pa of the ocular and ONH circulation. Therefore, disturbances in the PCA circulation can result in a variety of ocular and ONH vascular disorders, causing varying degrees of visual loss. I have investigated various aspects of the PCA circulation in health and disease by anatomic, experimental, and clinical studies since 1955. The objective of this lecture is essentially to summarize the main findings of those studies. It is beyond its scope to review the extensive literature on the subject that has accumulated over recent years. <img src=" /> Ref - BD chaurasia 6e vol3 pg 212


Question: Axillary nerve supplies

Posterior division of axillary nerve supplies the posterior pa of deltoid muscle and teres minor. Teres minor is one of the muscle in rotator cuff muscles. B D Chaurasia 7th edition Page no : 180


Question: Hirsprung disease is due to

C i.e. Failure of migration of neural crest cells from cranial to caudal direction

Loss of ganglionic cell in paraveebral sympathetic chain

Failure of migration of neural crest.cell from cranial tocaudal direction


Question: Ergot alkaloid commonly used to prevent postpaum haemorrhage is

Methylergometrine (methergin) is administered during delivery of anterior to prevent postpaum hemorrhage Ref-KDT 6/e p322


Question: Metrinidazole is least likely to be effective in the treatment of

Ref-KDT 6/e p686 Metranidazole is not effective against pneumocyst infection. The DOC for this condition is cotrimoxazole

Infection caused by bacteroides fragilis


Question: Centrum of veebra is formed from

In the veebrate spinal column, each veebra is an irregular bone with... The upper and lower surfaces of the centrum are flattened and rough in order to give attachment to the interveebral discs.BD CHAURASIA S HUMAN ANATOMY Vol1


Question: High calcium intake can lead to

Refer Robbins page no Milk alkali syndrome is due to excessive ingestion of calcium and absorbabke antacids such as milk or calcium carbonate .This is associated with the development of metastatic Calcification


Question: Major flexor of hip joint

The hip flexors Vesi are (in descending order of impoance to the action of flexing the hip joint): Collectively known as the iliopsoas or inner hip muscles: Psoas major Iliacus muscle Anterior compament of thigh Rectus femoris (pa of the quadriceps muscle group) Saorius One of the gluteal muscles: Tensor fasciae latae Medial compament of thigh Pectineus Adductor longus Adductor The psoas major is a long fusiform muscle located on the side of the lumbar region of the veebral column and brim of the lesser pelvis. It joins the iliacus muscle to form the iliopsoas. Ref - BDC 6th edition vol2 ; pg 139


Question: In child's criteria paial encephalopathy, bilirubin 2.5mg/dl, albumin 3gm/dl, prothrombin time 5min and controlled ascites indicates

Refer previous question child-Turcotte point score table Ref: Sabiston 20th edition Pgno : 1436


Question: Intraocular muscle supplied by Edinger Westphal nucleus is

All pas of the muscle are supplied by parasympathetic nerves. The pathway involves the Edinger-Westphal nucleus, oculomotor nerve, and the ciliary ganglion. The nerve to inferior oblique gives a branch for the ciliary ganglion. This branch brings the fibres of Edinger-Westphal nucleus (GVE) to the ganglion for relay. The postganglionic fibres end up in supplying the ciliaris for enhancing the anterior curvature of the lens and the sphincter pupillae for narrowing the size of the pupil. Both these are intraocular muscles required for accommodation. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition


Question: If circumflex aery gives the posterior interventricular branch, this circulation is described as aEUR'

Left dominance Dominance of the coronary aerial system depends on which aery gives rise to the posterior interventricular branch (posterior descending aery). This branch supplies adjacent areas of both ventricles and posterior third of the IV septum.Right dominance: In this more conzmon type the posterior interventricular aery is a brute of . coronary aery. Seen in 67 to 90% of the population (67% according to Moore's 5/e and 90% according to Snell's 6/e and BDC 4/e, and some middle values on internet)Left dominance: The circumflex aery, the continuation of left coronary provides the post. IV branch (Seen in 10 to 15%)Codominance/balanced: Branches of both right and left coronary aery run in or near the sulcus.Note that the term 'Right dominance' is misleading, since the left aery almost always supplies a greater volume of tissue.


Question: A "Potential Anastomosis" seen in

Aerial anastomosis is the communication between the aeries, or branches of aeries. It may be actual or potential. Actual Aerial Anastomosis: In actual aerial anastomosis the aeries meet end to end. For example, palmar arches, plantar arch, circle of Willis, intestinal arcades, labial branches of facial aeries. Potential Aerial Anastomosis: In potential aerial anastomosis the communication takes place between the terminal aerioles. Such communications can dilate only gradually for collateral circulation. Therefore on sudden occlusion of a main aery, the anastomosis may fail to compensate the loss. The examples are seen in the coronary aeries and the coical branches of cerebral aeries. Ref - Medscape.com


Question: Choledochal cyst in intrahepatic biliary tree

Todani Modification of Alonso-Lej classification Type I - Dilation of extrahepatic biliary tree Type Ia- cystic dilation Type Ib - focal segmental dilation Type Ic- fusiform dilation Type II - Diveicular dilation of extrahepatic biliary tree Type III - Cystic dilation of intra duodenal poion of common bile ducts (choledochocele) Type IVA- Dilation of the extrahepatic and intrahepatic biliary tree Type IVB- Dilation of multiple secretion of extrahepatic bile ducts Type V - Dilation confined to intrahepatic bile ducts (caroli's disease) Type VI - Cystic dilation of cystic duct (not included in Todani's modification) Ref: Sabiston 20th edition Pgno :1510-1511


Question: Contraindication of TIPSS is

Contraindications of TIPSS Absolute Right sided hea failure Polycystic liver disease Pulmonary hypeension Hepatopulmonary syndrome Relative Poal vein thrombosis Hypervascular liver tumors Encephalopathy Ref: Sabiston 20th edition Pgno :1439


Question: Muscles of the anterior compament of the leg are innervated primarily by

In the leg, the deep peroneal nerve supplies muscular branches to the Tibialis anterior, Extensor digitorum longus, Fibularis (Peroneus) teius, and Extensor hallucis longus, and an aicular branch to the ankle-joint.


Question: Foramen scarpa is another name of


Question: ANCA is most specific and sensitive marker for

Robbins 9/e p 910-911 merulonephritis and cases of crescentic glomerulone- phritis that occur as a component of systemic vasculitis, and the similar pathologic features in either setting, have led to the idea that these disorders are pathogeneti- cally related. According to this concept, all cases of crescentic glomerulonephritis of the pauci-immune type are manifestations of small-vessel vasculitis or polyangiitis, which is limited to glomerular and perhaps peritubular capillaries in cases of idiopathic crescentic glomerulonephritis. Since these entities are viewed


Question: Treatment of choice for cyanide poisoning is

Refer kDT 6/e p527 Administer a cyanide antidote if the diagnosis of cyanide toxicity is strongly suspected, without waiting for laboratory confirmation. Available antidotes are hydroxocobalamin (Cyanokit) and sodium thiosulfate and sodium nitrite (Nithiodote). Both are given intravenously. Patients who present with more than minimal symptoms that resolve without treatment should be admitted for observation and suppoive care. In patients with acute poisoning from hydrogen cyanide (HCN) gas or soluble salts, the principal acute care concerns are hemodynamic instability and cerebral edema. The continuous cardiac monitoring, respiratory and cardiovascular suppo, and frequent neurologic evaluation these patients require is generally best provided in an intensive care unit.


Question: Middle cerebellar peduncle transmits fibres of


Question: Kayser Fleischer ring is seen in

Refer Robbins page no 850 Toxic injury to the brain primarily affects the basal ganglia, paicularly the putamen, which shows atrophy and even cavita- tion. Nearly all patients with neurologic involvement develop eye lesions called Kayser-Fleischer rings, green to brown depos- its of copper in Descemet membrane in the limbus of the cornea.


Question: Largest lymphoid organ is

(B) Spleen [BDC II4-279# Largest lymphatic organ in the human body is the spleen.> Primary function of the spleen is to purify the blood and store blood cells.> It helps the immune system identify and combat foreign antibodies.> Spleen consists of white pulp and red pulp.> White pulp generates blood cells and synthesizes antibodies, and the red pulp removes old blood cells and filters the blood.


Question: Balthazar scoring system is used for

Computed Tomography severity index(CTSI) for acute pancreatitis CTSI= Balthazar grade score + necrosis score Highest attainable score =10 CTSI score 0-3: Moality 3%,Morbidity 8% 4-6: Moality 6%, Morbidity 35% 7-10: Moality 17%, Morbidity 92% Refer CTSI table Ref: Sabiston 20th edition Pgno :1527


Question: Failure of descent of thyroid analage can be seen in the tongue

Near the base of tongue close to foramen caecum


Question: Safety muscle of tongue is


Question: Deep injury of neck always involves

Investing layer lies deep to the platysma and surrounds the neck like a collar. The surgeon has to stitch platysma muscle separately so that skin does not adhere to deeper neck muscles otherwise the skin will get an ugly scar. Ref BDC volume 3;sixth edition pg 81


Question: Hanging cast is used in

Refer Maheshwari 6th/e 94 Most of the closed fractures can be treated by hanging cast from shoulder to wrist with the elbow flexed to 90 degree Other methods of conservative Treatment areU-slab,chest arm bandage and functional castbrace


Question: Auxillary ohotopic liver transplant is indicated for

Indication of Auxillary Paial Ohotopic Liver Transplantation (APOLT) Reversible fulminant hepatic failure Small for size grafts Non- Cirrhotic metabolic liver disease ABO incompatibility AOPLT In fulminant hepatic failure, APOLT provides temporary suppo until the native liver recovers and then immunosuppression can be withdrawn APOLT can compensate for enzyme deficiency in non-cirrhotic metabolic liver disease Transplants of ABO incompatible grafts are often unavoidable due to limited number of potential donor candidates. A high incidence of early graft failure with a high rate of biliary and vascular complication in ABO incompatible liver transplantation is repoed. The remnant liver could sustain a patients life if the anticipated graft failure occurred in an ABO incompatible case In small for graft size, the remnant liver is expected to suppo the function of implanted graft during the early post op period. The graft liver expands its function in propoion to volume growth. After the graft liver has grown sufficiently, it can be expected to meet the hepatic functional demands of the reciepient Ref: Blumga 5th edition Pg no : 1689-1693

As a standby procedure until finding a suitable donor

Acute fulminant liver failure for any cause


Question: Biceps brachii does not arise from

BICEPS BRACHII:-Origin: Two heads-Long head-supraglenoid tubercle of scapula and glenoid labrum.Sho head-coracoid process of scapula.Inseion:-posterior rough pa of radial tuberosity Nerve supply:-musculocutaneous nerve.Action: supination of forearm when elbow is flexed.Flexion of forearm when elbow is extended.Biceps reflex:-Tapping tendon of biceps brachii by reflex hammer with forearm pronated and paially extended at elbow. Normal reflex confirms the integrity of musculocutaneous nerve and C5 and C6 spinal segments.{Reference: Vishram Singh, pg no.105}


Question: The layer responsible for strength of an intestinal anastomosis is

Mechanical propeiesThe mechanical propeies of the intact intestine in axial and transversal directions were different. The mechanical strength of the intact intestinal wall was conditioned by the submucosa and muscularis, while the serosa and mucosa showed no significant strength. Comparison of axial specimens&; mechanical propeies of the intact intestinal wall and intestinal wall with all layers sutured through determined that only the submucosa supplies mechanical strength to the anastomosis.Other layers contribute no significant force to anastomotic strength. The strength applied to the thread during knot tying does not change the paicipation of the intestinal layers in supplying suture-holding capacity for 8 and 12 mm stitch depth. (Refer:


Question: Testis lies in deep inguinal ring upto

Descent of testis The testes develop in relation to the developing mesonephros, at the level of segments T10 to T12. Subsequently, they descend to reach the scrotum. Each testis begins to descend during the second month of intrauterine life. It reaches the iliac fossa by the 3rd month Rests at the deep inguinal ring from the 4th to the 6th month, Traverses the inguinal canal during the 7th month, Reaches the superficial inguinal ring by the 8th month and the bottom of the scrotum by the 9th month. An extension of peritoneal cavity called the processus vaginalis precedes the descent of testis into the scrotum, into which the testis invaginates. The processus vaginalis closes above the testis. Descent does not occur after one year of age. Ref - BDC 6th edition vol2 pg 227


Question:
Most common cranial nerve palsy in basilar skull
fracture


Question: Hemorrhagic infraction is seen in

Ref Harrison 18/e p162,9/e p123 A hemorrhagic infarct (HI) can be defined as an ischemic infarct in which an area of bleeding exists within necrosing cerebral tissue. This definition includes smallhemorrhages confined to minor ischemic areas in grey matter as well as much larger lesions involving coical and deep hemispheric regions. Cerebral venous sinus thrombosis (CVST) is the presence of thrombosis in the dural vein, which occurs when a blood clot forms in the brain's venous sinus that prevents blood from draining out of the brain . Patients with venous sinus thrombosis have a variety of symptoms . Venous hemorrhagic infarction (VHI) is presented as a severe form of clinical symptom and a poor prognostic factor of CVST .


Question: Griesofulvin is not useful in one of the following

Refer CMDT 2010/110 *griesofulvin is used for dermatophytoses including Tinea capitis, Tinea cruris, Tinea pedis, Tinea ungunum and Tinea corporis *Tinea versicolor is caused by yeast Malassezia furfur .it is treated by selenium sulfide AMD ketaconazole shampoo


Question: Elimination of alcohol follows

Elimination of alcohol from blood is always linear with time, i.e., zero order kinetics. Ref-KDT 6/e p38


Question: a patient was brought to psychiatry casuality with contraction of the neck , the patient told that it was painul. this symptom staed after the injection given at the psychiatry hospital for his psychosis. the type of side effect caused by the drug is

Acute dystonia * <48 hours of staing antipsychotics * M.C in======Younger black males * If a patient develops dystonia he is more prone for eps Patient considers this as an Allergic reaction , thereby may stop drugs Layryngeal dystonia is a Psychiatric emergency, should be treated with IV lorazepam TREATMENT * Diphenhydramine * Benztropine mesylate * Prophylactic anticholinergics helps Ref. Kaplonand sadock, synopsis of psychiatry, 11 th edition, page no. 925


Question: In ductus venous, the fetal blood from the placenta reaches to the liver through

when there is an increase in placental circulation, to facilitate the rapid transpo of blood through the liver ,a large passage is formed between left umbilical vein and right hepato cardiac channel.This passage is called ductus venosus REFERENCE: TEXTBOOK OF CLINICAL EMBRYOLOGY... VISHRAM SINGH SECOND EDITION....PAGE NO:241


Question: charecterstic of anorexia nervosa is

Anorexia nervosa Anorexia nervosa is a eating disorder where the patient has decreased weight and altered body image and persistent desire to maintain thinness * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Intense fear of becoming fat * Restriction of food intake * Restricting type * Binge eating and purging type * Amenorrhea is not needed for diagnosis, previously amenorrhea is considered as a diagnostic criteria for diagnosis, in recent DSM 5 amenorrhea is considered for a diagnosis * Association= * OCD and depression * Decreased interest in sex * Complication * 7-14% moality * ECG changes * Hypokalemic alkalosis because of induced vomiting * Gastric dilation * Drugs * Cypro hepatidine * SSRI * Management * Admit in severe cases * Prevent vomiting by making restroom inaccessible for 2 hours after food intake * Avoid laxatives * Small frequent meals * Avoid refeeding syndrome Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509


Question: Three point bony relationship Of the elbow is disturbed

Fracture lateral condyle of the humerus Three point bony relation ship of elbow Fracture of medial or lateral and condyke/epicondyle/intercanglylar area Fracture of olecranon Elbow dislocation Refer Kenneth A Evil 4th p 609


Question: Most common benign tumor of liver is

Most common benign tumor of the liver Mainly seen in women of 45 years Small capillary hemangiomas(no clinical significance), larger cavernous hemangioma Usually single and <5 cm in diameter, occur equally in right and left liver Giant hemangioma: lesion>5cm Pathology Microscopically: Endothelium-lines, blood filled spaces that are seperated by thin, fibrous septa Enlargement of hemangiomas are by ectasia rather than neoplasia Clinical features Most commonly asymptomatic and incidentally found on imaging studies Large compressive masses may cause vague upper abdominal symptoms Kasabach-Merritt syndrome; syndrome of thrombocytopenia and consumptive coagulapathy Rarely seen LFT's and tumor markers are normal Diagnosis Diagnosis is made radiologically CT and MRI are diagnostic if a typical peripheral nodular enhancement pattern is seen Percutaneous biopsy is potentially dangerous and inaccurate not recommended Treatment Observation for asymptomatic cases Enucleation with inflow control is TOC for symptomatic cases Ref : Sabiston 20th edition Pgno :1456-1457


Question: Maximum unsaturated fatty acids are seen in

FatsPUFASafflower oil75Sunflower seed oil65Soya bean oil62Margarine 50Groundnut oil31Palm oil10Butter 3Coconut oil2(Refer: K. Park's Textbook of Preventive and Social medicine, 24thedition, pg no: 649)


Question: Regarding sexual differentiation of the fetus

OptionB: SRY Gene located on Y chromosome encodes Testis Determining Factor which leads to the development of male genital organs Option C&D: Development of external genitalia is similar in males and females till the 6th week of IUL(Indifferent stage)....later develops in the direction of hormones. REFERENCE: TEXTBOOK OF CLINICAL EMBRYOLOGY... VISHRAM SINGH SECOND EDITION..PAGE NO:277

Gonadal development begins at 5th week of intrauterine life

Y chromosome determines the differentiation of ovaries

Female external genitalia development is completed by 10 weeks

Male sexual differentiation occurs earlier than females


Question: Amyloid is

Ref Robbins 9/e p256 Amyloidosis is a condition associated with a number of inherited and inflammatory disorders in which extracel- lular deposits of fibrillar proteins are responsible for tissue damage and functional compromise. These abnormal fibrils are produced by the aggregation of misfolded pro- teins (which are soluble in their normal folded configura- tion) or protein fragments. The fibrillar deposits bind a wide variety of proteoglycans and glycosaminoglycans, including heparan sulfate and dermatan sulfate, and plasma proteins, notably serum amyloid P component (SAP). The presence of abundant charged sugar groups in these adsorbed proteins gives the deposits staining charac- teristics that were thought to resemble starch (amylose). Therefore, the deposits were called "amyloid," a name that is firmly entrenched despite the realization that the depos- its are unrelated to starch.


Question: Not a branch of posterior cord of Brachial plexus

Long thoracic nerve arises from the nerve root of C5-C7 and it supplies serratus anterior muscle. The axillary nerve supplies the deltoid and teres minor muscles. The thoracodorsal nerve supplies the latissimus dorsi muscle. The radial nerve supplies 3 heads of triceps brachii and 12 muscles on the back of the forearm. Mnemonic Posterior cord - ULTRA U- upper subscapular nerve L-lower subscapular nerve T-thoracodorsal R-radial nerve A-axillary nerve B D Chaurasia 7th edition Page no: 58 Fig: 4.14,page no:55 BD chaurasia 6th edition.


Question: Most common site of ectopic pancreatic tissue

Accessory pancreatic tissue found in stomach duodenum or mechel's diverticulam.


Question: Anterior neuropore closes at

Clinical neuroanatomy; Vishram Singh; Pg no:7 Anterior/cranial neuropore closes at 24th day of intrauterine life if dont close Anencephaly


Question: Poosystemic shunt is not sent in

At the liver, hepatic sinusoids& superior epigastric veins are forming poocaval anastomosis, at rectum superior rectal&middle, inferior rectal vein forms, at oesophagus between left gastric and azygos vein. Ref: Gray's 39e/p1026


Question: Ferruginous bodies are seen in

Inorganic paicles may become coated with iron protein complexes and ate called Ferruginous bodies A ferruginous body is a histopathologic finding in interstitial lung disease suggestive of significant asbestos exposure (asbestosis). Asbestos exposure is associated with occupations such as shipbuilding, roofing, plumbing, and constructio Refer robbins 9/e


Question: Neutrophil secretes

ref Robbins 7/e p73 Cathepsin G also secreted by neutrophil


Question: Laryngeal prominence is formed by

Thyroid cailage is V-shaped in cross-section.It consists of right and left laminae. each lamina is roughly quadrilateral.The laminae are placed obliquely relative to the midline,their posterior borders are far apa but the anterior borders approach each other at an angle that is about 90 degree in the male and about 120 degree in the female. The lower pas of the anterior borders of the right and left laminae fuse and form a median projection called the laryngeal prominence.


Question: The nerve that emerges from the two superficial heads of lateral pterygoid muscle is


Question: Anterior 2/3 of tongue develops from

The anterior two-thirds: From two lingual swellings which arise from the first branchial arch. Therefore, it is supplied by lingual nerve of first arch and chorda tympani of second arch The posterior one-third: From cranial large pa of the hypobranchial eminence, that is from the third arch. Therefore, it is supplied by the glossopharyngeal nerve The posterior-most pa from the fouh arch. This is supplied by the vagus nerve <img src=" /> Ref BDC volume 3,sixth edition pg 270


Question: Length of male urethra is

Length of male urethra is 20 cm long and female urethra is 4 cm long. Male urethra contains 3 pas- Prostatic urethra- 4 cm Membranous urethra-0.5-0.6 cm Spongy urethra -15 to 20 cm


Question: Sacrotuberous ligament is pierced by

Ans: A Perforating cutaneous nerveSacrotuberous ligament (STL) -Stabiliser of sacro-iliac joint.Connects bony pelvis to veebral column.Structure piercing STL - Perforating cutaneous nerve.Perforating cutaneous nerve:Cutaneous nerve that arises from the 52 and 53 nerve roots of the sacral plexus.Supplies lower medial pa of buttock.


Question: Deformity with decreased carrying angle is

Refer Apleys 9th e p 372 Cubitus varus develops which is reduced carrying angle and Cubitus valgus is increased carrying angle


Question: Fibrous pericardium in supplied by

Fibrous pericardium in supplied by phrenic Nerve. Visceral pericardium does not have somatic sensation.


Question: Ramu, 40 year old male, chronic alcoholic, diagnosed as cirrhosis, presents with a lump in the right lobe of liver. Serum AFP level is normal. Most probable diagnosis is

This is a typical presentation of hepatocellular carcinoma (age, cirrhosis, presence of lump, all perfectly match.) The only problem is that AFP is not elevated. This should not prevent us from making a diagnosis of HCC as Schwaz writes-"It must be kept in mind that only 60 to 75% of HCCs produce AFP; therefore, a normal serum AFP level does not rule out HCC." Hepatocellular adenoma and focal nodular hyperplasia (I' could not find any term as Fibrohyperplasia) are seen in women of reproductive age gp. They are associated with OCPs. Ref : Schwaz 9/e, p 1110


Question: Left ovarian vein drains into

Ovarian veins crosses the ureter anteromedially halfway between bifurcation of the IVC and the point in which it joins the anterolateral inferior vena cava (IVC). The left ovarian vein ascends similarly into the abdomen but drains into the left renal vein. ref - BDC 6e vol2 pg384


Question: The role of bradykinin in process of inflammation is

Ref Robbins 8/e p65- 66 ; 9/e p89 Bradykinin is a potent endothelium-dependent vasodilator and mild diuretic, which may cause a lowering of the blood pressure. It also causes contraction of non-vascular smooth muscle in the bronchus and gut, increases vascular permeability and is also involved in the mechanism of pain.


Question: The marked area develops from(in green colour)

The marked area is floor of fossa ovalis that developes from septum primum


Question: Sexual intercourse with another man's wife with her consent and without the consent of that man is

Adultery Sexual intercourse with another man's wife with her consent and without the consent of that man is adultery. Man who commits the offence of adultery shall be punished with imprisonment up to 5 years or with fine or both. In such cases, the wife shall not be punishable as an abettor. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 308


Question: Stapes footplate covers


Question: Vitum's sign is seen in


Question: Procalcitonin is used as marker of

ref Harrison 18/e p3419 Procalcitonin is an acute phase reactant which is now useful for being a marker of sepsis Procalcitonin (PCT) is a biomarker that exhibits greater specificity than other proinflammatory markers (eg, cytokines) in identifying patients with sepsis and can beused in the diagnosis of bacterial infections

Cardiac dysfunction in acute coronary syndrome


Question: Following cells are responsible for acid secretion in kidney


Question: Length of female urethra

The female urethra, about 4 cm in length, is fused with the anterior wall of the vagina. It ends between the clitoris and the vagina. The male urethra, about 20 cm in length, comprises three pas: prostatic, membranous, and spongy Ref - BDC 6e vol2 pg379


Question: Most common presentation of cardiac Lupus is


Question: cleft palate is the side effect of

- SIDE EFFECTS OF THE DRUG - APLASTIC ANEMIA - AGRANULOCYTOSIS - Hyponatremia - Steven Johnson's syndrome - Liver enzyme elevation - It has teratogenic potential - CLEFT PALATE, FINGER NAIL HYPOLASIA, - SPINA BIFIDA Ref, kaplon and sadock, synopsis of psychiatry, 11 th edition,pg no.935


Question: Cephalic vein drains into

CEPHALIC VEIN:-&;begins as continuation of lateral end of dorsal venous arch. Crosses roof of anatomical snuff box. Ascends On radial border of forearm, continues in front of elbow,along biceps. Pierces deep fascia at lower border of pectoralis major. Runs in cleft between deltoid and pectoralis major. Pierces clavipectoral fascia. Drains into axillary vein.&; Cephalic vein is accompanied by lateral cutaneous nerve of forearm. {Reference: vishram singh, pg no.98}


Question: The arrow indicating the anatomical identification of structure


Question: Best investigation to differentiate scar from recurrence after mastectomy done for carcinoma breast

PET Scan Investigation of choice for recurrences in scarred breast. UUseful in multifocal disease and in helping detect axillary involvement Ref:Sabiston 20th edition pgno : 826-828


Question: The last organ to putrefy after death is

As general rule organs show putrefactive changes in the following order 1) Larynx and trachea2) Stomach, intestines, and spleen3) Liver, lungs4) Brain5) Hea6) Kidney, bladder, uterus, prostate7) Skin, muscle, tendon8) Bones


Question: mood stabilizer used in the tretament of rapid cycling

Lamotrigine is a mood stabilizer which works best in BIPOLAR DEPRESSION Lithium is a mood stabilizer which works best in BIPOLAR MANIA valproate is a mood stabilizer which works best in RAPID CYCLING ref. kaplon and sadock, synopsis of psychiatry, 11 thedition, pg no.935


Question: Irresistible desire to buy something is

Oniomania Irresistible desire to buy things (shopping addiction) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 360


Question: Xeroderma pigmentosum is caused due to group of closely related abnormalities in

Ref Harrison 17/e p387; Robbins 7/e p287; 9/e 314 Xeroderma Pigmentosum. Xeroderma pigmentosum (XP) is the classical human recessive disorder caused by defective nucleotide excision repair of DNA damage, including pyrimidine dimers induced by UV radiation. Symptoms may include a severe sunburnafter only a few minutes in the sun, freckling in sun exposed areas, dry skin and changes in skin pigmentation. Nervous system problems, such as hearing loss, poor coordination, loss of intellectual function and seizures, may also occur.Complications include a high risk of skin cancer, with about half having skin cancer by age 10 without preventive effos, and cataracts. There may be a higher risk of other cancers such as brain cancers.[


Question: CYP 3A4 enzyme are affected by

CYP3A4 cary out biotransformation of large numberof drugs. The inhibition of this isoenayme by erythromycin, clarithromycin, ketoconazole, itraconazole etc is responsible for impoant drug interactions with terfenadine, astemizole and cisapride. Rifamps barbiturates and other anticonvulsants are impoant inducers. Ref-KDT 7/e p24


Question: Chassaignac's tubercle lies at level of

The anterior tubercle of the transverse process of the sixth cervical veebra is the largest of all such processes and is called the carotid tubercle (of Chassaignac). The common carotid aery can be best pressed against I this tubercle, deep to the anterior border of the I sternocleidomastoid muscle. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 6th edition pg 300


Question: The function of 8th cranial N. is related to

Balance The 8th cranial N. or vestibulo cochlear N. has two divisions:Cochlear division -4 concerned with hearingVestibular division concerned with equilibrium & balance


Question: Generalized necrotizing lymphadenopathy is


Question: Structure NOT passing through esophageal opening

At T8 - IVC hiatus in central tendon through which IVC and few branches of Rt. phrenic nerve passes At T10 - Oesophageal opening is present through which passes: Esophagus Esophageal branch of left gastric aery Anterior and posterior vagal trunk At T12 - Aoic hiatus posterior to diaphragm formed by median arcuate ligament through which passes: Aoa Thoracic duct Azygous vein


Question: Calcium channel blocker with maximum efficiency on conduction on hea is

Refer katzung 11e p181 Verapamil, is a medication used for the treatment of high blood pressure, angina, and supraventricular tachycardia. It may also be used for the prevention of migraines and cluster headaches. It is given by mouth or by injection into a vein


Question: Caseous necrosis in granuloma are not found in

ref Robbins 7/e p73,9/e p98 It is also seen in wegener's granulomatosis. Caseous necrosis is a form of cell death in which the tissue maintains a cheese-like appearance. The dead tissue appears as a soft and white proteinaceous dead cell mass. CausesEdit Frequently, caseous necrosis is encountered in the foci of tuberculosis infections. It can also be caused by syphilis and ceain fungi. A similar appearance can be associated with histoplasmosis, cryptococcosis, and coccidioidomycosis. AppearanceEdit In caseous necrosis no histological architecture is preserved. On microscopic examination with H&E staining, it is characterized by acellular pink areas of necrosis surrounded by a granulomatousinflammatory process. When the hilar lymph node for instance is infected with tuberculosis and leads to caseous necrosis, its gross appearance can be a cheesy tan to white, which is why this type of necrosis is often depicted as a combination of both coagulative and liquefactive necrosis. However, in the lung, extensive caseous necrosis with confluent cheesy tan granulomas is typical. The tissue destruction is so extensive that there are areas of cavitation (also known as cystic spaces). See Ghon's complex


Question: Isthmus of thyroid gland lies against following tracheal rings

The thyroid gland lies against veebrae C5, C6, C7 and T1 embracing the upper pa of the trachea Each lobe extends from the middle of thyroid cailage to the fouh to fifth tracheal ring The isthmus extends from the second to fouh tracheal ring. Ref BDC volume 3,Sixth edition pg 141


Question: Inferior meatus drains


Question: Temporalis muscle is inserted into


Question: Cranial nerve involved in sarcoidosis is


Question: Mapleson's classification of an anaesthetic breathing system

The Mapleson D may be described as a co-axial modification of the basic T-piece system, developed to facilitate scavenging of waste anaesthetic gases. Function: The Bain circuit is a modification of the Mapleson D system. It is a co-axial system in which the fresh gas flows through a narrow inner tube within the outer corrugated tubing. Essentially, the Bain circuit functions in the same way as the T-piece, Except that the tube supplying fresh gas to the patient is located inside the reservoir tube. Inspiration - The patient inspires fresh gas from the outer reservoir tube. Expiration - The patient expires into the reservoir tube. Although fresh gas is still flowing into the system at this time, it is wasted, as it is contaminated by expired gas. Expiratory pause - Fresh gas from the inner tube washes the expired gas out of the reservoir tube, filling it with fresh gas for the next inspiration. Spontaneous ventilation Normocarbia requires a fresh gas flow of 200-300 ml/kg. Controlled ventilation A fresh gas flow of only 70 ml/kg is required to produce normocarbia. Bain and Spoerel have recommended the following: 2 L/min fresh gas flow in patients <10 kg 3.5 L/min fresh gas flow in patients 10-50 kg 70 ml/kg fresh gas flow in patients >60 kg The recommended tidal volume is 10 ml/kg and respiratory rate is 12-16 breaths/minute

Describes the T-piece system as requiring a fresh gas flow rate of 1.5 - 2 times the minute volume.


Question: If circumflex artery gives the posterior interventricular branch, this circulation is described

In about 10% of hearts, the right coronary is rather small and is not able to give the posterior interventricular branch.
In these cases the circumflex artery, the continuation of left provides the posterior interventricular branch and called left dominant.


Question: The axis of abduction and adduction of digits passes through the centre of

The third metacarpal is the longest and the axis of abduction and adduction passes through its centre.Ref: Chaurasia; Volume 2; 6th edition; Page no: 31


Question: Rupture of Berry aneurysm causes

Subarachnoid hemorrhage Rupture of sacular Berry aneurysm which is usually located in one of the vessels in the Circle of Willis. Berry aneurysm occurs due to congenital defect or degenerative change in the muscle layer and internal elastic lamina. Only the initimal layer and adventitia of the aery form the dome of the aneurysm. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 174


Question: A 40 year old male underwent coronary aery bypass grafting. During the procedure the surgeon applied clamp to the vessel lying anterior to thhe transverse pericardial sinus. The vessel is

The aoa lies anterior to the transverse pericardial sinus. The reflections of the serous pericardium are arranged as two tubes- one enclosing the aoa and the pulmonary trunk and the other enclosing the vena cavae and the four pulmonary veins. The zone of reflection surrounding the vein is j-shaped and the cul-de-sac formed within the j is the oblique pericardial sinus. This lies posterior to the left atrium. The transverse sinus is a passage between the two 'tubes'. The aoa and the pulmonary trunk lie anterior and the superior vena cava and the atria lie posterior to it. Ref: Gray's Anatomy 41st edition Pgno: 995


Question: The receptor of joint capsule and ligaments is

Receptors can be classified into rapidly adapting (phasic) receptors and slowly adapting (tonic) receptors.Rapidly adapting receptorsSlowly adapting receptorsCutaneous mechanoreceptors such as:Meissner corpuscles (respond to changes in texture and slow vibrations)Pacinian corpuscles (respond to deep pressure and fast vibration)Cutaneous mechanoreceptors such as:Merkel cells (respond to sustained pressure and touch)Ruffini endings (respond to sustained pressure)ProprioceptorsNociceptors (free nerve endings - respond to thermal, chemical and thermal noxious stimuli)(Refer: Ganong&;s Review of Medical physiology 24th edition, pg no: 158)


Question: Eye of the hand is

The median nerve controls coarse movements of the hand, as it supplies most of the long muscles of the front of the forearm. It is, therefore, called the labourer&;s nerve. It is also called "eye of the hand" as it is sensory to most of the hand.Reference: Vishram Singh Anatomy; 2nd edition; Page no: 177


Question: Osteoclast are stimulated by

Refer Robbins page no 1207-1208 Parathyroid hormone related protein (PTHrP) is a local factor, expressed by perichondrial stromal cells and early proliferating chondrocytes, that activates the PTH receptor and maintains proliferation of chondrocytes.


Question: A Toxic doses, zero order kinetics is seen in

Phenytoin follows nonlinear (or zero-order) kinetics at therapeutic concentrations, because the rate of metabolism is close to the maximum capacity of the enzymes involved Ref-KDT 6/e p31


Question: Water hammer pulse is seen

Ref Harrison 19 th ed pg 1535 A rapidly rising "water-hammer" pulse, which col- lapses suddenly as aerial pressure falls rapidly during late systole and diastole (Corrigan's pulse), and capillary pulsations, an alternate flushing and paling of the skin at the root of the nail while pressure is applied to the tip of the nail (Quincke's pulse), are characterist


Question: Medial aspect of great toe supplied by

DEEP PERONEAL:- Muscular branches to muscles of anterior compament of leg: Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus teius.Extensor digitorum brevis Cutaneous: dorsal digital nerves for adjacent sides of big toe and second toe. Aicular branches:Ankle joint, tarsal joints, tarsometatarsal joints and metatarsophalangeal joint of big toe. COMMON PERONEAL:-Branch of sciatic nerve Root value:L4,L5,S1,S2 Branches:Muscular branch: sho head of biceps Cutaneous:lateral cutaneous nerve of calf.Aicular: superior lateral,inferior lateral and recurrent genicular .Terminal branches: superficial and deep peroneal. SUPERFICIAL PERONEAL:-Muscular branches: peroneus longus and brevis Cutaneous branches:Digital branches to medial side of big toe, adjacent sides of 2nd and 3rd, 3rd and 4th, and 4th and 5th toes. <img src=" /> {Reference:BDC 6E page no.173,174}


Question: A 30 year old primipara in labor with transverse lie treatment of choice is

Patients in labor with transverse lie can be managed by external cephalic version followed by surgical rupture of membrane But it is impoant to note that the patient is primigravuda with age 30years i.e, elderly primi so ECV is contraindicated This patient requires emergency cesaream section


Question: Crooke's hyaline body is present in

Basophil cells of pituitary gland in Cushing syndrome


Question: Neurovascular bundle in axilla is surrounded by sheath derived from

The neurovascular bundle in axilla is covered by axillary sheath which is derived from preveebral fascia. Reference : BD chaurasia, 7th edition, page no 50-Fig.4.5 & page no 60-Facts to remember


Question: Adductors of vocal cord

movements and muscle 1. elevation of larynx: thyrohyoid, mylohyoid 2. depression of larynx: sternothyroid, sternohyoid 3.opening inlet of larynx: thyroepiglottic 4. closing inlet of larynx: aryepiglottic 5.abductor of vocal cords: posterior cricoarytenoid only 6. adductor of vocal cords: lateral cricoarytenoid transverse and oblique arytenoids Ref BDC volume 3; sixth edition pg 258


Question: Most common site of Ewings sarcoma

Most common site of Ewings sarcoma is diaphysis of femur followed by diaphysis of tibia Refer : Textbook of skeletal oncology p 315


Question: Mikulicz cell and Russell bodies are seen in

Granulomatous disease of the nose BacterialFungalUnspecified causeRhinoscleroma Syphilis TuberculosisLupusLeprosy RhinosporidiosisAspergillosis Mucormycosis CandidiasisHistoplasmosis Blastomycosis Wegner's granulomatosisNon healing midline granuloma Sarcoidosis Churg Strauss syndrome RhinoscleromaAgent - Klebsiella rhinoscleromatisSite - nose, nasopharynx, oropharynx, larynx, trachea, bronchi Atrophic stageFoul smelling purulent nasal dischargeGranulomatous stage Subdermal infiltration of lower pa of external nose & upper lip - woody feelRubbery nodules - Tapir nose Cicatricial stage Stenosis of nares Distoion of upper lip Adhesions of nose, nasopharynx, oropharynx Subglottic stenosisNose deformity - Hebra nose Soft palate deformity - Gothic arch deformity Diagnosis Biopsy - infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells ( large foam cells with central nucleus & vacuolated cytoplasm containing causative bacilli ) & Russell bodies(homogenous eosinophilic inclusion bodies found in plasma cells)The culture of the organism Treatment - Streptomycin (1g/day) & tetracycline (2g/day) for 4 - 6 weeks (Refer: PL Dhingra, Textbook of Ear, Nose, Throat, 6thedition, pg no: 156)


Question: Ascending pharyngeal artery is a branch of


Question: The embryonic vascular layer of the eye is derived from

(Mesoderm) (8-9-Khurana 4th) (5-Parson 20th)Structures derived from the Embryonic layers1. Surface ectoderm2. Neural ectoderm(a) The crystalline lens(b) Epithelium of the cornea(c) Epithelium of the conjunctiva(d) Lacrimal glands(e) Epithelium of eyelids and its derivatives, viz.: cilia, tarsal glands, and conjunctival glands.(f) Epithelium lining the lacrimal apparatus (Lacrimal glands, Tarsal glands)(a) Retina with its pigment epithelium(b) Epithelial layers of ciliary body(c) Epithelial layers of iris(d) * Sphincter and dilator papillae muscles(e) Optic nerve (neuroglia and nervous elements only)(f) Melanocytes - Retinal pigment epithelium(g) Secondary vitreous(h) Ciliary zonules3. Associated paraxial mesoderm(a) ** Blood vessels of choroid, iris, ciliary vessels, central retinal artery, other vessels (Vascular endothelium of eye and orbit)(b) Primary vitreous(c) Substantia propria, Descemet's membrane, and endothelium of cornea(d) The sclera(e) Stroma of iris(f) Ciliary muscle(g) Sheaths of optic nerve(h) Extraocular muscle(i) Fat, ligaments and other connective tissue structures of the orbit(j) Upper and medial walls of the orbit(k) Connective tissue of the upper eyelid4. Visceral mesoderm of maxillary process below the eye(a) Lower and lateral walls of orbit(b) Connective tissue of the lower eyelid.


Question: If the seventh nerve is damaged on the right side of the face

the muscles of mastication would be denervated

the	muscles	of	facial	expression	would	be denervated

taste from the right anterior two thirds of the tongue would not be affected

sympathetic	fibre	to	salivary	gland	would	be interrupted


Question: Glands of Van Ebner are present in

The minor salivary glands are numerous and are widely distributed in the mucosa of oral cavity. Some of the minor salivary glands are the Von Ebner's gland in tongue, buccal glands in cheeks and labial glands in lips. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no., 251.


Question: Commonest stone in case of UTI

Phosphate or struvite stones are infection stones associated with urea-splitting organisms i.e. Proteus, Pseudomonas, Providencia, Klebsiella, Staphylococci and Mycoplasma. The high ammonium concentration desired from urea-splitting organisms results in an alkaline urinary pH, required for the precipitation of phosphate crystals. Ref : Bailey & Love 25/e p1296


Question: The largest organ of the body is

The liver is the largest gland in the body and has a wide variety of functions (265-Snell 7th )
The liver is the largest gland in the body. (283-BDC-2)
Femer is the longest and the strongest bone of the body (16-B DC-2)
Skin is the largest organ of the body (278-K- Sembulingam physiology)
Skin is considered as the largest sense organ in the body it has many nerve endings, which are specialized to form cutaneous receptors (281-K. Sembulingam physiology 3rd )


Question: A patient presented with pain in right testis Examination reveals bay of worms suggestive of varicocele. Right testicular vein drains into

Right testicular vein drains into IVC
Left testicular vein drains into left renal vein


Question: Line from midinguinal point to adductor tubercle represent

Femoral aery surface marking:- Upper two third of the line joining midinguinal point and adductor tubercle. Mid inguinal point: a point midway between the anterior superior iliac spine and pubic symphysis. Adductor tubercle: lies at lower end of the cord like tendon of adductor magnus. The tendon can be felt in a groove just behind the prominence of vastus medialis when the thigh is semiflexed, abducted and laterally rotated. Upper 1/3 rd of line-upper half of line lying in femoral triangle. Middle 1/3 rd- lower half of aery lying in adductor canal. Lower 1/3 rd- descending genicular and saphenous branches of the aery. {Reference: BDC 6E pg no. 165}


Question: Maintenance of high urinary pH is impoant during methotrexate treatment because

Ref-KDT 6/e p823 Methotrexate is a weak acid and basic reabsorbed in acids urinary PH. Higher plasma concentration may result in toxicity. Therefore to decrease the reabsorptiion through renal tubes urinary pH must be maintained

It decreases renal tubular secretion of methotrexate

Leucovorin toxicity is increased in a dehydrated patient


Question: Stomach contents will have smell of bitter almond in

Postmoem appearance Froth may be present at the mouth and nostrils. Postmoem staining and blood will have bright red color. In a case of suspected cyanide poisoning, cranial cavity has to be opened first because the odour of hydrocyanic acid is well evident in the brain. All the internal organs will be congested. Lungs will be congested and edematous. There may be corrosion of the mucosa of the mouth esophagus and stomach. Stomach will be intensely congested and the contents may have the smell of bitter almond. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 473


Question: Eversion is

- Eversion - Movement of sole of the foot outward. Foot eversion occurs at subtalar joint by Peroneus longus, Peroneus brevis and Peroneus Teius. - Inversion: Movement of the sole of the foot inward so that the soles face toward each other. Done by Tibialis anterior and Tibialis posterior.Additional information:


Question: Dorello's canal transmits in tip of temporal bone

Dorello canal is an opening to cavernous sinus that transmit abducent nerve underneath the superior petrosal sinus.


Question: In after coming head the following bone is perforated during craniotomy

Craniotomy is perforating the fetal skull and evacuating the contents and then delivering the fetal pas. In after coming head in breech occipital bone is the perforation site


Question: Fleischer's ring is seen in;

KERATOCONUS Non -Inflammatory central corneal thinning Young male with constantly changing power of glasses with myopia & high cylinder SIGNS IN KERATOCONUS Munson sign. Scissor reflex on retinoscopy (Earliest Clinical Sign) Enlarged corneal nerves-lower lid indentation on downgaze. Oil droplet reflex. Rizutti's sign Acute Hydrops - aqueous accumulated in stroma Fleischer ring-Paial or complete iron deposition ring in deep epithelium encircling the base of the cone. Characteristic in eyes with keratoconus.


Question: "Abducent nucleus" is present in

The abducent nucleus (CN VI) is located in the dorsomedial tegmentum of the pons. fig:-crossection atthe level of lower pons

Midbrain, at level of inferior colliculus


Question: The doctrine of RESRES IPSA LOQUITUR means

The doctrine of RES IPSA LOQUITUR It means that" The thing speaks for itself" and the patient need not prove negligence when this doctrine is applied. The burden of proving the innocence lies upon the doctor. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 379


Question: The superior oblique muscle is supplied by

Superior oblique muscle is supplied by fouh cranial nerve i.e,trochlear nerve. It supplies only the superior oblique muscle of the eyeball. Superior oblique muscle helps in depression,abduction and intoion. Note: When trochlear nerve is damaged, diplopia occur looking downwards; vision is single so long as the eye look above the horizontal plane. Ref:BDC 6th edition of no.208


Question: In couinaud's classification, segment IV of liver is

Segments nomenclature I Caudate lobe (sometimes subdivided into left and right pas called segment IX) II Left lateral superior segment III left lateral Inferior segment IV left medial segment or Quadrate lobe V Right anterior Inferior segment VI Right posterior Inferior segment VII Right posterior superior segment VIII Right anterior superior segment


Question: Genu of internal capsule carries

The genu of internal capsule contains coiconuclear and coicospinal fibres for head and neck. It also contains, fibres of superior thalamic radiations and frontopontine fibres. (Ref: Vishram Singh textbook of neuroanatomy second edition pg-166, also refer table 14.1)


Question: Stain not used for lipids

Ref Bancrofts 's histopathology 5/e p204 Congo red is used for staining amyloid and not lipids


Question: Melanocytes are developed from the following

Derivatives of neural crest: Mnemonic:SOME GAP S-Schwann cells -Skeleton of face O-odontoblasts M-Meninges(pia and arachnoid) E-Endocardial cushion G-Ganglia(autonomic and dorsal root ganglia) A-Adrenal medulla -Aoicopulmonary septum P-Pigmant cells(melanocytes) -Pharyngeal arches(nerves and cailage) -parafollicular c cells of thyroid


Question: Normal reticulocyte count at bih is

Reticulocytes are 2 to 6 % of rbc count in the circulation at bihthey decreade to less than 1% during week after bih at which level they remain throughout life


Question: The reduction of a physiological hernia occurs at

Physiological hernia appears by 6 wks and gets reduced by 10 wks . Ref - pubmed.com


Question: In patient with chronic pancreatitis limited to tail and body with MPD diameter 4mm, ideal treatment would be

Surgical procedures in chronic pancreatitis Ideal procedure : DPPHR (Beger's) In presence of poal vein thrombosis : Frey's Small duct disease : V-shaped excision Disease recurrence in body and tail (after DPPHR, Whipple's or Longmire-Transverso procedure) : V-shaped drainage Disease limited to tail : Spleen - preserving distal pancreatectomy Ref: Sabiston 20th edition Pgno :1534


Question: Edema in nephrotic syndrome occurs due to


Question: Worm like filling defect is seen In

On USG Thickened sinus, interrupted mucosal folds (earliest sign) Toous radiolucencies of variable size The "worm-eaten" smooth lobulated filling defects Ref: Wolfgang Radiology 2nd edition Pg no : 509


Question: Sistrunk's operation is used ina) Parotid tumourb) Thyroglossal fistulac) Thyroglossal cystd) Branchial fistula

Thyroglossal Cyst Cystic swelling developed in the remnant of the thyroglossal duct or tract Present in any pa of the thyroglossal tract (extends from foramen caecum to isthmus of thyroid) Common sites Subhyoid (MC) Floor of mouth Region of thyroid cailage Suprahyoid Beneath the foramen caecum Clinical features It is a midline swelling, except in the region of thyroid cailage, where thyroglossal tract is pushed to one side, usually to the left Though its a congenital swelling MC age of presentation is between 15 and 30 years Cyst can be moved sideways but not veically Peculiar characteristics which helps in distinguishing thyroglossal cyst from other neck swelling Moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue Moves with deglutition so do all thyroid swellings, subhyoid bursitis Cyst is lined by pseudostratified columnar epithelium and squamous epithelium with hetero topic thyroid tissue present in 20% of cases Complications Recurrent infections Formation of thyroglossal fistula Carcinomatous change (papillary carcinoma) Treatment Sistrunk operation : En-bloc cystectomy and excision of central hyoid bone to minimize recurrence Ref: Sabiston 20th edition Pgno :1861


Question: Muscle of mastication are derivative of


Question: Drugs used for rare diseases are known as

An orphan drug is a pharmaceutical agent developed to treat medical conditions which, because they are so rare, would not be profitable to produce without government assistance. The conditions are referred to asorphan diseases Refer 6/e p6


Question: Mitral cells are seen in

Mitral cells are neurons that are pa of the olfactory system. They are located in the olfactory bulb in the mammalian central nervous system. They receive information from the axons of olfactory receptor neurons, forming synapses in glomeruli. Axons of the mitral cells transfer information to a number of areas in the brain, including the piriform coex, entorhinal coex, and amygdala. Mitral cells receive excitatory input from olfactory sensory neurons and external tufted cells on their primary dendrites, whereas inhibitory input arises either from granule cells onto their lateral dendrites and soma or from periglomerular cells onto their dendritic tuft. Mitral cells together with tufted cells from an obligatory relay for all olfactory information entering from the olfactory nerve.


Question: Unpaired muscle of perineal body among the following is

The two Unpaired muscles of perineal body are

Longitudinal muscle of anal canal
External and sphincter


Question: Collecting pa of kidney of derived from


Question: Deep venous system of brain consist of

It is single median vein formed by union of 2 internal cerebral vein. along with inferior petrosal sinus terminate in straight sinus. Its tributaries are basal vein, veins from pineal body, colliculus, cerebellum& occipital lobes. Ref: Gray's 40e/p256

Superior sagittal sinus with straight sinus


Question: Common cause of acute osteomyelitis is DLETE

Hematogenous osteomyelitis is the commonest form of osteomyelitis and most common source if bone and joint infection is Hematogenous Refer Maheshwari 6th/e 168


Question: Most common nodule found in the liver is

Hemangioma Most common benign tumor of the liver Mainly seen in women of 45 years Small capillary hemangiomas(no clinical significance), larger cavernous hemangioma Usually single and <5 cm in diameter, occur equally in right and left liver Giant hemangioma: lesion>5cm Ref:Sabiston 20th edition Pgno :1456-1457


Question: Not a muscle of the tongue

Intrinsic muscles of the tongue:

Muscles found entirely within the tongue
Longitudinal, transverse, and vertical muscles
Function - change the shape of the tongue.

Extrinsic muscles of the tongue:

Genioglossus, Styloglossus, and hyoglossus, Palatoglosus.
All insert into the tongue, originate from surrounding structures


Question: Perscualr lymphocytes and microglial nodules are seen in

Refer Robbins page no Pg 1278 HIV encephalitis is best characterized by microscopically as a chronic inflammatory reaction with widely distributed infiltrates of microglial nodules


Question: Drug of choice for pneumocystis carinii is

The treatment of choice for PCP is trimethoprim-sulfamethoxazole (TMP-SMX), given either IV or PO for 14-21 days .TMP-SMX, which interferes with the organism's folate metabolism, is at least as effective as alternative agents and is better tolerated. Ref Harrison 19th edition pg 1019 Davidson edition23rd pg 587


Question: Hutchinsons secondaries In skull are due to tumors in

Adrenal neuroblastomas are malig8nant neoplasms arising from sympathetic neuroblsts in Medulla of adrenal gland Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.Neuroblastoma most commonly arises in and around the adrenalglands, which have similar origins to nerve cells and sit atop the kidneys.


Question: Formation of primary ovary in female foetus takes place by


Question: Muscle not inseed on the greater tuberosity is

The supraspinatus, infraspinatus, teres minor and subscapularis muscles comprise the rotator cuff muscle group. The main role of these muscles is stabilization of the humeral head in the glenoid fossa. Tendons of teres minor, supraspinatus, and infraspinatus inse on the greater tuberosity of the humerus, and subscapularis tendon inses on lesser humeral tuberosity. Actions of these muscles are internal rotation (subscapularis), external rotation (teres minor and infraspinatus) and early abduction from 0@ to 30@ (supraspinatus). The subacromial bursa lies between supraspinatus tendon and the acromion.


Question: In stable angina

Ref Harrison 19 th ed pg 1593 Necrotic myocardial fibres release a variety of enzymes into blood stream. In stable angina necrosis of the cell does not occur so there is no elevation of serum enzymes.

The level of cardiac markers remain un changed


Question: Gartner's duct is remnant of


Question: Meckel&;s diveiculum is a remnant of

A Meckel's Diveiculum is a vestigial remnant of omphalomesenteric or vitellointestinal duct. As a congenital anomaly, it is a true diveiculum that includes all three coat of small intestine. ref - BDC 6e vol2 pg 265


Question: Chronic osteomyelitis is diagnosed mainly by

* SEQUESTRUM -- is a piece of dead bone , surrounded by infected granulation tissue trying to "eat" the sequestrum away. It appears pale having smooth inner surface and a rough outer. * When SEQUESTRUM IS COMPLETE, it lies in the free cavity and is LESS attacked by granulation tissue and is absorbed more slowly. * Meanwhile , the surrounding living bone attempts to wall off the infection by forming a thick , dense wall , the INVOLUCRUM. * (INVOLUCRUM is the dense sclerotic bone overlying the sequestrum). * An involucrum usually has multiple openings, the cloacae , through which exudate , bone debris , and sequestra find exit and pass through sinus tracts to the surface. * CONSTANT DESTRUCTION of neighboring soft tissue leads to THIN skin which is easily traumatised , skin epithelium grows inwards to line the sinus tract. * In chronic osteomyelitis of long standing , multiple cavities and sequestra exist throughout the bone * The shaft becomes thickened , irregular and deformed. ref : maheswari 9th ed


Question: Vaginal epithelium  develops from

Vagina develops from merodum of parameronephric duct endodum of urogenital ridge.


Question: Dose response curves of salbutamol for bronchodilation and tachycardia are widely separated on dose axis. This information suggested that sulbutamol is

Ref-Katzung 10/e p28,29 Wide Separation of two curves on DRC suggest that the dose required to produce one action is much higher than the other.


Question: Sister marry Joseph nodules are found in

Refer Robbins page no Pg 8th/786 In medicine, the Sister Mary Joseph nodule or more commonly node, also called Sister Mary Joseph sign, refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen


Question: Action of 20mcg/kg/min dopamine is

Less than 2mcg/kg/min: Renal VD 2-10mcg/kg/min: B1 stimulation More than 10: alpha stimulation -VC


Question: The direction of the flow of venous blood in conditions of valve incompetence affecting perforating veins of lower limb is

PERFORATING VEINS:- Connect superficial with the deep veins. Small saphenous vein -1 perforator. Great saphenous vein perforators:- 3 medial perforators-just above ankle.1 perforator just below knee 1 in the region of adductor canal. These contain valves to prevent backflow of venous blood .i.e prevent flow from deep to superficial. Incompetence of these valves makes vein dilated and touous leading to varicose veins. If the valves in the perforating veins or at the termination of superficial veins become incompetent, the defective veins become "high-pressure leaks" through which high pressure of deep veins produced by muscular contractions is transmitted to superficial veins. This results in dilatation of superficial veins and to gradual degeneration of their walls producing varicose veins and varicose ulcers {Reference: BDC 9 E}


Question: Absolute lymphocytosis is seen in

ref to P.JMehta 14/e p374 CLL and brucellosis is also the answer Leukocytosis is white cells (the leukocyte count) above the normal range in the blood. It is frequently a sign of an inflammatory response, most commonly the result of infection, but may also occur following ceain parasitic infections or bone tumors as well as leukemia


Question: 3rd Ventricle develops from

Inderbir Singh&;sHuman embryologyTenth editionPg 335The cavity of diencephalon forms the third ventricle


Question: Major Disadvantage of peripheral line is

Ref: Bailey and love 27th edition Pg no :287


Question: Secondary amyloidosis is associated with

Ref Robbins 8/e p252-253,9/e p257 The AA (amyloid-associated) fibril is a unique nonim- munoglobulin protein derived from a larger (12-kDa)serum precursor called SAA (serum amyloid-associated) protein that is synthesized in the liver. SAA is synthesized by liver cells under the influence of cytokines such as IL-6 and IL-1 that are produced during inflammation; thus, long-standing inflammation leads to elevated SAA levels, and ultimately the AA form of amyloid deposits. However, increased production of SAA by itself is not sufficient for the deposition of amyloid. Elevation of serum SAA levels is common to inflammatory states but in most instances does not lead to amyloidosis. There are two possible explanations for this. According to one view, SAA nor- mally is degraded to soluble end products by the action of monocyte-derived enzymes. Conceivably, people who develop amyloidosis have an enzyme defect that results in incomplete breakdown of SAA, thus generating insoluble AA molecules. Alternatively, a genetically determined structural abnormality in the SAA molecule itself renders it resistant to degradation by macrophages


Question: Glossopharyngeal nerve supply


Question: Most common complication of common bile duct exploration

Most common complication of CBD exploration is retained stone Clearance of all common bile duct stones is achieved in 75-95% of patients with laparoscopic CBD exploration The rate of retained CBD stone is <5% Ref: Sabiston 20th edition Pgno :1496


Question: Erb's point is


Question: If the origin of the masseter muscle is more medial on the zygomatic arch (ramus perpendicular), the space in the distobuccal area is


Question: Broca’s area is located at


Question: The structure that passes between middle cerebellar peduncle and pons is

Trigeminal nerve exits the brain by a large sensory root and a smaller motor root coming out of the pons at its junction with the middle cerebellar peduncle.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg-81, fig 8.9)


Question: Number of primodial follicles in ovary at bih are

At bih the number of login is(primordial follicles) in an ovary is about one millionSo for two ovaries, it is about 2 millionInderbir Singh&;s Human Histology Seventh edition Pg 346


Question: Coical representation of body in cerebrum is


Question: maternal disomy of chromosomes 15 is seen in

Prader Willi syndrome could be present because of the following ; Deletion of paternal chromosome 15 .Or Uniparentral disomy of maternal chromosome 15 refer robbins 8/172


Question: Action of inferior oblique

The actions of inferior oblique are: At veical axis-elevates At horizontal axis-abducts At anteroposterior axis-extorsion Notes; The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. This muscle is situated near the anterior margin of the orbit. Ref BDC volume3.sixth edition pg 211


Question: Structure passing through esophageal opening of diaphragm

Oesophageal opening transmits gastric or vagus nerves. B D CHAURASIA&;S HUMAN ANATOMY LOWER LIMB ABDOMEN AND PELVIS VOLUME-2,SIXTH EDITION Page no-333


Question: Vestibular ocular reflex


Question: Most impoant for diapedisis

Ref Robbins 8/e p50;9/e p77 Leukocytes normally flow rapidly in the blood, and in inflamma- tion, they have to be stopped and brought to the offending agent or the site of tissue damage, which are typically outside the vessels. The sequence of events in the recruitment of leuko- cytes from the vascular lumen to the extravascular space consists of (1) margination and rolling along the vessel wall; (2) firm adhesion to the endothelium; (3) transmigra- tion between endothelial cells; and (4) migration in inter- stitial tissues toward a chemotactic stimulus (Fig. 2-5). Rolling, adhesion, and transmigration are mediated by the interactions of adhesion molecules on leukocytes and endothelial surfaces (see later on). Chemical mediators-- chemoattractants and ceain cytokines--affect these pro- cesses by modulating the surface expression and binding affinity of the adhesion molecules and by stimulating direc- tional movement of the leukocytes. Margination and Rolling. As blood flows from capillaries into postcapillary venules, circulating cells are swept by laminar flow against the vessel wall. Because the smaller red cells tend to move faster than the larger white cells, leukocytes are pushed out of the central axial column and thus have a better oppounity to interact with lining endothelial cells, especially as stasis sets in. This process of leukocyte accumulation at the periphery of vessels is called margination. If the endothelial cells are activated by cytokines and other mediators produced locally, they express adhesion molecules to which the leukocytes attach loosely. These cells bind and detach and thus begin to tumble on the endothelial surface, a process called rolling. Adhesion. The rolling leukocytes are able to sense changes in the endothelium that initiate the next step in the reaction of leukocytes, which is firm adhesion to endothelial sur- faces. This adhesion is mediated by integrins expressed on leukocyte cell surfaces interacting with their ligands on endothelial cells


Question: The initiating mechanism in endotoxic shock is

ref Robbins 9/e p131-132 The principal mechanism for septic shock includes: Peripheral vasodilation and pooling of blood Endothelial activation/injury Leukocyte induced injury Disseminated intravascular coagulation Activation of cytokine cascades


Question: Thyroid gland develops from


Question: Iliofemoral ligament arises from

SSIliofemoral Ligament is also called Ligament of Bigelow.SSStrongest ligament in the body.SSInveed Y shaped, strengthens the anterior pa of capsule of HIP JOINTThe upper half of the anterior inferior iliac spine gives origin to the straight head of the rectus femoris. The rough lower pa of this spine gives attachment to the iliofemoral ligamentReference: Chaurasia; 6th edition; Chapter 2; Bones of the lower limb


Question: A 45 year old lady is having persistent reflux symptoms. Most accurate investigation in establishing the diagnosis before surgical treatment is

GERDGERD is often associated with hiatus hernia type IClinical featuresInvestigationsClassical traid: retrosternal burning pain, epigastric pain, and regurgitation.HeaburnsRegurgitationAbdominal painCoughDysphagia for solidsBelchingBloatingManometry for measuring LES tone24 hrs pH monitoringEsophagogram TreatmentLifestyle modifications: cessation of smoking, decreased caffeine intake and avoidance of large meal at nightMedical management: double dose of PPI'SSurgical therapy: laparoscopic Nissen's fundoplication, modern fundoplication, 3600 floppy fundoplication (Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1081)


Question: Nutrient aery arises to fibula from

Nutrient aery to fibula:- The peroneal aery gives off nutrient aery to fibula.Enters the bone on its posterior surface.Nutrient foramen directed downwards. <img src=" /> {Reference: BDC 6E}


Question: 3. Drug used in the Pseudomonas treatment

Psedomonas is inherently resistant to most of the antibiotics. Cephalosporins such as ceftazidime ,cefoperazone, ceftolozane and cefepime are used to treat it


Question: Most common tumor of infancy is

Refer robbins 8/e p584 A rhabdomyoma is a benign tumor of striated muscle. Rhabdomyomas may be either "cardiac" or "extra cardiac" (occurring outside the hea). Extracardiac forms of rhabdomyoma are sub classified into three distinct types: adult type, fetal type, and genital type. Cardiac rhabdomyomas are the most common primary tumor of the hea in infants and children. It has an association with tuberous sclerosis. In those with tuberous sclerosis, the tumor may regress and disappear completely, or remain consistent in size. It is most commonly associated with the tongue, and hea, but can also occur in other locations, such as the vagina. Malignant skeletal muscle tumors are referred to as rhabdomyosarcoma. Only rare cases of possible malignant change have been repoed in fetal rhabdomyoma. The differential diagnosis in the tongue includes ectomesenchymal chondromyxoid tumor.


Question: Epithelium lining of lingual surface of epiglottis is

Stratified squamous epithelium is present in pharynx, lingual surface of epiglottis which is non keratinised in nature whereas in laryngeal surface of epiglottis it is lined by pseudostratified ciliated columnar epithelium (respiratory epithelium).


Question: Cox pathway is not inhibited by

Aspirin inhibits Cox irreversibly by acetylating one of its serine residues;return of Cox activity depends are depends on synthesis of freshers I enzymes. other NSAIDs like indomethacin, diclofenac, etc are competative and Irreversible inhibitors of Cox, return of activity depends upon the dissociation from enzyme which in turn is governed by pharmacokinetic characteristics of its compound coicosteroids like betamethasone act by inhibiting phospholipase A2.


Question: Facial artery is a branch of

The facial artery is the chief artery of the face. It is a branch of the external carotid artery .


Question: Pyramidalis is supplied by

The pyramidalis is a small and triangular muscle, anterior to the rectus abdominis, and contained in the rectus sheath. The muscle is innervated by the ventral poion of T12. Anterior division of the twelfth thoracic nerve (subcostal nerve) communicates with the iliohypogastric nerve of the lumbar plexus and gives a branch to the Pyramidalis. Ref - semantischolar.org


Question: The remnant of an omphalomesenteric duct is

The omphalomesenteric duct is an embryonic structure which connects the yolk sac to the midgut, it gets obliterated between the 5thand 9th week of gestation, failure of which result in remnants like Meckel's diveiculum or cyst or fistula The median umbilical ligament is a remnant of the urachus The medial umbilical ligaments are a remnant of the umbilical aeries Ref: Gray's 39e/p-1289


Question: Thyroid Ca causes laryngeal paralysis due to

The nerves found in close relationship to the thyroid gland and therefore likely to be involved in the malignant spread and thyroid surgery are recurrent laryngeal nerve and the superior laryngeal nerve. Ref : Schwaz Surgery 9/e p1346


Question: Extension of knee joint is caused by


Question: Most dependent pa of abdomen in standing position is

The recto-uterine pouch (cul-de-sac or pouch of Douglas) is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus. It is the most inferior aspect of the peritoneal cavity and therefore the first location where free fluid accumulates . ref - BDC 6e vol2 pg244


Question: Reduced liver transplants

Reduced size liver transplant Liver can be reduced to a functional unit of appropriate size for the recepient It can overcome the donor - recepient size discrepancy, but it does not increase the absolute number of grafts Ref: Sabiston 20th edition Pgno : 637-638

Given to two recepients after dividing into two pas

Left lateral lobe divided and given to child

Left lateral segment divided from segment 2 and gives to child

Pa of liver segment transplanted into recepient depending upon requirement


Question: The simple columnar and stratified columnar epithelia lining the lower pa of the anal canal is derived from

The anal canal is formed from two components--the hindgut and proctodeum. The epithelium lining the lower anal canal is derived from ectoderm lining the proctodeum. above the pectinate line develop from:-endodermal cloacae beiow the pectinate line delelop from :-ectodermal proctodeum


Question: Radial bursa is the synol sheath covering the tendon of

The radial Bursa is a collection of synol fluid around the Tendon of the Flexor Pollicis Longus muscle, the primary flexor of the thumb ulnar bursa is a synol sheath in the carpal tunnel of the human hand. It contains tendons of the flexor digitorum an and the flexor digitorum profundus


Question: Excessive bleeding during hemothorax is caused by

Massive Hemothorax: Collection of more than 1500 ml of blood in the pleural cavity is called massive hemothorax. Massive hemothorax is usually the result of major pulmonary vascular injuries or major aerial wounds, while minor lung injuries cause small hemothorax. Also know Most common cause of hemothorax is due to injuries of Internal mammary Aery. Ref : Sabiston 18/e p498


Question: The components of Levator ani are

Pubococoygeus & lliococcygeus together is known as Levator ani

Pubococoygeus, Iliococcygeus & Ischiococcygeus


Question: Sacral ala is related to

Ans. is 'd' i.e., Iliolumbar aery,Ala of sacrum is a large triangular surface either side of sacral base, continuous with iliac fossa (akin to adapted and joined transverse and costal processes elsewhere spine)The smooth medial pa of the ala of sacrum is associated with the subsequent 4 structures from medial to lateral side: 1. Sympathetic chain. 2. Lumbosacral trunk. 3. Iliolumbar aery. 4. Obturator nerve.The ventral ramus of L5 nerve is really tight that it grooves the ala.The rough lateral pa of the ala provides origin to iliacus muscle anteriorly and connection to the lumbosacral ligament posteriorly.


Question: Primary and secondary palates are divided by

D. i.e. Incisive foramenThe incisive foramen is dividing landmark between the primary & secondary palateQ; and anterior & posterior cleft deformities


Question: The primary palate is formed from the

The primary palate develops from the intermaxillary segment that is formed by the fusion of two medial nasal prominences. The two medial nasal prominences fuse to form the intermaxillary segment, which has the following components: Labial component that forms the philtrum of the upper lip Upper jaw component that forms the medial pa of the maxillary bone with the four upper incisor teeth Palatal component that forms the triangular area in the front called as the primary palate. Ref: Inderbir Singh Human Embryology 11e pg 160.


Question: Dura Mater derives its name from

(D) Tough mother # Dura mater, or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord.> It is derived from Mesoderm.> Other two meningeal layers are the pia mater and the arachnoid mater.> Dura surrounds the brain and the spinal cord and is responsible for keeping in the cerebrospinal fluid.> Name "dura mater" is derived from the Latin "hard mother" or "tough mother", and is also referred to by the term "pachy-meninx".


Question: Child's criteria is used in Cirrhosis

Variables of CTP score Serum albumin Serum bilirubin Prothrombin time Ascites Encephalopathy Ref: Sabiston 20th edition Pgno : 1436


Question: Efferent cremastric reflex is carried by

Ans. (b) Genito-femoral nerveRef: Clinically Oriented Anatomy by Keith, Moore, 5thEd,/223# CREMASTERIC REFLEXEfferent: genital branch of genitofemoral nerveAfferent: Femoral branch of genitofemoral nerve* Contraction of the cremaster muscle is elicited by lightly stroking the skin on the medial aspect of the superior part of the thigh with an applicator stick or tongue depressor.* The ilioinguinal nerve supplies this area of skin.The rapid elevation of the testis on the same side is the cremasteric reflex. This reflex is extremely active in children* A hyperactive cremasteric reflex may simulate undescended testes.


Question: Unilateral supranuclear lesion of facial nerve involves

Only contra lateral lower part of the face


Question: Fastest acting receptor/transduction mechanism is

Ref-KDT 6/e p40 Drugs acting and ionotropic receptor are fast acting where as those acting through nuclear receptors are slowest in action


Question: Hoffbauer's cells are present in


Question: Diagnostic procedure for postmenopausal bleeding

Gold standard is hysteroscopic directed endometrial sampling. Next, best is endometrial aspiration as it gives a global endometrial sample by viue of suction. D and C and EB should never be done to diagnose the cause of postmenopausal bleeding. The most common cause overall is senile endometritis and the most common malignant cause is endometrial cancer


Question: Not a premalignant condition

Ref Robbins 9/e p169 Fragile X syndrome is a genetic condition that causes a range of developmental problems including learning disabilities and cognitive impairment. Usually, males are more severely affected by this disorder than females. Affected individuals usually have delayed development of speech and language by age 2. Most males with fragile X syndrome have mild to moderate intellectual disability, while about one-third of affected females are intellectually disabled. Children with fragile X syndrome may also have anxiety and hyperactive behavior such as fidgeting or impulsive actions. They may have attention deficit disorder (ADD), which includes an impaired ability to maintain attention and difficulty focusing on specific tasks. About one-third of individuals with fragile X syndrome have features of fragile X syndrome. Most males and about half of females with fragile X syndrome have characteristic physical features that become more apparent with age. These features include a long and narrow face, large ears, a prominent jaw and forehead, unusually flexible fingers, flat feet, and in males, enlarged testicles (macroorchidism) after pubey. Fragile X syndrome is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome), a mutation in the only copy of a gene in each cell causes the disorder. In most cases, males experience more severe symptoms of the disorder than females. In women, the FMR1 gene premutation on the X chromosome can expand to more than 200 CGG repeats in cells that develop into eggs. This means that women with the premutation have an increased risk of having a child with fragile X syndrome. By contrast, the premutation in men does not expand to more than 200 repeats as it is passed to the next generation. Men pass the premutation only to their daughters. Their sons receive a Y chromosome, which does not include the FMR1 gene.


Question: Following type of epithelium is present in

The above picture represents non-keratinized stratified squamous epithelium.Numerous cell layers, the most superficial of which are squamous, characterize stratified squamous epithelium. The function of this type of tissue is protection.Examples of non-keratinized stratified squamous epithelium include corneal epithelium, lining mucosa of the oral cavity, oesophagus, anal canal, ectocervix, vagina, foreskin, and the internal poion of the lips. Moist areas don&;t need protection from desiccation and are therefore nonkeratinized.


Question: Best prognosis in CA GB is seen in

Histological types in gallbladder Carcinoma Diffuse infiltrative :MC type Nodular or mass forming Papillary : Exhibits polypoid or cauliflower appearance and have best prognosis Adenocarcinoma : MC histological subtype of CA GB Ref: Sabiston 20th edition Pgno :1512-1514


Question: Anchovy sauce pus is a feature of

Amoebic liver abscess Entamoeba histolytica is endemic in many pas of the world. It exists in vegetative form outside the body and is spread by the faecal-oral route. The most common presentation is with dysentery, but it may also present with an amoebic abscess, the common sites being paracaecal and in the liver. The amoebic cyst is ingested and develops into the trophozoite form in the colon, and then passes through the bowel wall and to the liver the poal blood. Diagnosis is by isolation of the parasite from the liver lesion or the stool and confirming its nature by microscopy. Often patients with clinical signs of an amoebic abscess will be treated empirically with metronidazole (400- 800mg t.d.s. for 7-10 days) and investigated fuher only if they do not respond. Resolution of the abscess can be monitired using ultrasound. Ref: Bailey and love 27th edition Pg no : 1169


Question: Joint between epiphysis and diaphysis of a long bone is a type of


Question: Deep flexors of forearm are supplied by

Deep flexors of forearm are Flexor digitorum profundus, Flexor pollicis longus, and Pronator quadratus. Flexor digitorum medial half is supplied by Ulnar nerve and lateral half is supplied by the anterior interosseous nerve. Flexor pollicis longus and pronator quadratus are supplied by anterior interosseous nerve. REF:B D Chaurasia edition 7th page no:110.


Question: Cytokines

Ref ananthanarayana 7/e p143; Harrison 16/e p 1915; Robbins 7/e p202 Cytokines are a broad and loose category of small proteins (~5-20 kDa) that are impoant in cell signaling. Cytokines are peptides, and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrine signaling, paracrine signaling and endocrine s as immunomodulating agents The four-a-helix bundle family: member cytokines have three-dimensional structures with four bundles of a-helices. This family, in turn, is divided into three sub-families: the IL-2 subfamily the interferon (IFN) subfamily the IL-10 subfamily.


Question: Main Aerial supply of the tonsil is from

Facial aery supplies face, tonsil Ref: Gray's 40e/p-262


Question: Light microscopic characteristic features of apoptosis is