Question: Function of hepatic stellate cells are

The hepatic cells are of mesenchymal origin , found in space of Dessie. The stellate cells play a role in the storage and metabolism of vitamin A and are transform into collagen producing myofibroblast when there is inflammation and Fibrosis of liver. Refer 9/e p436


Question: Tendon of Todaro connects

Tendon of Todaro is a pa of Koch's triangle Base: ostium of coronary sinus Superior boundary: tendon of Todaro connects central fibrous body. Inferior boundary: septal cusp of tricuspid value. Apex: bundle of his & AV node.

Coronary sinus to tricuspid valve annulus


Question: Holocrine glands are

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:204 Sebaceous glands The outer most cells are small and reston a basement membrane. the inner cells are larger more rounded and filled with lipid. this lipid is discharged by disintegration of the innermost cells that are replaced by proliferation of outer cells .the sebaceous glands are, therefore examples of holocrine glands


Question: Calcitriol acts on

Bioactive vitamin D or calcitriol is a steroid hormone that has long been known for its impoant role in regulating body levels of calcium Nuclear or cytosolic receptors include the binding sites for steroid hormones, thyroid hormones, vitamin D, and retinoic acids Ref-Goodman and Gillman 12th/e p1282


Question: Following surgical removal of a firm nodular swelling in the right breast and exploration of the right axilla, on examination the patient was found to have a winged right scapula. Most likely this could have occurred due to injury to the


Question: Rotter's node is

Ans: A Interpectoral nodes Interpectoral (Rotter's) lymph nodes - Small interpectoral lymph nodes located between pectoralis major & pectoralis minor muscles.


Question: Nerve supply of deltoid is

Anterior division of axillary nerve supplies most pa of the deltoid muscle.Posterior division of axillary nerve supplies the posterior fibres of deltoid muscle.B D Chaurasia 7th edition Page no: 180


Question: Variant of Giant cell tumor is

GCT is adult counterpa of chondroblastoma. Chondroblastoma is an epiphyseal tumor which occurs in 2nd decade while GCT is an epiphyseal tumor which occurs in adults Refer https ://emedicine. Medscape.com/aicle/125449-overview


Question: A drug that blocks the uptake of dopamine and norephinephrine into presynaptic Nerve terminals and also block sodium channels in the axonal membrane is

Ref-KDT 6/e p117 It is a local anaesthetic agent(act by inhibiting Na+ channel in the axonal membrane) that also possess indirect sympathomemtic activity


Question: Treatment of choice in Choledochal cyst is

Treatment of Choledochal cyst Type I : Roux-en-Y hepaticojejunostomy Type II: Excision with T-tube REPAIR, Roux-en-Y hepaticojejunostomy Type III: Endoscopic sphincterectomy and cyst unroofing Type IVA: Hepatic resection for localised disease, Liver transplantation for diffuse diseases Type IVB: Transduodenal sphicteroplasty and Roux-en-Y hepaticojejunostomy Type V: Hepatic resection for localised disease, Liver transplantation for diffuse disease Ref: Sabiston 20th edition Pgno :1511


Question: Buccal branch of facial nerve suppplies

Buccinator and superior constrictor muscle

Buccinator and quadrates labii superioris muscle


Question: Most common primary malignant tumor of liver in adult is


Question: The nerve that supplies the marked structure

marked structure is Levator scapulae Nerve supply C5 Dorsal scapular nerve supplies Levator scapulae and Rhomboids major/ remarks : brachial plexus is repeat topic ref : GRAYS ANATOMY AND BD CHAURASIA


Question: Structures passing through superior orbital fissure

superior orbital fissure * lateral pa lacrimal and frontal nerves, trochlear nerve, superior ophthalmic vein, meningeal branch of lacrimal aery, anastomotic branch of middle meningeal aery, which anastomoses with recurrent branch of lacriamal aery. * middle pa Upper and lower divisions of oculomotor nerve, nasociliary nerve, abducent nerve *medial pa Inferior ophthalmic vein .sympathetic nerve from plexus around internal carotid aery <img alt="" src=" /> Ref BDC volume 3; 6th edition pg 56


Question: The palatal muscle that ends in a tendon that hooks around the hamulus and is inserted in the palate is the


Question: Struther's ligament is another name for

Struther's ligament is another name for Third head of Coracobrachialis. Median nerve runs below the ligament and undergoes compression and leads to Struther's syndrome.

Radial collateral ligament of Elbow joint

Ulnar collateral ligament of Elbow joint


Question: The vertebral artery

The vertebral artery is a branch of first part of subclavian artery. It lies posterior to inferior thyroid artery. It passes posterior to lateral mass of atlas.

Arises from the second part of subclavian artery , from behind scalenus anterior

Lies anterior to inferior thyroid artery

Passes through the C6 foramen transversarium

Passes anterior to the lateral mass of atlas and then enters the foramen magnum


Question: Creola bodies are seen in

Refer ribbons 9/e p682 Creola bodies are a histopathologic finding indicative of asthma. Found in a patient's sputum, they are ciliated columnar cells sloughed from the bronchial mucosa of a patient with asthma. Other common findings in the sputum of asthma patients include Charcot-Leyden crystals, Curschmann's Spirals, and eosinophilsCreola bodies are a histopathologic finding indicative of asthma. Found in a patient's sputum, they are ciliated columnar cells sloughed from the bronchial mucosa of a patient with asthma. Other common findings in the sputum of asthma patients include Charcot-Leyden crystals, Curschmann's Spirals, and eosinophils


Question: Hyperbaric oxygen is useful in

Hyperbaric oxygen is currently considered a primary treatment modality for carbon monoxide poisoning, cerebral aerial gas embolism, osteoradionecrosis, decompression sickness, and clostridial gas gangrene. It is also considered an adjunctive therapy for acute exceptional blood loss anemia, acute thermal burns, compromised skin grafts or skin flaps, crush injury, compament syndrome, necrotizing soft-tissue infections, non-clostridial gas gangrene, radiation tissue damage, refractory osteomyelitis, selected problem wounds, and intracranial abscesses. Treatment of frostbite injuries with HBO is considered experimental. The treatment protocol for frostbite includes rapid rewarming, close observation, elevation and splinting daily hydrotherapy, and serial debridements.- Ref : Bailey & Love 25/e p39, (24/e p124)


Question: Plasma cells

Ref Robbins 8/e p183_184;7/e p82;9/e p191 Plasma cells, also called plasma B cells, plasmocytes, plasmacytes, or effector B cells, are white blood cells that originate in the bone marrow and secrete large quantities of proteins called antibodies in response to being presented specific substances called antigens.


Question: Ureter develops from (2018)

Ureteric bud arises from the lower pa of the mesonephric duct. ureter is derived from the pa of the ureteric bud. Ureteric bud also give rise to Renal pelvis,major and minor calyces, Renal papilae and collecting tubules Ref:- Inderbirsingh, pg num:-241,243, 246


Question: Blood flow in intervillous space at term

A mature placenta has 500 m blood out of which 150 no is in the intervillous space and 350 ml in villi system. Ref: Datta Observe 9e pg 29.


Question: Samter's triad refers to the association of aspirin sensitive asthma and

Samter's triad Asthma Asprin sensitivity Nasal polyposis Ref Harrison 19th edition pg 1680


Question: The antidiabetic drug with anorectic effect is

Oral hypoglycemic agents Enhance insulin secretion Sulfonylureas ( K-ATP channel blockers )I - TolbutamideSafer in elderly & those prone to hypoglycemia, Controls postprandial hyperglycemia II - Glibenclamide, Glipizide, Gliclazide, GlimepiridePotent drugs with lower incidence of hypoglycemic attacks Meglitinide analogues Repaglinide, NateglinideStimulates insulin secretion & limits post prandial hypoglycaemiaGLP-1 receptor agonists Exenatide, Liraglutide Lowers post prandial hypoglycaemia , fasting blood glucose , HbA1c and body weight Produces anorectic effect DPP 4 inhibitors Sitagliptin, Vida gliptin, Saxagliptin, Alogliptin, LinagliptinBoosts postprandial insulin release, decreases glucagon secretion, lowers meal time & fasting blood glucose Overcome insulin resistanceBiguanide ( AMP-K activator )Metformin Suppresses hepatic gluconeogenesis, enhances insulin-mediated glucose uptake in skeletal muscle & fat, promotes peripheral glucose utilization Thiazolidinediones ( PPARg activator )Pioglitazone, Rosiglitazone, Troglitazone Suppresses hepatic gluconeogenesis, an activator of genes regulating fatty acid metabolism & lipogenesis in adipose tissue, lowers HbA1c and insulin levels Miscellaneous drugsa-glucosidase inhibitors Acarbose , Voglibose , Miglitol Reduces post prandial glycemia , lowers HbA1C levels Amylin analogue Pramlintide Delay gastric emptying, retard glucose absorption & promotes satiety Dopamine D2 receptor agonist Bromocriptine Suppresses glycemic peak, reduce body weight SGLT - 2 inhibitor Dapagliflozin, CanagliflozinProduces round the clock glucosuria, lowers blood glucose levels


Question: Strawberry cervix is caused by

Strawberry cervix is caused by Trichomonas vaginalis. Severe inflammation of the cervix with macular haemorrhages gives it a strawberry appearance and hence the name. Similar inflammation with haemorrhages on the vagina is called colpitis macularis.


Question: Denver shunt is used in

Denver shunt It is used for the relief of ascites due to chronic liver disease To prevent high occlusion rates as seen in Le-Veen shunt, a fuher development was the inseion of a chamber placed over the costak margin to allow digital pressure and evacuation of any debris within the peritoneovenous shunt Ref: Textbook of hepatology by Erwin kuntz Pgno :317


Question: Most impoant component of Bishop score

The most impoant component of bishop score is dilatation of cervix


Question: The vitelline vein forms the


Question: The ideal temperature of water to cool down the burned area is

Cool the burn wound. This provides analgesia and slows the delayed microvascular damage that can occur after a burn injury. Cooling should occur for a minimum of 10 minutes and is effective up to 1 hour after the burn injury. It is a paicularly impoant first aid step in paial-thickness burns, especially scalds. In temperate climates, cooling should be at about 15degC, and hypothermia must be avoided Ref bailey and love 27e p620


Question: The normal angle of the neck of the femur to shaft is approximately....

The normal angle of the neck of the femur to the shaft is approximately 125deg. This is known as neck shaft angle or angle of inclination. This facilitates the movement at the hip joint, enabling the limb to move freely. Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 1348.


Question: delirium in ICD 10 is calssified under

ICD CHAPTERS ICD is a text book for classification of psychiatric disorders. The below table comprises chapter numbers dealing with various psychiatric disorders. Ref.International classiication of disorders, ICD 10 th edition


Question: bulimia nervosa isassosiated with

Bulimia nervosa * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Binge eating at least once a week for 3 months * Uses laxatives, diuretics, self-induced vomiting * Association= * Impulsive behaviors * increased interest in sex * They may be of normal weight * Less secretive * Mood disorders * Complication * Electrolyte abnormalities * Hypokalemia * Hypochloremia alkalosis * Russel's sign==== as these patients uses their fingers to be stick out in the throat and vomit, there is a lesion in meta carpo phalangeal joints. * Drugs * Carbamazepine * MAOI * SSRI Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no 509


Question: Popliteal aery is difficult to palpate because

D i.e. Not superficial & does not pass over prominent bony structure

Does not pass over prominent bony structure

Superficial but does not pass over prominent bony structure


Question: The testis descends the inguinal canal during...month.


Question: Increase in height in first year is by

Length at bih- 50 cms, while at the end of 1st year, it is 75 cms, i.e., height increases by 25cms, which will be 50% 50% of 50cms (at bih) will be 25cms, and by adding this 25cms to 50cms it'll account to 75 cms( at the end of 1yr) Ref: Nelson's 20th edition, pg 84-89


Question: Nerve for adductor compament of thigh

OBTURATOR NERVE:- Branch of lumbar plexus Nerve of adductor compament Arises from ventral division of ventral rami of L2,L3,L4 segments. It emerges on the medial border of psoas major muscle within the abdomen.It crosses the pelvic brim to run downwards and forwards on the lateral wall of pelvis to reach upper pa of obturator foramen. Terminates by dividing into anterior and posterior Divisions. BRANCHES:-Anterior division 1. Muscular branches: pectineus, adductor longus, adductor brevis,gracilis.2. Aicular: hip joint.3. Vascular and cutaneous: femoral aery.Posterior division 1. Muscular: obturator externus,adductor magnus(adductor pa)2. Aicular: knee joint 3. Vascular and cutaneous: popliteal aery. {Reference: BDC 6E pg no. 172}


Question: Catastrophic variant of Ehler Danlos syndrome is

Ehlers danlos syndrome comprise group of clinically and genetically heterogeneous group of disorder that result from defects in synthesis or structure of fibrillar collagen. Ref Robbin's 9th/146


Question: In the intraepthielial region of the mucosa of intestine the predominant cell population is that of

IEL are6 a distinctive population of T cells dispersed among the luminal epithelial cells. paicularly in the small intestine there is a predominantly of CD8+T cells


Question: Palmar interossei is supplied by

All palmar interossei are supplied by the deep branch of the ulnar nerve (C8, T1). Ref : B D Chaurasia's Human Anatomy, Seventh edition , volume 1 , pg. no, 124


Question: The distance of gastroesophageal junction from upper incisor is

Oesophagus begins at the lower border of cricoid cailage (at the level of C5 veebrae)Q, passes through diaphragm at the level of T10 veebrae and ends in the abdomen at the cardiac orifice of stomach at the level of Tn veebrae. Its is 25 cm long.- Small aggregation of lymphoid tissue is present in submucosaQ near lower end (not mucosa) Circular muscle fibers of lower end of esophagus form physiological sphincter at cardioesophageal junction.Oesophagus don't have serous covering except over a sho length near its lower end.


Question: Right superior intercostal vein drains into

The right superior intercostal vein drains the 2nd, 3rd, and 4th posterior intercostal veins on the right side of the body. It flows into the azygos vein. The left superior intercostal veins drains the 2nd and 3rd posterior intercostal veins on the left side of the body. It drains into the left brachiocephalic vein B D CHOURASIAS HUMAN ANATOMY UPPER LIMB THORAX VOLUME, 1 SIXTH EDITION, page no,221


Question: Haversian system is seen in

* Microscopically, the bone is of five types, namely lamellar (including both compact and cancellous), woven, fibrous, dentine and cement. 1. Lamellar bone: Most of the mature human bones, whether compact or cancellous, are composed of thin plates of bony tissue called lamellae. These are arranged in piles in a cancellous bone, but in concentric cylinders (Haversian system or secondary osteon) in a compact bone. 2. Woven Bone: seen in fetal bone, fracture repair and in cancer of bone 3. Fibrous bone is found in young foetal bones, but are common in reptiles and amphibia. 4. Dentine and 5. Cement occur in teeth. * Compact bone ( coical bone) In shaft (diaphysis) of long bone - lamellae arranged to form Haversian system - Bone marrow Yellow which stores fat after pubey. It is red before pubey - Hard and ivory-like * Cancelled bone spongy, or trabecular bone - In the epiphyses of long bone - arranged in a meshwork, so Haversian systems are not present - bone marrow red, produce RBCs, granular series of WBC and platelets - spongy * Nails are made of a tough protective protein called keratin - consists of the nail plate, the nail matrix and the nail bed below it, and the grooves surrounding it (Reference : BDC Handbook of General Anatomy , 5th edition, pg 39)


Question: Not a predisposing factor for cholangiocarcinoma

Choledocholithiasis, not the cholelithiasis is a risk factor for cholangiocarcinoma Risk factors for cholangiocarcinoma Choledochal cyst Primary sclerosing cholangitis Ulcerative colitis. RPC or hepatolithiasis. Biliary enteric anastomosis HBV, HIV, HCV Choledocholithiasis Clonorchis sinensis and opisthorchis viverrini Cirrhosis Radon Asbestos, Nitrosamines, Dioxib(AND). Diabetes, Obesity, OCP's, smoking, Thorotrast, Isoniazid(DOSTI) Ref: Sabiston 20th edition Pgno :1514


Question: Cranial nerve related to apex of petrous temoporal bone

Cranial nerve 5 & 6 are related to apex of petrous bone.
Only 1st & 2nd cranial nerves do not arise from brain stem and so do not pass through posterior-cranial fossa. And all other C.N (i.e. 3rd to 12th) pass through posterior cranial fossa.
Trochlear (4th) nerve is the only cranial nerve to emerge dorsally from the brain stem & has longest infra cranial course and most slender cranial nerve (in terms of axons it contains)


Question: In erect posture commonest site of foreign body in bronchus is

From Schwa, 7/e- "The most common anatomic location for a foreign body is the right main stem bronchus or the . lower lobe." " The right main stem bronchus is wider, shoer and veically placed, and therefore the posterior segments of the right upper lobe (if the pt. aspirated while supine) are anatomically susceptible to aspiration pneumonia. The superior segments of the right lower lobe and left lower lobe (if the pt. supine) are also susceptible to aspiration pneumonia. These three segments are often referred to as the aspiration segments of the lung. The basilar segments of both lungs are susceptible to aspiration if the pts. aspirates while erect or sitting up." Aspiration in Supine Position : RL upper lobe - posterior segment Rt. lower lobe - superior segment Lt. lower lobe - superior segment Aspiration in sitting or erection position Rt. basilar segments (of lower lobe). Ref : Schwaz 9/e p1420


Question: Hemiazygous vein crosses left to right at the level

Hemiazygos vein crosses from left to right at the level of T8, after piercing the left crus of diaphragm while ascending.


Question: Diagnosis of Hodgkin's disease is confirmed by


Question: Hyperkalemia means more than

Normal plasma K+ concentration is b/w 3.5 & 5.0 mEq/L. Hyperkalemia is defined as a plasma potassium level more than 5.5 mEq/L Hypokalemia: plasma K+ < 3.5 mEq. Severe hyperkalemia is K+ > 6.0 mEq. > 8.0 mEq- Causes diastolic arrest (Systolic arrest seen when Ca > 13 mg %) Causes of hyperkalemia: Pseudo hyperkalemia: Fist clenching, narrow bore needle, cooling of sample, TLC |, Platelet |, RBC| Acidosis: Trans-cellular shift CKD/AKI Aldosterone | - Addison disease, histoplasmosis, HIV, Waterhouse Frederickson syndrome Gordon syndrome - + gain of function of NaCl cotranspo ECG changes in Hyperkalemia - Tall tented T wave ST elevation Broad QRS If > 8.0 mEq: SINE WAVE PATTERN is seen. Treatment: Antagonism: Calcium gluconate , calcium chloride Redistribution: Insulin drip with 50% dextrose; salbutamol nebulization Removal of potassium: Furosemide, resin sodium polystyrene sulphonate etc


Question: Multiple intrahepatic bile duct dilation with bile lakes and concurrent sepsis is suggestive of

Caroli's disease Clinical features : Symptoms include cholangitis (64%), poal hypeension (22%) and abdominal pain(18%) More common in males Septa containing poal veins protrude into the lumen of the ecstatic bile ducts (central dot sign) The main and often the only symptom of bacterial cholangitis secondary to caroli's disease is fever without abdominal pain and jaundice Frequent episodes of cholangitis indicates poor prognosis Most stones are pigmented in caroli's disease Ref: Sabiston 20th edition Pgno :1511


Question: Mediastinal surface of right lung is related to

> (because hea & its blood vessels should be preferred first as an answer as they cause direct impression on lungs). * mediastinal surface of Right lung contains Left lung contains Hea (right atrium) Superior vena cava Inferior vena cava Azygos vein Esophagus Right subclan aery & vein arch over and are related to superior lobe of right lung. Hea (left ventricle) Aoic arch Thoracic aoa Esophagus Left subclan aery & vein arch over & related to superior lobe of left lung. fig;- major structure related to mediastinal surface of right lung Right lymphatic duct - not related to lung Thoracic duct - related to left lung mediastinal surface But they do not put great impression on lungs * Trachea is more towards right lung * Esophagus is more towards left lung


Question: A paitent met an accident with a car and has been in `deep coma' for the last 15 days. The most suitable route for the administration of protein and calories is by

Unless the gastrointestinal tract is non-functional, its use for nutritional suppo is preferable to the use of either the central or a peripheral venous route. However, in a patient who is comatose either nasogastric feeding or feedings through a gastrostomy tube may lead to vomiting and aspiration. This problem can be avoided by using a nasoenteric tube with the tip placed in the jejunum under fluoroscopic or endoscopic control. Alternatively, a catheter may be placed directly into the proximal jejunum through a small upper abdominal incision


Question: Posterior boundary of Epiploic foramen is formed by

Posterior boundary of Epiploic foramen is formed by Inferior venacava, T12 Vertebra and Right Suprarenal gland


Question: Punishment for penetrative sexual assault under POSCO act is

Protection of Children from Sexual Offences Act(POSCO) According to this act, child is a person below 18 years of age. Punishment for penetrative sexual assault : shall be punished with imprisonment for 7 years which may be extended for life and also liable for fine. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 307


Question: 1st spinal nerve is related to

The anterior primary ramus of C1 joins with hypoglossal nerve, which distributes the motor fibres to the geniohyoid and thyroid muscles. C1 is the first spinal nerve which is unique in that it contains only motor fibres. (Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg 107)


Question: Drug remains in the body after three lives is

Cp - > Cp/2 in 1 half-life i.e. 50.0 % lost 50.0 % Cp - > Cp/4 in 2 half-lives i.e. 25.0 % lost 75.0 % Cp - > Cp/8 in 3 half-lives i.e. 12.5 % in body and lost 87.5 % Cp - > Cp/16 in 4 half-lives i.e. 6.25 % lost 93.75 % Cp - > Cp/32 in 5 half-lives i.e. 3.125 % lost 96.875 % Cp - > Cp/64 in 6 half-lives i.e. 1.563 % lost 98.438 % Cp - > Cp/128 in 7 half-lives i.e. 0.781 % lost 99.219 % Ref-KDT 7/e p30


Question: Osteomyelitis in sickle cell anemia is due to DELETE

Most common cause of osteomyelitis in sickle cell anemia is salmonella Refer Maheshwari 6tg/e p 168


Question: Ureters is lined by

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:318


Question: E cadherin gene deficiency is seen in

Ref Robbins 9/e p291 Cadherins is derived from the calcium dependant adherence protein.It paicipate in interactions between cells of same type.The linkage of cadherins with the cytoskeleton occurs through the catenins.The cell to cell interactions mediated by cadherins and catenins play a major role in regulating cell motility, proliferation,and differentiation and account for the inhibition of cell proliferation that occurs when cultured normal cells contact each other ( contact inhibition) Reduced functions of E cadherins is associated with ceain types of breast and gastric cancer


Question: Magnan's symptom', 'crack lung' and 'crack dancing' are seen in chronic use of

Chronic use of cocaine The face will be pale, eyes sunken and marked evacuation, black discoloration of teeth and involuntary tooth grinding(bruxism) There may be persistent rhinitis nasal erosion with perforation Males suffer from loss of libido, impotence and infeility. Females suffer from galactorrhoea, amenorrhoea, and infeility. The person may suffer from paranoid or depressive psychosis, hallucinations, delusions, convulsions, and delirium due to degenerative changes in CNS The person may have tactile hallucination that insects are crawling under the skin. This is called Magnan's symptom or Cocaine bugs/ formication. Crack lung refers to hypersensitivity, bronchospasm, dysnoea, and pneumonia occurs as a result of cocaine smoking. crack dancing refera to extra pyramidal signs and symptoms after cocaine intake. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 485


Question: Ascending pharyngeal aery is branch of

*Ascending pharyngeal aery is a small branch that arises from the medial side of the external carotid aery. *It arises very close to the lower end of external carotid aery. *It runs veically upwards between the side walls of the pharynx, and the tonsil, medial wall of the middle ear and, the auditory tube. *It also sends meningeal branches into the cranial cavity through the foramen lacerum, the jugular foramen, and the hypoglossal canal. <img src=" /> Ref: BDC 6th edition pg 103 ,230


Question: Medial boundary of Cubital fossa is

CUBITAL FOSSA:-Triangular hollow in front of the elbow. Boundaries:-1. Lateral:- medial border of brachioradialis.2. Medial: lateral border of pronator teres.3. Base: imaginary horizontal line joining two epicondyles of the humerus.4. Apex: It is directed downwards, and is formed by the area where brachioradialis crosses the pronator teres muscle.5. Floor: brachialis (upper pa) Contents: medial to lateral 1. Median nerve 2. Brachial aery.3. Biceps tendon.4. Radial nerve. mnemonic: MBBR Brachial pulse- recording BPMedial cubital vein- collect blood samples & iv injection. REF: BD Chaurasia 7th edition page no: 97.


Question: Drug of choice in PSVT is

Table 276-3 Adenosine 6-18 mg (rapid bolus) N/A Terminate reentrant SVT involving AV node --ref Harrison 20th edition pg 1435


Question: Pain in early labor is limited to dermatomes

In early stages of labor pain is mainly uterine in origin . Distributed along the cutaneous nerve distribution T10 - L1 In later stages pain is due to dilatation of cervix referred to back through sacral plexus


Question: Least common site for lung abcess is

About the site of lung abscess associated with aspiration . "Because of the effect of gravity, foci of infection tend to develop in the subpleural regions of the superior segments of the lower lobes and in the posterior segments of the upper lobes. The right lung is involved more frequently, presumably because of the less acute angle of the right main bronhus. thus the right upper and lower lobes are the most commonly affected, followed by the left lower lobe and right middle lobe." Ref : Schwaz 9/e p.549


Question: The normal ratio of CD4to CD8 is

Ref Robbins 9/e p190-191 A normal CD4/CD8 ratio is 2.0, with CD4lymphocytes equal to or greater than 400/mm3 and CD8 lymphocytes equal to 200 to 800/mm3. If your ratio is higher than 2, it means your immune system is strong and you may not have HIV. If your ratio is less than 1, you may have: HIV.


Question:
Microcephaly is seen in
Beckwith hypoglycaemic syndrome
Fanconi syndrome
Down syndrome
Achondroplasia

A condition in which a baby's head is significantly smaller than expected, often due to abnormal brain development. Causes of microcephaly include infections, malnutrition or exposure to toxins.
Symptoms vary and include intellectual disability and speech delay. In severe cases, there may be seizures and abnormal muscle functionality.


Question: Base of the hea is formed by

Base of hea is formed by left atrium and the small pa of right atrium. BD CHAURASIA&;S HUMAN ANATOMY.VOLUME 1. 6TH EDITION.PAGE NO 253


Question: A patient presented with a 1 X 1.5 cms growth on the lateral border of the tongue. The treatment indicated would be

Radiation therapy may be curative in early cancer (T1 and some T2) and may preserve maximal normal anatomy and function. Brachytherapy allows delivery of a large radiation boost to the primary tumour bed


Question: Afferent component in corneal reflex is mediated by

Ophthalmic nerve carries sensory fibres from the structures derived from frontonasal process. In injury to ophthalmic nerve, there is loss of corneal blink reflex. This reflex is mediated by V1 which is afferent pathway and VII nerve which subserves as efferent pathway. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3.


Question: Inheritance of gardener syndrome is

It is sub type of familial adenomatosis polyposis inherited as an autosomal dominant disorder Gardener syndrome ;intestine polyps +epidermal cysts+fibromatosis+osteomas Refer 8/e p816


Question: Superior vena cava opens into right atrium at the level of

SVC open into right atrium at the level of T5 . Ref - BDC 6th edition vol 1 pg272


Question: The gold standard for diagnosis of pulmonary embolism

Pulmonary embolism The risk factors for pulmonary embolism are the risk factors for thrombi formation within the venous circulation.The most common site for DVT: Calf veinsMost common source of pulmonary emboli: proximal vein of lower extremity (femoropopliteal and iliac vein)Calf venous thrombosis is itself associated with a low risk for embolism but when the thrombosis progresses proximally to involve the larger veins then the risk factors become very highClinical featuresFactors for clinical assessment of pulmonary embolismSymptoms: dyspnoea (MC), chest pain, hemoptysis, coughSigns: tachypnoea (MC), fever, unilateral leg swelling, wheeze, pleural friction rubClinical signs and symptoms of DVTAn alternative diagnosis is less likely than pulmonary embolismHea rate > 100/minImmobilization or previous surgery in 4 weeksPrevious DVT/PEHemoptysisMalignancy (on treatment, treatment in past 6 months)ECG changesDiagnosisFeatures suggesting acute right hea strain on ECG occur relatively infrequently, these include :Acute right axis detionP pulmonaleRight bundle branch blockInveed T wavesST segment changeECG changes highly predictive (but found in <12% pts) S wave in lead IQ wave in lead IIIInveed T wave in lead III (S1Q3T3)S wave in lead I, II, and III (S1S2S3)D-dimer is an excellent screening test for the diagnosis of PE Best investigation when there is clinical suspicion of PE: Multidetector Contrast CTLung scanning is now a second line diagnostic test for PE.Pulmonary angiography is the gold standard for the diagnosis of PE ECG changesDiagnosisFeatures suggesting acute right hea strain on ECG occur relatively infrequently, these include :Acute right axis detionP pulmonaleRight bundle branch blockInveed T wavesST segment changeECG changes highly predictive (but found in <12% pts) S wave in lead IQ wave in lead IIIInveed T wave in lead III (S1Q3T3)S wave in lead I, II, and III (S1S2S3)D-dimer is an excellent screening test for the diagnosis of PE Best investigation when there is clinical suspicion of PE: Multidetector Contrast CTLung scanning is now a second line diagnostic test for PE.Pulmonary angiography is the gold standard for the diagnosis of PE (Refer: Harrison's Principle of Internal Medicine, 18thedition, pg no- 2174)


Question: F 30 in ICD 10 denotes

ICD CHAPTERS ICD is a text book for classification of psychiatric disorders. The below table comprises chapter numbers dealing with various psychiatric disorders. Ref. International classification of mental disorders, 10 th edition


Question: Axillary aery is divided into 3 pas by

Axillary aery is divided into 3 pas by Pectoralis minor The 3 pas are Superior thoracic aery Thoracoacromial trunk Subscapular aery Ref : BD Chaurasia Human Anatomy 5e vol 2 pg 55.


Question: Azygos lobe is found

Azygous lobe is seen in lungs . Ref - BDC 6thedi vol 1 pg236


Question: Trachoma is characterized by the presence of

Trachoma - Chronic keratoconjunctivitis Affects the superficial epithelium of conjunctiva and corneaCaused by Chlamydia trachomatis (TRIC) agentA, B, Ba, C - Hyperendemic trachomaD to K - Neonatal and adult inclusion conjunctivitisTrachoma Disease spectrumConjunctivaCorneaSigns Congestion of upper tarsal conjunctivaFollicles over upper tarsal or palpebral conjunctiva, lower fornix, plica semilunaris Arlt's line - linear scar in sulcus Sub tarsalisPapillary hyperplasia Concretions Superficial keratitis Herbe follicles Pannus - infiltration, and vascularization of the cornea Corneal ulcer Herbe pits Corneal opacity SequelaeConcretions Pseudocyst Xerosis SymblepharonTrichiasis Corneal opacity Ectasia Corneal xerosis Corneal pannus Epidemiological criteria Follicles on the upper tarsal conjunctivaLimbal follicles like Herbe pitsConjunctival scarring (Trichiasis, Entropion )Vascular pannus at superior limbus(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 62-66)


Question: The only cranial nerve to emerge from dorsal aspect of brainstem is

.Surface attachment. Trochlear nerve is attached to the superior medullary velum one on each side of the frenulum veil just below the inferior colliculus. It is the only cranial nerve which emerges on the dorsal aspect of the brainstem. Ref : B D Chaurasia's Human Anatomy, sixth edition, volume 3 , pg. no. 364 Ref : B D Chaurasia's Human Anatomy, sixth edition, volume 3 , pg. no. 364 ( fig . 24. 1 )


Question: Auditory transmission is via


Question: The lymphatic drainage of the glans penis is


Question: Middle superior alveolar nerve is branch of

MAXILLARY NERVE DIVISION: IN MIDDLE CRANIAL FOSSA-Meningeal branch IN PTERYGOPALATINE FOSSA-Ganglionic branches Zygomatic: a.Zygomaticotemporal b.Zygomaticofacial Posterior superior alveolar IN INFRAORBITAL CANAL-Middle superior alveolar Anterior superior alveolar ON FACE-Infraorbital:palpebral,labial,nasal Ref BDC volume 3,sixth edition pg 368


Question: Eruption of 1st molar permanent tooth occurs at the age of

Eruption of permanent molar teeth: First molar( upper jaw) - 6-7 yrs First molar ( lower jaw) -. 6-7 yrs Second molar (upper jaw)- 12-13yrs Second molar(lower jaw)-11-13yrs Third molar(upper jaw)-17-21yrs Third molar(lower jaw)-. 17-21yrs Hence, the eruption of first molar permanent tooth is at the age of 6-7 yrs. Ref: Ghai, 9th edition- Pg-11.


Question: Not present in sideroblastic anemia is

Ref Harrison 19 th ed pg 628 when the marrow smear is stained for iron, 20-40% of developing erythroblasts--called sideroblasts--will have visible ferritin granules in their cytoplasm. This represents iron in excess of that needed for hemoglobin synthesis. In states in which release of iron from storage sites is blocked, RE iron will be detectable, and there will be few or no sideroblasts.


Question: A congeital hydrocele is treated by

Congenital hydrocele will resolve spontaneously within 1 year. The operation is required only when it persists for longer than 1 year" In congenital hydrocele, the processes vaginalis is patent and connects with the peritoneal cavity. The communication is usually too small to allow herniation of intra-abdominal contents. Pressure on the hydrocele does not always empty it but the hydrocele fluid may drain into the peritoneal cavity when the child is lying down; thus, the hydrocele is often intermittent. Ascites should be considered if the swellings are bilateral. "Congenital hydroceles are treated by herniotomy if they do not resolve spontaneously" Treatment usually, no treatment of congenital hydrocele is indicated because this condition typically resolves spontaneously by age 1. Most surgeons advocate observation in the majority of infants less than 12 months. Others may continue to be observed for longer, as the majority of patent processes vaginalis will close within the first 12-24 months of life


Question: Abducens supplies

*Abducent is the 6th cranial nerve *All the extraocular muscles are supplied by 3rd cranial nerve except lateral rectus and superior oblique *Lateral rectus by abducent nerve and superior oblique by trochlear nerve NOTE:MNEMONICS:LR6 & SO4 <img src=" /> Ref: BDC 6th edition pg:208(3rd vol)


Question: Type of connective tissue present in the arrow marked area is

The arrow mark shows the deep reticular layer of dermis, which is made up of dense and irregular connective tissue. Location Dense irregular: Capsule of visceral organs Periosteum, perichondrium Sheaths of nerves, muscles etc Dense regular Tendons, aponeurosis, ligament Deep fascial


Question: Freezing point of normal human plasma is

The freezing point of normal human plasma averages _0.54degC which corresponds to osmolar concentration in plasma of 290 mOsm/L The term tonicity is used to describe the osmolality of a solution relative to plasma A 0.9% saline solution and 4% glucose solution is isotonic when initially infused intravenously osmolarity= 2(Na+)(mEq/L)+0.055(glucose)(mg/dL)+0.36(BUN)(mg/dL) Red Robbins 9/e p420 and ananthanaraya


Question: A most common tumour of urinary bladder is

3 histological types of Bladder cancer are seen transitional cell ca -90% squamous cell ca -5~10% adenocarcinoma - 2%


Question: D_Dimer is the most sensitive diagnosis test for

Ref Robbins 9/e p127 D-Dimer ia a fibrin degradation product ,a small protein fragment present in blood after a blood clot is degraded by fibrinolysis,it is so named because it contains 2crosselinkedDFragments of fibrinogen protein


Question: One of the following is a midline neck swelling

Midline swelling of the neck from above downwards Ludwigs angina Enlarged submental lymph nodes Sublingual dermoid Lipoma in the submental region Thyroglossal cyst Subhyoid bursitis Goitre Lipoma & enlarged lymph nodes in the suprasternal space of burns Retrosternal goitre Thymic swelling (A dermoid cyst may occur anywhere in the midline) Ref : Bailey & Love 25/e p729


Question: Orchiectomy is not indicated in

For tubercular epididymitis, usually ATT is sufficient, if resolution does not occur, then epididymectomy can be done. (Orchiectomy is done if pt. has orchitis, non-responsive to ATT).


Question: Filum terminate extend up to

(C) Coccyx # Level of Spinal Cord:> Spinal cord extends from C1 to L1 (lower border) in adults> Spinal cord extends from C1 to L3 (upper border) in infants.> Filum terminate extends from lower end of spinal cord (L1 or L3) to the tip of coccyx.> Piamater extends up to tip coccyx> Dural sheath extends up to S2 vertebra.> Subdural space extends up to S2> Subarachnoid space extends up to S2


Question: The main Side effect of Imatinib mesylate

The main side effects are fluid retention, nausea, muscle cramps, diarrhea, and skin rashes.


Question: Internal opening of brachial fistula is located at


Question: A “Potential Anastomosis” seen in

Arterial anastomosis is the communication between the arteries, or branches of arteries. It may be actual or potential.

Actual Arterial Anastomosis: In actual arterial anastomosis the arteries meet end to end. For example, palmar arches, plantar arch, circle of Willis, intestinal arcades, labial branches of facial arteries.
Potential Arterial Anastomosis: In potential arterial anastomosis the communication takes place between the terminal arterioles. Such communications can dilate only gradually for collateral circulation. Therefore on sudden occlusion of a main artery, the anastomosis may fail to compensate the loss. The examples are seen in the coronary arteries and the cortical branches of cerebral arteries.


Question: Kviem siltzbach test is is used in diagnosis of

The Kviem-Siltzbach procedure is a specificdiagnostic test for sarcoidosis. An intradermalinjection of specially prepared tissue derived from the spleen of a known sarcoidosis patient is biopsied 4-6 weeks after injection. Ref Harrison 19th edition pg 2210


Question: Posterior communicating aery connects

Posterior communicating aery connects the internal carotid aery with posterior cerebral aery.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 172)

Posterior cerebral aery with middle cerebral aery

Posterior cerebral aery with internal carotid aery

Anterior cerebral aery with middle cerebral aery


Question: Vanishing bile duct syndrome is seen in

Vanishing bile duct syndrome Rare condition characterised by decreased number of bile ducts seen in liver biopsy specimens Causes Chronic rejection after liver transplantation Graft versus host disease after BMI transplantation Sarcoidosis Drugs: Chlorpromazine Idiopathic Ref : Harrison's 19th edition Pgno : 2027-2028


Question: Rotator interval is between

Refer Essentials of Ohopedic surgery Rotator interval is a triangular poion of shoulder capsule which lies between supraspinatus and subsacapularis tendon


Question: Lewis triple response is caused due to

Ref Goodman and Gilman 10/e p650 With injection of histamine there is triple response Red spot Wheal Flare


Question: Nerve of inguinal canal is

The inguinal canal is a passage in the anterior abdominal wall that in men conveys the spermatic cord and in women the round ligament of uterus. The inguinal canal is larger and more prominent in men. There is one inguinal canal on each side of the midline. ref -BDC 6e vol2 pg211-216


Question: A derivative of neural Crest is

Neural Crest Cells During elevation of the neural plate, a group of cells appears along each edge (the crest) of the neural folds (Fig. 18.2). These neural crest cells are ectodermal in origin and extend throughout the length of the neural tube. In addition to forming sensory ganglia, cells of the neural crest differentiate into sympathetic neuroblasts, Schwann cells, pigment cells, odontoblasts, meninges, and mesenchyme of the pharyngeal arches. Ref: Langman's embryology; Pg 306 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: Inferior Gluteal Nerve Supplies

INFERIOR GLUTEAL NERVE :Root value: L5, SI, S2Course: Enters the gluteal region through greater sciatic notch below piriformis muscle Branches: It gives a number of branches to gluteus maximus muscle only. It is the sole supplier to the large antigravity, postural muscle with red fibers, responsible for extending the hip joint.Reference: Chaurasia Volume II; 7th edition; Page no: 73


Question: Inferior thyroid artery arises from

Thyrocervical trunk of 1st part of subclavian artery


Question: Hemiazygous vein crosses left to right at the level of

Hemiazygos vein turns to the right at the level of T8 B D CHAURASIA&;S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 SIXTH EDITION Page no-224


Question: The vein in the cardiac anterior interventricular groove is

The Great cardiac vein accompanies first the anterior interventricular aery and then the left coronary aery to enter the left end of the coronary sinus. B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 FIFTH EDITION Page no-254


Question: The pharmakokinetic change occurring in geriatric patient is due to

One of the most impoant pharmacokinetic changes associated with aging is decreased renal elimination of drugs. After age 40, creatinine clearance decreases an average of 8 mL/min/1.73 m2/decade; however, the age-related decrease varies substantially from person to person. Serum creatinine levels often remain within normal limits despite a decrease in GFR because older adults generally have less muscle mass and are generally less physically active than younger adults and thus produce less creatinine. Maintenance of normal serum creatinine levels can mislead clinicians who assume those levels reflect normal kidney function. Decreases in tubular function with age parallel those in glomerular function. Refer katzung 11/e p1039


Question: Aicularis genu is related to

Vastus intermedius- arises from the upper three-fouhs of the anterior and lateral surface of shaft of femur. Aicularis genu arises just below the vastus intermedius. Vastus lateralis-arises from upper pa of interochanteric line, anterior and inferior aspects of the greater trochanter, the lateral margin of the gluteal tuberosity, and the upper half of the lateral lip of linea aspera. Vastus medialis: lower pa of interochanteric line, the spiral line, medial lip of linea aspera, and the medial supracondylar line. Rectus femoris: Straight head- anterior inferior iliac spine.Reflected head-margin of acetabulum and capsule of hip joint. <img src=" /> {Reference: BDC 6E pg no.16,17}


Question: Lattice degeneration seen in

Peripheral retinal degenerations common in pathological myopia


Question: The cerebrospinal fluid

The cerebrospinal fluid is a modified tissue fluid. It is contained in the ventricular system of the brain and in the subarachnoid space around the brain and spinal cord. The bulk of cerebrospinal fluid is formed by the choroid plexuses of the lateral ventricles and lesser amounts by the choroid plexuses of third and fouh ventricles Ref BDC volume3,6th edition pg 331

Mostly found in skull bones than in spine

Through aqueduct passes from lateral ventricle to 3rd ventricle


Question: Sperm maturation takes place in

Sperm maturation takes place in epididymis. The seminiferous tubules of the testis are the staing point of the process, where spermatogonial stem cells adjacent to the inner tubule wall divide in a centripetal direction- beginning at the walls and proceeding into the innermost pa or lumen to produce immature sperm. Ref - BDC 6e vol2 pg226


Question: Left common cardinal vein is reduced to

Left common cardinal vein is reduced to coronary sinus Ref Human embryology Inderbir singh Tenth edition Page 232


Question: In a detached retina, the site of detachment is found

The site of retinal detachment is between the pigment epithelial layer and the layer of outer segments of rods and cones; this corresponds to the intraretinal space between the inner and outer layers of the optic cup. Retinal detachment occurs when fluid from the vitreous compament passes through a retinal hole and separates the pigment epithelial layer from the layer of outer segments of rods and cones.

Between the inner nuclear layer and the outer nuclear layer

Between the pigment epithelial layer and the layer of outer segments of rods and cones


Question: LMP 1 gene plays a role in oncogenesis induced by

Ref Robbins 9/e p328 LMP 1 gene plays a role in oncogenesis induced by EBV Epstein-Barr virus latent membrane protein 1 (LMP1) is expressed in multiple human malignancies, including nasopharyngeal carcinoma and Hodgkin and immunosuppression-associated lymphomas. LMP1 mimics CD40 signaling to activate multiple growth and survival pathways, in paicular, NF-kB. LMP1 has critical roles in Epstein-Barr virus (EBV)-driven B-cell transformation, and its expression causes fatal lymphoproliferative disease in immunosuppressed mice. Here, we review recent developments in studies of LMP1 signaling, LMP1-induced host dependency factors, mouse models of LMP1 lymphomagenesis, and anti-LMP1 immunotherapy approaches


Question: Location of beta 3 receptors include


Question: Typical JVP finding in cardiac tamponade

Ref Harrison 19 th ed pg 1462 Cardiac tamponade is characterized by jugular venous diatenaiod ( increased JVP) with a prominent X descent but an ,absent Y descent.


Question: Muscle attached to anterior surface of greater trochanter

Gluteus minimus is most anterior in attachment & Gluteus Maximus is most posterior. Muscle Inseion Gluteus maximus Gluteal tuberosity (1/4), iliotibial tract (3/4) Gluteus Medius Greater trochanter of femur (Lateral surface) Gluteus minimus Greater trochanter of femur (anterior surface) Piriformis Apex of greater trochanter of femur


Question: A carbuncle is best treated by

Treatment - Carbuncle Proper excision by cruciate incision will usually treat the condition effectively Surgical incision and drainage of all Suppurative collections with antibiotics Ref: www.ncbi.nlm.nih.gov


Question: Hyperoxygenation of premature infants may result in

Retrolental fibroplasia results from hyperoxygenation of premature infants. In premature infants, high oxygen concentration results in obliteration of the terminal aerioles, leading to hemorrhage and infarction of the retina. This phenomenon is peculiar to the incompletely vascularized peripheral retina.


Question: Ureter develops from

Development of GU system and Neuro-vascular supply of pelvis & perineum


Question: Embryonic period is upto

Embryo refers to the product of conception from the day of feilization to 8 weeks Prenatal period Ovum- 0-2 wks Embryo- 3-8wks Foetus- 9wks - bih Postnatal period Newborn- first 4wks after bih Infant- Bih to 12months Toddler- 1yr to 36 months Preschool child- 37 to 72 months School age child- 73 months to 12yrs Adolescence Early- 10-13 yrs Middle- 14-16 yrs Late- 17-20yrs Ref: Ghai, 9th edition, Chapter 2, Table 2.1


Question: Zero order kinetics occur in following drug with high dose

Phenytoin and thiophylline follows zero order kinetics with high dose as it follow linear with time Ref -KDT 6/e p31,138


Question: Fascia around nerve bundle of brachial plexus is derived from

The muscular floor of the posterior triangle is covered by preveebral layer of deep cervical fascia which forms the fascial carpet of the floor of posterior triangle.The axillary sheath around subclan aery and brachial plexustravelling from root of neck to the upper limb.pus collected in the posterior triangle deep to its fascial carpet from tubercular cervical veebrae may track downwards and laterally along the axillary sheath to first appear in the axilla or even in the arm subsequently.Reference: Textbook of anatomy, Upper limb, and thorax, Vishram Singh, 2nd edition, page no.80


Question: Verocay bodies are seen in

Schwannoma are well circumscribed encapsulated masses that abut the associated nerve without invading it


Question: Posterior superior iliac spine is at the level of

PSIS line identifies the S2 spinous process most frequently


Question: drug with teratogenic potential is

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


Question: The diameter of Tricuspid orifice is

ValveDiameter of OrificePulmonary2.5cmAoic2.5cmMitral3cmTricuspid4cmRef: BD Chaurasia; Volume 1; 6th edition; Table 18.1


Question: A 12 year old boy presents with hemetemesis, melena and mild splenomegaly. There is no obvious jaundice or ascites. The most likely diagnosis is

Extrahepatic poal venous obstruction (EHPVO) EHPVO is a vascular disorder of the liver Obstruction of the extrahepatic poal vein with or without involvement of the intrahepatic poal veins or splenic or SMV Most common site of obstruction is at the confluence of splenic vein and SMV EHPVO is the most common cause of upper Gastrointestinal bleeding in children Accounts for almost 70: of pediatric patients with poal hypeension Clinical features It can present in two forms Recent EPHVO : Abdominal pain, ascites or fever, may be asymptomatic Chronic EPHVO : Repeated, well tolerated bleeding episodes from esophageal varices Ectopic varices are common (duodenum, anorectal region, biliary tree and gallbladder) manifest as obscure GI bleed, bleeding per rectum or biliary obstruction Moderate splenomegaly is universal and may be a presenting feature A propoion of children have growth retardation Ref: Blumga 5th edition Pgno : 1099-1105


Question: Most common tumor of appendix is

Refer Robbins page no 9/e 816 Cancer of the appendix may causeappendicitis or rupture of appendicitis. Mostly this is the first symptom of appendix cancer. The majority of appendiceal tumors arecarcinoids, while the remaining 10% to 20% are mucinous cyst-adenocarcinoma,adenocarcinoma, lymphosarcoma,paraganglioma, and granular-cell tumors.


Question: Sho gastric aeries are branches of

The left gastric aery arises from the celiac aery. It supplies the lower third of the esophagus and the upper right pa of the stomach.The right gastric aery arises from the hepatic aery at the upper border of the pylorus and runs to the left along the lesser curvature. It supplies the lower right pa of the stomach.The sho gastric aeries arise from the splenic aery at the hilum of the spleen and pass forward in the gastrosplenic omentum (ligament) to supply the fundus.The left gastroepiploic aery arises from the splenic aery at the hilum of the spleen and passes forward in the gastrosplenic omentum (ligament) to supply the stomach along the upper pa of the greater curvature.


Question: In obstruction of second pa of axillary aery, the anastomosis between the following aery will maintain the blood supply of upper limb

When the axillary aery is blocked, collateral circulation is established through the anastomosis around scapula which links the first pa of the subclan aery with the third pa of axillary aery(apa from the communications with the posterior intercostal aeries). The transverse cervical aery is a branch of the subclan aery and the subscapular aery is a branch of the second pa of the axillary aery. BD Chaurasia 7th edition Page no: 55

Deep branch of transverse cervical aery & subscapular aery

Posterior circumflex humeral & circumflex scapular aery

Suprascapular & anterior circumflex humeral aery


Question: Posterior belly of digastric is supplied by


Question: Mesodermal in origin among the following is

There is a third type of neuroglial cell called microglia. This type doesn't develop from the cells of the neural tube but migrates into it along with blood vessels. These cells are believed to be of mesodermal in origin HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:116


Question: In breast, Copper's ligament extends from subcutaneous tissue to

B. i.e. Pectoral fascia Strands of fibrous tissue (forming the suspensory ligament of Cooper) connect the dermis of overlying skin to the ducts of breast (mammary gland) and pectoral fasciaQ. These suppo mammary gland lobule and help to maintain the protuberence of young breast. They also cause pitting of oedematons skin that results from malignant involvement of dermal lymphatics (peaud' orange) and dimpling of skin d/t fibrosis associated with ceain breast carcinomas.The fibrous stroma forms septa known as suspensory ligaments of cooper, which anchor the dermis of skin and gland to superficial pectoral fasciaQSuperficial pectoral fascia has two layers;- Superficial layer - Camper's fascia which contain mammary gland and?- Deep layer scarpa's fascia upto which Cooper's ligament extend


Question: Obstruction of IVC leads to


Question: Thoracic duct crosses at

In the neck thoracic duct arches laterally at the level of C7 <img src=" /> B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 SIXTH EDITION Page no-285


Question: The perilymph, present in the scala vestibule and scala tympani, drains into the CSF through the

The perilymphatic chamber of the vestibular system has a wide connection to scala vestibuli, which in turn connects to scala tympani by an opening called the helicotrema at the apex of the cochlea. Scala tympani is then connected to the cerebrospinal fluid (CSF) of the subarachnoid space by the cochlear aqueduct. ref - BD chaurasia 6e vol3 pg


Question: The position of the hip in a patient with posterior dislocation of the hip is

Position and attitude of hip pathology Flexion, Abduction, External rotationFlexion, Adduction, Internal rotationu1st stage of TB hip uAnterior dislocation of hip uFracture shaft of femur uPolio hipuHip joint effusion u2nd and 3rd stage of TB hip uPosterior dislocation of the hip uTraumatic hip dislocation (Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition,pg no: 901-935)


Question: Acute cholecystitis is caused by

Causes of Acalculous cholecystitis Common causes Elderly and critically ill patients after trauma Burns Longterm TPN Major operations(Abdominal aneurysm repair and cardiopulmonary bypass) Diabetes mellitus Uncommon causes Vasculitis Obstructing GB adenocarcinoma GB torsion Parasitic infestation Unusual bacterial infection - Leptospira, streptococcus, salmonella , Vibrio cholera Ref: Harrison's 19th edition Pgno : 2081


Question: In a female child at bih, oocyte is in a stage of

Inderbir Singh&;s Human embryology; Tenth edition; Pg 24At the time of bih, all primary oocytes are in the prophase of the first meiotic division.


Question: Hofbauer cells are associated with

Hofbauer cells are oval eosinophilic histiocytes with granules and vacuoles found in the placenta, which are of mesenchymal origin, in mesoderm of the chorionic villus, paicularly numerous in early pregnancy.


Question: NOT a content of Jugular Foramen

(A) Hypoglossal nerve# JUGULAR FORAMEN may be subdivided into three compartments, each with their own contents.> Anterior compartment transmits the inferior petrosal sinus.> Intermediate transmits the glossopharyngeal, vagus, and accessory nerves ( cranial nerves number IX, X, and XI respectively).> Posterior transmits the sigmoid sinus (becoming the internal jugular vein) and some meningeal branches from the occipital and ascending pharyngeal arteries.


Question: Superior intercostal aery is a branch of

Superior intercostal arery is a branch of costocervical trunk of subclan aery. BD chaurasia's human anatomy.6th edition volume 1.page no 219.


Question: Conversion of uroporphyrinogen III to coproporphyrinogen III is an example of


Question: Treatment in a patient suffering from Diffuse macular retinopathy is


Question: The supinator muscle is supplied by

SupinatorOrigin1.Lateral epicondyle of the humerus. 2.Radial collateral ligament of the elbow joint. 3.Annular ligament. 4.Supinator crest of the ulna, and the posterior pa of the triangular area in front of it.Inseion: Upper one-third of the lateral surface of the radius.Nerve Supply: Posterior interosseous nerve (C6, C7).Action: Supination of the forearm.Note: The muscles have two layers, superficial and deep. The posterior interosseous nerve runs downwards between these layers.Ref: BD Chaurasia; Volume 1; 6th edition; Page no: 133


Question: Efficacy of the drug refers to

Efficacy means effectiveness, i.e. the ability of something, e.g. a medicine, to produce the results you want Ref-KDT 7/e p54

Affinity of the drug to bind to the receptor

Affinity of the drug that binds to the receptor and activates it

Dose that required to to produce response


Question: Procedure to be performed in the case of arrest of after coming head due to contracted pelvis in breech

The last rescue for entrapped fetal head in term fetus is replacement of the fetus higher into the vagina and uterus followed by cesarean delivery this is zavanelli maneuver


Question: Nerve not carrying taste sensation from tongue

Trigmenial nerve does not carry taste sensation from tongue. Taste from tongue is medicated by chorda tympani nerve, a branch of facial nerve.


Question: Sclerosis of bony orbit is seen in

Meningismus are tumor most common in women. Arising from the meningeal endothelial cells of the arachnoid villi. It is characterized by optiociliary shunts .if it involves the optic nerve sheath and in intracranial meningioma. It causes sclerosis of bony orbit Refer khurana 6/e p 423


Question: Most common testicular tumour

Seminoma is the most common germ cell tumor of the testis or, more rarely, the mediastinum or other extra- gonadal locations. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages.


Question: Primary action of superior oblique is

actions of superior oblique: veical axis: depresses main action horizontal axis: abducts anteroposterior axis:rotates medically( intorsion) Ref.BDC volume 3:sixth edition pg 211


Question: Cutaneous supply over parotid gland is by

3 main salivary glands include parotid gland, submandibular gland and sublingual gland. The skin over the parotid gland is supplied by the greater auricular nerve and auriculotemporal nerve. Greater auricular nerve supplies the greater pa of auricle& the auriculotemporal nerve supplies the anterior pa of auricle and temporal area, also carries secretomotor fibers to the parotid gland and sensory innervation of parotid gland Preganglionic parasympathetic fibers to the oticGanglion come from the glossopharyngeal nerve. Facial nerve (VII) exits the skull through stylomastoid foramen & then passes into parotid gland, where it usually divides into upper & lower trunk.


Question: After surgery, there was 50ml bile output from abdominal drain 1st preoperative day. Management is

"A small amount of biliary drainage following cholecystectomy should cause no alarm because it usually dissapears within 1 or 2 days. However, excessive bile drainage through the wound or drain site, jaundice, sepsis or a combination of these events early in post-operative period should suggest a bile-duct injury, as should copious biliary drainage for more than few post-op days Ref: Blumga 5th edition Pg no : 524-525


Question: Nerve of anterior compament of leg

ANTERIOR COMPAMENT( leg):- Muscles:-1. Tibialis anterior 2. Extensor hallucis longus3. Extensor digitorum longus 4. Peroneus teius. Aery:anterior tibial aery.The blood supply of anterior compament is reinforced by the perforating branch of peroneal aery. Nerve:-Deep peroneal nerve. Arrangement:-From medial to lateral-Tibialis anterior EHLAnterior tibial aery and deep peroneal nerve EDL Peroneus teius 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. <img src=" /> {Reference: BDC 6E pg no.93 diagram 8.4}


Question: Loss of alignment and over riding of bones of cranial vault seen in

spadling sign Loss of alignment and over riding of the bones of cranial vault occurs due to shrinkage of the brain after death. This is known as spadling's sign. It may be detected within a few days of death of fetus in utero. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE NO 148


Question: Hereditary chronic pancreatitis is caused by mutation of

Hereditary pancreatitis Autosomal dominant disease Due to a missence mutation on cationic trypsinogen, or PRSS1(Protease, serine 1) results in premature, intrapancreatic activation of trypsinogen The incidence is equal in both sexes Ref: Sabiston 20th edition Pgno :1532


Question: Pharmacodynamics includes

Pharmacodynamics- the branch of pharmacology concerned with the effects of drugs and the mechanism of their action. Ref-KDT 7/e p1


Question: Nucleus pulposus is a remnant of

Inderbir Singh&;sHuman embryologyTenth edition Pg 60 As the embryo enlarges the notochord elongates considerably and lies in the midline in the position to be later occupied by veebral columnHowever, notochord does not give rise to veebral columnMost of it disappears but pas of it persist in the region of each interveebral disc as nucleus pulposus


Question: Ligament of Treitz

1.It is a fibromuscular band to suppo the duodenojejunal flexure and arises from the right crus of the diaphragm.2.It has both the skeletal (diaphragmatic) as well as smooth (intestinal) muscles in it.3.It increases the DJ angulation and may cause paial obstruction at the site.It is also known as Suspensory ligament of the duodenum


Question: Triangle of ausculatation is seen in

Triangle of auscultation is seen in 6 the intercoastal space B D CHOURASIAS HUMAN ANATOMY UPPER LIMB THORAX VOLUME, 1 SIXTH EDITION, PAGE NO, 64


Question: The most common complication in spinal anaesthesia is

During surgery 1. Hypotension most common complication Rx. Prophylactic preloading with 1-1.5L of fluids (colloid preferred) Curative: a Foot end elevation b Infusion of fluids (colloids better than crystalloids) c Vasopressors Mephentermine Ephedrine Phenyl Ephrine Dopamine (if not controlled) 2. Bradycardia Rx-Atropine 3. High Spinal complications depends on levels of block up to cardio-accelrator fibres then bradycardia & hypotension, if involves cervical Diaphragmatic paralysis occur Rx. IPPV 4. Resp. paralysis (Apnea) 5. Nausea & Vomiting Rx- oxygenation Correct hypotension Metoclopramide/ Ondansetron (if not C/I) 6. Apprehension & anxiety Rx-sedate the patient Post op. 1. urinary retention 2. Neurological complications A. Post spinal headache B. Cauda equina syndrome C. Paraplegia (mostly because of epidural haematoma) Rs: Exploration & drainage of haematoma D. Paralysis of cranial N. 6th most commonly (1st ,9th, 10th are not involved) E. Anterior spinal A. syndrome F. Meningitis 3. Backache


Question: Anticholinesterases are ineffective against

Refer katzung 11/e p 106,107 Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions. These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder. These are ineffective against carbamate poisoning


Question: Diagnostic accuracy of a test is determined by its

(Refer: K. Park's Textbook of Preventive and Social medicine, 24thedition, pg no: 149)


Question: Green discharge is most commonly seen with

A black or green discharge is usually the result of duct ectasia and its complications. Ref: Bailey and love 27th edition Pg no : 864


Question: Brodie&;s abscess is the terminology for

It is a long standing localized pyogenic abscess in the bone(long standing because of strong defence mechanism of the body.) It usually involves long bones. Brodie&;s abscess - A circumscribed, round/oval cavity containing pus and pieces of dead bone (sequestra) surrounded sclerosis - Most commonly seen in tibial / femoral metaphysis *may occur in epiphysis / cuboidal bone (eg: calcaneum) - Metaphyseal lesion cause no / little periosteal reaction - Diaphyseal lesion may be associated with periosteal new bone formation and marked coical thickening . ref : maheswari9th ed


Question: Superficial branch of ulnar nerve supplies

Superficial branch of ulnar nerve supplies palmaris brevis and gives digital branches to medial 1 1/2 digits including medial 1 1/2 nail beds till the interphalangeal joints . Opponens pollicis is supplied by the recurrent branch of median nerve . Adductor pollicis and abductor digiti minimi is supplied by the deep branch of ulnar nerve . B D Chaurasia 7th edition Page no : 124


Question: Sacrotuberous and sacrospinous ligaments attach sacrum to

The sacrotuberous ligament is a strong broad band of fibrous tissue. It has broad upper end and narrow lower lateral end.Upper end is attached from above downward to posterior superior iliac spine, posterior inferior iliac spine, lower pa of posterior surface and lateral border of sacrum and adjoining pa of coccyx. The lower end is attached to medial margin of ischial tuberosity. Some of the fibres from lower end continue on to the ramus of ischium as the falciform process.The sacrospinous ligament is a triangular sheet of fibrous tissue with its apex attached laterally to the ischial spine and base medially to the side of sacrum and coccyx.The sacrospinous and sacrotuberous ligaments conve the greater and lesser sciatic notches of the hip bone into greater and lesser sciatic foramina-the two impoant exits from the pelvis.Reference: Textbook of anatomy, Abdomen and Lower limb, Vishram Singh, 2nd edition, page no.204


Question: Teratospermia refers to

Increased abnormal forms Teratospermia -----increased number of abnormal sperms. Regarding sperm morphology, the WHO criteria as described in 2010 state that a sample is normal (samples from men whose paners had a pregnancy in the last 12 months) if 4% (or 5th centile) or more of the observed sperm have normal morphology. Aspermia-------------absence of semen Azoospermia--------absence of sperms in semen. Total sperm count, or total sperm number, is the total number of spermatozoa in the entire ejaculate. By WHO, lower reference limit (2.5th percentile) is 39 million per ejaculate Oligospermia-------decreased sperm count Asthenospermia----decreased motility of sperms. The World Health Organization has a value of 50% and this must be measured within 60 minutes of collection Necrospermia-------increased number of dead sperms.


Question: Superior orbital fissure synd. includes

superior orbital fissure * lateral pa lacrimal and frontal nerves, trochlear nerve, superior ophthalmic vein, meningeal branch of lacrimal aery, anastomotic branch of middle meningeal aery which anastomoses with recurrent branch of lacrimal aery. *middle pa upper and lower divisions of oculomotor nerve, nasociliary nerve, abducent nerve * medial pa inferior ophthalmic vein, sympathetic nerve from plexus around internal carotid aery Ref BDC volume 3; 6th edition pg 56


Question: Schwannoma of 8th cranial nerve site is


Question: Vascular inflow occlusion of the liver is by

Pringle Maneuver (Total inflow occlusion) Total clamping of the hepatic pedicle, by placing an atraumatic clamp across the foramen of Winslow Appropriate sized vascular clamp or loop snare easily controls hemorrhage from either the poal vein or the hepatic aeries Inflow occlusion durations of upto 39 minutes can be tolerated safely in cirrhotic livers and possibly upto 60 minutes in early disease If Prolonged occlusion is required, intermittent clamping can be used with repeated clamping of 10-20 minutes duration, each followed by 5 minutes declamping Ref: Sabiston 20th edition Pgno : 439


Question: Yoke muscle of right lateral rectus is

(A) Left medial rectus[?]Yoke muscle (contra-lateral synergists):Reference to muscles which are primary muscles (one from each eye) that accomplish (contract) a given version.YOKE MUSCLES IN CARDINAL POSITIONS OF GAZE* Eyes up & rightRSR & LIO* Eyes up & leftLSR & RIO* Eyes rightRLR & LMR* Eyes leftLLR & RMR* Eyes down & rightRIR & LSO* Eyes down & leftLIR & RSOContralaterally paired extra-ocular muscles that work synergistically to direct the gaze in a given direction.For example, in directing the gaze to the right, the right lateral rectus and left medial rectus operate together as yoke muscles. ACTION OF EXTRA-OCULAR MUSCLESBeing approximately horizontal, when the visual axis is in its primary position, i.e. directed to the horizon, they rotate the eye medially (adduction) or laterally (abduction) about an imaginary vertical axis.They are antagonists.Visual axis can be swept through a horizontal arc by reciprocal adjustment of their lengths.When, as is usual, both eyes are involved, the medial & lateral recti of each eye either can adjust both visual axes in a conjugate movement from point to point at infinity (their axes remaining parallel), or they can converge or diverge the axes to or from nearer or more distant objects of attention in the visual field.Medial & lateral recti do not rotate the eye around its horizontal axis and so cannot elevate or depress the visual axes as gaze is transferred from nearer to more distant objects or the reverse.Normally, movements of the two eyes are harmoniously coordinated.Such coordinated movements of both eyes are called conjugate ocular movements.Conjugate movements are usually horizontal or vertical, but oblique conjugate movements may also occur.Dissociated movements of the two eyes are known as disjunctive movements (skew deviation).Levator palpebrae superioris elevates the upper lid, & its antagonist is the palpebral part of orbicularis oculi.


Question: Canal of Herring are seen in


Question: Diagnostic investigation in carcinoma pan2

MDCT Diagnostic investigation in carcinoma pancreas is MDCT MDCT is investigation of choice for evaluation of lesions arising in the pancreas Investigation of choice for diagnosis, staging and follow up in CA pancreas : MDCT Ref:Sabiston 20th edition Pgno :1544


Question: Azygos vein

(Ascends through the aortic opening in the diaphragm) (213-BDC-l) (128-Snell 7th)AZYGOS VEIN - The origin of the azygos vein is variable. It is often formed by the union of the right ascending lumbar vein and the right subcostal vein. It ascends through the aortic opening in the diaphragm on the right side of the aorta to the level of the fifth thoracic vertebra. Here it arches forward above the root of the right lung to empty into the posterior surface of the superior vena-cava.* In obstruction of the superior or inferior vena cava, the azygos veins provide an alternate pathway for the return of venous blood to the right atrium of the heart.


Question: Nerve emerging through the trapezoid body of pons is

The trapezoid body is located in the caudal pons, or more specifically the pontine tegmentum. The trapezoid body is pa of the auditory pathway where some of the axons coming from the cochlear nucleus decussate, or cross over to the other side before traveling on to the superior olivary nucleus. This is believed to help with localization of sound. (Ref: vishram Singh textbook of clinical neuroanatomy second edition pg 80)


Question: Parotid duct opens at


Question: LE cell phenomenon is seen in

Ref Robbins 9/e p222 LE cell or hematoxylin body is a phagocytic leukocyte that has engulfed the denatured nucleus of an injured cell


Question: Gene for Wilms tumor iis located on

characterized by Wilms tumor, aniridia, genital anomalies, and mental retardation. Their lifetime risk of developing Wilms tumor is approximately 33%. Individuals with WAGR syndrome carry constitutional (germline) deletions of 11p13. Studies on these patients led to the identification of the first Wilms tumor-associated gene, WT1, and a contiguously deleted autosomal dominant gene for aniridia, PAX6, both located on chromosome 11p13. Patients with deletions restricted to PAX6, with normal WT1 function, develop sporadic aniridia, but they are not at increased risk for Wilms tumors Refer Robbins 9/e 481


Question: Albumino cytologic dissoscition occurs in cases of

Gullian Barre syndrome What are the symptoms of Guillain-Barre syndrome? tingling or prickling sensations in your fingers and toes. muscle weakness in your legs that travels to your upper body and gets worse over time. difficulty walking steadily. difficulty moving your eyes or face, talking, chewing, or swallowing. severe lower back pain. Refer Robbins page no 1231


Question: Most common liver cell tumor in those on OCP's

Hepatic adenoma It is a benign proliferative disorder of hepatocytes Predominantly found in young women (20-40yrs) associated with OCP's Usually single ( multiple lesions in 12-30%)


Question: Best investigation of bilhemia is

Bilhemia It is an extremely rare condition Bile flows into the blood stream either through the hepatic veins or poal vein branches Etiology High intra biliary pressure, exceeding that of venous system (CBD stone). Gallstones eroding into the poal vein. Accidental or iotrogenic trauma Clinical features Rapidly increasing jaundice, marked direct hyperbilirubinemia The condition can be fatal secondary to embolization of large amounts of bile into the lungs Most often, bile flow is low and the Fistulas Spontaneously closes Diagnosis ERCP is investigation of choice (Diagnostic and therapeutic) Treatment Treatment is directed at lowering intra biliary pressure either through stents or sphincterectomy Ref : Sabiston 20th edition Pgno : 1473-1474


Question: Eversion of foot is produced by

Eversion: movement in which the lateral border of the foot is elevated so that the sole faces laterally. Inversion: movement in which the medial border of the foot is elevated so that the sole faces medially. In eversion and inversion, the entire pa of the foot below the talus moves together. Inversion is accompanied by plantar flexion of the foot and adduction of the forefoot. Eversion is accompanied by the dorsiflexion of the foot and adduction of the forefoot. JOINTS TAKING PA:-Subtalar Talocalcaneonavicular Transverse talar AXIS:-These movements take place around an oblique axis which runs forwards, upwards and medially, passing from the back of the calcaneum, through sinus tarsi,to emerge at the superomedial aspect of the neck of the talus.The obliquity of the axis pay accounts for the adduction, abduction, plantar flexion and dorsiflexion which are associated with these movements. RANGE:-Inversion is more free than eversion The range of movements is increased in plantar flexion. MUSCLES PRODUCING MOVEMENTS:- Main Inversion Tibialis anterior Tibialis posterior FHL FDL Eversion Peroneus longus Peroneus brevis {Reference:BDC 6E}


Question: .Drug of choice for alcohol withdrawal

Treatment of alcohol dependence comprises 2 steps namely detoxification and de addiction DETOXIFICATION Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pf no.625


Question: Exposure of left subclan aery by supraclavicular approach does not require cutting of

Scalenus medius is located posterior to the subclan aery. Hence there is no need to cut this to expose the subclan aery. Ref - Bdc 6th e Vol 3 pg165,166 , pubmed.com


Question: Aery of hindgut is

Aerial supply of hindgut is inferior mesenteric aery imageref - researchgate.net


Question: Ecadherin Gene deficiency is seen in

ref Robbins 8/e p96; 9/e p297 Cadherins are derived from the "calcium dependant adherence protein".it paicipate in interaction between cells of same type The linkage of cadherins with the cytoskeleton occurs through catenins .the cell to cell interaction mediated by cadherins and catenins play a differentiation and account for the inhibition of cell proliferation that occurs when cultured normal cells contact each other


Question: Tubercles of Montgomery are present in

Montgomery's glands or Montgomery Tubercles are the large sebaceous and rudimentary milk glands present in the areola surrounding the nipple of the female breast.


Question: 40yr old male patient having pain with daily morning stiffness of spine for 30 minutes and reduced chest movements. Most probable diagnosis is

The information in question are 40yr male Morning stiffness in spine Limited chest expansion *****all fit into clinical criteria for diagnosis of Ankylosing spondylitis x ray of ankylosing spondylitis -BAMBOO SPINE AS is a chronic, progressive immune-mediated inflammatory disorder that results in ankylosis of the veebral column and sacroiliac joints . * The spine and sacroiliac joints are the common affected sites -- Chronic spinal inflammation (spondylitis) can lead to fusion of veebrae (ankylosis) . Characteristic Pathologic Features : * Chronic inflammation in: - Axial structures (sacroiliac joint, spine, anterior chest wall, shoulder and hip) - Possibly large peripheral joints, mainly at the lower limbs (oligoahritis) - Entheses (enthesitis) * Bone formation paicularly in the axial joints Axial manifestations: * Chronic low back pain * With or without buttock pain * Inflammatory characteristics: - Occurs at night (second pa) - Sleep disturbance - Morning stiffness * Limited lumbar motion * Onset before age of 40 years Refer maheswari 9th ed


Question: Nerve supplying Gemellus inferior

Nerve to Obturator internus supplies obturator internus and Gemellus superior.
Nerve to Quadratus femoris supplies Quadratus femoris and Gemellus inferior


Question: An adult old man gets burn injury to his hands .over few weeks .the burner skin heals without the need for skin grafting . The most impoant critical factor responsible for rapid healing in this case is

ref baley and love 23/e p189 Burn wounds of the skin result in a rupture of the cutaneous barrier that can have serious consequences such as loss of proteins and body fluids, infection, and death (Figure 65.1). Moreover, chronic wounds or improper scarring and the development of skin cancers (Owens and Watt, 2003; Perez-Losada and Balmain, 2003). A first-degree burn wound affects only the epidermis and heals spontaneously without scarring; the reconstitution of epidermal integrity results from the migration and the proliferation of <a style="box-sizing: border-box; margin: 0px; padding: 0px; background-color: transparent; overflow-x: auto; color: ; transition: color 0.3s ease 0s, border-bottom-color 0.3s ease 0s; text-decoration-line: none;" title="Learn more about Keratinocyte from ScienceDirect's AI-generated Topic Pages" href=" from the nearby epidermis or appendages


Question: Roots involved in Erb's palsy are

Erb's point is formed by the roots of C5 and C6, anterior and posterior divisions of upper trunk, suprascapular nerve and nerve to subclavius muscle. So the nerve root involved in Erb's palsy is C5 and C6.


Question: The type of Epithelium associated with the Vermilion Zone of the Lips is

The External Aspect and Vermilion Zone of the Lips are covered by thin skin, which contains a Stratified Squamous Keratinized epithelium.


Question: Epithelium covering the Bowman's capsule

Simple squamous epithelium's typical locations

Vascular system (endothelium)
Body cavities (mesothelium)
Bowman’s capsule (kidney)
Respiratory spaces in lung


Question: Most essential medicines are formulated as

Essential medicines are those that satisfy the priority health care needs of the population. Criteria for selection of essential medicines Essential medicines are selected with due regard to disease prevalence and public health relevance, evidence of clinical efficacy and safety, and comparative costs and cost-effectiveness. Refer 7/e p24


Question: Dementia in ICD 10 is classified under

ICD CHAPTERS ICD is a text book for classification of psychiatric disorders. The below table comprises chapter numbers dealing with various psychiatric disorders. Ref.Kaplon and Sadock, synopsis of Psychiatry, 10th edition


Question: Shock lung is characterized by

ref Robbins 7/r p715,9/e p134 Harrison 17/e p1680_1681 The cellular and tissue effects of shock are essentially those of hypoxic injury (Chapter 1) and are caused by a combina- tion of hypoperfusion and microvascular thrombosis. Although any organ can be affected, brain, hea, kidneys, adrenals, and gastrointestinal tract are most commonly involved. Fibrin thrombi can form in any tissue but typically are most readily visualized in kidney glomeruli. Adrenal cor- tical cell lipid depletion is akin to that seen in all forms of stress and reflects increased utilization of stored lipids for steroid synthesis. While the lungs are resistant to hypoxic injury in hypovolemic shock occurring after hemorrhage, sepsis or trauma can precipitate diffuse alveolar damage (Chapter 12), leading to so-called shock lung.


Question: Most sensitive investigation of pancreatic carcinoma is

Investigation of choice for carcinoma pancreas is MDCT Currently CT is probably the single most versatile and cost effective tool for diagnosis of pancreatic cancer Ref: CSDT 11th edition Pgno :645


Question: Adhesion of platelet to collagen is due to

Ref Robbins 9/e p117 Von Willebrand Factor's primary function is binding to other proteins, in paicular factor VIII, and it is impoant in platelet adhesion to wound sites. It is not an enzyme and, thus, has no catalytic activity. VWF binds to a number of cells and molecules. The most impoant ones are: Factor VIII is bound to VWF while inactive in circulation; factor VIII degrades rapidly when not bound to VWF. Factor VIII is released from VWF by the action of thrombin. In the absence of VWF, factor VIII has a half-life of 1-2 hours; when carried by intact VWF, factor VIII has a half-life of 8-12 hours. VWF binds to collagen, e.g., when collagen is exposed beneath endothelial cells due to damage occurring to the blood vessel. Endothelium also releases VWF which forms additional links between the platelets' glycoprotein Ib/IX/V and the collagen fibrils


Question: Muscle not supplied by median nerve REPEATED

Opponens pollicis, abductor pollicis brevis and first lumbrical is supplied by the recurrent branch of median nerve in palm.Extensor pollicis brevis is supplied by the deep division of radial nerve in the forearm.B D Chaurasia 7th edition Page no: 182


Question: Gluteus maximus is supplied by

INFERIOR GLUTEAL NERVE:- Root value:L5,S1,S2Course: Enters gluteal region through greater sciatic notch below pyriformis muscle.Branches: Gluteus maximus.It is the sole supply to the large antigravity, postural muscle with red fibers, responsible for extending hip joint. SUPERIOR GLUTEAL NERVE Root value: L4,L5,S1Course: enters the gluteal region through greater sciatic notch above pyriformis muscle. Runs between gluteus medius and gluteus minimus to end in tensor fascia lata. Branches :-it supplies 1. Gluteus medius 2. Gluteus minimus3. Tensor fascia lata SCIATIC NERVE:-Root value: L4,L5,S1,S2,S3 ventral rami Thickest nerve in the body.Terminal branch of lumbosacral plexus.Tibial pa and common peroneal pa. Tibial pa:ventral division of ventral rami of L4,L5,S1,S2,S3.Common peroneal pa: dorsal division of ventral rami of L4, L5, S1, S2. Course: arises in pelvis.Leaves pelvis by passing through greater sciatic foramen below pyriformis to enter gluteal region.In gluteal region, it lies deep to gluteus maximus and crosses superior and inferior gamellus, obturator internus, quadratus femoris to reach thigh.During its sho course it lies between ischial tuberosity and greater trochanter.Gives no branches in gluteal region. Branches:--Muscular1. From tibial pa: semitendinosus, semimembranosus, long head of biceps femoris, ischial pa of Adductor Magnus.2. From common peroneal :Sho head of biceps femoris. Aicular: hip joint Terminal:tibial and common peroneal. {Reference: BDC 6E pg no.173}


Question: Common site of fracture in tibia is

The tibia is commonly fractured at the junction of upper two-thirds and lower one-third of the shaft as the shaft is most slender here. Such fractures may unite slowly, or may not unite at all as the blood supply to this pa of the bone is poor. This may also be caused by tearing of the nutrient aery.Ref: Chaurasia; Volume 2; 6th edition; Page no: 25

Junction of upper two-thirds and lower one-third


Question: charecterstic feuture 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: Mode of injury of a cotton fracture is

Cotton fracture is due to abduction and external rotational injury. It is also known as TRIMALLEOLAR FRACTURE. There is fracture of the medial,lateral and posterior malleolus. It more often requires open reduction and internal fixation.


Question: any behaviou that is followed by reward is increased, this is

Behavioral therapy is learning given by BF Skinner , according to him all behaviors are learned phenomenon and thus can be unlearned Positive reinforcement a type of reinforcement when a behavior is rewarded there is more chance that the behavior is repeated Negative reinforcement is that when a behavior is done and an aversive response is removed, the behavior is repeated. When I go and meet my girlfriend, she checks my messages and picks up fight (aversive response) suddenly I delete all messages one day and that day there was no fight (no aversive response) then that behavior is repeated (delete all messages before meeting my girlfriend) Extinction is the type of reinforcement where a behavior is done and a rewarding response is removed the chance is that behavior will not be repeated A child likes to play with children( reward) but when the child fights with other children( undesirable behavior) the child will be removed from playing( removing a reward) , then the child stops fighting with other children( reduction of undesirable behaviour) Ref. kaplon and sadock synopsis, 11 th edition, pg no. 845


Question: An anterolaternal corodotomy relieving pain in right leg is effective because it interrupts the

C i.e. Left lateral spinothalmic tract The anterior/ ventral - spinothalmic tract carries crude touch and pressueQ from opposite half of body; whereas lateralspinothalmic tract carries pain and temperature from the opposite half of body. Therefore any lesion in lateral spinothalmic tract will result in loss of pain and temperature sensation contralaterally below the level of lesion; and lesion of anterior spinothalmic tract will 1/ t loss of crude touch & pressure sensation contralaterally.


Question: Tone of the anal sphincter in maintained by

The anal sphincters and puborectalis are the primary muscles responsible for continence. There are two sphincters: the internal anal sphincter, and the external anal sphincter. The internal sphincter is responsible for 85% of the resting muscle tone and is involuntary. ref - BDC 6e vol2 pg413-416


Question: Superficial incision on posterior triangle of neck leads to

Ans is 'a' i.e. difficulty in shrugging of shoulder Nerves in the posterior triangle of neck (only motor nerves)Spinal accessory nerveTwo small branches to levator scapulae(C3,4)Nerve to RhomboideNerve to serratus anteriorNerve to subclaviusSuprascapular nerveWhen a superficial incision is made in the post triangle, the nerve most likely to be injured is spinal accessory nerve, because it runs through a tunnel in the fascia forming the roof of triangle.Rest all nerves are either deep or have a very small course in the lower part of the triangleSpinal accessory nerve supplies 2 muscles -Trapezius andsternocleidomastoidAction of Trapezius* :Elevation of scapulaRetraction of scapulaRotation of scapulaAction of sternocleidomastoid* :Turns the face to opposite side *Tilts the head towards the same shoulder.When SCM of both sides contracts draws the head forwards.

Difficulty in rotation of face towards the same side


Question: Tropical spastic paraparesis is caused by

Oncogenic RNA Viruses The study of oncogenic retroviruses in animals has pro- vided spectacular insights into the genetic basis of cancer. However, only one retrovirus, the human T cell lympho- tropic virus-1 (HTLV-1), has been demonstrated to cause cancer in humans. HTLV-1 is associated with a form of T cell leukemia/lymphoma that is endemic in ceain pas of Japan and the Caribbean basin but is found sporadically elsewhere, including the United States. Similar to the human immunodeficiency virus (HIV), HTLV-1 has tropism for CD4+ T cells, and this subset of T cells is the major target for neoplastic transformation. Human infec- tion requires transmission of infected T cells through sexual intercourse, blood products, or breastfeeding. Leukemia develops only in about 3% to 5% of infected persons after a long latent period of 20 to 50 years. There is little doubt that HTLV-1 infection of T lympho- cytes is necessary for leukemogenesis, but the molecular mechanisms of transformation are not clear. The HTLV-1 genome does not contain a viral oncogene, and in contrast with ceain animal retroviruses, no consistent integration site next to a cellular oncogene has been discovered. Indeed, the long latency period between initial infection and devel- opment of disease suggests a multistep process, during which many oncogenic mutations are accumulated. The genome of HTLV-1 contains, in addition to the usual retroviral genes, a unique region called pX. This region contains several genes, including one called TAX. The TAX protein has been shown to be necessary and sufficient for cellular transformation. By interacting with several transcription factors, such as NF-kB, the TAX protein can transactivate the expression of genes that encode cytokines, cytokine receptors, and costimulatory molecules. This inappropriate gene expression leads to autocrine signaling loops and increased activation of promitogenic signaling cascades. Fuhermore, TAX can drive progression through the cell cycle by directly binding to and activating cyclins. In addition, TAX can repress the function of several tumor suppressor genes that control the cell cycle, including CDKN2A/p16 and TP53. From these and other observa- tions, the following scenario is emerging (Fig. 5-31): The TAX gene turns on several cytokine genes and their recep- tors (e.g., the interleukins IL-2 and IL-2R and IL-15 and IL-15R), setting up an autocrine system that drives T cell proliferation. Of these cytokines, IL-15 seems to be more impoant, but much remains to be defined. Additionally, a parallel paracrine pathway is activated by increased pro- duction of granulocyte-macrophage colony-stimulating factor, which stimulates neighboring macrophages to produce other T cell mitogens. Initially, the T cell prolifera- tion is polyclonal, because the virus infects many cells, but because of TAX-based inactivation of tumor suppressor genes such as TP53, the proliferating T cells are at increased risk for secondary transforming events (mutations), which lead ultimately to the outgrowth of a monoclonal neoplas- tic T cell population.


Question: Common Facial vein is formed by the union of

The scalp on each side of the midline is drained by five veins. The veins of the scalp accompany the arteries and have similar names. These are as follows:

Supratrochlear and supraorbital veins: They join each other at the medial angle of the eye to form the angular vein, which continues downwards as the facial vein behind the facial artery.
Superficial temporal vein: It descends in front of tragus to enter the parotid gland where it joins the maxillary vein to form the retromandibular vein, which terminates by dividing into anterior and posterior divisions. The anterior division unites with the facial vein to form common facial vein, which drains into the internal jugular vein.
Posterior auricular vein: It descends behind the auricle and  unites with the posterior division of the retromandibular vein to form the external jugular vein, which drains into the subclavian vein.
Occipital vein: It terminates in the suboccipital venous plexus.

Anterior facial and posterior facial veins

Anterior facial and posterior auricular veins

Anterior facial and anterior branch of the posterior facial vein


Question: Toughest layer in esophagus is

The wall of oesophagus has the usual four layers viz., mucosa, submucosa, muscularis externa and an external adventitia. The oesophagus does not have a serous covering except over a sho length near its lower end. The Mucosa - The mucous membrane of the oesophagus shows several longitudinal folds that disappear when the tube is distended. The mucosa is lined by stratified squamous epithelium, which is normally not keratinised. Occasional melanocytes and endocrine cells are present. A columnar epithelium, similar to that lining the cardiac end of the stomach, may extend for some distance into the abdominal pa of the oesophagus. Finger-like processes (or papillae) of the connective tissue of the lamina propria project into the epithelial layer (just like dermal papillae). This helps to prevent separation of epithelium from underlying connective tissue. At the upper and lower ends of the oesophagus some tubuloalveolar mucous glands are present in the lamina propria. The muscularis mucosae is absent or poorly developed in the upper pa of the oesophagus. It is distinct in the lower pa of the oesophagus, and is thickest near the eosophagogastric junction. It consists chiefly of longitudinal muscular fibres, but a few circular fibres are also present. The Submucosa - The only special feature of the submucosa is the presence of compound tubuloalveolar mucous glands. Small aggregations of lymphoid tissue may be present in the submucosa, specially near the lower end. Some plasma cells and macrophages are also present. The Muscularis Externa- The muscle layer consists of the usual circular and longitudinal layers. However, it is unusual in that the muscle fibres are paly striated and paly smooth. In the upper one-third (or so) of the oesophagus the muscle fibres are entirely of the striated variety, while in the lower onethird all the fibres are of the smooth variety. Both types of fibres are present in the middle onethird of the oesophagus. The Adventitia - The muscle layer of the oesophagus is surrounded by dense fibrous tissue that forms an adventitial coat for the oesophagus. The lowest pa of the oesophagus is intra-abdominal and has a covering of peritoneum. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 264,265.


Question: Most impoant mediator of chemotaxis is

ref Robbins 7/e p56 ,9/e p77 C5a is a strong chemoattractant and is involved in the recruitment of inflammatory cells such as neutrophils, eosinophils, monocytes, and T lymphocytes, in activation of phagocytic cells and release of granule-based enzymes and generation of oxidants, all of which may contribute to innate immune functions or tissue ...