Question: Medial branch of External Carotid aery is

Branches of the External carotid aery:Anterior: Superior Thyroid, Lingual and FascialPosterior: Occipital and Posterior auricularMedial: Ascending Pharyngeal aeryReference: Chourasia; 6th edition; 101 page


Question: Thrombosis of the following cerebral vessels leading to the Hemiplegia by

(Middle cerebral) (388-BDC-3- 4th edition)* HEMIPLEGIA - is a common condition. It is an UMN type of paralysis of one half of the body including the face* It is usually due to an internal capsule lesion caused by thrombosis of one of the lenticulostriate branches of the middle cerebral artery (Cerebral thrombosis)* Wallenberg's syndrome (lateral medullary syndrome) caused by thrombosis of the posterior inferior cerebral artery


Question: Most sensitive test for screening of " SLE" is

Ref Robbins 9/e p219, 8/e p214 ,7/e p228 Spectrum of Autoantibodies in SLE Antibodies have been identified against a host of nuclear and cytoplasmic components of the cell that are specific to neither organs nor species. Another group of antibodies is directed against surface antigens of blood cells, while yet another is reactive with proteins in complex with phospho- lipids (antiphospholipid antibodies) (Chapter 3). * Antinuclear antibodies. ANAs are directed against several nuclear antigens and can be grouped into four catego- ries: (1) antibodies to DNA, (2) antibodies to histones, (3) antibodies to nonhistone proteins bound to RNA, and (4) antibodies to nucleolar antigens. Table 4-10 lists several autoantibodies, including ANAs, and their asso- ciation with SLE as well as with other autoimmune dis- eases, to be discussed later. The most widely used method of detecting ANAs is the indirect immunofluo- rescence assay (IFA), which screens for autoantibodies that bind to a variety of nuclear antigens, including DNA, RNA, and proteins. Four staining patterns are seen with IFA: homogeneous or diffuse, rim or periph- eral, speckled, and nucleolar. While each pattern can be suggestive of the presence of specific autoantibodies, the strength of these associations is limited and should not be relied on. ANA testing by IFA is extremely sensitive, as more than 95% of patients with SLE will test positive, but the test's specificity is quite limited, because patients with other autoimmune diseases, chronic infections, and cancer will test positive as well. Fuhermore, ANAs are seen in approximately 5% to 15% of healthy people, and the incidence increases with age. Recently, the IFA has been replaced in many clinical laboratories by multiplex flow cytometry immunoassays that can simultaneously test for multiple specific autoantibodies, but these assays may lack the sensitivity of the IFA. Antibodies to double- stranded DNA (dsDNA) and the so-called Smith (Sm) antigen can be detected by ELISA or multiplex flow methods and are specific for SLE. * Other autoantibodies. Antibodies against blood cells, including red cells, platelets, and lymphocytes, are found in many patients. Antiphospholipid antibodies are present in 40% to 50% of patients with lupus and react with a wide variety of proteins in complex with phospholipids. Some bind to cardiolipin antigen, used in serologic tests for syphilis, so patients with lupus may have a false-positive test result for syphilis. Antiphos- pholipid antibodies contribute to coagulation abnormal- ities, which are described below. Mechanisms of Tissue Injury Regardless of the exact sequence by which autoantibodies are formed, they are likely to be the mediators of tissue injury, probably through multiple mechanisms. * Most organ damage in SLE is caused by immune complex deposition. Skin and kidney biopsies from patients with SLE typically demonstrate diffuse and heavy granular deposits of complement and immunoglobulin. Autoan- tibodies complexed with DNA can be detected as well. These deposits of immune complexes had been thought to cause tissue damage by activating the classical com- plement pathway (type III hypersensitivity); 75% of patients will have reduced serum levels of C3 and C4 at the time of SLE flares, presumably because complement is being activated and consumed faster than it can be produced. However, people and rodents deficient in C1q are not protected from SLE and actually can spon- taneously develop SLE, raising the possibility that complement-independent mechanisms may also con- tribute to tissue damage. * Autoantibodies of different specificities contribute to the pathology and clinical manifestations of SLE (type II hyper- sensitivity). Autoantibodies against red cells, white cells, and platelets opsonize these cells and lead to their phagocy- tosis, resulting in cytopenias. Autoantibodies against various phospholipids lead to increased thrombosis in patients, with varied clinical consequences, including recurrent spontaneous aboion and thrombotic epi- sodes. These disorders are pa of the antiphospholipid syndrome. Paradoxically, these antibodies interfere with clotting tests and are actually called "lupus anticoagu- lants." Autoantibodies are also produced against clot- ting factors such as thrombin, and these too may contribute to clotting disorders. Autoantibodies against central nervous system receptors for various neurotransmit- ters have been implicated in the neuropsychiatric com- plications of the disease. * There is no evidence that ANAs can permeate intact cells. However, if cell nuclei are exposed, the ANAs can bind to them. In tissues, nuclei of damaged cells react with ANAs, lose their chromatin pattern, and become homogeneous, to produce so-called LE bodies or hema- toxylin bodies. An in vitro correlate of this is the LE cell, a neutrophil or macrophage that has engulfed the dena- tured nucleus of another injured cell. When blood is withdrawn and agitated, a number of leukocytes are sufficiently damaged to expose their nuclei to ANAs, with secondary complement activation; these antibody- and complement-opsonized nuclei are then readily phagocytosed. Although the LE cell test is positive in as many as 70% of patients with SLE, it is now largely of historical interest.


Question: Tardy ulnar nerve palsy is due to

Tardy ulnar nerve palsy is due to cubitus valgus. Fracture of the lateral condyle of humerus in the long run can lead to complications such as Cubitus valgus. Friction neuritis of the ulnar nerve as it moves over the medial epicondayle every time the elbow is flexed and extended may result in a late ulnar nerve palsy called as 'TARDY ULNAR PALSY'.

Fixation of the nerve in the groove by osteoahritis


Question: Oogonia are derived from

Inderbir Singh&;s; Human Histology; Seventh edition; Pg 346The stem cells from which ova are derived are called Oogonia. These are large round cells present in the coex of the ovary. Oogonia are derived from the primordial germ cells that are formed in the region of the yolk sac and migrate into the developing ovary


Question: The abductor of vocal cord is

Ans. a (Posterior cricoarytenoid) (Ref BDC vol. 3/4th/243)Posterior Cricoarytenoid is known to be the only abductor of the larynx. It opens space between the vocal cords (abduct) by rotating the arytenoids laterally (abduct), causing the vocal cords to separate opening the rima glottidis. Posterior cricoarytenoid muscle is called the safety muscle because ail the intrinsic muscles are adductors of the vocal cords except posterior cricoarytenoids which are abductors. The cricothyroid muscle is the only tensor of the larynx aiding with phonation and should not to be confused with the posterior cricoarytenoid muscles, which are the only muscles directly responsible for opening (abducting) the space between the vocal cords.Laryngeal muscleAction1.Aryepiglottic MuscleDraws the epiglottis posteriorly and downward during swallowing2.Oblique ArytenoidDraws arytenoid cartilages together, adducting vocal folds3.Transverse ArytenoidDraws arytenoid cartilages together, adducting vocal folds4.ThyroarytenoideusDraws arytenoid cartilage forward, relaxing and adducting the vocal folds5.Vocalis muscle^Relaxes segments of the vocal ligament, thereby adjusting voice pitch.Educational Points# Larynx begins at C4 & ends at C7 vertebral levels Q# The only intrinsic muscle of larynx that lies outside the laryngeal framework is Cricothyroid.LIGAMENTS OF LARYNX# The extrinsic ligaments of the larynx are those connecting the thyroid cartilage and epiglottis with the hyoid bone and the cricoid cartilage with the trachea.# The intrinsic ligaments of the larynx are those connecting several cartilages ofthe organ to each other. They are considered the elastic membrane of the larynx.A Structural ligaments - hold larynx, hyoid and trachea together1. Thyrohyoid membrane-link thyroid cartilage to hyoid bone;medial part is median thyrohyoid ligament.2. Cricothyroid membrane - links cricoid to thyroid cartilage; thickened medial and anterior part called Median cricothyroid ligament.3. Cricotracheal ligament - links cricoid to first tracheal cartilage.4. Quadrangular membrane - links arytenoid to epiglottis; lower free edge is called vestibular ligament.5. Thyroepiglottic ligament - links epiglottis to thyroid cartilage.B. Functional LigamentsConus elasticus - elastic membrane forming vibrating lips; arises from entire upper edge of arch of cricoid; attaches anteriorly to thyroid cartilage, posteriorly to vocal processes of arytenoid cartilages; upper free edges are thickened to form vocal ligaments; opening between vocal ligaments is called rima glottidis. Functions of conus elasticus: Sound production and Closing rima glottidis.


Question: Purkinje cells are situated in

Purkinje Cells It is the characteristic cell of cerebellum.It gets stimulated by climbing fibers coming from inferior olivary nucleus .The main output of this cell is to cerebellar nuclei and is inhibitory in nature. Ref.B D Chaurasia's human anatomy.vol.3


Question: Most common cause of hemobilia

Hemobilia Bleeding into the biliary tract from an abnormal aerial source to intrahepatic biliary tract fistula Poal venous bleeding into the biliary tree is rare, minor and selflimited Aerial hemobilia is the most common source Etiology Trauma : Iatrogenic (PTC) is the most common cause, blunt trauma is more common cause than penetrating trauma Gallstones Vascular pathology : Aneurysm, angiodysplasia, Parasitic infestation, liver abscess, cholangitis Ref: Sabiston 20th edition Pgno :1472-1474


Question: Sternum attached to scapula

Sternum or chest bone is attached to scapula which is present on posterior surface with help of clavicle or collar bone so that weight of upper limb is transmitted to axial skeleton scapula,Clavicle and sternum


Question: Best skin disinfectant for central line inseion is

Chlorhexidine is now the disinfectant recommended for all catheter placementprocedures and for routine site cleansing during dressing changes. "Use of antiseptic solution for skin disinfection at the catheter inseion site helps prevent catheter-related infection. Chlorhexidine-based solutions appear to be superior to both aqueous and alcohol-based povidone-iodine in reducing the risk for catheter colonization and catheter-related bloodstream infection. If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor or 70 per cent alcohol can be used as alternatives


Question: The following drug selectively acts on beta receptors

Isoprenaline acts only on beta 1 and beta 2 receptors.


Question: Endogenous chemoattractant is

Ref Robbins 8/e p66;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 ...


Question: Nerve for motor function of buccinator muscle

The buccal branch of mandibular nerve is sensory is nature and supplies the skinand mucous membrane related to the buccinator. The buccal branch of facialnerve is motor in nature and it supplies the buccinator muscle.


Question: The efferent limb of cremaster reflex is carried by

CREMASTER REFLEX: When we touch upper medial thigh in males, cremaster muscle contracts & pull the ipsilateral testicle towards inguinal canal. Afferent sensory information is carried by Femoral branch of Genitofemoral N. > Ilioinguinal N. towards spinal cord at level of L1 Efferent motor signal- Genital branch of Genitofemoral N. towards cremaster muscle to elevate the scrotum. Iliohypogastric Nerve (L1): Supplies skin above inguinal ligament Ilioinguinal Nerve (L1): Supplies skin of anterior scrotum and adjacent thigh Genitofemoral (L1, L2): Supplies skin below inguinal ligament, motor to cremaster muscle Note: Both the ilioinguinal nerve and genital branch of the genitofemoral nerve pass through the inguinal canal.


Question: Sweat gland near the lid margins

Ans. is 'a' i.e., MollGlands of Moll (Moll's gland) are apocrine sweat glands just next to the eyelashes.Zeis glands are sebaceous glands near lid margins.Meibomian gland (tarsal glands) are specialized sebaceous gland at the rim of eyelids inside the tarsal plate.Krause's glands are accessory lacrimal glands underneath the eyelid.


Question: Light microscope characteristic feature of Apoptosis is

Ref Robbins 9/e p14_15 ,26_27,9/e p53 The morphologic features characteristic of Apoptosis includes Cell srinkage: the cell is smaller in size having dense cytoplasm and the organelles are tightly packed. Chromatin condensation : This is the most characteristic feature of Apoptosis formation of cytoplasmic bleeds and apoptotic bodies


Question: Foot drop is caused by damage to

The common peroneal nerve is a component of the sciatic nerve. In the posterior thigh, it supplies the sho head of biceps femoris. It curves around neck of fibula deep to peroneus longus and divides into superficial and deep peroneal nerves. The superficial peroneal nerve innervates peroneus longus and peroneus brevis which are the eveors of foot and to the skin over the dorsal area of foot except the first webspace and lateral side of little toe. The deep peroneal nerve innervates all muscles of anterior compa which are the dorsiflexors of foot, extensor digitorum brevis, first two dorsal interossei muscles and skin between great and second toes. Hence, injury to common peroneal nerve will lead to weakness of dorsiflexion of foot or foot drop, loss of eversion, loss of extension of toes and sensory loss along anterior and lateral side of leg, dorsum of foot including medial side of great toe. Ref: Gray&;s Anatomy 41st edition PGno: 632


Question: Posterior cord supplies

The axillary nerve from the posterior cord supplies teres minor and deltoid muscle. Coracobrachialis is supplied by a musculocutaneous nerve from the lateral cord. Pectoralis minor is supplied by medial pectoral nerve arising from the medial cord and lateral pectoral nerves arising from lateral cord. The long head of biceps brachii is supplied by a musculocutaneous nerve from the lateral cord. BD Chaurasia 7th edition Page no: 57


Question: Urethral Crest is situated in

Dissection of prostate showing prostatic urethra and urethral crest on posterior wall.In males, the urethral crest is known as the crista urethralis masculinae, or the crista phallica, and is a longitudinal fold on the posterior wall of the urethra extending from the uvula of the bladder through the prostatic urethra. ref - researchgate.net


Question: Teres minor muscle is supplied by


Question: Vena comitans

Vena comitans are the Veins accompanying aeries. Vena comitans is a vein that is usually paired, with both veins lying on the sides of an aery. They are found in close proximity to aeries so that the pulsations of the aery aid venous return.


Question: Most sensitive investigation of early bone infection

Bone scan is very sensitive and is positive for changes appear on x-ray Refer Maheshwari 6th/e p 168


Question: Most common organs involved in the wagners granulomatosis are

Refer robbins 9/e p511 Granulomatosis with polyangiitis (formerly called Wegener's) is a rare disease of unceain cause that can affect people of all ages. It is characterized by inflammation in various tissues, including blood vessels (vasculitis), but primarily pas of the respiratory tract and the kidneys. The areas most commonly affected by GPA include the sinuses, lungs, and kidneys, but any site can be affected


Question: Broca's area is located in


Question: Commonest cause of cerebral infarction is

Refer Robbins page no 1263 Infarction is tissue death (necrosis) due to inadequate blood supply to the affected area. It may be caused by aery blockages, rupture, mechanical compression, or vasoconstriction. The resulting lesion is referred to as an infarct (from the Latin infarctus, "stuffed into").


Question: Nucleus pulposus is seen in

(Intervertebral disc) (210-BDC-1 6th edition) (689-snell 9th edition)* The intervertebral disc is made up of a peripheral annulus fibrosus and a central nucleus pulposus* The physical characteristics permit them to serve as the shock absorbers* No discs are found between the first two cervical vertebrae or in the sacrum or coccyx* Laminae are connected by ligament flava* Spines are connected together by interspinous ligament and the ligamentous nuchae (represents the supra spinous ligament). The ligament gives origin to the splenius rhomboid and trapezius muscle* The intervertebral disces form about one quarter the length of the colomn* Discs are thickest in the lumber region* The most characteristic feature of the thoracic vertebrae is the body has costal facetsStructure of an intervertebral disc, (a) Superior view, (b) arrangement of laminae, and (c) vertical section


Question: Inherited coagulation disorders are

Ref Harrison 16/e p685 Primary (Genetic) Common (>1% of the Population) Factor V mutation (G1691A mutation; factor V Leiden) Prothrombin mutation (G20210A variant) 5,10-Methylene tetrahydrofolate reductase (homozygous C677T mutation) Increased levels of factor VIII, IX, or XI or fibrinogen Rare Antithrombin III deficiency Protein C deficiency Protein S deficiency Very Rare Fibrinolysis defects Homozygous homocystinuria (deficiency of cystathione b-synthetase)


Question: In Osteogenic sarcoma predominantly histology finding is DELETE

Osteioid bone formation by tumor cells is Diagnostuc if OGS Refer Maheshwari 6th/e p 239


Question: Good collateral circulation occurs in

Collateral circulation is the alternate circulation around a blocked aery or vein another path, such as nearby minor vessels. It may occur preexisting vascular redundancy (analogous to engineered redundancy), as in the circle of willis in the brain, or it may occur new branches formed between adjacent blood vessels (neovascularisation), as in the eye after a retinal embolism. Its formation may be provoked by pathological conditions such as high vascular resistance or ischemia . An example of the usefulness of collateral circulation is a systemic thromboembolism in cats. This is when a thrombotic embolus lodges above the external iliac aery (common iliac aery), blocking the external and internal iliac aeries and effectively shutting off all blood supply to the hind leg. Even though the main vessels to the leg are blocked, enough blood can get to the tissues in the leg the collateral circulation to keep them alive. Ref - sciencedirect.com


Question: Minimum dose of estrogen in combined OCP's


Question: Simple squamous epithelium is seen in

Squamous epithelium lines theinside of the hea ,where it is called endothelium INDERBIR SINGH&;S TEXT BOOK OF HUMAN HISTOLOGY-REFERENCE page no:41


Question: Wound contraction is mediated by

ref, Robbins 9/e p105 The chief physiological function of myofibroblasts in mammalian tissues has been in wound healing and specifically in contraction of the wound. Typically there are four overlapping phases of wound healing: Haemostasis, inflammation, proliferation, and remodelling


Question: Opsonins are


Question: The substance used in OCG is

Iopanoic acid is used in oral cholecystography Biligraffin is used in IV cholangiography Ref: Sabiston 20th edition Pgno :1487


Question: Central sulcus is an example of

Limiting sulcus develops along the plane of the coical areas, which differ in the function they primarily subserve. Central sulcus (of Rolando) forms the boundary between the motor area of cerebral coex in front and sensory area behind. Calcarine sulcus is also a limiting sulcus. Axial sulci develop along the long axis of rapidly growing homogenous areas. Operculated sulcus is similar to limiting sulcus in that it separates functionally different areas but transition occurs in the lip and not on the floor. Complete sulcus is deep enough to produce an elevation in the wall of ventricle.(Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg- 142)


Question: Lining Epithelium of respiratory bronchiole is

The Bronchioles are subdivided into terminal bronchioles which fuher divides to form respiratory bronchioles. Respiratory bronchiole is the smallest bronchiole & it is lined with Simple Cuboidal Cells.

Pseudo Stratified Columnar with Goblet Cells


Question: Medial boundary of Femoral Ring

Femoral Ring:It is represented by a horizontal line 1.25 cm long over the inguinal ligament, 1.25 cm medial to the midinguinal pointIt is bounded anteriorly by the inguinal ligament, posteriorly by the pectineus and its covering fascia, medially by the concave margin of the lacunar ligament, and laterally by the septum separating it from the femoral vein. The inferior epigastric vessels are closely related to the junction of the anterior and lateral walls of the ring. The femoral ring is closed by a condensation of extraperitoneal connective tissue called the femoral septum. The femoral canal contains a lymph node of Cloquet or of Rosenmuller, lymphatics, and a small amount of areolar tissue. The lymph node drains the glans penis in males and the clitoris in femalesReference: Chaurasia Volume II; 7th edition; Page no: 51


Question: Duct of Rivinus is associated with


Question: In cholangiography CBD stone appears as

Mr cholangiography : provides excellent anatomic detail, with sensitivity and specificity of 95 %and 98 %respectively for CBD stones Typical meniscus sign is seen when the CBD stone is wedged at the level of the papilla Ref: Sutton 6th edition Pgno : 971


Question: Snowfield vision is characteristic of

Methyl alcohol poisoning Visual disturbances may be the early symptoms. The person may develop photophobia, blurring of vision (Snowfield vision), central and peripheral scotoma, dilated pupils and sudden failure of vision. Blindness is caused by formic acid accumulation in the retinal cells and optic disc show degenerative changes and edema on fundoscopy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 444


Question: Impotant adverse effect of nesiritide is

Ref-Goodman and Gillman 12/e p696 Commonly repoed side effects of nesiritide include: asymptomatic hypotension, hypotension, symptomatic hypotension, and increased serum creatinine.


Question: patient has decreased weight, need for thinness, the diagnosis 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: Tennis Racquet cells are seen in

Refer Robbins page no 1001 Embryonal RMS, primarily a lesion of the head and neck region, especially the orbit, is a type of tumor usually occurs in youngsters and at the age of 10 years. This tumor is characterized by a mixture of round cells and cells with an eccentric nucleus, so called "tadpole" or tennis "racquet".<img alt="" src=" />


Question: Gasless abdomen in xRay is a sign of

Radiological appearance of Acute pancreatitis Renal halo sign Gasless abdomen. Ground glass appearance Colon cut off sign Sentinel loop Ref: Sabiston 20th edition Pgno : 1527


Question: Acinar cells of the Exocrine Pancreas secrete

Several Proteases are synthesized by Pancreatic Acinar Cells and are delivered the Pancreatic Duct to the Duodenum


Question: Styloid process is derived from

The styloid process,the stylohyoid ligament and muscle are derived from the second branchial arch. REF.BDC VOL.3,Fifth Edition,


Question: Medial border of triangle of auscultation is

Triangle Of Auscultation It is a small triangular interval interval bounded medially by the lateral border of the trapezius, laterally by the medial border of the scapula,and inferiorly by the upper border of the latissimus dorsi.The floor of the triangle is formed by the seventh rib,sixth and seventh intercostal spaces,and the rhomboideus major. Ref.B D Chaurasia's human anatomy vol.1.


Question: The most common site for Amoebiasis

Refer Robbins page no Pg p 795 Amoebiasis is seen most definitely in the cecum and ascending colon


Question: Grynfeltt triangle not bounded by

Lumbar hernias- Hernias through the superior lumbar triangle (Grynfeltt triangle) are more common and bounded by the 12th rib, paraspinal muscles, and internal oblique muscle. Inferior Lumbar / Petit triangle- bounded by the iliac crest, latissimus dorsi muscle, and external oblique muscle.


Question: Almost exclusively urinary bladder is lined by

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:320


Question: Increased risk of cancer is seen in

Ref Robbins 8/e p276; 9/e p279 Ceain non neoplastic disorders _ the chronic atrophic gastric of pernicious Anemia, solar keratosis of skin, chronic ulcerative colitis and leukoplakia of the oral cavity, vulva and penis, have such a well defined association with cancer that they have been termed precancerous condition


Question: Special visceral efferent DOESN'T include

Dorsal nucleus of tenth cranial nerve belongs to GVE (general visceral efferent) neural column It supplies the three effectors under autonomic system: cardiac muscles, smooth muscles and glands. Special visceral efferent (SVE) neural column supplies skeletal muscles developing in pharyngeal arches. Ref: Gray's 39e/p-227


Question: Most impoant clinical feature of primary biliary cirrhosis

Primary biliary cirrhosis Believed to be an autoimmune etiology, leading to progressive destruction of intrahepatic bile ducts More common in females Associated with autoimmune disorders (CREST, Sicca syndrome, Autoimmune thyroiditis, Renal tubular acidosis) Clinical features Most patients are asymptomatic, pruritus the commonest and earliest symptom. Pruritus precedes jaundice in PBC, Pruritus is most bothersome in evening Jaundice, fatigue, melanosis (gradual darkening of exposed areas of skin), deficiency of aft soluble vitamins due to malabsorption Xanthomas and xanthelesmas due to protracted elevation of serum lipids Ref: Sabiston 20th edition Pgno : 639


Question: Major neurotransmitter released at end organ effectors of the sympathetic division of the autonomic nervous system is

Neurotransmitter secreted it in organ effectors of sympathetic system is mostly nor-adrenaline (except in sweat glands and haur follicle, where it Is acettacetylch) where as it is acetylcholine at parasympathetic system Ref-KDT 6/e p116


Question: IgE receptors are present on

Ref Robbins 9/e p201 Type 1 hypersensitivity is a rapid immunological reaction occuring in a previously sensitized individual that is triggered by the binding of an antigen to IgE antibody on the surface of mast cells


Question: Muscle(s) supplied by facial nerve is/are

Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition. The nerve to the stapedius, branch of facial nerve arises opposite the pyramid of the middle ear, and supplies the stapedius muscle.


Question: Biopsy of the exposed surface of the palatine tonsil reveals the following type of tissue

The palatine tonsil is situated at the oropharyngeal isthmus. Its oral aspect is covered with stratified squamous nonkeratinized epithelium, which dips into the underlying tissue to form the crypts. The lymphocytes lie on the sides of the crypts in the form of nodules. The tonsil has two surfaces medial and lateral. The medial surface is covered by stratified squamous epithelium continuous with that of the mouth. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.

Pseudostratified columnar ciliated epithelium


Question: Hyoid bone is a derivative of


Question: Successful antibiotic penetration of a burn eschar can be achieved with

Mafenide acetate is the antibiotic agent that penetrates burn eschar to reach the interface with patient's ble tissue This agent has the Disadvantage that it is quite painful on any paial thickness areas and it is carbonic anhydrase inhibitor that interferes with renal buffering mechanism Metabolic acidosis can occur Ref: schwaz's principle of surgery 10th edition Pg no: 232


Question: Most common aery involved in pancreatic pseudoaneurysm

Aeries involved in pseudoaneurysm associated with pancreatic pseudocyst Splenic Aery (30-50%):Most common Gastroduodenal aery : (10-15%) Inferior and superior pancreaticoduodenal aery (10%) Ref: Maingot 11th edition Pgno :977


Question: Primordial germ cell is derived from

Primordial germ cell is derived from epiblast, earlier they were believed to arise from endoderm of yolk sac They became evident at the distal end of primitive streak by the 2nd week of intrauterine life, these cells migratory and reach the endodermal wall of yolk sac, they reach the gonad by the 5th week Gray's 39e/p-210-220


Question: mood stablizer used in the management of temporal lobe epilepsy

Carbamazepine - USES - TRIGEMINAL NEURALGIA - TEMPORAL LOBE EPILEPSY - SECOND LINE MOOD STABILIZER Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no.935


Question:
Sensory supply to external auditory meatus is by /
sensory nerve supply to external ear is by


Question: Mouth opening is due to action of


Question: The second stage of deglutition is characterized by

Peristalsis of Pharyngo esophageal sphincter


Question: Agent of first choice in an acute attack of Prinzmetal's angina is

Ref Harrison 19 th ed pg 1598 Prinzmetal's Variant Angina Nitrates and calcium channel blockers are the main therapeutic agents. Aspirin may actually increase the severity of ischemic episodes, possibly as a result of the sensitivity of coronary tone to modest changes in the synthesis of prostacyclin.


Question: Nerve supply of Glans penis is

Innervation of penis : nerves deriving from S2-S4. Sensory & sympathetic innervation: provided by the dorsal nerve of penis (terminal branch of pudendal nerve), which runs lateral to dorsal aery of penis. It Supplies both skin and glans. The sensory endings are more numerous on the glans). Ilioinguinal nerve branches supply skin at the root. Parasympathetic innervation: provided by cavernous nerves that innervate the helicine aeries in the corpora cavernosa (that is why erection is parasympathetically stimulated). Ref - medscape.com


Question: seizure is a side effect of

CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients * Side effects * Agranulocytosis * Myocarditis * Seizure * Constipation * Weight gain * Metabolic syndrome Sialorrhea Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no, 935


Question: Plunging goitre is

Refer Robbins page no 1092 Multinodular goiters are multilobulated, asymmetrically enlarged glands that can reach weights of more than 2000 gm. The pattern of enlargement is quite unpredictable and may involve one lobe far more than the other, producing lateral pressure on midline structures, such as the trachea and esophagus. In other instances the goiter grows behind the sternum and clavicles to produce the so-called intrathoracic or plunging goiter. Occasionally, most of it is hidden behind the trachea and esophagus; in other instances one nodule may stand out, impaing the clinical appearance of a solitary nodule. On cut section, irregular nodules containing variable amounts of brown, gelatinous colloid are present (Fig. 24-15A). Older lesions have areas of hemorrhage, fibrosis, calcification, and cystic change. The microscopic appearance includes colloid-rich follicles lined by flattened, inactive epithelium and areas of follicular hyper- plasia, accompanied by degenerative changes related to phys- ical stress. In contrast to follicular neoplasms, a prominent capsule between the hyperplastic nodules and residual com- pressed thyroid parenchyma is not present


Question: The surface marking of the arch of aoa is as follows

ARCH OF AOA It lies behind the lower half of the manubrium sterni.Its upper convex border is marked by a line which begins at the right end of the sternal angle,arches upwards and to the left through the centre of the manubrium and ends at the sternal end of the left second costal cailage.Note that the beginning and end of the arches are at the same level.When marked on the surface as descried above the arch looks much smaller than it actually is because of foreshoening. BD CHAURASIA 'S HUMAN ANATOMY VOL.1,FIFTH EDITION


Question: Thorium induced tumor


Question: Mammography was performed in 45 year old female for screening of breast cancer. The finding is suggestive of

Mammography Soft tissue radiographs are taken by placing the breast in direct contact with ultrasensitive film and exposing it to low-voltage, high-amperage x-rays. The dose of radiation is approximately 0.1 cGy and, therefore, mammography is a very safe investigation. The sensitivity of this investigation increases with age as the breast becomes less dense. In total, 5% of breast cancers are missed by population-based mammographic screening programmes; even in retrospect, such carcinomas are not apparent. Thus, a normal mammogram does not exclude the presence of carcinoma. Digital mammography is being introduced, which allows manipulation of the images and computer-aided diagnosis. Tomo-mammography is also being assessed as a more sensitive diagnostic modality. Ultrasound Ref: Sabiston 20th edition Pgno : 861


Question: Resting pressure in the anal canal is because of

Anal manometry has been used in the study of patients who have fecal incontinence as an attempt to quantify anal sphincter function. Typical basic parameters are resting pressure and squeeze pressure. Resting pressure denotes resting tonicity and thus is used as an index parameter for internal anal sphincter which is in charge of that tonicity, while squeeze pressure denotes the strength of voluntary contraction and is used for contractility of external anal sphincter. But resting pressure is usually regarded more reliable as an index of continence function judging from physical propeies during metric procedure because squeeze pressure depends more on patient's subjective effo with resultant more variation. Resting pressure has, however, a restriction that it represents cross sectional status of the anal canal without taking into consideration its three dimensional structure. Resting pressure gradient (RPG) of the anal canal is devised as one of the advanced parameters to make up for such a restriction. The RPG is given by the ratio of pressure difference between maximum resting pressure and basal resting pressure to interval distance between their levels. Therefore, it can be said that it has 2 components as factors of determination, which are pressure and length factor, respectively. Ref - pubmed.com <a href="


Question: NCPF is due to

Pathology of Non-cirrhotic poal fibrosis Characterized by fibrous intimal thickening of the poal vein or its branches Hallmark of disease is thrombosis/sclerosis of the poal vein branches Poal and peripoal fibrosis of varying extent (No bridging fibrosis) Poal vein is dilated with sclerosis of the walls and in autopsy thrombin in the medium or small poal vein branches with accompanying areas of ischemic necrosis Aberrant intrahepatic vessels may be present in the peripoal area, which corresponds to dilated terminal poal vein branches or venues, termed as megasinusoids or peripoal angiomatosis Ref: Blumga 5th edition Pgno : 1088

Intrahepatic post sinusoidal obstruction


Question: Paneth cells cotain

Refer Robbins page no Pg 804 Paneth cell contains zinc along with lysozyme.they ate involved in gut defence


Question: Sphincterectomy of sphincter of oddi is performed at

Transduodenal Sphincterectomy This cut is made Superiorly (at 11 O'clock position) for 4 to 5 mm. The sphincter is incised at the 11 O'clock position to avoid injury to the pancreatic duct Ref: Sabiston 20th edition Pgno :1496


Question: Phase 2 of Damage control surgery occurs at

Deadly triad of trauma Following a trauma protracted surgery in physiologically unstable patient, the three factors that carry moality are Hypothermia Acidosis Coagulopathy Hence originated a phenomenon - DAMAGE CONTROL SURGERY Phases of damage control surgery Phase1 :Initial exploration Phase 2: Secondary Resucitation Phase 3: Definitive operation Phase 1(initial exploration) Control of active hemorrhage and contamination Midline incision--4 quadrant packing done GIT perforation done with sutures or staples External drains kept for pancreatic or bile duct injuries Temporary closure of abdomen using plastic sheet known as OPSITE This technique of closure is known as VACPAC or OPSITE SANDWICH Phase 2( secondary resuscitation) Transfer to ICU Ventilatory suppo Correct the deadly triad Hypothermia, acidosis, Coagulopathy Phase 3(definitive treatment) Planned re exploration and definitive surgery Done 48-72 hrs after secondary phase Complex reconstruction must be avoided Ref : Bailey and love 27th edition Pgno: 318-326, 378-380, 426


Question: Root of mesentery is crossed by

i.e. (Aorta): (2474-BDC-2 5thed)Root of mesentery is crossed by abdominal aortaROOT OF THE MESENTERY - is 15 cm long and is directed obliquely downwards and to the right. If extands from the duodenojejunal flexure on the left side of vertebra L2 to the upper part of the right sacroiliac jointsIt crosses the following1. The third part of the duodenum where the superior mesenteric vessels enter into it2. The abdominal aorta3. Inferior vena cava4. Right ureter5. Right psoas major* Commonest variation in the arteries arising from the arch of aorta is - Left common carotid artery arising from brachiocephalic trunk**


Question: Mandibular nerve exits the cranial cavity by passing through

Mandibular nerve begins in the middle cranial fossa through a large sensory root and a small motor root. The sensory root arises from the lateral pa of the trigeminal ganglion and leaves the cranial cavity through the foramen ovale. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Inferior epigastric artery forms the boundary of

HESSELBACH'S TRIANGLE:-
Boundaries-
1. Medially-Lateral border of rectus abdominis
2. Laterally- inferior epigastric artery.
3. Base - inguinal ligament.
FEMORAL TRIANGLE:-
Triangular depression in front of the upper one-third of the thigh immediately below the inguinal ligament.
BOUNDARIES:-
1. Laterally: medial border of Sartorius.
2. Medially: medial border of adductor longus.
3. Base: inguinal ligament.
4. Apex: directed downwards.formed by the point where the medial and lateral boundaries cross.apex is continuous with the adductor canal.
5. Roof: skin, superficial fascia and deep fascia. Superficial fascia contains superficial inguinal lymph nodes, a femoral branch of the genitofemoral nerve, branches of ilioinguinal nerve, superficial branches of the femoral artery with accompanying veins and the upper part of the great saphenous vein.
6. Floor: medially by adductor longus and pectineus, and laterally by the psoas major and iliacus.

CONTENTS:-
1. Femoral artery and its branches.-
        Superficial branches-superficial external pudendal, Superficial epigastric and Superficial circumflex iliac
        Deep branches-profunda femoris, muscular branches and deep external pudendal
2. Femoral vein and its tributaries
3. Femoral sheath
4. Femoral nerve
5. Nerve to pectineus
6. Femoral branch of genitofemoral nerve.
7. The lateral cutaneous nerve of thigh.
8. Deep inguinal lymph nodes.
The vein is medial to the artery (base)
Vein posteromedial to the artery (apex)


Question: Most common site for thyroglossal cyst

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


Question: Synaptic transmission in autonomic ganglia is


Question: Pain insensitive structure in brain is

Pain Insensitive structures in Brain :Brain parenchymaEpendymaChoroid plexusPia matterArachnoidDura over convexity of skull ( Dura around vascular sinuses and vessels is sensitive to pain)Pain Sensitive structures in Brain :Cranial venous sinuses with afferent veinsAeries at base of brain and aeries of dura including middle meningeal aery.(Ref: Gray&;s anatomy, page 404)

Dural she ath surrounding vascular sinuses


Question: Most common cause of pancreatic pseudocyst is

Pseudopancreatic cyst A chronic collection of pancreatic fluid surrounded by a nonepithelized wall of granulation tissue and fibrosis Pseudocyst accounts 75% of cystic lesions of the pancreas Most common complication of chronic pancreatitis Located anywhere from the mediastinum to the scrotum Found most often in the lesser sac or anterior pararenal space Traumatic pseudocysts tend to occur anterior to the body of the gland Chronic pancreatitis pseudocyst are commonly located within the substance of the gland Incidence of pseudocyst :, Acute pancreatitis (10-20%) of patients. Chronic pancreatitis (20-40%) of patients Multiple in 17% cases Alcohol is the most common cause of pancreatitis related pseudocyst Ref: Sabiston 20th edition Pgno :1531


Question: Commonest benign tumor of liver is


Question: treatment of tardive dyskinesia is

TARDIVE DYSKINESIA Involuntary Choreo athetoid movements Involving the face, trunks and limbs M.C SITE-=========== peri oral movements Exacerbated by stress Relieved by rest TREATMENT Benztropine Benzodiazepine Vitamin E Ondansean clozapine Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no. 925


Question: Thoracic sympathetic nerve trunk lies

The chain crosses the head of second to tenth rib BD CHAURASIA&;S HUMAN ANATOMY UPPER LIMB THORAX SIXTH EDITION VOL 1PAGE NO 224


Question: Chocolate cyanosis seen in

Methemoglobinemia Signs and symptoms Headache, nausea, vomiting, breathlessness, confusion, coma, convulsion, severe metabolic acidosis. Hemolysis may occur in G6PD deficiency. Blood is chocolate brown in color (chocolate cyanosis) Ref: FORENSIC MEDICINE AND Toxicology Dr PC IGNATIUS THIRD EDITION PAGE 430


Question: Medial arch of foot is made up of

ARCHES OF FOOT:- Helps in fast walking, running, jumping, weight bearing and providing upright posture.Types: 1. Longitudinal- medial and lateral.2. Transverse - anterior and posterior. MEDIAL LONGITUDINAL ARCH:-Higher, more mobile than lateral. Ends:-1. Anterior end-Head of 1st , 2nd , and 3rd metatarsal.2. Posterior end-medial tubercle of calcaneum.Summit:-Superior aicular surface of talus Pillars:-1. Anterior pillar- talus, navicular, and first three metatarsal.2. Posterior pillar-medial pa of calcaneum.Joint- Talocalcaneonavicular. LATERAL LONGITUDINAL ARCH:-Ends:- 1. Anterior end- head of 4th and 5th metatarsal.2. Posterior end- lateral tubercle pf calcaneum. Summit:- aicular facet of superior surface of calcaneum. Pillars:-Anterior-cuboid and 4th and 5 th metatarsal.Posterior- lateral half of calcaneum. Joint:- calcaneocuboid ANTERIOR TRANSVERSE ARCH:- Formed by heads of 5 metatarsals.Complete because heads of first and fifth come in contact with the ground. POSTERIOR TRANSVERSE ARCH:-Formed by cuboid, 3 cuneiform and bases of 5 metatarsal. Factors responsible for maintenance of stability of arches:-1. Shape of bones concerned.2. Intersegmental ties:-Spring ligament for the medial longitudinal arch.Long and sho plantar ligaments for lateral longitudinal arch.Transverse arch - interosseus muscles.3. Tie beams or bowstrings 4. Slings5. Suspension. <img src=" /> {Reference: BDC 6E chapter 13.}


Question: Ducts of bellini are found in

The Uriniferous Tubules - From a functional point of view the kidney may be regarded as a collection of numerous uriniferous tubules that are specialised for the excretion of urine. Each uriniferous tubule consists of an excretory pa called the nephron, and of a collecting tubule. The collecting tubules draining different nephrons join to form larger tubules called the papillary ducts (of Bellini), each of which opens into a minor calyx at the apex of a renal papilla. Each kidney contains one to two million nephrons. Urinary tubules are held together by scanty connective tissue. Blood vessels, lymphatics and nerves lie in this connective tissue. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 304.


Question: Spinal cord in children ends at the lower border of

Veebral level and spinal cordSpinal cord in adults ends at L1, L2Spinal cord in children ends at L3Highest point of iliac crest is at L4


Question: "Nucleus ambiguus" is present at

The nucleus ambiguus is found in the lateral medulla; it gives rise to the SVE (Special visceral efferent fibers ) components of cranial nerves IX and X. fig:- crossection at the level of medulla(upper pa)

Midbrain, at level of superior colliculus

Midbrain, at level of inferior colliculus


Question: Pharmacological stressor used in PET scan to detect cardiac function is

Instead of treadmill test,dobutamine can be used.


Question: The muscles attached to perineal body are A/E

Ten muscles of the perineum converge and interlace in the perineal body - a) Two unpaired : (i) External anal sphincter, (ii) Fibres of longitudinal muscle coat of anal canal. b) Four paired:- (i) Bulbospongiosus, (ii) Superficial transverse perenei, (iii) Deep transversus perenei, (iv) levator ani, In females, sphincter urethrovaginalis is also attached here. Ref: Gray&;s anatomy text book of anatomy BD chaurasia 21st Ed.


Question: Hyperosmolarcoma are caused by the following excep t by

though the concentration of proteins is large they only contribute 2mosm/lbecause of their very high molecular weights

Increased concentration of plasma proteins


Question: Cricothyroid is supplied by


Question: Predominant blood supply to the Supra duodenal bile duct is derived from

Vascular supply of biliary tract The Supra duodenal and infrahilar bile duct are Predominantly supplied by two axial vessels that run in a 3- and 9-'o clock position These vessels are derived from the superior pancreaticoduodenal, right hepatic, cystic, gastroduodenal and retro duodenal aeries It has been estimated that only 2% of the aerial supply to this poion of the bile duct is segmental and arises directly off of the proper hepatic aery The bile duct and its bifurcation in the hilum derive their aerial supply from a rich network of multiple small branches from surrounding vessels Retro pancreatic bile duct derives its aerial supply from the retroduoden aery Venous drainage of the bile duct parallels the aerial supply and drains into the poal venous system The venous drainage of the gallbladder empties into the veins that drain the bile duct and doesnot flow directly to the poal vein Ref: Sabiston 20th edition Pgno : 1482-1483

Vessels that run upward along the bile duct from the duodenal end of the duct such as the retro duodenal and gastroduodenal aeries

Vessels that run downward along the bile duct from the hepatic end of the duct such as the right hepatic aery

Vessels that arise from the hepatic aery proper run up along the CBD and supplies it with twigs in Non-axial distribution


Question: Most sensitive indicator of intravascular volume depletion in child is

Capillary refill is a simple test that assesses how quickly blood returns to the skin after pressure is applied. It is carried out by applying pressure to the pink pa of the nail bed of the thumb or big toe in a child and over the sternum or forehead in a young infant for 3 seconds. The capillary refill time is the time from release of pressure to complete return of the pink color. It should be less than 3 seconds. If it is more than 3 seconds the child may be in shock. Lift the limb slightly above hea level to assess aeriolar capillary refill and not venous stasis. This sign is reliable except when the room temperature is low, as the cold environment can cause a delayed capillary refill. In such a situation check the pulses and decide about shock


Question: Toynbee's muscle is

Tensor tympani is called as Toynbee muscle origin, the cailaginous pa of the pharyngotympanic (auditory) tube and the walls of its hemicanal just above the bony poion of the pharyngotympanic tube; inseion, handle of malleus; action, draws the handle of the malleus medially tensing the tympanic membrane to protect it from excessive vibration by loud sounds. nerve supply, branches of trigeminal through the otic ganglion Ref - Pubmed.com


Question: Musculocutaneous nerve is a branch of

REF.BDC VOL.1,FIFTH EDITION.pg.88 The musculocutaneous nerve is the main nerve of the front of the arm and continues below the elbow as the lateral cutaneous nerve of the forearm.It is a branch of the lateral cord of the brachial plexus,arising at the lower border of the pectoralis minor in the axilla.


Question: Most common nerve involvement in fracture surgical neck humerus

Refer Maheshwari 6th/e p 92 Axillary nerve is paicularly vulnerable, both from the injury and from surgery


Question: Superior pancreaticoduodenal aery is a branch of

The superior pancreaticoduodenal aery is an aery that supplies blood to the duodenum and pancreas. It is a branch of the gastroduodenal aery, which most commonly arises from the common hepatic aery of the celiac trunk, although there are numerous variations of the origin of the gastroduodenal aery. The pancreaticoduodenal aery divides into two branches as it descends, an anterior and posterior branch


Question: CD 99 is for


Question: Wharton's duct drains

(A) Submandibular gland # Submandibular gland: It is irregular in shape & about the size of a walnut.> It consists of a larger superficial and a smaller deep part, continuous with each other around the posterior border of mylohyoid.> It is seromucous (but predominantly serous) gland.# Wharton's duct emerges from the medial surface of this part of the gland behind the posterior border of mylohyoid.> It traversed the deep part of the gland passes at first up and slightly back for 0.5 mm, and then forwards between mylohyoid and hyoglossus.> It next passes between the sublingual gland and genioglossus to open in the floor of the mouth on the summit of the sublingual papilla at the side of the frenulum of the tongue. It lies between the lingual and hypoglossal nerves on hypoglossus, but, at the anterior border of the muscle, it is crossed laterally by the lingual nerve, terminal branches of which ascend on its medial side.> As the duct traverses the deep part of the gland it receives small tributaries draining this part of the gland like the parotid gland, the duct system of the submandibular gland can be visualized by sialography.


Question: Bursa communicating with the shoulder joint space is

Infraspinatus bursa may communicate with the shoulder joint. Subacromial bursa separates the acromion process and the coracoacromial ligaments from supraspinatus tendon and permit smooth motion. B D Chaurasia 7th edition Page no: 148


Question: Node of Rouviere is

Ref: Various articles & internet sources
Node of Rouviere is the most superior of the lateral group of the retropharyngeal lymph nodes. It is found at the base of the skull. They represent one of the first echelon lymphnodes typically involved in nasopharyngeal carcinoma (NPC).


Question: Lymph from glans penis drain into

Lymphatics from the glans drain into the deep inguinal nodes also called gland of Cloquet. Lymphatics from the rest of the penis drain into the superficial inguinal lymph nodes.Ref: Vishram Singh; Volume II; 2nd edition; Page no: 464


Question: Transistional epithelium is present in

Inderbir Singh&;s Human Histology Seventh edition Pg 49 Transitional epithelium is found in renal pelvis and calyces, ureter, urinary bladder and pa of urethra


Question: Posterior relation of poal vein

The poal vein usually measures approximately 8 cm in adults. It originates behind the neck of the pancreas and is classically formed by the confluence of the superior mesenteric and splenic veins. ref - BDC 6e vol2 pg282 , researchgate.net


Question: Rotter's lymph nodes are found between

Ans: C. Pectoralis major and Pectoralis minorRotter's lymph nodes - Small interpectoral lymph nodes located between pectoralis major & pectoralis minor muscles.Receive lymphatic fluid from muscles & mammary gland.Delivers lymphatic fluid to axillary lymphatic plexus.


Question: Corpora amylacea is seen in

Corpora amylacea are small hyaline masses of unknown significance found in the prostate gland, neuroglia, and pulmonary alveoli. They are derived from degenerate cells or thickened secretions and occur more frequently with advancing age. Ref - BDC 6e vol2 pg410 ,researchgate.net


Question: The power grip of hand is due to the main function of

The power grip is used to do things like carry heavy bags or hold on to a handle. In the power grip, the object is held in the palm of the hand, and the long flexor tendons pull the fingers and the thumb so that they can tightly grasp the object. This grip is made possible by the four other fingers flexing (bending) and, most impoantly, the ability of the thumb to be positioned opposite the fingers. With the hand in this position, larger objects such as a stone or a heavy bottle can be held and moved in a controlled way. The heavier the weight and the smoother the surface is, the more strength is needed to hold and move the object. ref - pubmed.com


Question: One year old male child with cat's reflex and raised IOT

Most common age of presentation in Retinoblastoma is within 18 months Refer khurana 6/e


Question: Third pa of duodenum is crossed by

The third pa, or horizontal pa or inferior pa of the duodenum begins at the inferior duodenal flexure and passes transversely to the left, passing in front of the inferior vena cava, abdominal aoa and the veebral column. The superior mesenteric aery and vein are anterior to the third pa of duodenum. Ref - BDC 6e vol2 pg262


Question: Lymphatic drainage of anterior pa of nose is to

Lymphatic from the anterior half of the lateral wall pass to the submandibular nodes,and from the posterior half,to the retropharyngeal and upper deep cervical nodes. Ref BDC volume;3,Sixth edition


Question: Pain of ovarian pathology is referred to

Pain of ovarian pathology is referred to the periumbilical (T10-T11) area (due to sensory fibres accompanying sympathetic nerves to aoic plexus) along the cutaneous distribution of obturator nerve on inner aspect of thigh (because obturator neurovascular bundle lie lateral to ovary in ovarian fossa).


Question: Blood supply of thoracic pa of esophagus

OESOPHAGUS-AERIAL SUPPLY 1.The cervical pa including the segment upto the arch of aoa is supplied by the inferior thyroid aeries. 2.The thoracic pa is supplied by the oesophageal branches of the aoa. 3.The abdominal pa is supplied by the oesophageal branches of the left gastric aery. REF:B D Chaurasia's human anatomy,Vol.1.Fifth edition.Pg 270


Question: A patient presents with a penetrating chest wound associated with intrathoracic haemorrhage. A thoracotomy is done by taking an incision in the 41h/51h intercostals space staing 1 cm away from the lateral margin of the sternum.This is done to avoid injury to the

C i.e. Internal thoracic aeryIntercostal (external, internal & innermost) muscles (not transverses thoracic) are pierced in pleural taping in mild axillary line.Latissimus dorsi, serratus anterior, rhomboidus major & intercostal muscles are cut in posterolateral thoracotomy whereas pectoralis is cut in anterior & anterolateral approach.Thoracotomy in upper 6 intercostal spaces is done by taking an incision 1 cm lateral to sternum to avoid injury to internal thoracic (mammary) aeryQ.


Question: An anaesthetic agent with boiling temperature more than 75 C


Question: After ovulation the discharged oocytes and surrounding layer of granulosa cells are known as

The corona radiata is the innermost layer of the cells of the cumulus oophorus and is directly adjacent to the zona pellucida, the inner protective glycoprotein layer of the ovum . Its main purpose in many animals is to supply vital proteins to the cell. It is formed by follicle cells adhering to the oocyte before it leaves the ovarian follicle, and originates from the squamous granulosa cells present at the primordial stage of follicular development. The corona radiata is formed when the granulosa cells enlarge and become cuboidal, which occurs during the transition from the primordia to primary stage . These cuboidal granulosa cells, also known as the granulosa radiata, form more layers throughout the maturation process, and remain attached to the zona pellucida after the ovulation of the graafian follicle . For feilization to occur, sperm cells rely on hyaluronidase (an enzyme found in the acrosome of spermatozoa) to disperse the corona radiata from the zona pellucida of the secondary (ovulated) oocyte, thus permitting entry into the perivitelline space and allowing contact between the sperm cell and the nucleus of the oocyte. Ref - Wikipedia.org


Question: The commonest site of peptic ulcer is

Conditions also. with peptic ulcer have already been described. Plummer Vinson Paterson Kelly syndrome consists of :- Iron deficiency anemia Dysphasia atrophic oral mucosa, glossitis brittle spoon-shaped fingernails. Typically pts are Woman over 40 yrs of age. Its a Pre-malignant condition* for both oral cavity & esophagus. Ref : S Das textbook, 3/e, p818


Question: Epitope spreading refers to

Ref Robbins 9/e p217 It is a phenomenon in which an immune response against one self antigens causes tissues damage releasing other antigens .and resulting in the activation of lymphocytes by these newly encountered epitope

A type of mechanism of spread of malignant tumor

One type of mechanism of HIV dissemination

A mechanism for the persistence and evolution of autoimmune disease


Question: In carcinoma head of pancreas nausea and vomiting is due to

PRESENTING SYMPTOM FREQUENCY Jaundice Weight loss Abdominal pain Nausea/vomiting Pruritus Fever Gastrointestinal bleeding Ref: Sabiston 20th edition Pgno: 1544

Proliferation and infiltration into duodenum


Question: Final centre for horizontal movements of eye is


Question: For oral iron supplements used for iron deficiency anemia

Refer Katzung 10/e p 530 Tolerable doses of elemental iron is 200mg per day Mass of elemental iron is more impoant in determining Daily Dose Treatment with oral iron should be continued even after reaching the desired hemoglobin level

Tolerable dose will deliver 40 to 60 mg of iron per day

Mass of total salt is impoant in determining Daily Dose

Treatment should be stopped as soon as normal hemoglobin levels is reached

Desired rate of hemoglobin improvement is 0.5 mg per day


Question: Node of Ranvier means

- Nodes of Ranvier or Myelin sheath gaps, are the gaps (approximately 1 micrometer in length) formed between the myelin sheaths generated by different cells. O A myelin sheath is a many-layered coating, largely composed of a fatty substance called myelin,that wraps around the axon of a neuron and very efficiently insulates it. O At nodes of Ranvier, the axonal membrane is uninsulated and therefore capable of generating electrical activity. O Since fat serves as a good insulator, the myelin sheaths speed the rate of transmission of an electrical impulse along the axon. O Electrical impulse jumps from one node to the next at a rate as fast as 120 meters/ second. O This rapid rate of conduction is called salutatory conduction. O Myelinated axons are rare in the autonomic nervous system. Inveebrates do not have myelinated sheaths.

Indentation Schwann cell due to synapsing of adjacent unipolar neuron

Gaps between dendrites and Schwann cells


Question: Teratomas may arise from the aberrant migration of

Epiblast cells form the primordial germ cells, which migrate from the region of primitive streak to the region of future gonads to form the gametes like sperm & oocyte.Abnormal remnants of epiblast/primordial germ cells at the primitive streak or their aberrant migration lead to forma on of teratomas.


Question: Great cerebral vein of Galen formed by the union of

Great cerebral vein: This is a single median vein. It is formed by the union of the two internal cerebral veins. It terminates in the straight sinus. Its tributaries include the basal veins and veins from the pineal body, the colliculi, the cerebellum and the adjoining pa of the occipital lobes of the cerebrum.Ref: BD Chaurasia; Volume 3; 6th edition; Page no: 388


Question: First stage of lung development is

Lung organogenesis is pa of the embryonal period. While fetal lung development consists in the pseudoglandular, canalicular and saccular stages, postnatal lung development comprises the stages of classical and continued alveolarization, as well as of microvascular maturation. The phases of lung development are mainly based on morphological criteria. Because most processes during lung development sta proximal and extend into the periphery, all phases of lung development overlap . Ref - pubmed.com


Question: After the pericardial sac has been opened anteriorly during surgery, by passing a surgical clamp through the transverse sinus, surgeons can stop/dive circulation of blood in

During surgery, a clamp is passed through the transverse sinus stops or dives the blood flow from the aoa and pulmonary trunk. Transverse pericardial sinus seperates the aerial end of the hea tube from the venous end. Aoa and pulmonary trunk lie anterior to the sinus and superior vena cava lies posterior to it. Therefore, during surgery, a clamp is passed through the transverse sinus stops or dives the blood flow from the aoa and pulmonary trunk. Ref: Gray's Anatomy 41st edition Pgno: 183


Question: The sequence of commonest fractured sites of Mandible is

The mandible is commonly fractured at the canine socket where it is weak. Involvement of the inferior alveolar nerve in the callus may cause neuralgic pain, and if the nerve is paralyzed, the area supplied by the mental nerve becomes insensitive. The next common fracture of the mandible occurs at the angle.Reference: Chourasia; 6th edition; 35th page; 1.29 Figure


Question: Maxillary prominence develops in


Question: After 72 hours of Myocardial infarction, the predominant cells are


Question: Solid and largest lymphatic organ of the body is

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


Question: Intrinsic muscles of the tongue are derived from

occipital somites Most of the tongue muscles are derived from myoblasts that migrate from the occipital somites.Embryological Origin of the TongueThe tongue's embryonic orgin is derived from first 4 pharyngeal arches contributing different components.Anterior 2/3" or body of tongue: is derived from 3 lingual buds- the median tongue bud (tuberculum impar) and 2 lateral lingual swellings developing at each side of the median tongue bud. All arising from the la pharyngeal arch. The lateral tongue buds rapidly increase in size, merge with each other, and overgrow the median tongue bud. The merged distal tongue buds form the anterior 2/3rd of the tongue. The median tongue bud forms no recognizable pa of the adult tongue. Since the mucosa covering the ant. 2/3rd of the tongue originates from the first pharyngeal arch; sensory innervation to this area is by the mandibular branch of the trigeminal nerve. (Taste sensation to the anterior 2/3rd of the tongue is provided by the chorda tympani branch of the facial nerve).Post 1/3" or root of the tongue: is formed from two median elevations;- The copula arising from the 2"d pair of branchial arches, just caudal to the foramen ceacum.- The hypopharyngeal or hypobranchial eminence developing caudal to the copula from the 3rd and dh pair of arches.As the tongue develops the copula is gradually overgrown by the hypopharyngeal eminence and disappears. As a result, the post pa of the tongue develops from the hypopharyngeal eminence( the 3rd and 4th pharyngeal arches) . Thus the sensory nerve supply to this pa of tongue is from the glossopharyngeal nerve.(taste sensation is also carried by the glossopharyngeal nerve).Pharyngeal arch mesenchyme forms the connective tissue and vasculature of the tongue. Some of the tongue muscles probably develop in situ from mesenchyme, but most develop from myoblasts that migrate from the occipital myotomes. The hypoglossal nerve accompanies the myoblasts during their migration and innervates the tongue muscles.The Nerve Supply of the Tonguea. Motor nerve- All the intrinsic & extrinsic muscles, except the palatoglossus, are supplied by the hypoglossal nerve. The palatoglossus is supplied by the cranial pa of the accessory nerve through the pharyngeal plexus.b. Sensory nerves:- Anterior 2/3 of tongue - The lingual nerve is the nerve of general sensation and the chorda tympani is the nerve of taste for the anterior two-thirds of the tongue.- Posterior 1/3 of tongue - The glossopharyngeal nerve is the nerve for both general sensation and taste for the posterior 1/3 of the tongue.- The posterior-most pa of the tongue is supplied by the vagus nerve through the internal laryngeal branch. You can also see animated embryological development of tongue at following sites: class="Style2"> 1 2/animations/contents.htm


Question: The aerial blood glucose concentration in normal humans after a meal is in the range of


Question: NOT a content of superior mediastinum

Mediastinum refers to the space between two lungs in thorax. SUPERIOR MEDIASTINUM Space above 2nd costal cailage CONTENTS: thymus, arch of aoa, superior venacava, pulmonary aeries, esophagus, trachea, T1 - T4 veebra, PICA - 1, 2. INFERIOR MEDIASTINUM Space below superior mediastinum, again divided into anterior, middle and posterior mediastinum. CONTENTS: pulmonary trunk, bronchus, thymus, hea, ascending aoa, PICA 3 - 12 esophagus, descending aoa, T5 - T12 veebra. Angle between manubrium of sternum & body of sternum is called angle of louis, which is 1630.


Question: F 10 denotes 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.Internation Classification disorders, 10 edition


Question: Annerix V on non permeable cell is indicative of

Ref, Robbins 8/ep27,9/ep56 Apoptotic cells express phosphatidylserine in the outer layers of their plasma membrane.This phospholipids move out from the inner layer where it is recognised by number of receptors on the phagocytes.


Question: This drug can clear trip trypansomes from Blood and lymph nodes and is active in late CNS stage of African sleeping sickness. it is

Ref-Katzung 10/e p863 Treatment of trypansomes is African sleeping sickness Early haemolymphatic stage :Suramin Late CNS stage: melarsoprol South American disease (chagas disease):nifuimox


Question: Bleeding vessel in haemorrhoids is

Bleeding vessel in haemorrhoids is superior rectal vein which is a branch of inferior mesenteric vein at the level of rectum. Dilation of these vessels leads to bleeding leading to internal haemorrhoids. Veins are better option than aery.


Question: Bag of membranes ruptures

Membranes usually rupture after full dilatation of cervix or sometimes even beyond in second stage


Question: Lining of oesophagus is


Question: The superior vesical aeries are direct branches of the

The umbilical aery is a branch of the internal iliac aery. In the fetus, the umbilical aery passes over the bladder and continues up the anterior body wall to the umbilical cord and out to the placenta. As it passes the bladder, it gives rise to the superior vesical aeries. After bih, the pa of the aery distal to the bladder becomes fibrous, but the proximal pa remains patent and continues to supply the bladder.


Question: Crura of Penis is supplied by

Dorsal artery of penis supplies the skin and fascia.
Deep artery of penis supplies the crura.


Question: Contents of posterior triangle of neck

Contents of posterior triangle of neck :

Occipital artery.
Spinal accessory nerve.
Subclavian vessels.
Trunks of brachial plexus.
Great auricular nerve, lesser occipital nerve, supraclavicular nerve, transverse cutaneous nerve.
External jugular vein.

Occipital artery, spinal accessory nerve, hypoglossal, ascending pharyngeal artery

Occipital artery, lesser occipital nerve, subclavian artery, spinal accessory nerve

Occipital artery, spinal accessory nerve, subclavian artery, hypoglossal nerve

Occipital artery, Lesser occipital nerve, ascending pharyngeal artery, vagus nerve


Question: Most common vascular tumor in AIDS patient is

Ref Robbins 8/e 523_524 KS is caused by a virus called human herpes virus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpes virus (KSHV). KS develops when infected cells that line lymph or blood vessels begin to divide without stopping and spread into surrounding tissues. Whereas most cancers begin in one pa of the body and may later spread to other areas, KS usually appears as lesions (abnormal bumps, spots or patches) on the skin or on mucosal surfaces (such as inside the mouth or in the genitals). Lesions can also develop in other pas of the body, such as in the lungs, lymph nodes or gastrointestinal tract. Having visible KS lesions can be upsetting. Nonetheless, they may develop very slowly without causing any serious complications. If KS is confined to the skin or lymph nodes without causing any swelling, it usually responds very well to treatment with anti-HIV drugs. Infection with HHV-8, the virus which causes KS, is widespread among gay men and in African countries. The virus can be found in saliva and may be passed on during sex, including through wet kissing, oral sex, and using saliva as a lubricant during sex. It can also be spread when adults pre-chew food for infants. There isn't a vaccine to prevent HHV-8 infection. A normally functioning immune system can usually keep HHV-8 infections under control and suppress the abnormal growth of cells into KS lesions. Most people who have HHV-8 never get KS. However, when the immune system is weakened and an unhelpful activation of the immune system in response to HHV-8 occurs, KS may develop. Generally, KS is a rare cancer in people who don't have HIV. Nonetheless, cases do occur in HIV-negative people, paicularly in people who take medications that suppress the immune system (such as coicosteroids). It is also one of the most common cancers in African countries, with large numbers of cases in people who don't have HIV.


Question: Following antineoplastic drugs should not be administered to a chronic alcoholic patient due to risk of development disulfiram like reaction

Ref-KDT 6/e p827 Procarbazine is a chemotherapy medication used for the treatment of Hodgkin's lymphoma and brain cancers. For Hodgkin's it is often used together with chlormethine, vincristine, and prednisone while for brain cancers such as glioblastoma multiforme it is used with lomustine and vincristine You should avoid the use of alcohol while being treated with procarbazine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating.


Question: Epithelial lining of the Tonsil is

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:144The palatine tonsils Each palatine tonsils consists of diffuse lymphoid tissue in which lymphatic nodules are present. the lymphoid tissue is covered by stratified squamous epithelium continuous with that of the mouth and pharynx

Squamous epithelium without Keratinisation


Question: First cellular change in hypoxia

Decreased oxidative phosphorylation in mitochondria

Alteration in cellular membrane permeability


Question: Posterior superior alveolar aery is branch of


Question: Following are required for normal growth

A,B,D are answers Ref Robbins 7/e p290; 9/e p280 A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate the cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK.


Question: Cranial part of accessory nerve supplies

Sternocleidomastoid and trapezius develop from branchial arch mesoderm and are supplied by spinal part of accessory nerve.
Levator scapulae are supplied by a branch from dorsal scapular nerve and branches from C3, C4.


Question: Bigelow's ligament is at


Question: Medial rotator of thigh at hip joint is

Gluteus medius, Gluteus minimus, Tensor fascia lata (collectively referred to as TRIO muscles)- Medial rotators of thigh Obturator internus, Obturator externus, Gluteus maximus -lateral rotators of thigh.


Question: The drug of choice for supraventricular tachycardia is

Refer katzung 11e 243,244 KDT 6/e p517 Adenosine is drug of choice for paroxysmal supraventricular tachycardia termination Verapamil is a drug of choice for prophylaxis of paroxysmal supraventricular tachycardia and for the management of sustained supraventricular tachycardia


Question: Fibro cailage is found in

Fibrocailage is shock absorber which provides strength to cailage and is found in Interveebral disc. Costal cailage and nasal septum are made up of Hyaline Cailage. Auditory tube has elastic cailage.


Question: Disease or infarction of neurologist tissues causes it to be replaced by

Neuroglia astrocytes are the principal cells in the central nervous system responsible for reactioj to injury repair and scar formation in the brain. They perform function similar to fibroblasts in the CNS Refer Robbins page no 1252


Question: The basal forebrain nuclei and the pedunculopontine nuclei are similar in that neurons within them

Receive innervation from the cingulate gyrus

Process information related to language construction

Utilize acetylcholine as their neurotransmitter


Question: Memory T cell can be identified using the following marker


Question: Regarding termination of drug action

Ref-KDT 6/e p23 Action of drug can be terminated by hepatic metabolism or by anal excretion. Most of the dexa inactivated by metabolism. However some Ducks may be activated from inactive form (prodrugs) and others may produce active metabolite Some drugs main activate from Blood example decoction lives bloodstream and enters the hea to produce it's action

Drugs must be excreted from the body to terminate their action

Metabolism of drugs always abolishes their Pharmalogical activity

Hepatic metabolism and renal excretion are the two most impoant mechanism involved

Distribution of a drug out of bloodstream terminated drugs effect


Question: Irreversible injury in cell is


Question: Middle meningeal vessel damage results in

Extradural hematoma (EDH), also known as an epidural hematoma, is a collection of blood that forms between the inner surface of the skull and outer layer of the dura, which is called the endosteal layer. They are usually associated with a history of head trauma and frequently associated skull fracture. The source of bleeding is usually aerial, most commonly from a torn middle meningeal aery. EDHs are typically biconvex in shape and can cause a mass effect with herniation. They are usually limited by cranial sutures, but not by venous sinuses. Both CT and MRI are suitable to evaluate EDHs. When the blood clot is evacuated promptly (or treated conservatively when small), the prognosis of EDHs is generally good. Intracranial venous extradural hemorrhages and spinal epidural hemorrhages are discussed separately Refer Robbins page no 1261 9th edition


Question: Peripheral necrosis of liver is caused by

Hepatocellular damageExamplesMicrovascular fatty changeTetracycline, salicylates, yellow phosphorus, ethanolMacrovascular fatty change Ethanol, methotrexate, amiodaroneCentrilobular necrosisBromobenzene , CCL4,acetaminophen,halothane ,rifampinDiffuse or massive necrosisHalothane, isoniazid, acetaminophen, methyldopa, trinitrotoluene, Amanita phalloides toxinHepatitis Methyldopa, isoniazid, nitrofurantoin, phenytoin, oxyphenisatinFibrosis-cirrhosis Ethanol, methotrexate, amiodarone, most drugs that cause chronic hepatitisGranuloma formation Sulfonamides, methyldopa, quinidine, phenylbutazone, hydralazine, allopurinolCholestasis Chlorpromazine, anabolic steroids, erythromycin, estolate, OCP, organic arsenicalsPeripheral necrosisPhosphorus (Refer: Robbins & Cotran's - Pathologic Basis of Disease, SAE, 1st edition, Vol II-pg no: 840 &841)


Question: Among the muscles of TMJ the following muscle opposing stabilizing and antagonistic muscle force as far as the disc is concerned


Question: hyper ammonemia is a side effect of

LETHAL SIDE EFFECTS OF VALPROATE - Hyperammonemia - Pancreatitis - Hepatic failure - Neural tube defects - Thrombocytopenia MINOR SIDE EFFECTS OF VALPROATE - Hair loss - PCOD - WEIGHT GAIN - TREMORS Ref.kaplon and sadock, synopsis of psychiatry,11 th editioon, pg no.935


Question: Vein used to bypass the coronary aery

Varicose veins are due to the touosity of the long saphenous vein and occur mostly due to prolonged standing.The long saphenous vein is used to bypass the coronary aery after inveing the vein.Ref: Chaurasia; Volume 2; 6th edition; Page no: 135


Question: Nuclear bag fibre detects


Question: Insulin resistance in liver disease is due to

Refer Robbins page no Insulin resistance is defined as the failure of target tissues to respond normally to insulin. It leads to decreased uptake of glucose ik muscle reduced glycolysis and fatty acid oxidation I'm the liver and inability to suppress hepatic gluconeogenesis


Question: Total duration of antibiotics in acute osteomyelitis is

Teatement is staed with , IV antibiotics until condition begins to improve or Crp values return to normal, usually for 2 weeks. Thereafter antibiotics ae given orally for another 4 weeks. Change of antibiotics or surgery is considered, if no improvement occurs within 48hrs of antibiotics. ref : maheswari 9th ed


Question: Primitive streak develops from

Around day 14, the epiblast cells form primitive streak .


Question: Bleeding vessel in hemorrhoids is (FMGE Dec 2018)

Blood of hemorrhoids is from vein > Aery > sinusoids. Hemorrhoids - engorgement of venous plexus at / inside anal sphincter. It has slight genetic predisposition, but obesity, straining during bowel movements, sedentary life- style can predispose to them. Symptoms -irritation, pain, swelling. External hemorrhoids: Hemorrhoids occurring at anal verge (distal boundary of anal canal below pectinate line) Normally have low tendency to bleed on straining at stool. Bleeding comes from inferior rectal vein. Internal hemorrhoids: Occur inside the rectum (above pectinate line) have high tendency to bleed. Bleeding from "superior rectal vein" Prolapsed hemorrhoids are internal hemorrhoids that pass outside anal canal & form lump, which may undergo thrombosis & become painful.


Question: Inveor of foot is

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 takes 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:- Muscles- Main Accessory Inversion Tibialis anterior Tibialis posterior FHL FDL Eversion Peroneus longus Peroneus brevis {Reference:BDC 6E}


Question: Tract ABSENT in superior cerebellar peduncle

* Dorsal spinocerebellar fibers pass through inferior (not superior) cerebellar peduncle. Peduncle Afferent Middle cerebellar peduncle Coico ponto cerebellar tract Inferior cerebellar peduncle Olivocerebellar tract Dorsal Spinocerebellar Superior cerebellar peduncle Ventral spinocerebellar Tectocerebellar * Efferent fiber of superior cerebellar peduncle : Dento Rubro thalamic tract


Question: Inferior rectal aery is a branch of

The inferior rectal aery arises near the posterior end of the pudendal canal from internal pudendal aery, and accompanies the nerve of the same name.The aery supplies the skin and muscles of the anal region, and anastomoses with the superior and middle rectal aeries And the other branches are - The perineal aery ( arises near the anterior end of the pudendal canal ), The aery of the penis or theclitoris Ref : B D Chaurasia's Human Anatomy, seventh edition , volume 2 , pg. no. 397


Question: Sphincter and dilator pupillae develops from

HUMAN EMBRYOLOGY-INDERBIR SINGH tenth edition Derivatives of neuroectoderm: R-Retina O-Optic stalk/optic nerve M-Muscles of iris(sphicter and dilator pupillae) E-Epithelium of iris/ciliary body


Question: Stage of 16 cells is

A morula is distinct from a blastocyst in that a morula (3-4 days post feilization) is a 16-cell mass in a spherical shape whereas a blastocyst (4-5 days post feilization) has a cavity inside the zona pellucida along with an inner cell mass


Question: Left Kidney is preferred for transplantation because

The left kidney is preferred because of implantation advantages associated with a longer renal vein making anastomosis easier Also know, procurement of kidney, In a brainstem dead donor, the organ to be procured should be preserved to maintain its functional integrity. For this purpose the organ should be perfused with organ preservative solution twice before it is transplanted to the recipient. The first perfusion is done just after the abdomen is opened at laporotomy and the second perfusion is done just after the organ has been removed from the donor. Commonly used preservative solutions include UW solution (University of Wisconsin) and Eurocollins solution. After removal from the donor, the organ is placed in two sterile bags and stored at 0-4degC by immersion in ice while they are transpoed to the recipient centre Ref srb's manual of surgery 5e p993 , Internet

Ease of surgery due to anatomical relations


Question: Largest carpal bone is

CARPAL BONES:-8 in number.Proximal row:-1. Scaphoid- boat-shaped.2. Lunate- moon shape/ crescentic.3. Triquetral-pyramidal.4. Pisiform-pea shaped.Distal row:-1. Trapezium - quadrilateral 2. Trapezoid- shoe shaped.3. Capitate- largest carpal bone.4. Hamate- wedge-shaped.{Reference: Vishram Singh, pg no.33}


Question: Opposition of thumb involves

Opposition of thumb involves adduction, flexion & medial rotation at 1st carpo - metacarpal joint.


Question: Engagement of fetal head is with reference to

Engagement is said to occur when the largest transverse diameter of fetal head crosses the pelvic inlet. Largest transverse diameter of fetal head is biparietal diameter


Question: The inability to perceive the texture & shape an object occurs in lesion of.

D. i.e. Nucleus cuneatus The middle pa of cuneate nucleus, the pars rotunds which receives impulses from digits, palm, dorsum of hand & forearm is specific for stereognosis.- Stereognosis is determination of texture & size of an object, is a function of cerebral coexThe sensory information of stereognosis to brain is carried by posterior column which includes tractus gracilis & tractus cuneatus Tractus gracilis bring sensation from lumber & sucral segments to nucleus gracilis (less specific for steriognosis)- Tractus cuneatus bring sensation from cervical & thoracic segments to nucleus cuneatus.Mnemonic - "Gracilis for lower segments & Cuneatus for upper segments - G comes after C


Question: hyponatremia is a side effect of

- 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. 955


Question: Tectal breaking is seen in

The normal tectum has a rounded or, sometimes, a squared appearance of the colliculi and a sho cranial-caudal length. In the Chiari II malformation, variable degrees of fusion of the colliculi and upward deflection of the tectum result in prominent beaking and elongation of the tectum.Arnold Chiari malformation consists of a downward displacement of the cerebellar tonsils through the foramen magnum resulting in obstructive hydrocephalus.Dandy-Walker malformation is characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the fouh ventricle, and enlargement of the posterior fossa.


Question: Muscle of mastication are derived from

First pharyngeal arch is also called mandibular archMUSCLES-Temporalis, Lateral pterygoid, Medial pterygoid, Masseter, Mylohyoid, Anterior belly of digastric, Tensor tympani, Tensor palatiSKELETAL ELEMENTS-Premaxilla,maxilla,zygomatic,temporal,Meckel&;s cailageLIGAMENTS-Anterior ligament of malleus, sphenomandibular ligamentNERVE-Mandibular nerveAERY-Maxillary aery


Question: Climbing fiber inputs in the cerebellum stimulate

Climbing fibers from contralateral inferior olive terminate on Purkinje cells, and also send a collateral innervation to the corresponding deep cerebellar nuclei RELAYS OF CEREBELLAR CIRCUIT Basket cells - Inhibits - Purkinje cell Stellate cells - Inhibits - Purkinje cell Climbing fibres - Stimulate - Purkinje cell Purkinje cells- Inhibits - Deep cerebellar nuclei Mossy fibres - Stimulate - Granule cells Granule cells - Stimulate - Stellate, basket, Purkinje, Golgi cells Golgi cells - Inhibitory - Interneuron NEURONS IN CEREBELLUM Granular cells > EXCITATORY NEURONS


Question: spina bifida is a complication of

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


Question: Recurrent laryngeal nerve has close relation to


Question: Drug of choice for night shift workers insomnia is


Question: Lynch syndrome is associated with cancers of the

Ref Harrison 17/e p575; Robbins 8/e p821- 822; 9/e p 810 Lynch syndrome is an autosomal dominant disorder it is called as hereditary non polyposis colon cancer It is caused because of defective DNA repair genes leading to micro satellite instability There is increased chances of multiple cancer such as colorectal cancer, endometrial,ovarian stomach, ureter, brain, small intestine,hepatobiliary tract, skin


Question: Hypochloremia, hypokalemia and alkalosis are seen in

Biochemical abnormality in congenital hyperophic pyloric stenosis is a regular feature of AIIMS and AI examinations it has been repeated several times. The biochemical abnormalities seen are: Hypokalemia Hypochloremia Alkalosis and Paradoxical aciduria Ref : Schwaz 9/e p59


Question: The lateral mesoderm is divided into two distinct layers by the formation of the

The lateral mesoderm is a subdivision of intraembryonic mesoderm and initially is a solid plate of mesoderm. The intraembryonic coelom forms in the middle of the lateral mesoderm, thereby dividing it into the intraembryonic somatic mesoderm and intraembryonic visceral mesoderm.


Question: Meralgia parasthetica is due to compression of

Meralgia parasthetica is due to compression of Lateral cutaneous Nerve of thigh below inguinal ligament. It is a condition where pain and numbness is seen in Outer thigh.


Question: Azygous vein drains

The azygous vein is formed by the confluence of the Lumbar azygous vein, Right ascending lumbar vein and right subcostal vein. It passes superiorly through the aoic apeure, posterior to the right diaphragmatic crus and anterior to the twelth veebral body. The azygos vein transpos deoxygenated blood from the posterior walls of the thorax and abdomen into the superior vena cava vein.


Question: Fibrous pericardium is attached to

Fibrous pericardium base is broad and inseparably blended with the central tendon of the diaphragm.Ref: BD Chaurasia; Volume I; 6th Edition; Page no: 249


Question: Cesarean section is mandatory in following presentation

In brow presentation, the engaging diameter is Mentoveical diameter which is 14 cms that cannot pass through cervix Hence,cesarean section is mandatory. Ref: Datta Obs 9e pg 368.


Question: Third tubercle of femur provides attachment to

The gluteal tuberosity gives attachment to pa of the Gluteus maximus: its upper pa is often elongated into a roughened crest, on which a more or less well-marked, rounded tubercle, the third trochanter, is occasionally developed. ref - Bdc vol2 6th ediiton p13


Question: Hepatocytes secrete

Hepatocytes synthesize several plasma proteins, including Fibrinogen, Prothrombin, and Albumin


Question: Fracture of the spine of sphenoid results in

Injury to the spine of sphenoid: Chorda tympani nerve is related on the medial side of the spine of the sphenoid, while auriculotemporal nerve is related to the lateral side. Chorda tympani gives secretomotor fibers to submandibular and sublingual salivary glands, whereas auriculotemporal gives secretomotor fibers to the parotid gland. So injury to the spine of sphenoid may injure both these nerves affecting the secretion of all three salivary glands.Ref: BD Chaurasia; Volume 3; 6th edition; Page no 298

Affects secretion of Submandibular, sublingual and Parotid glands

Loss of general sensation on Anterior 2/3rd of tongue


Question: Epithelium of "Trigone of bladder" is derived from

The urinary bladder is derived from the cranial pa of the vesicourethral canal (endoderm).The epithelium of the trigone is derived from absorbed mesonephric ducts (mesoderm)Reference: Inderbir Singh Embryology; 10th edition; Page no: 292


Question: AFP is raised in

Serum AFP levels are elevated In >70% of patients with HCC In 85-90% of patients with hepatoblastoma Ref : Sabiston 20th edition Pgno :1464


Question: Froment's sign is due to

Ans: A Ulnar nerve injury(Ref: Maheshwari 4h/e p. 65)Ulnar nerve injury:Adductor pollicis will be paralysed.Shows 'Froment's sign'or the'book test'.Procedure:The patient is asked to grasp a book between the thumb and index finger. Normally, a person will grasps book firmly with thumb extended, taking full advantage of adductor pollicis and the first dorsal interosseous muscles.Patient will hold the book by using the flexor pollicis longus (supplied by median nerve) in place of the inter-phalangeal joint of the thumb.This becomes more pronounced if the examiner tries to pull the book out while the patient tries to hold it.


Question: myocarditis is a side effect of

CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients * Side effects * Agranulocytosis * Myocarditis * Seizure * Constipation * Weight gain * Metabolic syndrome Sialorrhea Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 935


Question: Painful arc syndrome is caused by the tear of

Painful arc syndrome is caused by tear of the supraspinatus tendon. Subacromial bursitis, fracture of greater tuberosity also may produce Ref: Gray's39e/p-793-795


Question: Highest point on skull


Question: systematic desensitization was introduced by

SYSTEMATIC DESENSITIZATION JOSEPH WOLPE Joseph Wolpe gave the concept of systematic desensitization This is a treatment used in phobia In phobia there is a conditioned fear response to aversive neutral stimulus and avoidance of that response leads to phobia Whenever there is a fear response there is stimulation of sympathetic system In that case stimulation of parasympathetic system by relaxation there is reduction in anxiety First step is to make a step ladder which are arranged based on the severity Then is go step by step and along with doing applied relaxation Slowly the the sympathetic system is reduced The patient will be able to approach stimulus without anxiety Ref. kaplon and sadock, synopsis of psychiatry, 11 th editio, pg no. 845


Question: In the following nutrient aeries to bones, choose the wrong pair

Nutrient aery to tibia is a branch of a posterior tibial aery Ref: Gray's 39e/p112-127


Question: Deep surface of hyoglossus is related to


Question: A person having irresistible desire to do crime is

Psychopath: psychopath is a person who is having irresistible desire to do crimes. He behaves in an anti social manner. He is otherwise called a sociopath. He can plan and implement his antisocial acts including murders in an efficient way. Punishment and advice have no effect on him. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 361


Question: Length of male urethra

The male urethra measures, on average, 18-20 cm in length. It commences at the internal urethral orifice in the trigone of the bladder and opens in the navicular fossa of the glans penis at the external urethral meatus, which is the narrowest pa of the urethra. ref - BDC vol2 pg376


Question: Blood platelets in stored blood do not remain functional after

Platelet concentrates Volume :50ml Platelets are the only blood products which are stored at room temperature, 20-24 degC (Survival is 4-5 days) 1 unit of platelet increases the count by 5000-10000 The threshold for prophylactic platelet transfusion is 10000 /uL For invasive procedures, 50000/uL platelets is the usual target level Platelet count should be 1,00,000/uL before accepting the patient for surgery Transfused platelets generally survive for 2-7 days following transfusion ABO compatibility is desirable but not necessary Blood platelets in stored blood are non functional after 24 hours Ref: Harrison's 19th edition pgno: 953 Sabiston 20th edition pgno:588


Question: Examination of a person accused of rape by medical practitioner comes under

Sec53ACr.PC. Examination of person accused of rape by medical practitioner.- when a person is arrested on a charge of committing an offence of rape or attempt for rape, he shall be examined by a Govt registered medical practitioner and in the absence of such a practitioner within the radius of 16km from the place where the offence has been committed, by any other registered medical practitioner, at request of police officer not below the rank of sub inspector, using force reasonably necessary for that purpose. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 306


Question: The technique of laparoscopic cholecystectomy was first described by

History of Laparoscopic Cholecystectomy Dr. Ku Semm, the father of 'Pelviscopy', performed the first laparoscopic appendectomy in 1980 Eric Muhe performed the first laparoscopic cholecystectomy in 1982. He used a modified operating laparoscope placed at the umbilicus after establishing pneumoperitoneun In 1987, Phillip Mouret performed the first video laparoscopic cholecystectomy by using a camera attached to the laparoscope Ref: Blumga 5th edition Pgno :512