Question: In acute inflammation endothelial retraction leads to

ref Robbins 8/e p45,9/ep74 Several mechanisms may contribute to increased vascu- lar permeability in acute inflammatory reactions: * Endothelial cell contraction leading to intercellular gaps in postcapillary venules is the most common cause of increased vascular permeability. Endothelial cell con- traction occurs rapidly after binding of histamine, bra- dykinin, leukotrienes, and many other mediators to specific receptors, and is usually sho-lived (15 to 30 minutes). A slower and more prolonged retraction of endothelial cells, resulting from changes in the cytoskel- eton, may be induced by cytokines such as tumor necro- sis factor (TNF) and interleukin-1 (IL-1). This reaction may take 4 to 6 hours to develop after the initial trigger and persist for 24 hours or more. * Endothelial injury results in vascular leakage by causing endothelial cell necrosis and detachment. Endothelial cells are damaged after severe injury such as with burns and some infections. In most cases, leakage begins immediately after the injury and persists for several hours (or days) until the damaged vessels are throm- bosed or repaired. Venules, capillaries, and aerioles can all be affected, depending on the site of the injury. Direct injury to endothelial cells may also induce a delayed prolonged leakage that begins after a delay of 2 to 12 hours, lasts for several hours or even days, and involves venules and capillaries. Examples are mild to moderate thermal injury, ceain bacterial toxins, and x- or ultraviolet irradiation (i.e., the sunburn that has spoiled many an evening after a day in the sun). Endo- thelial cells may also be damaged as a consequence of leukocyte accumulation along the vessel wall. Activated leukocytes release many toxic mediators, discussed later, that may cause endothelial injury or detachment.

Delayed transient increase in permeability

Immediate transient increase in permeability

Delayed prolonged increase in permeability

Immediate transient decrease in permeability


Question: Nerve supply of skin around the umbilicus is

A dermatome is an area of skin that is mainly supplied by a single soinal nerve. There are 8 cervical nerves (C1 being an exception with no dermatome), 12 thoraxic nerves, 5 lumbar nerves and 5 sacral nerves. Each of these nerves relays sensation (including pain) from a paicular region of skin to the brain.A dermatome also refers to the pa of an embryonic somite. T10 peains to umblicus Ref - BDC 6e vol2 pg 198-200


Question: Nerve running along with profunda brachii aery, in spiral groove

The three nerves related to humerus:-1. Axillary nerve- at surgical neck2. Radial nerve-radial/spiral groove.3. Ulnar nerve-behind medial epicondyle.SPIRAL GROOVE:-Posterior surface of humerus Lodges profunda brachial vessels and radial nerve In the spiral groove, it hives off the following branches:-Lower lateral cutaneous nerve of the arm.Posterior cutaneous nerve of forearm.Nerve to lateral head of triceps.Nerve to medial head of tricepsNerve to anconeus.At the lower end of spiral groove, the nerve pierces lateral muscular septum of the arm and enters anterior compament of the arm.{Reference: Vishram Singh page no.24}


Question: Average time interval between radiation exposure and genesis of post radiation Osteosarcoma

Post radiation OGS usually arises after 12-16years Refer post radiation Osteosarcoma


Question: Nerve fibers in greater, lesser and least splanchnic nerves are

They also provide the sympathetic innervation to the adrenal medulla, stimulating catecholamine release. The nerve travels inferiorly, lateral to the greater splanchnic nerve. Its fibers synapse with their postganglionic counterpas in the superior mesenteric ganglia, or in the aoicorenal ganglion. image ref- medscape.com


Question: Oblique cord is related to

OBLIQUE CORD:-Strong fibrous band which extends from medial side of the tuberosity of ulna to the lower pa of tuberosity of radius.Fibres directed downwards and laterally.i.e, opposite to that of interosseous membrane.Oblique cord between ulnar and radial tuberosities represent degenerated tendon of FPL muscle.{Reference: Vishram Singh, pg no. 145}


Question: Retina develops from

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:362


Question: During Sx for meningioma, the left paracentral lobule was injured. It would lead to paresis of

Ans. is 'a' i.e Rt. Leg and perineum Paracentral lobule:On the medial surface of cerebral hemisphere, the U shaped gyrus around the end of the central sulcus is the paracentral lobule.Motor cortex is located in the precentral gyrus on the superolateral surface of the hemisphere and in the anterior part of the paracentral lobule.Stimulation in this area results in movements in the opposite half of the body.The body is represented upside down in this area.A look at the motor homunculus in Ganong will show that the leg and perineum are represented in the paracentral lobule.


Question: Investigation of choice in acute cholecystitis

Investigation of choice for acute cholecystitis : USG Gold standard for diagnosis of acute cholecystitis : HIDA scan USG is investigation for acute calculous cholecystitis, chronic cholecystitis and cholelithiasis Ref: Sabiston 20th edition Pgno :1493


Question: Trichology is the forensic examination of

Examination of hair(Trichiology) can provide valuable information in crime investigation. forensic trichiology : The first step of forensic identification and comparison of hairs begins with whole mount light microscopy. The hair(s) in question must be identified as to species, race and body (somatic) origin. Human hairs can be readily distinguished from animal hairs in primarily by examining the cuticles and medullae .Individualizing human hairs is done by examining coex features and by analyzing DNA. Forensic laboratory repos of hair comparisons normally will provide one of three answers: The hairs matched in microscopic characteristics, indicating an association. The hairs are not alike and therefore did not come from the same person. No conclusion can be drawn from the evidence. This may be due to insufficient specimen, racial mixtures, or unsuitable exemplars. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE No 107


Question: At the end of 8th month, testes descend into


Question: Foot drop results as a result of injury to

FOOT DROP:- Paralysis of muscles of anterior compament of the leg due to injury to deep peroneal nerve results in loss of power of dorsiflexion of foot and eversion. As a result, foot us plantar flexed. Ankle reflex is intact.This is usually caused by injury or disease of the common peroneal nerve due to trauma, leprosy or peripheral neuritis.Sensory loss- first interdigital cleft. {Reference: BDC 6E pg no.97}


Question: Most common lesion assoasiated with pathological fractures in hand is

Majority of the pathological fractures are caused by Enchondromas Refer Management of hand fractures


Question: Bui,opliao ligLal membrane develops froui.


Question: C_C beta chemokines includes

Ref ,Robbins 8/e 62-63 ,7/e p71; 9/e p87 The eotaxins are a CC chemokine subfamily of eosinophil chemotactic proteins. In humans, there are three family members: CCL11 (eotaxin-1) CCL24 (eotaxin-2) CCL26 (eotaxin-3)


Question: Advantage of contact lens over normal glasses;

Advantages: Less magnification (5%) of the image, elimination of aberrations and prismatic effect of thick glasses wider and better field of vision, cosmetically better accepted by young persons. Disadvantages: more cost, cumbersome to wear, especially in old age and in childhood, corneal complications may occur (Inflammation/ Infection).


Question: Adverse effects that limit the use of adrenoceptors blockers include

Ref-KDT 6/e p142 Beta blockers are contraindicated in acute CHF because this can exacterbate with the hea failure. Bronchoconstriction And impairment of blood glucose response is seen with beta blockers. This agents also decreases intraocular pressure and are used for the treatment of glaucoma.

Bronchoconstriction from alpha blocking agents

Hea failure exacerbation from beta blockers

Impaired blood sugar response with alpha blockers

Increased intraocular pressure with beta blockers


Question: Auto immunity in EBV infection is the result of

Ref Robbins 8/e p212; 9/e p216 Infection with Epstein-Barr virus (EBV), the cause of infectious mononucleosis, has been associated with subsequent development of systemic lupus erythematosus and other chronic autoimmune illnesses It is due to PolyclonalB B cell proliferation and activation


Question: Mucos membrane of vagina is lined by

VAGINA HISTOLOGY Mucos membrane lining: Nonkeratinized Stratified Squamous epithelium Lamina propria: Loose connective tissue Muscle coat Fibrous coat: Connective tissue There are NO GLANDS in vaginal mucosa Vaginal fluid in acidic: Due to glycogen-fermentation by Doderlein's bacilli

Keratinized Stratified Squamous epithelium


Question: Stratum germinativum is synonymous to

Stratum basale:

Also called stratum germinativum.
Made of single layer of columnar epithelium.
Contains keratinocytes and melanocytes.


Question: The basis of combining Ritonavir with Lopinavir

Refer Katzung 10/e p810 Ritonavir is a microsomal enzyme inhibitor paicularly of CYP3A4 .it decreases the metabolism of other drugs and thus lower dose of Lopinavir can be used in treatment of HIV when combined with Ritonavir

Ability to counteract side effects of Lopinavir


Question: Paranoid pseudocommunity was given by

o Norman Cameron====== paranoid pseudocommunity SS Patient incorporates all the people who are against her thoughts as working together and are against her SS Community which is false(pseudo) and that is against(paranoid) the patient ref.Kaplon and Sadock, synopsis of psychiatry, pg no 335


Question: Ganciclovir is preferred over acyclovir in the following condition

Ref-KDT 6/e p769 Ganciclovir is the drug of choice for CMV infections. Acyclovir is highly effective against Herpes simplex and Varicellal zoster (chicken pox and herpes zoster) but it has very little activity against CMV.

Cytomegalovirus retinitis in AIDs patients


Question: T.B. testis first affects

The disease first affects the epididymis. The body of testis may remain uninvolved for years, but the contra lateral epididymis often becomes diseased. Treatment is - ATT if ds. does not resolve, epididymectomy or orchidectomy is indicated. Ref : Bailey & Love 25/e p1383


Question: Opening in prostatic sinus is

Vesiculae seminales and ampulla of ductus deferens, seen from the front. Dissection of the prostate showing the prostatic urethra. The prostatic ducts are seen opening into the prostatic sinus, which lies on either side of the urethral crest and seminal colliculus. ref - BDC vol2 pg 401-404 , semantischolar.org


Question: Subarachnoid block as anaesthesia is contraindicated in


Question: Chief extensor of knee joint in hip flexion is


Question: Mucous glands are absent in

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:359 Vagina Mucous membrane The epithelium rests on dense connective tissue that is highly vascular,many veins being present .the tissue is rich in elastic fibres.no glands are seen in the mucosa,the vaginal surface being kept moist by the secretions if glands in the cervix of the uterus


Question: glomus tumor is seen

Glomus tumor is biologically a benign tumor that arises from the modified smooth muscle cells of the glomous body Glomus body is a specialised aeriovenous anastomosis that is involved in thermoregulation It is a often painful tumor Glomus tumor are most commonly found in distal poion of the digits especially under fingernails Excision is curative Refer robbins 9/e p517


Question: Reconstructive surgery for Choledochal cyst is not done in

According to Todani Modification of Alonso-Lej classification Type III : is Cystic dilation of intra duodenal poion of common bile duct (choledochocele) Treatment : Endoscopic sphincterectomy and cyst unroofing Ref: Sabiston 20th edition Pgno :1510-1511


Question: Obsession is a disorder of thought

obsession is a disorder of thought possession the very impoant question that is asked under the subject of psychiatry is regarding obsession the impoant qualities of obsession that as to be taken from the case scenario related questions are RECCURRENT IRRELEVANT INTRUSIVE IRRESSISTABLE DISTRESSING EGO DYSTONIC THOUGHTS. Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg.192


Question: Asymptomatic, solid 4cm tumor of distal pancreas. Treatment

Resectional Surgery for pancreatic Body and Tail Tumors Most body and tail cancers have already metastasized to distant sits or extended locally to involve nodes, nerves or major vessels by the time of diagnosis Splenic vein involvement or occlusion is not a sign of nonresectability Involvement of the splenic and SMV confluence generally precludes resection Resection involves a distal pancreatectomy either with or without concomitant splenectomy Splenectomy is usually performed with distal pancreatectomy in patients suspected of having carcinoma to obtain better margins, to remove the lymph nodes at the tip of the pancreas and hilum of the spleen, and to avoid tedious dissection of the splenic aery and vein Ref: Sabiston 20th edition Pgno :1547

Near total pancreatectomy with splenectomy


Question: Esophagus enters abdomen through

Oesophageal opening
-        Level- T10
-        At muscular portion derived from right crus
-        Structures transmitted

  Oesophagus
  Oesophageal branch of left gastric artery
  Vagus nerve


Question: Crossed occulomotor palsy is seen in occlusion of


Question: Type of Collagen in Hyaline Cartilage is

Types of Collagen in different tissues
Type I - Bone, skin
Type II - Hyaline and elastic Cartilage
Type III - Skin, ligament, blood vessels
Type IV - Basement membrane in various tissue
Type V - Blood vessel wall, Synovium, corneal stroma


Question: Muscle spared in Lateral epicondyle fracture

Nerve supply to Extensor carpi radialis longus is given before the redial nerve reaches lateral epicondyle.


Question: Root of mesentery doesn't cross the following

The mesentery of the small intestine arises from the root of the mesentery and is the pa connected with the structures in front of the veebral coloumn. The root is narrow and is directed obliquely from the duodenojejunal flexure at the left side of the second lumbar veebrae to the right sacroiliac aiculation. The root of the mesentery extends from the duodenojejunal flexure to the ileocaecal junction. This section of the small intestine is located centrally in the abdominal cavity and lies behind the transverse colon and the greater omentum. Structures passed by root of mesentry ref - BDC 6e vol2 pg235


Question: steven johnsons syndrome 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 psychiaty, 11 th edition, pg no.923


Question: The joint between the attachment of the 8th and the 9th rib to the 7th rib is a

The joint between the attachment of the 8th and 9th rib with the 7th rib is a synol joint. Most of the joints in the thoracic cavity- Interchondral, sternochondral, costoveebral and costotransverse joints, are plain synol joints because the thoracic cavity needs to expand during inspiration. The exception are : 1st sternocostal joint: Synahrosis (fibrous) Interchondral joint between the 9th and 10th cailages is never synol and sometimes absent. Costochondral joints are primary cailaginous joints (Synchondrosis) Midline joints like manubriosternal and xiphisternal joints are secondary cailagenous joints of symphysis type. Ref: Gray&;s Anatomy 41st edition Pgno: 940


Question: Migratory thrombophlebitis is seen in

Malignancies associated with Migratory thrombophlebitis CA pancreas(MC) CA lung GI malignancies Prostate cancer Ovarian cancer Lymphoma Troesseau's syndrome : Migratory thrombophlebitis Ref: Robbins 9tu edition Pgno :332,126


Question: Enzymes found in CSF

The diagnostic value of cerebrospinal fluid (CSF) enzyme activities in neurological disorders has been evaluated most extensively with the enzymes aspaate aminotransferase (ASAT), lactate dehydrogenase (LDH), creatine kinase (CK) and lysozyme Refer Robbins page no chatteejee shinde 8th/730


Question: Regula vein, aery and nerve ("VAN") arrangement

BD CHAURASIA S HUMAN ANATOMY Vol1 Pg 222 Sixth edition The general arrangement of first intercostal space is vein,aery and nerve(VAN)


Question: Blood supply to middle third of vagina is

Blood is supplied to the vagina by the uterine and vaginal aeries, both branches of the internal iliac aery. Venous return is achieved by the vaginal venous plexus, which drains into the internal iliac veins, the uterine vein. Lymphatic drainage is the iliac and superficial inguinal lymph nodes. <img src=" /> ref - BDC 6e vol2 pg394


Question: Not a pa of bony labyrinth

BONY LABYRINTH:The bony labyrinth consists of three pas(a)Cochlea anteriorly (b)Vestibule,in the middle (c)Semicircular canals posteriorly REF.,BDC VOL.3


Question: Circle of willis is formed by

Middle cerebral artery doesn’t form circle of willis.

Anterior cerebral artery, posterior communicating artery, middle cerebral artery, posterior cerebral artery, internal carotid artery

Anterior cerebral artery, posterior communicating artery, internal carotid artery, anterior communicating artery, middle cerebral artery.

Anterior communicating artery, posterior communicating artery, internal carotid artery, anterior inferior cerebellar artery, anterior cerebral artery.

Anterior communicating artery, posterior communicating artery, internal carotid  artery, posterior cerebral artery, anterior cerebral artery.


Question: Dermatomal distribution of gluteal fold is through

Dermatomal distribution of gluteal fold is through s3. BD CHAURASIA S HUMAN ANATOMY SIXTH Edition Pg no 66


Question: assosiated with anorexia nervosa is

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


Question: Type of anemia caused by ileoceacal TB is

In intestinal tuberculosis the ileoceacal junctioj6is the commonest site of involvement. Ileum is the physiological site for absorption of vitaminB12 also TB is mentioned to be a cause of holi acid deficiency which is therefore going to result in Megaloblastic anemia Refer Harrison 17th/649


Question: The growth and development in the craniofacial region occurs in following order

The head first, then width of face and length (or) depth of face after wards

the width of face, then head and length (or) depth of face after wards

The length (or) depth of face then width of face and the head

The head first, length (or) depth of face and then width of face


Question: Post traumatic osteomyelitis causing organism is

Staphylococcus aureus is the most common causative organism in all age groups. Salmonella is the commonest organism in sickle cell anemia patients(diaphyseal). Psuedomonas aeruginosa is the commonest organism in drug abusers. ref : maheswari 9th ed


Question: Oligodendrocytes are impoant in

Oligodendrocytes:According to their distribution they may be of intrafscicular,or perineural. The intrafascicular cells are found in the myelinated tracts.The perineuronal cells are seen on the surface of the somata of the neurons. REF.BDC Handbook of general anatomy,4th edition


Question: The boundary of the triangle of auscultation is not formed by

Triangle of auscultation is bounded medially by the lateral border of the trapezius, laterally by scapula and inferiorly by lattismus dorsi


Question: Strongest sutural joint among the following

Lambdoid suture is a dentianlate suture joint which is strongest among the given options.


Question: Crookes hyaline body is present in

In Cushing syndrome, the normal granular,basophillic cytoplasm of the ACTH producing cells in the anterior pituitary becomes parlor and homogeneous . This is due to accumulation of intermediate keratin filaments in cytoplasm

C. Basophill cells of pituitary gland in Cushing syndrome


Question: The type of joint present between ear ossicles is

JOINTS OF EAR OSSICLES The incudomalleolar joint is a saddle joint. The incudostapedial joint is a ball and socket joint. Both of them are type of synol joints. Ref BDC volume 3,sixth edition pg 280


Question: Notochord develops by

(C) 14-21 days post conception [Grays40-184; IBS7-47# Genesis of the notochord:> Notochord develops in 3rd week.> Around the 19th day cells that invade into the primitive node region & migrate along the median line cranially from the chordal process (also known as the axial process).> On the 25th day 9 the chordal plate cuts itself off from the endoderm, which then fuses again, & forms a complete cord:# Notochord:> This is in the middle of the mesoderm, between the ectoderm and endoderm, & plays a role in the induction of the neuro ectoblast that lies over it.> Notochord plays a role in the genesis of the vertebral body & becomes the nucleus pulposus in the intervertebral disk


Question: Floor of posterior triangle of neck is formed by

Muscles forming floor of posterior triangle of neck :

 Semispinalis capitis.
 Splenius capitis.
 Levator scapulae.
 Scalenus posterior.
 Scalenus medius.

Semispinalis capitis, elevator scapulae, scalenus anterior, scalenus medius

Levator scapulae, splenius capitis, scalenus medius, scalenus anterior

Semispinalis capitis, scalenus anterior, splenius capitis, sternocleidomastoid

Levator scapulae, scalenus posterior, semispinalis capitis,scalenus medius


Question: Foot eversion is caused by (FMGE Dec 2018)

Also known as FIBULARIS LONGUS. It is muscle of lateral compament of leg. ORIGIN: Upper 2/3rd of lateral surface of fibula, head of fibula & occasionally lateral tibial condyle. INSEION: Undersurface of lateral sides of distal end of medial cuneiform & base of metatarsal I. INNERVATION: Superficial fibular nerve (L5, S1, s2) Function: eversion & plantar flexion of foot, suppo arches of foot. Muscle Origin Inseion Innervation Function a) extensor digitorum longus | anterior compament of leg. Proximal 1/2 of medial surface of fibula & related surface of lateral tibial condyle. Via dorsal digital expansions into bases of distal & middle phalanges of lateral 4 toes. Deep fibular nerve (L5, S1) Extension of lateral 4 toes & dorsiflexion of foot b) tibialis anterior | anterior compament. Lateral surface of tibia & adjacent interosseous membrane. Medial & inferior surface of medial cuneiform & adjacent surface on base of metatarsal I. Deep fibular nerve (L4, L5) Dorsiflexion of foot at ankle joint, inversion of foot, dynamic suppo of medial arch of foot c) tibialis posterior | posterior compament of leg Posterior surfaces of interosseous membrane & adjacent regions of tibia & fibula Mainly to tuberosity of navicular & adjacent region of medial cuneiform Tibial nerve (L4, L5) Inversion & plantar flexion of foot, suppo medial arch of foot while walking.


Question: Predisposing factors for skin cancer are

Ref Robbins 9/e p1155; Harrison 16/e p497 Uvrays and chronic ulcer are also the answers proliferation. Dysplasia is encountered principally in epi- thelial lesions. It is a loss in the uniformity of individual cells and in their architectural orientation. Dysplastic cells exhibit considerable pleomorphism and often possess hyperchro- matic nuclei that are abnormally large for the size of the cell. Mitotic figures are more abundant than usual and frequently appear in abnormal locations within the epithe- lium. In dysplastic stratified squamous epithelium, mitoses are not confined to the basal layers, where they normally occur, but may be seen at all levels and even in surface cells. There is considerable architectural anarchy. For example, the usual progressive maturation of tall cells in the basal layer to flattened squames on the surface may be lost and replaced by a disordered scrambling of dark basal- appearing cells (Fig. 5-6). When dysplastic changes are marked and involve the entire thickness of the epithelium, the lesion is referred to as carcinoma in situ, a preinvasive stage of cancer (Chapter 18). Although dysplastic changes often are found adjacent to foci of malignant transforma- tion, and long-term studies of cigarette smokers show that epithelial dysplasia almost invariably antedates the appear- ance of cancer, the term dysplasia is not synonymous with cancer; mild to moderate dysplasias that do not involve the entire thickness of the epithelium sometimes regress completely, par- ticularly if inciting causes are removed. Clinical Features Although most of these lesions arise in the skin, they also may involve the oral and anogenital mucosal surfaces, the esophagus, the meninges, and the eye. The following com- ments apply to cutaneous melanomas. Melanoma of the skin usually is asymptomatic, although pruritus may be an early manifestation. The most impoant clinical sign is a change in the color or size of a pigmented lesion. The main clinical warning signs are 1. Rapid enlargement of a preexisting nevus 2. Itching or pain in a lesion 3. Development of a new pigmented lesion during adult life 4. Irregularity of the borders of a pigmented lesion 5. Variegation of color within a pigmented lesion These principles are expressed in the so-called ABCs of melanoma: asymmetry, border, color, diameter, and evolu- tion (change of an existing nevus). It is vitally impoant to recognize melanomas and intervene as rapidly as pos- sible. The vast majority of superficial lesions are curable surgically, while metastatic melanoma has a very poor prognosis. The probability of metastasis is predicted by measuring the depth of invasion in millimeters of the veical growth phase nodule from the top of the granular cell layer of the overlying epidermis (Breslow thickness). Metastasis risk also is increased in tumors with a high mitotic rate and in those that fail to induce a local immune response. When metastases occur, they involve not only regional lymph nodes but also liver, lungs, brain, and viually any other site that can be seeded hematogenously. Sentinel lymph node biopsy (of the first draining node of a primary melanoma) at the time of surgery provides additional information on biologic aggressiveness. In some cases, metastases may appear for the first time many years after complete surgical excision of the primary tumor, suggesting a long phase of dormancy, during which time the tumor may be held in check by the host immune response. Recognition of the likely role of the host immune response has led to therapeutic trials of immunomodula- tors. Some impressive responses in patients with advanced


Question: Roof of the Anatomical snuff box is formed by the

Anatomical snuff box boundaries: Lateral wall Abductor pollicis longus Extensor pollicis brevis Medial wall Extensor pollicis longus Roof Cephalic vein Sup branch of radial nerve Floor Radial styloid, scaphoid, trapezium,1st meta carpal Content Radial Aery Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 893.


Question: Origin of maxillary artery


Question: Enzyme not involved in DNA replication is

Enzymes required for ReplicationEnzymes involved in DNA replicationDescriptionHelicase Unwinding of DNA in 5' to 3' direction preceding replication forks Topoisomerase Relieves torsional strain that results from helicase induced unwinding DNA primase Initiates synthesis of RNA primers DNA polymerase Enzymes derived from RNA tumor viruses that make complementary DNA copies from RNA templates Restriction endonuclease Cut DNA into fragments at specific DNA sequences DNA ligase Seals the breaks between nascent chain and Okazaki fragments DNA gyrase Introduce negative supercoils into resting DNA (Refer: Harper's Illustrated Biochemistry, 26th edition, pg no: 328, table 36-5)


Question: The ventral surface of the adult hea as seen on gross examination or radiography is comprised primarily of the

Ventral surface(sternocostal surface) of hea is contributed by - 2/3rd of right ventricle (major contributor) 1/3rd of left ventricle Right atruim and left auricle. During embryological formation of the hea, the aerial and venous ends of the hea tube are fixed in place. As fuher growth continues, the hea tube folds to the right. This greatly contributes to the ventral surface of the adult hea being comprised primarily of the right ventricle.


Question: Lamina papercea separates nose from

Ans. is 'b' i.e., Orbit The lamina papyracea is a thin pa of ethmoid.The bone lamina papyracea divides the orbit from the nose and paranasal sinuses. The orbit and the paranasal sinuses are intimately related on three sides.The lamina papyracea separates the orbit and its contents from the ethmoidal sinus.Lamina papyracea aiculates :-Above with orbital plate of frontal bone.Below with maxilla and orbital process of palatine bone.In front with lacrimal boneBehind with sphenoid.Lamina papyracea is so called as it is paper thin and fractures easily.Fracture may cause entrapement of medial rectus.


Question: Pathological gambling is included in DSM 5 under

GAMBLING DISORDER * IMPOANCE===Newly classified in DSM 5 substance use and addictive disorders * MAIN CHARECTERSTICS==Lying to conceal the extent of involvement of gambling * Commission of illegal acts to finance gambling Reliance on others to pay off debts Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no.690


Question: Most commonly affected peripheral nerve in leprosy is

Although any peripheral nerve may be enlarged (including small digital and supraclavicular nerves), those most commonly affected are the ulnar, posterior auricular, peroneal, and posterior tibial nerves, with associated hypesthesia and myopathy. Ref : Harrison 17/e p1022


Question: Primary sinusoidal dilation of liver is also known as

Hepatic sinusoidal dilatation refers to the enlargement of the hepatic capillaries. Most of the time this condition is caused by hepatic venous outflow obstruction, which results in vascular stasis and congestion of hepatic parenchyma. In this setting, hepatic sinusoidal dilatation can be related to pericardial disease, hea failure, compression or thrombosis of the hepatic veins or inferior vena cava (i.e., Budd-Chiari syndrome) or central veins/sinusoids involvement (i.e., sinusoidal obstruction syndrome). Neveheless, some extrahepatic inflammatory conditions (such as pyelonephritis, cholecystitis, pneumonia, pancreatitis, intestinal bowel disease, and others) may be associated with hepatic sinusoidal dilatation without concurrent venous outflow obstruction. On contrast-enhanced cross-sectional imaging, hepatic sinusoidal dilatation is typically characterized by a mottled, reticular enhancement of the liver, usually referred to as "mosaic" pattern. Other hepatic and extrahepatic imaging features, such us the dilatation of the hepatic veins or the presence of ascites, can help in identifying the cause of sinusoidal dilatation. ref - pubmed.com


Question: Largest lymphatic organ in the human body is

Spleen: - Largest lymphatic organ connected to blood vascular system. Acts as filter for blood Plays an impoant role in immune response of body Lies mainly in hypochondrium & paly in epigastrium Normally not palpable Supplied by splenic aery - the largest branch of celiac trunk Splenic vein is formed at hilum of spleen Splenic tissue has no lymphatics Sympathetic fibres are derived from celiac plexus Functions: - Phagocytosis Hemopoiesis Immune responses Storage of RBC.


Question: Splenic infarction is associated with


Question: For examination of fungus from a sample, uniformly stain by

PAS-periodic acid schiff stain is used for carbohydrate paicularly glycogen, ,amobea, fungi Periodic acid-Schiff (PAS) is a stainingmethod used to detect polysaccharidessuch as glycogen, and mucosubstances such as glycoproteins, glycolipids and mucins in tissues. The reaction of periodic acid oxidizes the vicinal diols in these sugars, usually breaking up the bond between two adjacent carbons not involved in the glycosidic linkage or ring closure in the ring of the monosaccharide units that are pas of the long polysaccharides, and creating a pair of aldehydes at the two free tips of each broken monosaccharide ring. The oxidation condition has to be sufficiently regulated so as to not oxidize the aldehydes fuher. These aldehydes then react with the Schiff reagent to give a purple-magenta color. A suitable basic stain is often used as a counterstain. Refer Robbins page no 8th edition 336


Question: The term infantile polyaeritis nodosa was used for

Refer robbins 9/e 506 Kawasaki disease, also referred to as Kawasaki syndrome or mucocutaneous lymph node syndrome, affects children and includes several symptoms: fever rash swelling of the hands and feet irritation and redness of the whites of the eyes swollen lymph glands in the neck irritation and inflammation of the mouth, lips and throat These effects of Kawasaki disease are rarely serious. The acute phase of the condition commonly lasts 10-14 days or more. Most children recover fully. But, in some cases, Kawasaki disease can lead to long-term hea complications.


Question: Investigation of choice on Meckel's Diveicula in pediatric age group is

In case of children 99mTc-peechnetate is preferentially taken up by the mucus secreting cells of gastric mucosa and ectopic gastric tissue in Meckel's Diveicula. In adults less ectopic gastric tissue is seen so the test is not much accurate in adults Ref: Sabiston 20th edition Pgno :1285


Question: Transformation of one epithelium to other epithelium is known as


Question: Closure of neural tube begin from

Closure of neural tube at cervical region.
Cronial neuropore closes by 25th day.
Caudal neuropore closes by 28th day.


Question: Most common cause of bilateral Proptosis is

Most common cause of either bilateral or unilateral proptosis in adults is thyroid ophthalmopathy Refer khurana 6/e


Question: Infections of the ring finger spread to the

Infections of the ring and middle spread into the mid palmar space. Index finger to thenar space Little finger spread to ulnar bursa and mid palmar space. Ref: Internet sources.


Question: Most common cause of gastric varices is

Most common cause of gastric varices : Cirrhosis Most common cause of isolated gastric varices : Splenic vein thrombosis Ref: Sabiston 20th edition Pgno : 1232


Question: Average gain in length in first year is

Length at bih- 50cms At 3 months- 60cms At 6 months- 65cms At the end of 1st yr- 75cms Hence gain in length in first year is (75-50= 25cms) Ref: Ghai,9th edition, Table 2.1


Question: As viewed from the right atrium, the floor of the fossa ovalis is formed by

Fossa oavlis represents the site of embryonic spectum primum hence from right atrium its seems to be developed from septum primum. BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1. 6TH EDITION.PAGE NO 255


Question: Most common Paraneoplastic syndrome of HCC

Para neoplastic syndromes in HCC Hypocholesterolemia(most common) Hypoglycemia Erythrocytosis Hypercalcemia Ref:Sabiston 20th edition Pgno : 1458-1463


Question: Triangle of Koch is not formed by

Triangle of Koch is formed by

Tendon of Todaro
Coronary sinus
Septal Cusp of Tricuspid valve


Question: Guanidine special group is presesnt in

AMINO ACID SPECIAL GROUP Arginine Guanidinium Proline Pyrolidine Tryptophan Indole Phenylalanine Benzene Tyrosine Phenol Histidine Imidazole Methionine Thioether linkage Reference: Harpers illustrated biochemistry 30th edition


Question: 40 yr old male presented with cirrhosis. Special stain used here is


Question: Frig causing maximum peripheral neuropathy is

Refer WHO recommendations to treat adult and adolescent HIV/76 Stavudine b has maximum incidence of peripheral neuropathy whereas didanosine is associated with maximum risk of acute pancreatitis


Question: Congenital long QT syndrome can lead to

Polymorphic VT has a continually changing QRS morphology indi- cating a changing ventricular activation sequence. Polymorphic VT that occurs in the context of congenital or acquired prolongation of the QT interval often has a waxing and waning QRS amplitude creat- ing a "twisting about the points" appearance referred to as Torsade de Pointes Ref Harrison 20th edition pg 1445


Question: Oil red Or staining is used for

ref Bancroft histology 7/e p83 Fresh cryostat sections must be used for oil red o stain


Question: Arrange the following structures in the order they are pierced during lumbar puncture.(SEQUENTIAL ARRANGEMENT) a)Epidural space b)Interspinous ligament c)Supraspinous liament d)Ligamentum flavum e)Subarachnoid space

Lumbar puncture in adult: Pt lying on side with maximally flexed spine A line taken between highest points of axis at L4 level Skin cleaned & anesthetised Spinal needle inseed between L4 - L5 veebrae Structures pierced: skin, fat, supraspinous & interspinous ligaments, ligamentum flavum, epidural space, dura, arachnoid, subarachnoid space. CSF


Question: Nasolacrimal duct opens into

Nasolacrimal duct begins at the lower end of the lacrimal sac, runs downwards, backward and laterally, opens into the inferior meatus the nose. Fold of mucous membrane called the valve of Hasner forms an imperfect valve at the lower end of the duct. Ref.BDC volume 3;sixth edition pg no 77


Question: The lymphatic drainage of  testes is

Blood Supply and Lymphatic Drainage. The testis and epididymis are supplied by the testicular artery, and their veins drain into the pampiniform plexus, which forms the bulk of the spermatic cord. The veins of the pampiniform plexus often become varicose, a condition termed varicocele.


Question: Cyanosis NOT improving with 100% oxygen in case of

Presence of cyanosis that does not improve with supplemental oxygen suggest true pathological cardiac or pulmonary shunting of blood . Ref Harrison 19th edition pg 1248-49


Question: The cranial nerve with the largest intra cranial course is


Question: Age group affected by Osteosarcoma

This is predominantly a tumor of childhood or adolescence, occurring most commonly in the 10-25years Refer Maheshwari 6tg/e p 239


Question: assosiated with OCD 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: Inhibitors of apoptosis is


Question: Sec 174CrPC deals with

Police inquest The officer in charge of police station conducts the inquest(Sec 174CrPC). The police officer conducting the inquest is called the investigating officer. Police officer may summon persons for investigation purpose according Sec 175Cr PC. Refusak of the summons is punishable upto 6 months and fine upto 1000 rupees. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 7


Question: Visual area of coex is supplied by

Occipital lobe or visual coex is supplied by posterior cerebral aery Ref: Gray's40e/p-256


Question: Adenosine deaminase deficiency is seen in

Ref Robbins 8/e p244, 9/e p239 Adenosine deaminase (ADA) deficiency is an inherited disorder that damages the immune system and causes severe combined immunodeficiency (SCID). People with SCID lack viually all immune protection from bacteria, viruses, and fungi. They are prone to repeated and persistent infections that can be very serious or life-threatening. These infections are often caused by "oppounistic" organisms that ordinarily do not cause illness in people with a normal immune system


Question: Most common cause of liver abscess in chronic granulomatous disease

Pyogenic liver abscess in children In children Staphylococcus PLA is most common Occurs in the setting of chronic granulomatous disease disorder of granulocyte function and hematologic malignancies In chronic granulomatous conditions, abscess are dense and thick, early excision and treatment with antibiotics against Staphylococcus aureus is recommended Ref: Sabiston 20th edition Pgno : 1445-1449


Question: The complication least likely to occur in a pseudocyst of the pancreas

Pseudocyst complications Infection (MC) :14% Pain due to expansion Hemorrhage upto 10% Duodenal obstruction Rupture Abscess Ref: Shackelford 7th edition Pgno :1159


Question: Mechanism of action of digitalis in atrial fibrillation is

(Ref: KDT 6/ep502) Digitalis acts in CHF by inhibiting Na+-K+-ATPase whereas in AF, it acts by decreasing the conduction through AV node.

Increase in refractoriness of AV nodal tissue


Question: Nerve supply of the tympanic membrane is by the


Question: Epithelial lining of urinary bladder is

Urinary bladder is lined with transitional epithelial tissue that is able to stretch significantly to accommodate large volumes of urine. The transitional epithelium also provides protection to the underlying tissues from acidic or alkaline urine. ref - BDC 6e vol2 pg380


Question: Sensory supply of larynx, below the vocal cord

Sensory supply: The internal laryngeal nerve supplies the mucous membrane upto the level of the vocal folds. The recurrent laryngeal nerve supplies it below the level of the vocal folds. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following

"The posterior surface of the stomach is related to structures forming the stomach bed, all of which are separated from the stomach by the cavity of the lesser sac." Thus an ulcer on the posterior wall of the stomach would perforate into the lesser sac. Also, remember Most perforated ulcers are located on the anterior wall. The moality rate for a perforated gastric ulcer is higher than that for duodenal ulcer. This is generally due to the gastric ulcer patients' more advanced age, increased medical comorbidities, delay in seeking medical attention, and the larger size of gastric ulcers. Ref : CSDT 13/e p498


Question: Epithelium of ureter develops from

Epithelium of ureter developed from Mesonephric duct as the ureteric bud. Ref: Gray's 39e/p-1289


Question: The period of embryo extends

From the first week till the eighth week

From the period of ovum till the tenth week


Question: Maximum Infant Moality Rate is seen in

State (2014)IMR / 1000Tamil Nadu20Orissa/Odisha49Maharashtra22Kerala12Madhya Pradesh52(Refer: K. Park's Textbook of Preventive and Social medicine, 24thedition, pg no:604)


Question: In the lungs, bronchial arteries supply the bronchopulmonary tree

bronchial artery supplies bronchial tree till respiratory bronchiole.


Question: AA Direc acting cholinometic that is lipid soluble and has been used in the treatment of glaucoma is

Ref-KDT 6/e p98 Pilocarpine is a directly acting and physostigmine is an indirectly acting cholinomimetic useful for glaucoma


Question: Hofbauer cells are tissue macrophages of

Hoffbauer cells are the tissue macrophages of placenta


Question: Most common coronary artery to undergo atherosclerosis is

Most common coronary artery to undergo atherosclerosis is Left anterior descending artery


Question: Fetal midgut rotates in IUL

During development, midgut undergoes rapid phase of growth in which loops of midgut herniate outside the abdominal cavity of fetus & protrude into umbilical cord This is PHYSIOLOGICAL UMBILICAL HERNIA (occurs at 6 weeks of IUL) At week 10, it comes back to abdominal cavity. When midgut is Herniating into umbilicus, it follows superior mesenteric aery Thus, superior mesenteric aery becomes axis of rotation. While entering umbilical cord there is: 1. High point: duodenojejunal junction (small intestine). 2. Low point: ileocecal junction (large intestine) * Which rotates 1st 90 degree anti- clock wise resulting in small intestine to right side & large intestine to left side. While coming back to abdominal cavity, there would be another 180 degree anti - clock wise rotation. : Total of 270 degree anti-clock wise rotation occurs during development of midgut in IUL Duodenum become C - shaped and have 4 pas and colon will also have 4 pas (Ascending, transverse & descending & sigmoid colon).


Question: Bradykinin is for

Ref Robbins 8/e p65; 7/e p45,9/e p89 Bradykinin is a potent endothelium-dependent vasodilator and mild diuretic, which may cause a lowering of the blood pressure. It also causes contraction of non-vascular smooth muscle in the bronchus and gut, increases vascular permeability and is also involved in the mechanism of pain.


Question: Sternum attached to scapula (FMGE Dec 2018)

By forming sternoclavicular joint & Acromioclavicular joint, clavicle connects sternum (Axial skeleton) to scapula (Appendicular skeleton). Clavicle transmits the weight / force of appendicular skeleton to axial skeleton. acromioclavicular ligament is impoant in this. That's why clavicle is most commonly fractured bone in body -Sternum contains - Manubrium - Body - Xiphoid process * Manubrium of sternum: angled posteriorly on body of sternum at manubriosternal joint, forms sternal angle which is major surface landmark used by clinicians in physical examination. * RIBS: All ribs aiculate with thoracic veebrae posteriorly, most ribs (II to IX) have 3 aiculations with veebral column. anteriorly, costal cailages of ribs I to VII aiculate with sternum, VIII to X aiculate with inferior margins of costal cailage above them, XI & XII floating ribs - because they do not aiculate with ribs, costal cailage or sternum


Question: Pulsations of the following aery can be felt over the zygoma

The superficial temporal aery enters scalp in front of root of zygoma and divides into anterior and posterior branches.The pulsations of the facial aery can be felt 1.25 cm lateral to the angle of the mouth.Reference: Textbook of anatomy, head neck, and brain, Vishram Singh, 2nd edition, page no.49


Question: Alpha 1 anti trypsin deficiency is seen in

Alpha 1 anti trypsin deficiency is associated with panacinar emphysema Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. Refer robbins 9/e p466


Question: Association fibres are A/E


Question: Lateral boundry of ischiorectal fossa is formed by

Boudaries of ischiorectal fossa
Anterior - Perineal membrane
Posterior - Gluteus maximus
Lateral - Obturator internus
Medial - External anal sphincter and levator ani


Question: Deep nucleus of cerebellum

Nucleus of cerebellum (Lateral to medial ):Dentate, emboliform, globose &fastigial Cerebellar nuclei function Dentate working with lateral pa Co-ordinate movement of joint Fastigial working with central vermis Saccadic eye movement. Interposed nuclei (emboliform & globose) working with para vermal area Feedback mechanism from joints to have proper co- ordination of joint. Caudate nucleus and Lentiform nucleus (inner Globus pallidus + outer putamen) are Basal ganglia nuclei.


Question: ANCA antibody with peripheral rim distribution is indicative of

Ref 9/e p219,8/e p214,7/e 228 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,


Question: According to strasberg classification, lateral CBD injuries are classified as

Strasberg classification of Laparoscopic Biliary injuries Type A- Bile leaks from minor ducts still in continuity with the CBD IIncludes leakage from cystic duct stump and from a subvesical duct of Luschka. MC cause of biliary leaks seen after cholecystectomy. Type B- Occlusion of a pa of the biliary tree, almost always an aberrant right sectoral duct Type C- Transection without ligation of an aberrant right sectoral duct. Type D- A lateral injury to an extrahepatic duct. Type E- Includes biliary strictures, divided into E1 to E5 as classified by Bismuth Ref: Sabiston 20th edition Pgno :1502


Question: The immunosuppressant action of cyclosporin appears to be due to

Ref-KDT 6/e p838,839,840 Cyclosporine and tacrolimus acts by inhibiting calcineurin, which is involved in the activation of NFAT. Final result of this process is increased transcription of IL-2 gene. Sirolimus does not inhibit the transcription of IL-2 but interferes with its action. It inhibits the enzyme tyrosine kinase, known as mTOR (which is activated by IL-2).

Blockade of tissue response to inflammatory mediators

Inhibition of Gene transcription of interleukin


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

In about 10% of heas,the right coronary is rather small and is not able to give the posterior interventricular branch. In these cases the circumflex aery,the continuation of left provides the posterior interventricular branch and called left dominant. <img src=" /> B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME1 SIXTH EDITION Page no:265


Question: In left oblique breech presentation head engages in

Head in breech engages in opposite oblique diameter as that occupied by buttocks.since breech is in left oblique hence head will engage in right oblique diameter


Question: Persistence of omphalomesenteric duct is (JIPMER May 2019)

- Omphalomesenteric duct present inside the umbilical cord of baby is also called as vitello-intestinal duct * Yolk sac - forms gut tube (foregut, midgut & hindgut) * Midgut would be communicating with yolk sac by a duct called vitello-intestinal duct * This duct would be obliterated in course of time; if not results in Meckel's anomaly. (diveiculum/ fistula/ sinus/ cyst etc) present at anti-mesenteric border * Baby will be born with fecal matter at the umbilicus. * Meckel's anomaly - True anomaly as it has all the layers of the gut tube. - presented with pain at umbilicus (referred pain of midgut) Omphalomesenteric duct anomalies Meckel's diveiculum 98% of omphalomesenteric duct anomalies Meckel's diveiculum connected to the umbilicus by a fibrous cord Umbilical cyst. A fibrous cord connecting the ileum to the umbilicus predisposes to volvulus and bowel obstruction Umbilicoieleal fistula: Patent omphalomesenteric duct, resulting in fecal drainage from the umbilicus.


Question: Gerlach tonsil in Waldayer&;s ring is

A collection of lymphoid tissue is present in the nasopharynx, behind the tubal opening. It is called the tubal tonsil, also known as Gerlach's tonsil. It is continuous with the lateral pa of the pharyngeal tonsil. In Waldeyer's lymphatic ring, the most impoant aggregations are the right and left palatine tonsils. Posteriorly and above there is the pharyngeal tonsil; laterally and above there are the tubal tonsils, and inferiorly there is the lingual tonsil over the posterior pa of the dorsum of the tongue. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Agent of Chancroid is

Chancroid is an STD that presents as a genital ulcer. It is caused by H.ducreyi


Question: Treatment of choice in SSPE is


Question: Psammoma bodies are seen in

Refer Robbins page no Papillary carcinoma arr recognised based on nulcear6 features even in the absence of papillae. Psmmamoma bodies are a characteristic feature of papillary cancers these neoplasm often metastasizw6 by way of lymphatics, but the prognosis is excellent


Question: Physiological unlocking is caused by

Locking is produced by continued action of the same muscles that produce extension, i.e. the quadriceps femoris (the vastus lateralis, vastus medialis , vastus intermedius and the rectus femoris ). The locked knee joint can be flexed only after it is unlocked i.e., by lateral rotation of the femur. Unlocking is brought about by the action of the popliteus muscle. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 2, pg. no. 157


Question: Damage to the internal laryngeal nerve results in


Question: A Lymph node biopsy is taken in the posterior triangle of the neck. The most likely nerve damage occure

i.e. (Accessory): (843- Snell 8th) (132-133- BDC-8 5th ed)When a superficial incision is made in the posterior triangle, the nerve most likely to be injured is spinal accessory nerve, because it runs through a tunnel in the fascia forming the roof of the triangle.In the posterior triangle of the neck, the spinal part of the accessory nerve is relatively superficial as it emerges from the posterior border of the stemocleido mastoid and runs down ward and back ward to pass beneath the anterior border of the trapezius.POSTERIOR TRIANGLEThe posterior triangle is bounded posteriorly by the trapezius muscle, anteriorly by the sternocleidomastoid muscle and inferiorly by the clavicle. The posterior triangle of the neck is further subdivided by the inferior belly of the omohyoid muscle into a large occipital triangle above and a small supraclavicular triangle below.Nerves in the posterior triangle of neck (only motor nerve)* Spinal accessory nerve* Two small branches to levator scapulae* Nerve to Rhomboide* Nerve to serratus anterior* Nerve to subclavius* Suprascapular nerve


Question: BIRADS stands for

Category 1 Incomplete assessment, need additional imaging evaluation Category 2 Negative, routine mammogram in 1yr is recommended Category 3 Benign findings, routine management in 1 year is recommended Category 3 Probably benign findings, sho term follow up suggested Category 4 Suspicious abnormality, biopsy should be considered Category 5 Highly suggestive of malignancy, appropriate action should be taken Category 6 Known biopsy - proven malignancy


Question: Cervical veebra is differentiated from the thoracic veerbra by the presence of


Question: Aqueous humor is produced by the

Aqueous humor is produced by the ciliary processes of the ciliary body. It flows from the posterior chamber, through the pupil, into the anterior chamber, and finally to the canal of Schlemm, which empties into the extraocular/episcleral veins.


Question: The fascia around the nerve bundle of brachial plexus is derived from

The fascia around the brachial plexus is called axillary sheath and is a derivative of preveebral fascia Axillary sheath covers brachial plexus and axillary vessels Axillary sheath localises the anesthetic solution to the nerve plexus. Ref : Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 777


Question: Most common lymphoma associated with Sicca syndrome is


Question: Deep peroneal nerve supplies

DEEP PERONEAL:- Muscular branches to muscles of anterior compament of leg: Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus teius.Extensor digitorum brevis Cutaneous: dorsal digital nerves for adjacent sides of big toe and second toe. Aicular branches: Ankle joint, tarsal joints, tarsometatarsal joints and metatarsophalangeal joint of big toe. {Reference:BDC 6E }


Question: Superior parathyroid glands are derived from

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:136 Depament of parathyroid glands Parathyroid glands are derived as follows: The inferior parathyroid glands develop from endoderm of the third pharyngeal pouch The superior parathyroid glands develop from the endoderm of the fouh pharyngeal pouch


Question: F00 in ICD 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 of diseases, 10 th edition


Question: Movement of shoulder joint is controlled by

Nerue Supply to shoulder joint Axillary nerve.(C5,C6) Musculocutaneous nerve.(C5,C6,C7) Suprascapular nerve. Ref - BDC 6the p 144


Question: Alkalinization of urine is required for decreasing poisoning due to

For acidic drug poisoning like (barbiturates, salicylates and methotrexates) ,urinary alkinization agents are prescribed where as basic drug poisoning (morphine, amphetamine ,atropine etc) urinary acidification agents are prescribed. Refer Ltd 7/e p29


Question:
The suture between the two halves of the Frontal
bones is

Frontal bone ossifies in membrane.
It develops from 2 centres near frontal eminences, during 8th week of intrauterine life.
At birth, the bone is in 2 halves, separated in the midline by a suture, known as metopic suture, which soon starts to fuse.
The metopic suture occasionally persists in 3 to 8% of individuals.


Question: The upper 1/3rd of vagina develops from

Upper 1/3rd of vagina develops from uterovaginal canal(mesoderm) which is the union of lower veical pa of paramesonephric or mullerian duct. Lower 2/3rd of vagina develops from paramesonephric or mullerian tubercle arises from endoderrm of definitive urogenital sinus which gives two solid evagenations. The 2 solid evagenations growup and form sinovaginal bulb and then the 2 sinovaginal bulbs fuse together forming a thick cellular plate called the vaginal plate .


Question: In presence of secondary sexual characters cause screening for primary amenorrhea is done at

Primary amenorrhoea is defined as the absence of secondary sexual characters by 14 yrs of age or absence of menarche in the presence of secondary sexual characters till 16 yrs of age, In the sequence of pubeal development the changes are as follows thelarche, increased growth spu, pubarche, menarche. As menarche is the last stage ,in case secondary sexual characters have developed to account for constitutional delay investigation is begun at 16 years.


Question: Coronary sinus is guarded by

Opening of coronary sinus is guarded by thebesian valve. BD CHAURASIA'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.Page no -255


Question: Metabolism of a drug primarily results in

Ref-Katzung 10/e p50 After metabolism most of the drugs become inactive and their excreted through the kidney. Lipids soluble drugs wil be reabsprbed whereas water soluble drugs are easily excreted.thus, metabolism of drugs helps in the conversion of liquid soluble drugs to water soluble metabolites

Conversion of prodruv to active metabolite

Conversion of lipid soluble drugs to water soluble metabolites

Conversion of water soluble drugs to lipid solible metabolites


Question: Upper border of thyroid cailage is at

The thyroid gland lies against veebrae C5, C6, C7 and T1 embracing the upper pa of the trachea Each lobe extends from the middle of cailage to the fouh or fifth tracheal ring The isthmus extends from second to the fouh tracheal ring Ref BDC volume3,6th edition pg 140


Question: The lymphatic drainage to central pa of the lip is

Submental lymph nodes: these are three or four nodes situated across the midline below the chin in the submental triangle. Lymphatics of the central pa of the lower lip drain to the submental nodes,the lymphatics from the rest of the lower lip pass to the submandibular nodes. REF.BDC VOL.3,FIFTH EDITION


Question: The immunoglobulin involved in type 1 hypersensitivity reactions is

Ref Robbins 9/e p202 Immediate hypersensitivity is a tissue reaction that occurs rapidly (typically within minutes) after the interaction of antigen with IgE antibody that is bound to the surface of mast cells in a sensitized host. The reaction is initiated by entry of an antigen, which is called an allergen because it triggers allergy. Many allergens are environmental substances that are harmless for most persons on exposure. Some people apparently inherit genes that make them susceptible to allergies. This susceptibility is manifested by the propen- sity of such persons to mount strong TH2 responses and, subsequently, to produce IgE antibody against the aller- gens. The IgE is central to the activation of the mast cells and release of mediators that are responsible for the clinical and pathologic manifestations of the reaction. Immediate hypersensitivity may occur as a local reaction that is merely annoying (e.g., seasonal rhinitis, or hay fever), severely debilitating (asthma), or even fatal (anaphylaxis).


Question: In klumpke's paralysis nerve roots involved are

In klumpke's paralysis lower trunk of brachial plexus is involved that is mainly T1 and paly C8. C6 is mainly involved in Erb's paralysis along with C5. B D Chaurasia 7th edition Page no: 59


Question: Physiological locking is

A i.e., Internal rotation of femur over stabilized tibia

Internal rotation of tibia over stabilized femur

External rotation of tibia over stabilized tibia

External rotation of femur over stabilized tibia


Question: Triangle of doom is bounded by A/E


Question: Hea failure cells are seen in

Ref Robbins 8/e p535, 7/e p122,9/e p116 Cut surfaces of hyperemic or congested tissues feel wet and typically ooze blood. On microscopic examination, acute pulmonary congestion is marked by blood-engorged alveolar capillaries and variable degrees of alveolar septal edema and intra-alveolar hemorrhage. In chronic pulmo- nary congestion, the septa become thickened and fibrotic, and the alveolar spaces contain numerous macrophages laden with hemosiderin ("hea failure cells") derived from phagocytosed red cells


Question: Following resection of 2/3rd of the liver, regeneration is complete within

Following resection of 2/3rd of liver, regeneration is complete within 5-6 months


Question: Best suture for common bile duct is

Synthetic absorbable suture such as vicryl is preferred for CBD Vicryl sutures are used in general soft tissue approximation and vessel ligation Non absorbable sutures ordinarily remain when they are buried within the tissues. This can cause late complications such as the development of gallstones around Non-Absorbable sutures in the CBD or bladder stones in the urinary bladder. In these situations it is best to use absorbable materials Ref: Shackelford 7th edition Pgno : 2222-2224


Question: Burr cell is seen in

Ref Tejinder Singh 1/e p38, robbins 9/e pg 418 Other causes of microangiopathic hemolytic anemia include malignant hypeension, systemic lupus erythematosus, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and disseminated cancer. The morphologic alterations in the injured red cells (schistocytes) are striking and quite characteristic; "burr cells," "helmet cells," and "triangle cells" may be seen Burr Cell Uremia at 40x Magnification.Uremia is a condition in which urea and other nitrogenous substances accumulate to an abnormally high level in the blood. ... Some cases of uremia have also been associated with abnormal red blood cells, such asechinocytes, which are often better known asburr cells.


Question: Capillary refill time in a child with shock 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: Cell matrix adhesion are mediated by

ref, Robbins 8/e p96;9/ep24 The cell adhesion molecules are classified into four main families: Immunoglbulin family CAMs Cadherins Selectins


Question: The initial investigation of choice for a post cholecystectomy biliary stricture is

Computed Tomography CT is probably the best initial study, the results which help direct fuher investigations A good quality CT scan shows a dilated biliary tree and helps localise the level of ductal obstruction in patients with strictures CT identities fluid collections or ascites, which may suggest the possibility of vascular damage Other Radiological investigations in post cholecystectomy bile duct injury Duplex ultrasonography Percutaneous transhepatic cholangiography Magnetic resonance cholangiopancreatography. ERCP Isotopic scanning techniques Aretriography and delayed phase poography Ref: Blumga 5th edition Pgno :627


Question: Most common cause of biliary stricture is

Most common cause of benign biliary stricture is laparoscopic cholecytectomy I.e., operative trauma Incidence of bile duct injury during laparoscopic cholecystectomy is 0.3-0.85 % Ref:Sabiston 20th edition Pgno :1502


Question: Remnants of Wolffian ducts in a female are found in

Ganer's ductwhich is a remnant of wolffian duct, is present inbroad ligament.


Question: Order of structures in Porta hepatis are

Arrangement of structures at Porta hepatis from anterior to posterior
 = Bile duct
 = Hepatic artery
 = Portal vein

= Right anterior - Portal vein ;  = Posterior hepatic artery ;  = Left anterior - Bile duct

= Right anterior - Bile duct ;  = Posterior - Hepatic artery ;  = Left anterior - Portal vein

= Right anterior - Portal vein ;  = Posterior - Bile duct ;  = Left anterior - hepatic artery

= Right anterior - Hepatic artery ;  = Posterior -Posterior Vein ;  = left anterior - Bile duct


Question: Strasberg'e class 'B' bile injury means

Strasberg classification of Laparoscopic Biliary injuries Type A- Bile leaks from minor ducts still in continuity with the CBD Includes leakage from cystic duct stump and from a subvesical duct of Luschka. MC cause of biliary leaks seen after cholecystectomy. Type B- Occlusion of a pa of the biliary tree, almost always an aberrant right sectoral duct Type C- Transection without ligation of an aberrant right sectoral duct. Type D- A lateral injury to an extrahepatic duct. Type E- Includes biliary strictures, divided into E1 to E5 as classified by Bismuth Ref: Sabiston 20th edition Pgno :1502

Injury of bile duct not in communication with CBD

Circumferential injury to major bile ducts


Question: Cochleate uterus is

Cochleate uterus: A small adult uterus with a conical cervix and a body that is small, globular, and acutely flexed. ref - pubmed.com


Question: Transverse ulcers are seen in

Robbins page no Pg p376 This very rare affection of unknown origin, achieves a macroscopic and microscopic aspect similar to that described by Cruveillhier at the level of the stomach. The authors present a case of ulcer located on the transverse colon, at the free margin, with stenosing evolution and coexisting with duodenal ulceration of chronic character. The patient also had poal hypeension in the third stage and aeriopathy that had been diagnosed previously. Macroscopically, TB classically causesulceration, sho strictures, marked thickening of the bowel wall due to inflammation, fibrosis and adhesions, or a combination of these. The ulcers are transverse, often circumferential, with ill-defined, sloping or overhanging edges


Question: Best diagnostic method for breast lump is

First investigation for tissue sampling : FNAC Best and diagnostic investigation : Biopsy Ref: Sabiston 20th edition Pgno: 826-828


Question: Immunostimulant used for the treatment of malignant Melanoma Norma is

Ref-Katzung 10/e p906 It is a recombinant IL-2 used for the treatment of renal cell carcinoma and malignant melanoma


Question: Facial muscles are derived from


Question: Sphincter and dilator pupillae develop from

Muscles of the iris (sphincter and dilator papillae) and myoepithelial cells of the sweat glands are derived from ectoderm.Ref: Human Embryology; Inderbir Singh; Tenth edition; Page no:113


Question: Prognosis of poocaval shunt depends on

Prognosis of poocaval shunt depend on child's criteria ( Bilirubin, albumin, ascites, PT, encephalopathy) Ref: Sabiston 20th edition Pgno : 1436


Question: In stratified squamous epithelium, the basal layer of cells are

Stratified squamous epithelium Superficial layer - squamous Middle layer - Cuboidal Basal layer - Columnar Only one layer is in contact with the basement membrane, remaining layers adhere to each other maintaining the integrity. Ref: IB Singh textbook of histology 6e pg 45.


Question: In femoral triangle the most medial structure seen is

Femoral canal (Femoral sheath)
                      -        Medial compartment

   Opening - Femoral ring
   Content - Lymph nodes of Cloquet/Rosenmuller, Lymphatics, fat, areolar tissue.

 -        Intermedius compartment

   Content - femoral vein

 -        Lateral compartment

   Content - femoral artery, femoral branch of genitofemoral nerve

 Femoral ring Formation
-        Anterior - Inguinal ligament
-        Medial - Lacunar ligament
-        Posterior - Pectineus with fascia
-        Lateral - septum separating it from femoral vein


Question: Second constriction of oesophagus lies at the level of

(A) (Where aortic arch Crosses) (282-BDC-16(tm))CONSTRICTIONSNormally the oesophagus shows 4 constrictions at the following levels1. At its beginning 15 cm/6 inch form the incisor teeth where it is crossed by cricopharyngeus muscles2. Where it is crossed by the aortic arch, 22,5cm /19 inch from the incisor teeth3. Where it is crossed by the left bronchus, 27.5cm /11 inch from the incisor teeth4. Where it pierces the diaphragm 37.5 cm/15 inch from the incisor teethOESOPHAGUS* About 25 cm long (10 inch)* The pharyngo-oesophageal junction is the commoned part of the alimentary canal except for the vermiform appendix* It passes through the diaphragm at the level of the 10th thoracic vertebra to join the stomachImportant features of esophagus* Epithelium is stralified squamous non * keratinized epithelium* Muscularis mucosa contains only longitudinal layer and no circular layer* Mucosa is the toughest and strongest layer *** Serosa is absent* Muscmaris extern is made up skeletal muscle fibre only in the upper ihird, smooth muscle only in the lower third and both types of muscle fibres in middle third. At uppen end the longitudinal coat split into two bundles and the triangular interval between them is called Laimer's triangle which is filled with circular muscle fibers* Extent of esophagus is -C6 -T i j* Trachea bifurcates at carina, at the level of lower border of T4 or T4-T5 disc spaces* Oesophageal opening transmits1. Oesophagus2. Gastric or vagus nerve3. Oesophageal branches of the left gastric artery. With some oesophageal veins* Arterial supply- Upper third -inferior thyroid artery **- Middle third - Oesophageal branches of the ** descending thoracic aorta- Lower third - Left gastric artery **


Question: Aerial anastomosis around the shoulder is between

-Aerial anastomosis around the scapula is principally formed by the first pa of subclan and third pa of axillary aeries. -These anastomosis takes place at 2 sites :around the body of the scapula and over the acromion process of the scapula. -If the subclan and axillary aeries are blocked anywhere between these 2 sitesscapular anastomosis serves as a potential pathway of collateral circulation to ensure adequate blood supply to the upper limb -Reference: Textbook of anatomy,Upper limb and thorax, Vishram Singh, 2nd editon, page no.51

2nd pa of subclan aery with 2nd pa of axillary aery

1st pa of subclan aery with 3rd pa of axillary aery

3rd pa of subclan aery with 1st pa of axillary aery

3rd pa of subclan aery with 3rd pa of axillary aery


Question: Innermost layer of retina is composed of


Question: MCH restriction to antigen presentation is not done for

Ref Robbins 9/e p231-233 Immune Recognition of Allografts Rejection of allografts is a response mainly to MHC molecules, which are so polymorphic that most individuals in an outbred population differ in at least some of the MHC molecules they express (except, of course, for identical twins). There are two main mechanisms by which the host immune system recognizes and responds to the MHC mol- ecules on the graft (Fig. 4-23): * Direct recognition. Host T cells directly recognize the allo- geneic (foreign) MHC molecules that are expressed on graft cells. Direct recognition of foreign MHC seems to violate the rule of MHC restriction, which states that in every individual, all of the T cells are educated to recog- nize foreign antigens displayed by only that individual's MHC molecules. It is postulated that allogeneic MHC molecules (with any bound peptides) structurally mimic self MHC and foreign peptide, and so direct recognition of the allogeneic MHC is essentially an immunologic cross-reaction. Because DCs in the graft express high levels of MHC as well as costimulatory molecules, they are believed to be the major culprits contributing to direct recognition. The most impoant consequence of direct recognition is the activation of host CD8+ T cells that recognize class I MHC (HLA-A, -B) molecules in the graft. These T cells differentiate into CTLs, which kill the cells in the graft. Host CD4+ helper T cells may be trig- gered into proliferation and cytokine production by rec- ognition of donor class II MHC (HLA-D Indirect recognition. In this pathway, host CD4+ T cells recognize donor MHC molecules after these molecules are picked up, processed, and presented by the host's own APCs. This sequence is similar to the physiologic processing and presentation of other foreign (e.g., microbial) antigens. The activated CD4+ T cells then recognize APCs displaying graft antigens and secrete cytokines that induce inflammation and damage the graft. The indirect pathway is also involved in the pro- duction of antibodies against graft alloantigens; if these antigens are proteins, they are picked up by host B cells, and peptides are presented to helper T cells, which then stimulate antibody responses.


Question: Antibody used in treatment of RSV infection

Ref Harrison 19 th ed pg 923,1206 Palivizumab is a recombinant humanized,monoclo mon IgG antibody directed against the RSV fusion protein.


Question: In walking, gravity tends to tilt pelvis and trunk to the unsuppoed side, major factor in preventing this unwanted movements

Gluteus medius and minimus prevent the tilting of pelvis on the unsuppoed side Gluteus medius and minimus supplied by superior gluteal nerve


Question: The blood supply to femoral head is mostly by

The blood supply of the Femoral Head is derived mainly from retinacular aeries which are the branches of Medial Circumflex Femoral Aery .


Question: One of the following nerves is not related to parotid gland

Posterior superior alveolar nerve is not related to parotid gland.

Posterior superior alveolar branch of maxillary nerve


Question: In inversion of foot plantar surface faces

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:- Inversion :Tibialis anterior Tibialis posterior,FHL ,FDL eversion: peroneus longus and brevis {Reference:BDC 6E}


Question: Labourer's nerve is

(A) Median # MEDIAN NERVE controls the coarse movements of the hands, as it supplies most of the long muscles of the front of the forearm and therefore called the 'labourer's nerve'.EPONYMOUS NAMENERVE* Vidian nerveNerve of Pterigoid canal* Musician's nerveUlnar nerve* Labourer's nerveMedian nerve* Arnold's nerve or Alderman's N.Auricular branch of vagus* Nerve of Bell or Long thoracic N.Nerve to serratus anterior (Bell's palsy = LMN paralysis of Facial Nerve)* Nerve ErigentesParasympathetic outflow from Sacral plexus - S2,3,4* Nerve of KuntzGrey ramus running upwards from 2nd thoracic ganglion to 1st thoracic nerve* Jacobson's nerveTympanic branch of Glossopharyngeal nerve* Hering's nerveNerve transmitting impulses from carotid bodies to glossopharyngeal nerve* Thickest cranial nerveTrigeminal nerve* Thickest cutaneous nerveGreater occipital nerve


Question: Medical management of hydatid disease is indicated in

Chemotherapy without definitive resection or drainage is only considered for Widely disseminated disease Patients with poor surgical risk


Question: Posterior ethmoidal sinus opens into

The posterior ethmoidal air sinus consisting of 1-7 air cells open into the superior meatus of the nose. It is supplied by the posterior ethmoidal nerve and vessels and the orbital branches of pterygopalatine ganglion. Ref BDC volume 3,6th edition pg 246


Question: Third ventricle is derived from

C i.e. ThalamencephalonThe pa of the diencephalon of the brain that includes the thalamus, pineal gland, and adjacent structuresThalamencephalon also called thalamic region is a complex structure comprising thalamus (in the wider sense of the term thalamus, i.e. dorsal thalamus, or thalamus proper, plus subthalamus, or ventral thalamus) and several adjacent structures: epithalamus and metathalamusDEVELOPMENT:The cavity of the thalamencephalon opens behind into the cavity of the middle cerebral vesicle, and in front communicates with the hollow rudiments of the cerebral hemispheres, and eventually it becomes the cavity of the third ventricle.The floor of the thalamencephalon is ultimately developed into the optic chiasma, pa of the optic nerves, and the infundibulum.The latter comes in contact with a process from the mouth, uniting with which it ultimately forms the pituitary body.From the posterior pa of the roof of the thalamencephalon is developed the pineal gland .The anterior pa of the roof of the thalamencephalon becomes very thin, and its place is finally occupied by a thin membrane containing a vascular plexus, which persists in the roof of the third ventricle {choroidplexus).From the sides of the thalamencephalon, which become extremely thickened, are developed the optic thalami.


Question: The nerve of the 6th arch is

Description Human embryology Inderbeir Singh tenth edition Page no 133Occipital somites: laryngeal muscles from 4th to 6th arches supplied by the recurrent laryngeal nerve.


Question: Anal canal is NOT supplied by

Middle rectal aery supplies the rectum, but 'not' the anal canal.

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


Question: General visceral fibres do not supply

Skeletal muscle is not supplied by general visceral fibres Inderbir Singh&;s textbook of human Histology Seventh edition


Question: In a complete section of the ulnar nerve at the wrist, disability of the hand results from the paralysis of

Interossei involve all digits hence produce complete disability. Hypothenar muscles are paralyzed but affect only the muscles of the little finger. Branches to FDP and FCU are given off in the forearm and hence intact in a wrist lesion.** Both interossei, hypothenar effected, question asks which causes more disability hence interosseiReference: Chaurasia; 6th edition


Question: Pneumatocytes lines the

(Alveoli) (83-M. Kaul histology 3rd) (221- LB.Singh 5th)Respiratory system - Histology* Trachea - lined by pseudostratified ciliated columnar epithelium* Intrapulmonary Bronchus - lined by pseudostratified ciliated columnar epithelium* Terminal Bronchiole - lined by simple columnar epithelium* Respiratory Bronchiole - lined by cuboidal epithelium* Atria, alveolar ducts and alveoli - lined with squamous epitheliumALVEOLI - The main support of the alveoli is provided by elastic fibres* Majority of cells lining the alveoli are the squamous cells or type 1 pneumocytes. Few are larger cells or type II pneumocytes. Type II cells secrete the surfactant which lowers surface tension and prevents alveoli from collapsing* The exchange between the blood in the capillaries and air in the alveoli takes place through(a) Cytoplasm of endothelial cell of a capillary(b) Basement membrane of the capillary(c) Basement membrane of the alveolus(d) Cytoplasm of the epithelial cells of the alveolus* In CHF, heart failure cells are present in the sputum. These cells are the alveolar macrophages, containing hemosiderin of the red blood cells from the ruptured capillaries.


Question: Sure sign of malignancy is

Ref Robbins 8/e p269; 9/e p272 CHARACTERISTICS OF BENIGN AND MALIGNANT NEOPLASMS Nothing is more impoant to the patient with a tumor than being told: "It is benign." In general, benign tumors appear to be genetically "simple," harboring fewer muta- tions than cancers, and genetically stable, changing little in genotype over time. The latter feature probably explains why benign tumors such as lipomas and leiomyomas transform to malignancies rarely, if at all. In practice, the determination of benign versus malignant is made with remarkable accuracy using long-established clinical and anatomic criteria, but some neoplasms defy easy character- ization. Ceain features may indicate innocence, and others may indicate malignancy. Such problems are not the rule, however, and there are four fundamental features by which benign and malignant tumors can be distinguished: dif- ferentiation and anaplasia, rate of growth, local invasion, and metastasis. Differentiation and Anaplasia Differentiation and anaplasia are characteristics seen only in the parenchymal cells that constitute the transformed elements of neoplasms. The differentiation of parenchymal tumor cells refers to the extent to which they resemble their normal forebears morphologically and functionally. * Benign neoplasms are composed of well-differentiated cells that closely resemble their normal counterpas. A lipoma is made up of mature fat cells laden with cytoplasmic lipid vacuoles, and a chondroma is made up of mature cailage cells that synthesize their usual cailaginous matrix--evidence of morphologic and functional differentiation. In well-differentiated benign tumors, mitoses are usually rare and are of normal configuration. * Malignant neoplasms are characterized by a wide range of parenchymal cell differentiation, from sur- prisingly well differentiated (Fig. 5-3) to completely in sheets, with total loss of communal structures, such as glands or stratified squamous architecture. The more differentiated the tumor cell, the more com- pletely it retains the functional capabilities of its normal counterpas. Benign neoplasms and even well-differenti- ated cancers of endocrine glands frequently elaborate the hormones characteristic of their origin. Well-differentiated squamous cell carcinomas produce keratin (Fig. 5-3), just as well-differentiated hepatocellular carcinomas secrete bile. In other instances, unanticipated functions emerge. Some cancers may elaborate fetal proteins not produced by comparable cells in the adult. Cancers of nonendocrine origin may produce so-called ectopic hormones. For example, ceain lung carcinomas may produce adrenocor- ticotropic hormone (ACTH), parathyroid hormone-like hormone, insulin, glucagon, and others. More is said about these phenomena later. Despite exceptions, the more rapidly growing and the more anaplastic a tumor, the less likely it is to have specialized functional activity. Of relevance in the discussion of differentiation and ana- plasia is dysplasia, referring to disorderly but non-neoplastic undifferentiated. For example, well-differentiated ade- nocarcinomas of the thyroid may contain normal- appearing follicles. Such tumors sometimes may be difficult to distinguish from benign proliferations. Between the two extremes lie tumors loosely referred to as moderately well differentiated. The stroma carrying the blood supply is crucial to the growth of tumors but does not aid in the separation of benign from malignant ones. The amount of stromal connective tissue does deter- mine, however, the consistency of a neoplasm. Ceain cancers induce a dense, abundant fibrous stroma (des- moplasia), making them hard, so-called scirrhous tumors. * Malignant neoplasms that are composed of undiffer- entiated cells are said to be anaplastic. Lack of differen- tiation, or anaplasia, is considered a hallmark of malignancy. The term anaplasia literally means "back- ward formation"--implying dedifferentiation, or loss of the structural and functional differentiation of normal cells. It is now known, however, that at least some cancers arise from stem cells in tissues; in these tumors, failure of differentiation, rather than dedifferentiation of specialized cells, accounts for their undifferentiated appearance. Recent studies also indicate that in some cases, dedifferentiation of apparently mature cells does occur during carcinogenesis. Anaplastic cells display marked pleomorphism (i.e., variation in size and shape) (Fig. 5-4). Often the nuclei are extremely hyperchromatic (dark-staining) and large resulting in an increased nuclear-to-cytoplasmic ratio that may approach 1: 1 instead of the normal 1: 4 or 1 :6. Giant cells that are considerably larger than their neighbors may be formed and possess either one enormous nucleus or several nuclei. Anaplastic nuclei are variable and bizarre in size and shape. The chromatin is coarse and clumped, and nucle- oli may be of astounding size. More impoant, mitoses often are numerous and distinctly atypical; anarchic multi- ple spindles may produce tripolar or quadripolar mitotic figures (Fig. 5-5). Also, anaplastic cells usually fail to develop recognizable patterns of orientation to one another (i.e., they lose normal polarity). They may grow proliferation. Dysplasia is encountered principally in epi- thelial lesions. It is a loss in the uniformity of individual cells and in their architectural orientation. Dysplastic cells exhibit considerable pleomorphism and often possess hyperchro- matic nuclei that are abnormally large for the size of the cell. Mitotic figures are more abundant than usual and frequently appear in abnormal locations within the epithe- lium. In dysplastic stratified squamous epithelium, mitoses are not confined to the basal layers, where they normally occur, but may be seen at all levels and even in surface cells. There is considerable architectural anarchy. For example, the usual progressive maturation of tall cells in the basal layer to flattened squames on the surface may be lost and replaced by a disordered scrambling of dark basal- appearing cells (Fig. 5-6). When dysplastic changes are marked and involve the entire thickness of the epithelium, the lesion is referred to as carcinoma in situ, a preinvasive stage of cancer (Chapter 18). Although dysplastic changes often are found adjacent to foci of malignant transforma- tion, and long-term studies of cigarette smokers show that epithelial dysplasia almost invariably antedates the appear- ance of cancer, the term dysplasia is not synonymous with cancer; mild to moderate dysplasias that do not involve the entire thickness of the epithelium sometimes regress completely, par- ticularly if inciting causes are removed.


Question: Space of Disse is seen in

Histology of liver * The perisinusoidal space (or space of Disse) is a narrow gap between a plate of hepatocytes and a sinusoid. * The width of this perisinusoidal space is 0.2-0.5 micrometre. * Microvilli of hepatocytes, stellate cells, interstitial fluid and collagen fibres are the major constituents of this space. Ref:- Gray's Anatomy 41st Edition; Pg Num:- 1170


Question: Drug used in the management of mood stabilizer used ihe management of

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


Question: Sensory supply of from external auditory meatus

The skin lining the anterior half of the meatus is supplied by the auriculotemporal nerve, and that lining the posterior half, by the auricular branch of the vagus. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 6th edition 368


Question: Peribulbar injection is given in

Surgical spaces of the orbit are: Subperiosteal space Peripheral orbital space Central space(muscular cone or Retrobulbar space) Subcutaneous space Refer khurana 6/e


Question: Intercalated discs are seen in

Ans: b) Cardiac muscleIntercalated discs are cell membranes that separate individual cardiac muscle cells from one another. Cardiac muscle fibres are made up of many individual cells connected in series and in parallel in such a way that they form permeable "communicating junctions"- gap junctions that allow free diffusion of ions.


Question: Structure held by forceps is seen in

Appendix Epiploica is one of the numerous pouches of the peritoneum filled with fat and attached to the colon.


Question: Sec 84 deals with

McNaughten's rule IPC sec 84: Nothing is an offence which is done by a person who, at the time of doing it, by the reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing, what is either wrong or contrary to law. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 369


Question: Facial skeleton develops from

The viscerocranium forms the facial skeleton and the major pa of which develops from mesenchyme derived from 1st and 2nd pharyngeal arches.The lacrimal and nasal bones are derived from neural crest cells. The paraxial mesoderm undergoes segmentation to form somitomeres and somites that fuher differentiate into sclerotome, myotome, and dermatome. The intermediate mesoderm forms most of the genito-urinary system -eg; kidneys, testes, ovaries The lateral plate mesoderm forms body wall and body cavities. Reference: Textbook of clinical embryology, Vishram Singh,1st edition,page no.94,49


Question: Dilator papillae are supplied by

Dilator papillae are supplied by sympathetic fibers, which arises from the inter medio lateral horn of spinal cord segment of T-1 These pre-ganglionic T-1 sympathetic fibersclimbs up the cervical sympathetic chain and synapse in the superior (highest)cervical ganglion. Postganglionic fibers makes sympathetic plexus around the internal carotid aery and reach the dilator papillae muscle. Ref: Gray's 39e/p-227

Sympathetic fibers from the fronto - orbital branch of trigeminal nerve

Postganglionic sympathetic fibers from cervical sympathetic chain


Question: Oxigen are used as specific antidotes in

Oximes These are specific antidotes. The available oxigen are Diacetyl monoxime. 2- pyridine Aldoxime Methiodide Pralidoxime chloride Action: Oximes react with phosphate moiety of organophosphate- AchE complex and get phosphorilated. So AchE is released from the complex and thus reactivated. The oximes decreases the muscarinic, nicotine and CNS effects of organophosphates within 10-40 minutes Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 450


Question: The most commonly used resuscitation fluid in burns is

The most common fluid used is Ringer lactate/Hamann's solution Ringer lactate is a mixture of sodium chloride, sodium lactate, potassium chloride, calcium chloride in water. Crystalloids are said to be as effective as colloids for maintaining the intravascular volume and are given during initial 24 hrs Colloids should ideally be given after the first 12 hrs of burn because before this period, the massive fluid shift cause protein to leak out of cells.


Question: Principal blood supply to tonsil is from

Aerial supply of tonsil: Tonsillar branch of facial aery (Principal blood supply) Dorsalis linguae branches of lingual aery. Ascending palatine, a branch of facial aery. Ascending pharyngeal, a branch of external carotid aery. Greater palatine (descending palatine), a branch of maxillary aery.


Question: Torus Aoicus is present in

Torus aoicus is the prominent region of the right atrial septum, which marks the projection of the non-coronary aoic sinus into the right atrial wall. The bulge is superior to the coronary sinus and anterior to the fossa ovalisReference: Vishram Singh Anatomy; 2nd edition; Page no: 265


Question: Bullet changes it's direction by striking on some surface or object in

Ricochet bullet Bullet changes it's direction by striking on some surface or object. Ricochet occurs when it strikes on some intermediate objects before entering the body. Due to ricochet the bullet may be deformed and more superficially placed in the body. The external wound of entry will be larger, triangular or cruciate with irregular margins. The paicles of the surface on which the bullet is deflected eg: paint, fibre, mud, etc. may be sticking on the bullet. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 141


Question: Commonest cause of periumbilical pain after 30 min.of TURP done under spinal anesthesia with Bupivacaine

Perforation of bladder is one of the complications of TURP. It can present with periumblical pain. This pt. experiences pain 30 minutes after TURP. This is because he is under spinal anesthesia. In this pt. the effect of spinal anesthesia terminates 30 min. after the operation. Now he is able to perceive the pain of bladder perforation. Meteorism - is distention of the abdomen or intestines by gas. This is seen in Renal injury but not in TURP. Ref : Bailey & Love 25/e p1352


Question: Erb's palsy involves

ERB'S PARALYSIS:- upper plexus injury.Caused by the forceful widening of the angle between the head and shoulder which may occur by traction of the arm during the bih of a child or by fall on the shoulder.Involves upper trunk - C5, C6 roots. Leads to typical deformity in the limb- policeman's tip hand/ poer's tip hand. The arm hangs by the side, adducted and medially rotated. DISABILITY: The following movements are lost. Abduction and lateral rotation of the arm at shoulder joint flexion and supination of the forearm. biceps and supinator jerks are lost. sensations are lost over a small area over the lower pa of the deltoid. REF: BD Chaurasia 7th edition page no: 59.


Question: The most common cause of delayed umbilical cord separation is

Leukocyte adhesion deficiency may present with recurrent bacterial infections, defects in neutrophil adhesion, and a delay in umbilical cord sloughing. All other options given are various umbilical pathologies, but not related to delayed sloughing of cord


Question: Russell bodies are seen in

They are homogeneous eosinophillic inclusions that result from hugely distended endoplasmic reticulum


Question: Nikshay software is used for

Nikshay software is a web based solution for monitoring TB patients under Revised National Tuberculosis Control Programme (RNTCP). It was developed by National Informatics Center (NIC).


Question: Tongue muscle develop from

Occipital myotomes forms intrinsic and extrinsic muscler of fongus.