Question: Most essential drugs should be formulated as


Question: The roof of the olfactory region is formed by

The bony pa of the olfactory region is formed by: The vomer and The perpendicular plate of ethmoid.It's margins receive contributions from nasal spine of the frontal bone, the rostrum of the sphenoid and the nasal crests of the nasal palatine and maxillary bones. The cailaginous pa is formed by: The septal cailage and The septal processes of the inferior nasal cailages. The cuticular pa or lower end is formed by fibrofatty tissue covered by skin. Ref BDC volume 3,sixth edition


Question: Multiple cutaneous sebaceous adenoma are seen in


Question: non synthetic phase 1 reaction for drug detoxification is


Question: Power grip of hand is due to

In power grip, the extrinsic muscles provide the major force, the interossei are used as flexors and rotators at the metacarpophalangeal joints, and the thenar muscles are generally active


Question: Hypophysis cerebri is supplied by


Question: Commonest intrabronchial cause of haemoptysis is

The two most common causes for haemoptysis are bronchitis and bronchiogenic carcinoma. Bronchitis is not provided amongst the options and hence bronchiogenic carcinoma is the single best answer of choice Ref Harrison 19th edition pg 227


Question: Posterior pituitary bodies are

(A) Herring bodies ,# An interesting histologic feature of the NEUROHYPOPHYSIS is the presence of Herring bodies.> When viewed with an electron microscope, these are dilated areas or bulges in the terminal portion of axons that contain clusters of neurosecretory granules> The granules contain oxytocin or antidiuretic hormone, along with their associated neurophysins.> Herring bodies often are seen in association with capillaries.> They are somewhat difficult to identify unambiguously by light microscopy; in the image to the right, the label might better say ' probable Herring bodies".


Question: Association of choledocholithiasis in cholithiasis

Choledocholithiasis Found in 6-12% of patients with GB stones Retained stones discovered within 2 years of cholecystectomy Recurrent stones detected >2 years of cholecystectomy Ref: Sabiston 20th edition Pgno : 1494


Question: The cold water treatment of burns has a disadvantage of

A number of studies have shown that the infection rate is actually increased when patients are immersed in a tub because of the generalized inoculation of burn wounds with bacterial from what was previously a localized infection. Hydrotherapy, on a slant board, is a very useful approach once the wounds are in the process of being debrided and closed. Showering is also effective for wound cleansing in the more stable patient


Question: Urothelium is absent in

Transitional epithelium: In this type of multilayered epithelium all layers are made up of cuboidal, polygonal or round cells. The cells towards the surface of the epithelium are round. As transitional epithelium is confined to the urinary tract, it is also called urothelium. Location - Transitional epithelium is found in the renal pelvis and calyces, the ureter, the urinary bladder, and pa of the urethra. Because of this distribution it is also called urothelium. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no.,39,49.


Question: Caroli's disease is

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


Question: Focal lesions of liver is best detected by

MRI in liver lesions MRI gas emerged as the best imaging test for liver lesion detection and characterization MRI provides high lesion to liver contrast and does not use radiation Lievr specific contrast media, such as mangifodipir trisodium (taken up by hepatocytes) and ferrumoxides (taken up by kupffer cells) demonstrate selective uptake in the liver and are primarily used for lesion detection These two contrast agents are also useful in characterising specific liver tumors, such as FNH, hepatic adenoma and HCC Ref: Shackelford 7th edition Pg no : 1560, 1571


Question: Lateral ventricle is connected to third ventricle by

The lateral ventricle communicates with the third ventricle through interventricular foramen MonroThe foramen of luschka is an apeure through which the lateral recess opens into the subarachnoid space of cerebellopontine angleForamen of magendie is an opening in the roof of 4th ventricle through which its cavity communicates with the subarachnoid space of cerebellomedullary cistern.( Reference: Vishram Singh textbook of clinical neuroanatomy 2nd edition pg -137,121)


Question: Relaxation of mesangial cells of kidney is brought about by

Mesangial cells contractionMesangial cells relaxationEndothelinsAngiotensin IIVasopressinNor-epinephrinePlatelet -activation factorPlatelet-derived growth factorThromboxane A2PGF2LT-C4and D4HistamineANPDopaminePGE2cAMP(Refer: Ganong's Review of Medical Physiology 24thedition, pg no: 678-682)


Question: F20 in ICD 10 denotes

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


Question: Content(s) of bicipital groove is/are

BICIPITAL GROOVE:-Veical groove between greater and lesser trochanter.Contents:-1. Long head of biceps.2. Ascending branch of anterior circumflex humeral aery.Muscles attachments:/1. Pectoralis major- outer lip2. Teres major- inner lip3. Latissimus dorsi- floor of groove. {Reference: Vishram Singh, pg no.22}

Ascending branch of anterior circumflex aery

Ascending branch of posterior circumflex aery


Question: Fat embolism is commonly seen in


Question: Birbeck's granules in the cytoplasm are seen in

ref Robbins 9/e p622 Birbeck granules, also known as Birbeck bodies, are rod shaped or "tennis-racket" cytoplasmic organelles with a central linear density and a striated appearance. First described in 1961 (where they were simply termed "characteristic granules"), they are solely found in Langerhans cells.


Question: Bacterial endocarditis is most commonly caused by

Ref Harrison 19 th ed pg 819 The causative microorganism is primar- ily responsible for the temporal course of endocarditis. b-Hemolytic streptococci, S. aureus, and pneumococci typically result in an acute course, although S. aureus occasionally causes subacute disease. Endocarditis caused by Staphylococcus lugdunensis (a coagulase- negative species) or by enterococci may present acutely. Subacute endocarditis is typically caused by viridans streptococci, enterococci, CoNS, and the HACEK group. Endocarditis caused by Baonella species, T. whipplei, or C. burnetii is exceptionally indolent.


Question: Secondary ossification centre appears before bih at

Long Bone Diaphysis (shaft) - derived from primary ossification center. * present at 6 - 8 weeks of IUL. Epiphysis (ends) - derived from secondary ossification center. * appear after bih Except - Lower end of femur & sometimes upper end of tibia. | Their secondary ossification center appears before bih.


Question: Autonomous zone of sensory supply by radial nerve

Autonomous zone for radial nerve is 1st dorsal web space Refer Campbell 12th/e p 3100


Question: Sympathetic supply to hea

Sympathetic nerves are derived from upper four to five thoracic segments of spinal cord .that is from T1-T4 ganglia. BD CHAURASIS'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.Page no 267.fig.18.30


Question: Internal anal sphincter is pa of

The internal anal sphincter, IAS, (or sphincter ani internus) is a muscular ring that surrounds about 2.5-4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is about 5 mm thick and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Ref - BDC 6e vol2 pg413-416

Internal circular muscle fibres of rectum


Question: Lumbar plexus is situated in

Ans. b (Posterior portion of psoas) (Ref. BDC anatomy Vol. II 3rd ed., 278)LUMBAR PLEXUS# The lumbar plexus lies in the posterior part of the substance of the PSOAS MAJOR muscle.# It is formed by the ventral rami of the upper 4 lumbar nerves.Its branches include:- Ilioinguinal nerve (L1)- Lateral cutaneous nerve of the thigh (L2, L3 dorsal divisions)- Lumbosacral trunk (L4, 5; ventral trunk)- Genitofemoral nerve (L1, L2, ventral divisions)- Obturator nerve (L2, 3, 4; dorsal divisions)- Femoral nerve (L2, 3, 4; dorsal divisions)- Iliohypogastric nerve (L1)Branches of the lumbar plexusNerveSegmentMuscleMotionSensationIliohypogastricT12 -L1# Inter oblique# External oblique# Transversus abdominusAnterior abdominal wall# Inferior abdominal wall# Upper lateral quadrant of buttockIlioinguinalL1Internal obliqueAnterior abdominal wall# Internal medial inguinal ligament# GenitaliaGenitofemoralL1-L2CremasterTesticular# Inferior medial inguinal ligament# Spermatic cordLateral femoral cutaneousL2-L3 # Anterior, lateral and posterior aspect of thighFemoral Nerve1. Anterior division L2-L4# Sartorius,# Pectineus# Medial aspect of lower thigh# Adduction of thigh# Anterior medial skin of thigh2. Posterior division Quadriceps# Knee extension# Patellar movement# Anterior thigh hip and kneeObturator nerve1. Anterior division L2-L4# Gracilis# Adductor longus# Adductor brevis# PectineusThigh adduction# Posterior medial thigh# Medial knee# Hip2. Posterior division # Adductor magnus# Obturator externusThigh adduction with lateral hip rotationKnee


Question: Child criteria includes

Child - Turcotte-pugh(CTP) score CTP score is a measure to assess hepatic function in many liver diseases It was initially devised to classify patients into risk groups prior to undergoing Poo-systemic shunt surgeries It is used to assess prognosis in cirrhosis and many liver disease Divided into 3 classes Class A- 5-6 points( Major surgeries can only be done in this class) Class B - 7-9 points( Only minor surgical procedures can be performed) Class C - 10-15 points (no surgical intervention should be done) Variable 1 point 2 point 3 point Serum albumin >3.5 2.8-3.5 <2.8 Bilirubun(mg/dl) <2 2-3 >3 Prothrombin time or INR <4 <1.7 4-6 1.7-2.3 >6 >2.3 Ascites None Controlled Uncontrolled Enceohalopathy None Controlled Uncontrolled


Question: Hard palate lining contains

Palate -Roof of oral cavity Hard palate anteriorly Soft palate posteriorly Hard Palate Anterior fatty zone Posterior glandular zone may have some salivary gland Submucosa - absent in midline raphe of hard palate and gingiva. Palate is covered by a thick oho- keratinised stratified squamous epithelium suppoed densely by collagenous lamina propria Mucosa of the hard palate is bound to underlying bone by relatively dense submucosal tissue with a few accessory salivary glands.

Keratinized mucosa, absent submucosal layer, minor salivary glands

Keratinized mucosa, submucosal layer, minor salivary glands

Non-keratinized mucosa, submucosal layer, minor salivary glands

Non-keratinized mucosa, absent submucosal layer, minor salivary glands


Question: The parasympathetic secretomotor nerve supply to the nose is

The nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine ganglion. The parasympathetic fibres relay in this ganglion. Postganglion are parasympathetic fibres arising in the ganglion ultimately supply the lacrimal gland and the mucosal glands of the nose, palate, and pharynx. The gustatory or taste fibres do not relay in the ganglion and are distributed to the palate. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Lift of test is done to assess the function of

Refer Campbell's 13th p 2303 The test described in the question is lift off the test which is a test for subsacapularis muscle


Question: Polyaeritis nodosa does not involve in

Refer robbins 9/e 509/510 Polyaeritis nodosa (PAN), is a systemicnecrotizing inflammation of blood vessels (vasculitis) affecting medium-sized muscular aeries, typically involving the aeries of the kidneys and other internal organs but generally sparing the lungs' circulation. Polyaeritis nodosa may be present in infants. In polyaeritis nodosa, small aneurysms are strung like the beads of a rosary, therefore making "rosary sign" an impoant diagnostic feature of the vasculitis. PAN is associated with infection by the hepatitis B or hepatitis Cvirus


Question: Knudson two hit hypothesis is seen with

Ref Robbins 9/e p290 The Knudson hypothesis, also known as the two-hit hypothesis is the hypothesis that most genes require two mutations to cause a phenotypic change. It was first formulated by Alfred G. Knudson retinoblastoma, a tumor of the retina that occurs both as an inherited disease and sporadically. He noted that inherited retinoblastoma occurs at a younger age than the sporadic disease. In addition, the children with inherited retinoblastoma often developed the tumor in both eyes, suggesting an underlying predisposition. Knudson suggested that two "hits" to DNA were necessary to cause the cancer. In the children with inherited retinoblastoma, the first mutation in what later came to be identified as the RB1 gene, was inherited, the second one acquired. In non-inherited retinoblastoma, instead two mutations, or "hits", had to take place before a tumor could develop, explaining the later onset.


Question: Lens is derived from

Unlike the rest of the eye, which is derived mostly from the neural ectoderm, the lens is derived from the surface ectoderm. ... As the placode continues to deepen, the opening to the surface ectoderm constricts and the lens cells forms a structure known as the lens vesicle. Latin: lens crystallin Function: Refract light


Question: A lesion 3cms away from gastroesophageal junction contain columnar epithelium ,such a type of lesion is

Ref Robbins 8/e p10,265,;9/e p271 Metastasis Metastases are secondary implants of a tumor that are dis- continuous with the primary tumor and located in remote tissues (Fig. 5-11). More than any other attribute, the propey of metastasis identifies a neoplasm as malignant. Not all cancers have equivalent ability to metastasize, however. At one extreme are basal cell carcinomas of the skin and most primary tumors of the central nervous system, which are highly invasive locally but rarely metastasize. At the other extreme are osteogenic (bone) sarcomas, which usually have metastasized to the lungs at the time of initial discovery. Approximately 30% of patients with newly diagnosed solid tumors (excluding skin cancers other than melano- mas) present with clinically evident metastases. An additional 20% have occult (hidden) metastases at the time of diagnosis. In general, the more anaplastic and the larger the primary neoplasm, the more likely is metastatic spread, but as with most rules, there are exceptions. Extremely small cancers have been known to metastasize; conversely, some large and ominous-looking lesions may not. Dissemination strongly prejudices, and may preclude, the possibility of curing the disease, so obviously, sho of prevention of cancer, no achievement would confer greater benefit on patients than the prevention of metastases. Malignant neoplasms disseminate by one of three path- ways: (1) seeding within body cavities, (2) lymphatic spread, or (3) hematogenous spread. Spread by seeding occurs when neoplasms invade a natural body cavity. This mode of dissemination is paicularly characteristic of cancers of the ovary, which often cover the peritoneal sur- faces widely. The implants literally may glaze all peritoneal surfaces and yet not invade the underlying tissues. Here is an instance of the ability to reimplant elsewhere that seems to be separable from the capacity to invade. Neoplasms of the central nervous system, such as a medulloblastoma or ependymoma, may penetrate the cerebral ventricles and be carried by the cerebrospinal fluid to reimplant on the men- ingeal surfaces, either within the brain or in the spinal cord. Lymphatic spread is more typical of carcinomas, whereas hematogenous spread is ored by sarcomas. There are numerous interconnections, however, between the lym- phatic and vascular systems, so all forms of cancer may disseminate through either or both systems. The pattern of lymph node involvement depends principally on the site of the primary neoplasm and the natural pathways of local lymphatic drainage. Lung carcinomas arising in the respi- ratory passages metastasize first to the regional bronchial lymph nodes and then to the tracheobronchial and hilar nodes. Carcinoma of the breast usually arises in the upper outer quadrant and first spreads to the axillary nodes. However, medial breast lesions may drain through the chest wall to the nodes along the internal mammary aery. Thereafter, in both instances, the supraclavicular and infra- clavicular nodes may be seeded. In some cases, the cancer cells seem to traverse the lymphatic channels within the immediately proximate nodes to be trapped in subsequent lymph nodes, producing so-called skip metastases. The cells may traverse all of the lymph nodes ultimately to reach the vascular compament by way of the thoracic duct. A "sentinel lymph node" is the first regional lymph node that receives lymph flow from a primary tumor. It can be identified by injection of blue dyes or radiolabeled tracers near the primary tumor. Biopsy of sentinel lymph nodes allows determination of the extent of spread of tumor and can be used to plan treatment. Of note, although enlargement of nodes near a primary neoplasm should arouse concern for metastatic spread, it does not always imply cancerous involvement. The necrotic products of the neoplasm and tumor antigens often evoke immunologic responses in the nodes, such as hyperplasia of the follicles (lymphadenitis) and proliferation of macro- phages in the subcapsular sinuses (sinus histiocytosis). Thus, histopathologic verification of tumor within an enlarged lymph node is required. Hematogenous spread is the ored pathway for sarco- mas, but carcinomas use it as well. As might be expected, aeries are penetrated less readily than are veins. With venous invasion, the blood-borne cells follow the venous flow draining the site of the neoplasm, with tumor cells often stopping in the first capillary bed they encounter. Since all poal area drainage flows to the liver, and all caval blood flows to the lungs, the liver and lungs are the most frequently involved secondary sites in hematogenous dissemina- tion. Cancers arising near the veebral column often em- bolize through the paraveebral plexus; this pathway probably is involved in the frequent veebral metastases of carcinomas of the thyroid and prostate. Ceain carcinomas have a propensity to grow within veins. Renal cell carcinoma often invades the renal vein to grow in a snakelike fashion up the inferior vena cava, sometimes reaching the right side of the hea. Hepatocel- lular carcinomas often penetrate poal and hepatic radicles to grow within them into the main venous channels. Remarkably, such intravenous growth may not be accom- panied by widespread dissemination. Many observations suggest that the anatomic localiza- tion of a neoplasm and its venous drainage cannot wholly explain the systemic distributions of metastases. For example, prostatic carcinoma preferentially spreads to bone, bronchogenic carcinomas tend to involve the adre- nals and the brain, and neuroblastomas spread to the liver and bones. Conversely, skeletal muscles, although rich in capillaries, are rarely the site of secondary deposits. The molecular basis of such tissue-specific homing of tumor cells is discussed later on.


Question: The most common cause of intestinal obstruction is

Adhesions are the most common cause of intestinal obstruction in almost 40% of cases. The clinical manifestation are Intestinal obstruction Abdominal pain Abdominal distension Vomiting and constipation Ref: Bailey and love 27th edition Pg no : 1278


Question: Chloroma is


Question: The term fetal Adenoma is used for

Adenomas of the thyroid are typically discrete, solitary masses, derived from follicular epithelium, and hence they are also known as follicular adenomas. Clinically, follicular adenomas can be difficult to distinguish from dominant nodules of follicular hyperplasia or from the less common follicular carcinomas. In general, follicular adeno- mas are not forerunners to carcinomas; neveheless, shared genetic alterations suppo the possibility that at least of subset of follicular carcinomas arises in preexisting adeno- mas (see later). Although the vast majority of adenomas are nonfunctional, a small subset produces thyroid hor- mones and causes clinically apparent thyrotoxicosis. Hormone production in functional adenomas (


Question: Xenophobia is

fear of injection- needle phobia Fear of touch- hapnophobia Fear of strangers- xenophobia Fear of animals- zoophobia Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 361


Question: Posterior to sternum is

Posterior to sternum is right ventricle . Ref - medscape.com


Question: Absolute lymphocytosis seen in


Question: The cranial nerve passing through cavernous sinus is

The cavernous sinuses: drain the venous blood from brain & is placed lateral to the pituitary gland. Contents: Internal carotid aery Abducens nerve (VI) Oculomotor nerve Trochlear nerve Ophthalmic and maxillary division of trigeminal nerve. Mandibular division of trigeminal nerve is not a content of cavernous sinuses.


Question: Chief aery of lateral surface of cerebral hemisphere

The chief aery of lateral surface of brain is middle cerebral aeryThe chief aeries of medial and inferior surfaces anterior cerebral aery and posterior cerebral aeries respectively.(Ref: Vishram Singh textbook of clinical neuroanatomy Second Edition page 178)


Question: Treatment of choice for bleeding esophageal and gastric varices

Endoscopic Variceal Ligation For control of acute variceal bleeding EVL has been found to be as effective as EST. Technically more difficult than EST in the presence of massive bleed bf due to reduction in filed of view Variceal recurrence rates is higher in EVL since para oesophageal varices (perforating veins) are not obliterated Not suitable for small varices (grade I, II) EVL is associated with lesser complications and rebleeding Variceal eradication in fewer sessions but higher recurrence of varices Ref: Sabiston 20th edition Pgno : 1439


Question: Internal carotid artery is derivative of


Question: Relation of caudate lobe of liver is

The caudate lobe of the liver - It is situated on the posterior surface of the liver. Boundaries of caudate lobe of liver - It is bounded on the right - By the groove for the inferior vena cava, on the left - By the fissure for the ligamentum venosum, and inferiorly - By the poa hepatis. Above - It is continuous with the superior surface of liver. Below and to the right, just behind the poa hepatis - It is connected to the right lobe of the liver by the caudate process, Below and to the left - It presents a small rounded elevation called the papillary process Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 2 , pg. no. 333


Question: Infantile propoion in adult is seen in

Normal body propoion in adults Height = arm span Upper segment= lower segment Normal body propoion in infants is Height ( length)> arm span Upper segment> Lower segment. Infantile propoion means increased upper to lower segment ratio. Seen in conditions like Achondroplasia and hypothyroidism. Reverse infantile propoion means increased lower segment. Seen in Eunuchoidism, Marfans syndrome, Homocystinuria, Klinefelter's syndrome. Ref: Nelson's 20th edition, Pg- 3371.


Question: Treatment of choice for asymptomatic pseudocyst pancreas is

Treatment of Pancreatic pseudocyst Pseudocyst 5 cm in diameter and <6 weeks old should be observed, as they tend to resolve spontaneously Pseudocyst >5cm diameter is an indications for drainage If infection is suspected, the pseudocyst should be aspirated (not drained) by CT - or US - guided FNA, and the contents examined for organisms by Gran stain and culture If infection is present, and the contents resemble pus, external drainage is employed, using either surgical or percutaneous techniques Pseudocysts communicate with the pancreatic ductal system in upto 80% of cases, so external drainage creates a pathway for pancreatic duct leakage to and through the catheter exit site Methods of internal drainage Percutaneous catheter based methods (transgastruc puncture and stent placement to create a cystogastrostomy) Endoscopic methods (transgastric or Transduodenal puncture and multiple stent placements with or without a nasocystic irrigation catheter) Surgical methods (a true cystoenterostomy, biopsy of cyst wall, evacuation of all debris and contents) Surgical options : Cystogastrostomy, Roux-en-Y cystojejunostomy, cystoduodenostomy Preferred modality : Internal drainage of cyst by cystojejunostomy Ref: Sabiston 20th edition Pgno :1534-1535


Question: Uterus is formed by


Question: Vitamin k is required for post translational modification of

The role of vitamin K is in the post-translational modification i.e, gcarboxylation of glutamic acid residues in proteins such as : Coagulation factors : Factor II, VII, IX, X Protein C and S Osteocalcin Nephrocalcin Reference: Harpers illustrated biochemistry 30th edition


Question: BIRADS score 5 is

BIRADS score - Breast Imaging Repoing and Data System Category 5- Higly suggestive of malignancy, appropriate action should be taken


Question: While doing thoracocentesis, it is advisable to introduce needle along

Thoracocentesis is removal of fluid from space between lung and chest wall.needle is inseed in left 4-5intercostal spaces.needle should be passed upward and posteriorly from xiphocostal angle to reach pericardial cavity. BD CHAURASIA&;S HUMAN ANATOMY VOLUME 1. 6TH EDITION. Page no 300


Question: Cell mediated immunity is

Ref Robbins 8/e p197; 9/e p24 Type hypersensitivity reactions have been given the following names: Immediate type1 hypersensitivity Antibody mediated type 2 hypersensitivity Immune complex mediated or type3 hypersensitivity Cell mediated or type4 hypersensitivity


Question: Blood supply of upper pa of vagina

The vaginal aery is usually defined as a branch of the internal illiac aery. The vaginal aery can arise from the internal iliac aery or the uterine aery. However, the phrase vaginal branches of uterine aery are the term for blood supply to the vagina coming from the uterine aery. <img src=" /> Ref - BDC 6e vol2 pg 394


Question: Vein of Galen drains into

The vein of Galen,also known as the great cerebral vein or great vein of Galen is a single median vein.It is formed by union of the two internal cerebral veins.It terminates in the straight sinus.Its tributaries include the basal veins,and veins from the pineal body,the colliculi,the cerebellum,and the adjoining pa of the occipital lobes of the cerebrum. REF.B D Chaurasia's Human Anatomy,Vol 3,Fifth edition,Pg 448


Question: Apparent volume of distribution of a drug exceeds total body fluid volume, if a drug is

Lipid insoluble drugs do not enter cell. Ref-KDT 6/e p18


Question: The anterior triangle occupy the side of the neck in front of sternomastoid muscle. Each triangle presents boundaries in front

Anterior median line of the neck extending from symphysis menti to supra sternal notch

Midline of the neck upto the sternoclavicular joint


Question: Hassal's corpuscles are seen in

Corpuscles of hassall present in the medulla of thymus Formed from eosinophilic epithelial reticular cells arranged concentrically INDERBIR SINGH'S TEXTBOOK OF HUMAN HISTOLOGY SEVENT EDITION PAGE NO139


Question: The term physical half life is applicable to

Physical half-life is defined as the period of time required to reduce the radioactivity level of a source to exactly one half its original value due solely to radioactive decay. The physical half-life is designated tphys or more commonly t1/2 . Refer 6/e p252


Question: The thoracic duct crosses from the right to the left at the level of


Question: Sacral promontory is the landmark for

The superior hypogastric plexus or the presacral nerve lies in front of the bifurcation of the abdominal aoa and the body of fifth lumbar veebra just below which lies sacral promontery.Origin of inferior mesenteric aery is in front of L3.Origin of superior mesenteric aery is in front of L1.Reference: Textbook of anatomy,Abdomen and Lower limb, Vishram Singh, 2nd editon, page no.162,199,160


Question: Coronary ligament is present between

Part of fibrous capsule which is attached to the menisci and lies between menisci and tibial condyle- Coronary ligament.


Question: Bronze diabetes is seen in

Refer Robbins page no Pg 9th edition 849 Founately, hemochromatosis can be diagnosed long before irreversible tissue damage has occurred. Screening involves demonstration of very high levels of serum iron and ferritin, exclusion of secondary causes of iron over- load, and liver biopsy if indicated. Screening of family members of probands is impoant. Heterozygotes also accumulate excessive iron, but not to a level that causes significant tissue damage. Currently most patients with hemochromatosis are diagnosed in the subclinical, precir- rhotic stage due to routine serum iron measurements (as pa of other diagnostic workup). Treatment by regular phlebotomy steadily depletes tissue iron stores. With treat- ment, life expectancy is normal.


Question: Characterstic feature of compact bones is

When we examine a section of compact bone we can see concentric lamellae pervaded by lacunae called haversian system Inderbir Singh&;s textbook of human Histology Seventh edition Pg no94


Question: Inferior vena cava, pierces the central tendon of the diaphragm at the level of

A. i.e. (T8 vertebra) (316-BDC-2 4th)INFERIOR VENA CAVA* The IVC is formed by the union of the right and left common iliac veins on the right side of the body of vertebra L5. It ascends in front of the vertebral column on the right side of the aorta, grooves the posterior surface of the liver, pierces the central tendon of the diaphragm at the level of vertebra T8 and opens into the lower and posterior part of the right atrium*** Superior vena cava - begins behind the lower border of the sternal end of the first right costal cartilage, pierces the pericardium opposite the second right costal cartilage and terminates by opening into the upper part of the right atrium behind the third right costal cartilage. It has no valves.


Question: Half Life of digoxin is

Ref-KDT 7/e p55 Digoxin and digitoxin are the main digitalis products. Digoxin is absorbed quickly from the gastrointestinal tract with a bioavailability of between 75% and 95%. It is eliminated primarily through kidneys; therefore, it has a half-life of 36-48 hours in patients who have normal kidney function and 3.5-5 days in patients who are anuric. The reference range for digoxin is as follows: 0.8-2 ng/mL (1.2-2 nmol/L) Half-life: 36 hours Toxic level: more than 2 ng/mL


Question: Endolymph is secreted by

- Vestibule is the central chainberQ. All three semicircular canals (SCCs) form 2/3rd of a circle and are set at right (90deg) anglesQ to each other. 3 SCCs have only 5 openingsQ into the vestibule. Anterior & posterior SCCs are veical and lateral SCC is horizontalQ.Apex of conical modiolus of cochlea (& axis of TM) is directed anterolaterally & inferiorlyQ. Hollow spiral canal around it makes 2.5 (21/2) turnsQ with basal turn having biggest radiusQ.- Endolymph is secreted by secretory cells of stria vascularis of cochleaQ & dark cells in utricle.


Question: Punctate basophila are found in

Refer robbins 8/e p407 Lead poisoning occurs when lead builds up in the body, often over months or years. Even small amounts of lead can cause serious health problems. Children younger than 6 years are especially vulnerable to lead poisoning, which can severely affect mental and physical development. At very high levels, lead poisoning can be fatal. Symptoms Initially, lead poisoning can be hard to detect -- even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until dangerous amounts have accumulated. Lead poisoning symptoms in children Signs and symptoms of lead poisoning in children include: Developmental delay Learning difficulties Irritability Loss of appetite Weight loss Sluggishness and fatigue Abdominal pain Vomiting Constipation Hearing loss Seizures Eating things, such as paint chips, that aren't food (pica) Lead poisoning symptoms in newborns Babies exposed to lead before bih might: Be born prematurely Have lower bih weight Have slowed growth Lead poisoning symptoms in adults Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include: High blood pressure Joint and muscle pain Difficulties with memory or concentration Headache Abdominal pain Mood disorders Reduced sperm count and abnormal sperm Miscarriage, stillbih or premature bih in pregnant women


Question: The couinaud's segmental nomenclature is based on the position of the

Functional anatomy of the liver is based on couinaud's division of liver into eight (subsequently nine) functional segments, based upon the distribution of poal venous branches and location of hepatic veins in the parenchyma Couinaud 1957


Question: Most common cause of Cushing syndrome

Reference Robbins page no Pg 1125 What are the symptoms of Cushing's syndrome? weight gain. thin arms and legs. a round face. increased fat around the base of the neck. a fatty hump between the shoulders. easy bruising. wide purple stretch marks, mainly on the abdomen, breasts, hips, and under the arms. weak muscles


Question: The fusion of two bony structures with a ligament is known as


Question: A major function of the epididymis is


Question: Race of an individual can be found out by


Question: Ramesh 40 yrs make patient presenting with polyuria,pain abdomen,nausea,vomitings,altered sensorium was found to have bronchiogenic carcinoma.the electrolyte abnormality seen in him would be

Presence of polyuria, abdominal pain and general Symptoms such as nausea, vomiting,and altered sensorium in a patuent with bronchiogenic carcinoma suggest a diagnosis of hypercalcaemia secondary to paraneoplastic syndrome from PTH related peptide production. Ref Harrison 19th edition pg 313


Question: Nerve entrapped in pyriformis syndrome is

Entrapment of Sciatic nerve by inflamed pyriformis muscle is called as pyriformis syndrome.


Question: Parotid duct traverses


Question: Chasaignac tubercle is

The anterior tubercle of the sixth cervical veebra is known as the carotid tubercle or Chassaignac tubercle. This separates the carotid aery from the veebral aery and the carotid aery can be massaged against this tubercle to relieve the symptoms of supraventicular tachycardia . The carotid tubercle is also used as a landmark for anasthesia of the brachial plexus and cervical plexus . Ref - pubmed.com


Question: finger nail hypoplasia is a complication of

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


Question: Serum amyloid associated protein is found in

Ref Robbins 9/e p257;8/e 251-252;7/e pg 159 * The AA (amyloid-associated) fibril is a unique nonim- munoglobulin protein derived from a larger (12-kDa)


Question: Pyrogenic infection and brain infraction are associated with

Ref Robbins 9/e p43 Liquefactive necrosis is seen in focal bacterial or, occasionally, fungal infections, because microbes stimulate the accumulation of inflammatory cells and the enzymes of leukocytes digest ("liquefy") the tissue. For obscure reasons, hypoxic death of cells within the central nervous system often evokes liquefactive necrosis (Fig. 1-10). Whatever the pathogenesis, the dead cells are completely digested, transforming the tissue into a liquid viscous mass. Eventually, the digested tissue is removed by phagocytes. If the process was initiated by acute inflammation, as in a bacterial infection, the material is frequently creamy yellow and is called pus


Question: Primary motor area of brain is supplied by

Greater pa of lateral surface receives supply from middle cerebral aery, whearas medial surface of cerebrum is majorly supplied by anterior cerebral aery The upper limb and head Are represented on the lateral surface of the coex in homunculus, whereas pelvis and lower limb are on the medial surface of the hemispheres. Therefore the motor and sensory functions of the lower limb are supplied by the anterior cerebral aery while the motor and sensory functions of the upper limb and head are supplied by the middle cerebral aery. Ref: Gray's 39e/p-227


Question: The structures that pass between middle cerebellar peduncle and pons is

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


Question: Most anteriorly located valve of the hea is


Question: Vitamin D requirement for children

Daily requirement of vitamin D Adults - 100 lU Infants and children - 200 lU Pregnant and lactating- 400 IU


Question: A 27 year old male presents with low backache that occurs early in the morning assosciated with stiffness, and persists for more than 30 minutes.On examination his chest expansion is also restricted. The most probable diagnosis is

Ankylosing spondylitis causes destruction of aicular cailage and bony ankyloeis, especially of the sacroiliac and aprophyseal joints(between tuberosities and processes). It is also known as rheumatoid spondylitis and Mqrir-Strumpell disease.Disease involving sacroiliac joints and veebrae become symptomatic in the second and third affected individuals.


Question: Causes of chronic tropical pancreatitis is

Tropical (Nutritional) Pancreatitis Associated with mutations of PSTI or SPINK1 gene Protein calorie malnutrition and toxic products of some indigenous foodstuff may contribute to the disease Cassava root contains toxic glycosides, increases susceptibility to free radical injury to pancreas Ref: Sabiston 20th edition Pgno : 1530


Question: Superior relationship of omental foramen is

Omental foramen(epiploic foramen, foramen of Winslow ) has following border: anterior: the free border of the lesser omentum, known as the hepatoduodenal ligament. This has two layers and within these layers are the common bile duct, hepatic aery, and hepatic poal vein. posterior: the peritoneum covering the inferior vena cava superior: the peritoneum covering the caudate lobe. of the liver. inferior: the peritoneum covering the commencement of the duodenum and the hepatic aery, the latter passing forward below the foramen before ascending between the two layers of the lesser omentum. left lateral: gastrosplenic ligament and splenorenal ligament. ref - BDC 6e vol2 pg240


Question: Bulb of posterior horn of lateral ventricle is formed by

Bulb of posterior horn is present on medial wall of posterior horn of lateral ventricle and is formed by fibers of forceps major.


Question: Secretomotor fibres of parotid gland passes througha) Auricular temporal nerveb) Lesser petrosal nervec) Deep petrosal nerved) Otic ganglion


Question: The action of styloglossus muscle is


Question: The prochordal plate marks the site of the future

The prochordal plate is a circular, midline thickening of hypoblast cells that are firmly attached to the overlying epiblast cells. The plate will eventually develop into a membrane called the Buccopharyngeal membrane at the site of the future mouth.


Question: Total duration of antibiotics in acute osteomyelitis

Appropriate antimicrobial therapy 2 weeks intravenous and 4 weeks oral Refer Maheshwari 6th/e p 168


Question: Lower lateral cutaneous nerve of arm is a branch of

Lower lateral cutaneous nerve of arm (C5 , C6 ) is a branch of radial nerve given off in the radial groove . It supplies the skin of the lower half of the lateral side of the arm. B D Chaurasia 7th edition Page no : 79


Question: Veins are an example of

the veins are examples of capacitance vessels


Question: Middle ear cavity is formed by pharyngeal pouch

Pouch Derivatives 1st Eustachian tube(opens into nasopharynx) and middle ear cavity 2nd Lines tonsillar crypts, forms endodermal epithelium of tonsil 3rd Dorsal - Inferior parathyroid glands Ventral - Thymus 5th fuses with 4th pouch Dorsal - Superior parathyroid glands Ventral - Ultimobranchial body recieves neural crest cells and changes to parafollicular c cells


Question: Growth factor oncogene is

Ref Robbins 7/e p182 A number of nuclear transcription factors are the products of oncogene like my,fos, jun myb and rel. Out of these myc is most commonly involved in tumors .SIS oncogene in the only example of a growth factor oncogene in the given options .it's over expression is seen in cancers like astrocytoma and osteosary The other growth factor are described in text


Question: The commonest anatomical position of appendix is

A. i.e. Retrocaecal- Vermiform appendix develops from midgut loops, is supplied by appendicular branch of ileocolic aery. It has mesoappendix (mesentery) but no teniaMost common posiion of vermiform appendix is retrocecal (12 o'clock = 65%) followed by pelvic or 4 o'clock positions


Question: Bilateral lymphadenopathy , along with non caseating granulomas is a characteristic feature of

Patients are usually evaluated for possible sarcoidosis based on two scenarios .In the first scenario, a patient may undergo biopsy revealing a noncaseating granuloma in either a pulmonary or an extrapulmonary organ. In the second scenario, signs or symptoms suggesting sarcoidosis such as the presence of bilateral adenopathy may be present in an otherwise asymptomatic patient or a patient with uveitis or a rash consistent with sarcoidosis. Ref Harrison 19th edition pg 2205-2206


Question: Most common microsomal enzyme involved in metabolism of xenobiotics is

Ref Goodman and Gilman 12th/129 CYP 3A4 is involved in metabolism of xenobiotics


Question: Raised LDH levels in aqueous is seen in

All the three enzymes: LDH(lactose dehydrogenase) NSE(neuron specific enolase) PGI(phosphoglucoisemerase) Are raised in patients of Retinoblastoma Refer khurana 6/e p 303


Question: NOT a Spiral muscle among the following is

Spiral muscle are

Supinator
Pectoralis major
Trapezius
Latissimus dorsi


Question: Nerve supply of kidney is from

Celiac plexus is formed by the greater and lesser splanchnic nerves of both sides, and fibers from the anterior and posterior vagal trunks. Contribute to renal plexus ref - sciencedirect.com


Question: Interpeduncular fossa contains

Contents of interpeduncular fossa are

 Infundibulum
 Mammillary bodies
 Oculomotor nerve
 Posterior perforating substance.

Mammillary bodies, pineal gland, oculomotor nerve, infundibulum

Oculomotor nerve, mammillary bodies, infundibulum, posterior perforating substance

Tuber cinerium, mammillary bodies, oculomotor nerve, anterior perforating substance

Oculomotor nerve, mammillary bodies, optic chiasma, anterior perforating substance


Question: Posterior communicating aery a branch of

Posterior communicating aery is a branch of internal carotid which connects posterior cerebral aery Ref: Gray's 40e/p-250-251


Question: Meconium peritonitis occurs

Meconium Peritonitis Meconium is a sterile mixture of epithelial cells, mucin, salts, fats and bile and is formed when the fetus commences to swallow amniotic fluid. Meconium peritonitis is due to intestinal perforation mostly the result of some form of neonatal intestinal obstruction (eg. meconium ileus in cystic fibrosis patients). When meconium enters the peritoneal cavity, an exudate is secreted that organizes rapidly, matting of intestinal loops occur, and in many cases in a matter of weeks, the extruded becomes calcified. Meconium remains sterile until about 3 hrs after bih; thereafter, unless the perforation has become sealed, sterile meconium peritonitis gives place to acute bacterial peritonitis which unless treated promptly is rapidly fatal. The clinical picture may be that of peritonitis and/or intestinal obstruction. Meconium peritonitis should always be suspected when a baby is born with a tense abdomen, who is vomiting and in whom there is a failure to discharge meconium. Treatment Prognosis is poor but recovery may follow prompt operation. Treatment consists of elimination of intestinal obstruction, closure of perforation and drainage of the peritoneal cavity. Ref : Bailey & Love 24/e, p 1141


Question: Erb's palsy occurs due to involvement of

ERB'S PARALYSIS:- upper plexus injury.Caused by forceful widening of the angle between the head and shoulder which may occur by traction of 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, forearm is extended and pronated. 1. Adduction of arm due to deltoid paralysis.2. Medial rotation of arm-paralysis of supraspinatus, infraspinatus and teres minor.3. Extension of elbow- paralysis of biceps brachii4. Pronation of forearm- paralysis of biceps brachi5. Loss of sensation over outer aspect of arm due to C6 spinal nerve involvement.{Reference: vishram singh, page no. 62}


Question: The upper lip is derived from

The upper lip is formed by the fusion of two maxillary prominences with the two medial nasal prominences Ref : Langman's Medical Embryology 14e pg 295,298.

Maxillary prominence and mandibular prominence

Maxillary prominence and medial nasal prominence

Maxillary prominence and lateral nasal prominence

Mandibular prominence and medial nasal prominence


Question: Duval procedure in case of chronic pancreatitis involves

Surgical procedures in chronic pancreatitis Drainage procedure Duval procedure : Distal pancreatictomy with Roux-en-Y pancteaticojejunostomy (caudal PJ) Ref: Sabiston 20th edition Pgno : 1535

Distal resection of tail of pancreas with end to end pancteaticojejunostomy

Distal resection of tail of pancreas with longitudinal opening of duct and pancteaticojejunostomy

Duodenum preserving pancreatic head resection

Local section of pancreatic head with longitudinal pancteaticojejunostomy


Question: First primary ossification centre to appear of carpal bones is

(A) Capitate # Appearance of Capitate slightly earlier than Hamate, the 3rd carpal which showed its appearance at the age of 3 :o 5 years was Triquetral.> Trapezium, trapezoid and Scaphoid ossified between the ages of 5 to 9 year's in both the sexes


Question: Duschenne dystrophy is a

duchennes Dystrophy is progressive waeknessof gene muscles Dystrophin gene defects Unable to walk after age 13 Progressive. Kyphoscliosis Respiratory failure in 2nd or 3rd decade Refer Robbins 7th/1336


Question: Cholangiocarcinoma has been associated with infection by

Risk factors for cholangiocarcinoma Choledochal cyst Primary sclerosing cholangitis Ulcerative colitis. RPC or hepatolithiasis. Biliary enteric anastomosis HBV, HIV, HCV Choledocholithiasis Clonorchis sinensis and opisthorchis viverrini Cirrhosis Radon Asbestos, Nitrosamines, Dioxib(AND). Diabetes, Obesity, OCP's, smoking, Thorotrast, Isoniazid(DOSTI) Ref: Sabiston 20th edition Pgno :1514


Question: Mental spines provide attachment to

Mental spine also known as genial tubercle, is a small bony elevation found on the inner surface of mandible, in the midline.
There are 4 mental spines - superior and inferior pair.

Superior genial tubercle gives origin to genioglossus muscle of tongue.
Inferior genial tubercle gives origin to geniohyoid muscle.

Anterior & posterior bellies of digastric


Question: Ca urinary bladder commonly presents as

Painless haematuria is by far the most common symptom and should be regarded as indicative of a bladder carcinoma untill proven otherwise." MC primary tumor which gives secondary to penis - bladder carcinoma Commonest tumor of Urinary bladder - transitional cell Ca Commonest tumor of U.B. in a child - rhabdomyosarcoma MC symptom of renal cell Ca - painless hematuria MC symptom of wilm's tumor - mass in abd. MC symptom of bony metastasis - pain MC symptom of renal stone - pain Earliest symptom of vesical calculus - Frequency Cardinal symptom of renal trauma - Hematuria MC symptom of acute aerial occlusion - pain Ref : Bailey & Love 25/e p1336


Question: Deletion of the sho arm of chromosome 11 is seen in

Ref Robbins 8/e p479-480, 9/e pPathogenesis and Genetics. The risk of Wilms tumor is increased with at least three recognizable groups of congenital malformations associated with distinct chromosomal loci. Although Wilms tumors arising in this setting account for no more than 10% of cases, these syndromic tumors have provided impoant insight into the biology of this neoplasm. * The first group of patients has the WAGR syndrome, characterized by Wilms tumor, aniridia, genital anoma-lies, and mental retardation. Their lifetime risk of developing Wilms tumor is approximately 33%. Individuals with WAGR syndrome carry constitutional (germline) deletions of 11p13. Studies on these patients led to the identification of the first Wilms tumor-associated gene, WT1, and a contiguously deleted autosomal dominant gene for aniridia, PAX6, both located on chromosome 11p13. Patients with deletions restricted to PAX6, with normal WT1 function, develop sporadic aniridia, but they are not at increased risk for Wilms tumors.9 479-480


Question: Most common cause of hematocolpos

Hematocolpos is collection of blood in the vagina. Which means the level of obstruction should be at or below the hymen. Cervical atresia will result In hematometra. The commonest cause is imperforate hymen followed by low transverse vaginal septum. The complications include hematometra, hematosalpinx, endometriosis and infeility.


Question: An 18yr old male presents with a draining sinus on his left leg with pus discharge and discharge of bony pieces since 3 months. the diagnosis is

Chronic osteomyelitis is the most common complication of acute osteomyelitis. If infection persists, pus and tiny sequestrated spicules of bone may continue to discharge through perforation in involucrum(cloacae). The hallmark of chronic osteomyelitis is infected dead bone within a compromised soft-tissue envelope. The infected foci within the bone are surrounded by sclerotic, relatively avascular bone covered by a thickened periosteum and scarred muscle and subcutaneous tissue. This avascular envelope of scar tissue leaves systemic antibiotics essentially ineffective. * Secondary infections are common, and sinus track cultures usually do not correlate with cultures obtained at bone biopsy. * Multiple organisms may grow from cultures taken from sinus tracks and from open biopsy specimens of surrounding soft tissue and bone. symptoms Pain, swelling. Discharging sinus. Bone thickening. Deformity. Joint stiffness. Shoening of limb, Pathological fracture. Sinus track malignancy. ref : maheswari 9th ed


Question: In case of IVD with transverse are, following can be done

Management of transverse lie and IUD is done best by ceserean section and others like evisceration and decapitation


Question: 'Boiled lobster' skin appearance seen in

Boric acid dermal: Generalised erythema creating a 'boiled lobster' appearance. There is massive desquamation which is indistinguishable from epidermal necrolysis or staphylococcal scalded skin syndrome in neonates. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 416


Question: Most stable position of ankle is

DORSIFLEXION FOOT:- The forefoot is raised, and the angle between the front of the leg and the dorsum of the foot is diminished.The wider anterior trochlear surface of the talus fits into the lower end of narrow posterior pa of the lower end of tibia.No chance of dislocation in dorsiflexion. PLANTAR FLEXION OF FOOT:-Forefoot is depressed and the angle between leg and foot is increased.The narrow posterior pa of trochlear surface of talus loosely fits into the wider anterior pa of lower end of tibia.High heels causes plantar flexion of ankle joint and its dislocation. 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. Ref - BDC 6e vol 2 pg 150


Question: Commonest acute presentation of sickle cell anemia is

Ref Harrison 19 th ed pg 634 abnormalities provoke unpredictable episodes of microvascular vasoocclusion and premature RBC destruction (hemolytic anemia). Hemolysis occurs because the spleen destroys the abnormal RBC. The rigid adherent cells clog small capillaries and venules, causing tissue ischemia, acute pain, and gradual end-organ damage. This venooc- clusive component usually dominates the clinical course. Prominent manifestations include episodes of ischemic pain (i.e., painful crises) and ischemic malfunction or frank infarction in the spleen, central nervous system, bones, joints, liver, kidneys, and lungs


Question: Embryo proper is derived from

Outer cell mass forms trophoblast.
Inner cell mass forms embryoblast.


Question: Area that lies immediately lateral to the anterior perforating substance is.

Limen insula lies immediately lateral to substantia perforate anterior (i.e. anterior perforating substance).


Question: Diencephalon represents

The diencephalon is the pa of brain between the cerebrum and brainstem.The cavity within it is called third ventricleThe pas of diencephalon are:ThalamusMetathalamusEpithalamusSubthalamusHypothalamus(Ref: Vishram Singh textbook of clinical neuroanatomy Second Edition pg -123)


Question: Primary auditory area is

The cerebrum is the largest pa of the brain and consists of two cerebral hemispheres connected corpus callosum. The surface layer of each hemisphere is called the coex and is composed of gray matter.The frontal lobe is situated in front of the central sulcus and above the lateral sulcus.The parietal lobe is situated behind the central sulcus and above the lateral sulcus.The precentral gyrus lies immediately anterior to the central sulcus and is known as the motor area and control voluntary movements on the opposite side of the body.Most nerve fibers cross over to the opposite side in the medulla oblongata as they descend to the spinal cord. The postcentral gyrus lies immediately posterior to the central sulcus and is known as the sensory areaThe superior temporal gyrus lies immediately below the lateral sulcus. The middle of this gyrus is concerned with the reception and interpretation of sound and is known as the auditory area.Broca's area, or the motor speech area, lies just above the lateral sulcus. The visual area is situated on the posterior pole and medial aspect of the cerebral hemisphere in the region of the calcarine sulcus. It is the receiving area for visual impressions.


Question: Superficial epigastric aery is a branch of

branches of femoral aery - In the femoral triangle, it gives off six branches, three superficial and three deep. The superficial branches are the superficial external pudendal, the superficial epigastric and the superficial circumflex iliac. The deep branches are the profunda femoris, the deep external pudendal and muscular branches. Ref : B D Chaurasi's Human Anatomy , seventh edition , volume 2 , pg. no., 48


Question: Epsilon wave is seen in

Arrhythmogenic right ventricular dysplasia


Question: Mental foramen is located near

On the medial surface of the mandible is the mandibular foramen for inferior alveolar nerve and vessels. The foramen leads in to mandibular-canal which opens on the lateral surface of the mandible at mental foramen, situated below the second premolar tooth.
Fracture of mandible most commonly involves neck.


Question: Treatment of choice for extrahepatic poal thrombosis

Since obstruction is in the poal vein, to bypass the obstruction the shunt should be preferably REX shunt (mesenteric-left poal shunt) Splenorenal shunt is also done in EHPVO but in 50% of patients of EPHVO, splenic vein is thrombosed, not available for splenorenal shunt


Question: In Apoptosis ,cytochrome C acts through

Ref Robbins 8/e p29; 9/e p55 APAF1 (Apoptotic Peptidase Activating Factor 1) is a Protein Coding gene. Diseases associated with APAF1 include Dystrophinopathies and Lung Cancer. Among its related pathways are ApoptosisModulation and Signaling and TP53 Regulates Transcription of Cell Death Genes.


Question: Graham Cole test refers to

Oral cholecystography (Graham Cole Test) Once considered the diagnostic test of choice for gallstones, oral cholecystography has been replaced by ultrasonography It involves oral administration of a Radiopaque compound that is absorbed, excreted by the liver, and passed into the gallbladder Successful visualisation of GB in oral cholecystography depends on Blood flow to liver Ability of the liver cells to excrete dye into the bile (functioning liver) Patency of hepatic and cystic duct system Ability of GB to concentrate to excreted dye (by absorbing water) Ref: schwaz's principle of surgery 10th edition Pgno : 1141


Question: First cell in RBC development is


Question: NOT a hybrid muscle among the following is

Nerve supply of above muscles-
Brachialis

Musculocutaneous Nerve and Radial nerve (proprioception)

Flexor pollicis brevis

Superficial head by Median Nerve
Deep head by Ulnar nerve

Sternocleidomastoid

Spinal accessory nerve and C3 , C4

Adductor pollicis

Ulnar nerve


Question: Reffered pain to Inferior angle of right scapula in acute cholecystitis is known as

It is seen in acute cholecystitis Boa's sign - Hyperaesthesia below the right scapula Murphy's sign- Inspiratory arrest with deep palpation in the RUQ in acute cholecystitis (also known as Naunyn's sign) Cullen's Sign- Periumbilical ecchymosis. Seen in retro peritoneal bleeding associated with severe Pancreatitis Ref: Sabiston 20th edition Pgno : 1526, 1494


Question: Nerve involved in Foot drop

The deep peroneal nerve is the nerve of the anterior compament of the leg and the dorsum of the foot. It is a terminal branch of common peroneal nerve. Its muscular branches are1. Muscles of the anterior compament of the leg; These include: (i) Tibialis anterior, (ii) Extensor hallucis longus. (iii) Extensor digitorum longus, and (iv) Peroneus Teius.2. The extensor digitorum brevis (on the dorsum of the foot), is supplied by the lateral terminal branch of the deep peroneal nerveParalysis of muscles of the anterior compament of the leg results in loss of the power of dorsiflexion of the foot. As a result, the foot is plantar flexed. The condition is called as "foot drop".Reference: Chaurasia Volume II; 7th edition; Page no: 105


Question: An influenza is treated by

Refer KDT 6th/777,778 Oseltamivir and zanamivir are used for An influenza


Question: Most common tumour of hea is

Ref Harrison 19 th ed pg 1577: 289e-1 Myxomas are the most common type of primary cardiac tumor in adults, accounting for one-third to one-half of all cases at postmoem examination, and about three-quaers of the tumors treated surgically. They occur at all ages, most commonly in the third through sixth decades, with a female predilection. Approximately 90% of myxomas are sporadic; the remainder are familial with autosomal dominant transmission.


Question: Choledochal cyst

Carcinoma in Choledochal cyst More than half tumors occur within the cyst itself(intracystic) and may recur after cyst excision Risk of malignancy is decreased after cyst excision, but risk persist even after cyst excision Type I and IV cysts have highest risk of cancer When present most commonly seen along posterior cyst wall If is age related Ref: Sabiston 20th edition Pgno :1511


Question: Right tracheobronchial angle is

Right tracheobronchial angle is 25-30 degree . Ref - Researvhgate.net


Question: Endochondral ossification is seen in

Long bones and medial end of clavicle bone develop by endochondral ossification Flat bones of skull; facial skeleton; mandible and lateral end of clavicle develop by intramembranous ossification. Ref: Gray's39e/p185-210


Question: Sump syndrome occurs most commonly after

SUMP SYNDROME Paiculate matter, stones and food debris accumulate and stagnate in the distal, "blind" end of the common duct SUMP syndrome occurs after choledochoduodenostomy Occasional cause of recurrent cholangitis that can result in anastomotic stricture Management Endoscopic management, consisting of sphincterectomy with or without balloon dilation of the anastomosis End - to-side hepatic jejunostomy, Roux-en-Y, to prevent persistent regurgitation of intestinal contents and to remove the "sump" permenantly, is preferred surgical procedure Ref: Blumga 5th edition Pgno :632


Question: Geniculate ganglion is concerned with


Question: Skin immediately around the umbilicus is supplied by

The immediately around the umbilicus is supplied by the 10th thoracic spinal nerve. The umbilicus itself lies in the junction of the veebrae L3 and L4. ref - BDC 6e vol2 pg198-200

Anterior cutaneous branches of thoracoabdominal nerve T10

Lateral cutaneous branches of thoracoabdominal nerve T10

Anterior cutaneous branches of thoracoabdominal nerve T12

Lateral cutaneous branches of thoracoabdominal nerve T12


Question: Abductor of larynx is

movements and muscles Elevation of larynx; thyrohyoid, mylohyoid Depression of larynx; sternothyroid, sternohyoid Opening inlet of larynx; thyroepiglottic Closing inlet of larynx: aryepiglottic Abductor of vocal cords: posterior cricoarytenoid only Adductor of vocal cords: lateral cricoarytenoid transverse and oblique arytenoids Ref BDC volume 3,sixth edition


Question: Bone tumor arising from epiphyses is

Giant cell tumor refer Robbins page no 1233 Pathogenesis. Current evidence suggests that the neoplas- tic cells of giant cell tumor are primitive osteoblast precur- sors but they represent only a minority of the tumor cells. The bulk of the tumor consists of non-neoplastic osteoclasts and their precursors. The neoplastic cells express high levels of RANKL, which promotes the proliferation of osteoclast precursors and their differentiation into mature osteoclasts RANK expressed by these cells. However, the feedback between osteoblasts and osteoclasts that nor- mally regulates this process during bone remodeling is absent. What results is a localized but highly destructive resorption of bone matrix by reactive osteoclasts. Giant cell tumors arise in the epiphysis but may extend into the metaphysis. The majority arise around the knee (distal femur and proximal tibia), but viually any bone can be involved. The typical location of these tumors near joints frequently causes ahritis-like symptoms. Occa- sionally, they present with pathologic fractures. Most are solitary;


Question: Derivative of 3rd pharyngeal arch

On left , aoic arch; on right, proximal pa of right subclan aery

Common Carotid aery and proximal pa of internal carotid aery

Proximal pa of pulmonary aeries and (on the left only) ductus aeriosus


Question: Esophagus stas at the level of

Esophagus begins in neck at lower border of cricoid cailage. BD CHAURASIA&;S HUMAN ANATOMY.VOLUME 1. 6TH EDITION.PAGE NO 282


Question: The structure passing through the central tendon of diaphragm

IVC passes through central tendon at T8 Veebra level *Along with this few branches of right phrenic N passes.


Question: Coicosteroids are absolutely contraindicated in the following type of Tuberculosis

Ref-KDT 6/e p749 Coicosteroids are absolutely contra-indicated in intestinal TB due to risk of perforation


Question: Acute mesenteric lymphadenitis is caused by

Acute mesenteric lymphadenitis is the diagnosis usually given when enlarged, slightly reddened lymph nodes are encountered at the root of mesentery along with normal appendix when a pt. suspected of appendicitis is opened. "Whether this is a single, discrete entity is unclear, since the causative factor is not known. Some of these patients have an infection with Y. pseudo tuberculosis or Y. enterocolitis, in which case the diagnosis can be established by culture of the mesenteric nodes or by serologic titres. Children seem to be affected more frequently than men.


Question: A typical feature of thoracic veebrae

Typical Thoracic VeebraA. The body is hea-shaped with roughly the same measurements from side to side and anteroposteriorly. On each side, it bears two costal demifacets.B. The veebral foramen is comparatively small and circular.C. The veebral arch1. The pedicles are directed straight backward. The superior veebral notch is shallow, while the inferior veebral notch is deep and conspicuous.2. The laminae overlap each other from above.3. The superior aicular processes project upwards from the junction of the pedicles and laminae. The aicular facets are flat and are directed backward and a little laterally and upwards. This direction permits rotatory movements of the spine.4. The inferior aicular processes are fused to the laminae. Their aicular facets are directed forwards and slightly downwards and medially.5. The transverse processes are large and are directed laterally and backward from the junction of the pedicles and laminae. The anterior surface of each process bears a facet near its tip, for aiculation with the tubercle of the corresponding rib.In the upper six veebrae, the costal facets on the transverse processes are concave and face forwards and laterally. In lower six, the facets are flat and face upwards, laterally and slightly forwards.6. The spine is long and is directed downwards and backward. The fifth to ninth spines are the longest, more veical and overlap each other. The upper and lower spines are less oblique in direction.Ref: Chaurasia; Volume 1 Chapter 13; Bones and Joints of the Thorax


Question: Following inflammatory cells are predominantly seen in tissue with


Question: Upper premolars are supplied by


Question: Most common site of prostatic carcinoma

Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other pas of the body, paicularly the bones and lymph nodes. It may initially cause no symptoms. ref - BDC vol2 6e pg 402


Question: In the treatment of hydatid cyst, PAIR is contraindicated in

Contraindication to PAIR Inaccessible location Pulmonary hydatid cyst Complicated cyst( communicating with biliary tract)

Not amenable to treatment with albendazole


Question: Taste sensation to anterior 2/3 of tongue is supplied by


Question: The connection between External and Internal Jugular vein is

In the middle of the neck, the internal jugular vein may communicate with the external jugular vein through the oblique jugular vein which runs across the anterior border of the sternocleidomastoidReference: Chourasia; 6th edition; 86th page


Question: Nuclei deep within the medial temporal lobes of the brain

The amygdala (almond shaped) is pa of the basal ganglia, and is situated in the temporal lobe. It has many connections with other pas of the brain, most paicularly with the limbic system, for which reason it is considered pa of the limbic system (although not pa of the limbic lobe itself). The amygdala is critically involved in computing the emotional significance of events. The raphe nuclei are a moderate-size cluster of nuclei found in the brain stem. Their main function is to release serotonin to the rest of the brain.The Dentate nucleus is located within the deep white matter of each cerebellar hemisphere. It is the largest of the four deep cerebellar nuclei, the others being the fastigial nucleus and the interposed nucleus (globose and emboliform nuclei combined). It is responsible for the planning, initiation and control of volitional movements.The red nucleus is a structure in the rostral midbrain involved in motor coordination.


Question: Paraxial mesoderm contributes to the development of

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:62At first the cells of the paraxial mesoderm are homogenously arranged. later,the mesoderm gets segmentedThe segments are of two categories, somitomeres, and somitesOccipital somites form muscles of the tongue. somites form the axial skeleton, skeletal muscle, and pa of the skin


Question: Vegetations on under surface of cusps are found in

Refer robbins 9/e 562 Vegetations of libman sacks endocarditis occur on surface of cusps.both surfaces are involved but most commonly affects under surface


Question: Most common cerebellar tumor in children


Question: Paranasal sinuses present at bih

The sinuses are rudimentary or even absent at bih.They enlarge rapidly during the age of 6 to 7 years i.e, at thevtime of eruption of permanent teeth and then after pubey.From bih to adult life, the growth of the sinuses is due to the enlargement of the bones; in old age, it is due to resorption of the surrounding cancellous bone. Ethmoid and maxillary sinuses present at bih Ref BDC volume;3.Sixth edition


Question: Brunner&;s glands are present in

Submucosal glands of duodenum are Brunner's glands, they are mucus, bicarbonate-secreting glands. This helps in protecting duodenal epithelium from acidic secretions of the stomach.


Question: Pancreas is derived from

Pancreas is derived from foregut. Liver and pancreas are present at the junction of foregut and midgut. Oesophagus,stomach,liver,pancreas and duodenum are derived from endoderm of foregut.


Question: Nerve supply to vocal cords is by


Question: Kidney coex contain

Malpighian corpuscle contains bowman capsule and glomerulus which is present in renal coex. End of renal pyramids called papilla along with minor calyx is present in Renal medulla which is inner poion of kidney.


Question: Ureter dervies its blood supply from

The aerial supply of the middle ureter is derived from the common iliac and gonadal aeries. Finally, the distal ureter is supplied by branches of the common iliac and internal iliac branches, paicularly uterine and superior vesical aeries.The venous drainage is paired with the aeries. ref - BDC 6e vol2 pg318


Question: Most common nerve involved in an intracranial aneurysm is

D i.e. Occulomotor nerveIntra cranial aneurysm commonly presents with either an occulomotor (IIIrd)or abducent (VIth) nerve palsy


Question: Lower leg perforators are named after


Question: CRAFFT Questionnaire is used for

Screening parents for abusive tendencies


Question: Neurogenic shock is characterized by

High spinal cord injury there is failure of sympathetic outflow and adequate vascular tone (neurogenic shock). The cause in sepsis is less clear but is related to the release of bacterial products (endotoxin) and the activation of cellular and humoral components of the immune system. There is maldistribution of blood flow at a microvascular level with aeriovenous shunting and dysfunction of cellular utilization of oxygen.


Question: Best graft for infra inguinal approach bypass

The great saphenous veins should be used preferentially in all bypasses, especially in those reconstructions using below-knee popliteal and small tibial aeries as the distal target vessels. PTFE grafts can be used for bypasses to above-knee popliteal aerial segments with satisfactory patency rates. Ref: Sabiston 20th edition Pgno: 1774


Question: Lithogenic bile has the following propeies

An excess of cholesterol relative to bile acids and phospholipids allows cholesterol to form crystals and such bile is called lithogenic or supersaturated bile Lithogenic bile Increased Biliary cholesterol Obesity Cholesterol rich diet Cholesterol therapy Decreased Bile Acids Primary biliary cirrhosis OCP's Mutation of CYP7A1 gene Impaired enterohepatic circulation of bile acids : Ileal disease or resection, cholestyramine or colestipol(bile acid sequestrants) Decreased biliary Lecithin MDR-3 gene mutation leads to defective Lecithin secretion inBile Ref : Sabiston 20th edition Pgno :1492


Question: Muscle not supplied solely by Median nerve

Flexor pollicis brevis is primarily supplied by median nerve. But it's deep head gets supply from Ulnar nerve.


Question: The tip of the T3 spinous proces corresponds to

The tip of the T3 spinous process corresponds to the root of the spine of the scapula. Other impoant surface markings of scapula: Superior angle of scapula : at the level of 2nd rib and veebrae T2. Inferior angle of scapula: opposite the T7 veebral spinous process. Spinous process and their significance Spinous process Significance C2 spinous process Most superior bony protuberance in the midline inferior to the skull C7 spinous process Lower extent of ligamentum nuchae T3 spinous process Level of the root of the spine of the scapula T7 spinous process Level of the inferior angle of the scapula T12 spinous process Midpoint of a veical line between the inferior angle of the scapula and the iliac crest L4 spinous process Level marks the highest point of the iliac crest S2 spinous process Sacral dimples that mark the position of the posterior superior iliac spine are level Ref: Gray's Anatomy 41st edition Pgno: 748


Question: Dissoscited sensory loss is seen in

Refer Robbins page no 1258 Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, paralysis, weakness, and stiffness in the back, shoulders, and extremities.


Question: A patient needs antibiotic treatment for Aificial valve, culture positive infective entercoccal endocarditis. His medical history include several anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with

Ref-KDT 6/e 732 * Severe allergy to penicillins rule out the use of amoxicillin and cefazolin. * Vancomycin is highly effective against MRSA and enterococcal intections. * Drugs for VRSA and VRE (Vancomvcin Resistant enterococcus faecalis) include linezolid and daptomycin.


Question: Structure passing through anterior part of jugular foramen


Question: Somites develop from

Ans. a (Paraxial mesoderm) (Ref. Human Embryology by IB Singh; 6th/ pg. 46)# Splanchnopleuric mesoderm (from lateral plate mesoderm) forms mesothelial covering of visceral organs;# Intermediate plate mesoderm forms urinary and genital systems, adrenal cortex;# Somites that are derived from paraxial mesoderm form the axial skeleton, voluntary musculature, etc.DERIVATIVES OF THE MESODERMAL GERM LAYERRegions of the epiblast that migrate and ingress through the primitive streak have been mapped and their ultimate fates determined, as appended below:# Cells that ingress through the cranial region of the node become notochord;# Those migrating at lateral edges of node and from cranial end of the streak become paraxial mesoderm:# Cells migrating through the midstreak region become intermediate mesoderm:# Those migrating through the more caudal part of the streak form lateral plate mesoderm: and# Cells migrating through the caudal-most part of the streak contribute to extraembrvonic mesoderm.# Intermediate mesoderm connects paraxial and lateral plate mesoderm.Additional educational point:# Sclerotomes give rise to vertebral arches (dorsal sclerotome), vertebral bodies (ventral sclerotome), base of the skull, costal processes and ultimately ribs (in thoracic region).


Question: Operculated sulcus is another name of


Question: The length of oesophagus in adult is

(25 cm) (267-IBS4th) (134-35-Snell 7th)OESOPHAGUS* It extends from the lower part of the neck to the upper part of the abdomen.* The oesophagus is about 25 cm long (10 inch)* The pharyngo-oesophageal junction is the narrowed part of the alimentary canal except for the vermiform appendix.* The oesophagus begins in the neck at the lower border of the cricoid cartilage. It ends by the opening into the stomach at its cardiac end at the level of 11th thoracic vertebra.Constriction-4DistanceCervicalBronchoaorticDiaphragmaticDuodenumDistance from incisor teeth6 in (15 cm)10 in (25 cm)16 in (41 cm)22-26 in (56-66 cm)Distance from nostrils7.2 in (18 cm)11.2 in (28 cm)17.2 in (44 cm)23.2-27.2 in (59-69 cm)Arterial supply* Upper third = Inferior thyroid artery** Middle third = Oesophageal branches of the descending thoracic aorta** Lower third = Left gastric artery*


Question: Antineutrophil cytoplasmic antibodies(ANCA) are seen in

Refer robbins 9/e p511 Granulomatosis with polyangiitis (GPA), formerly known as Wegener granulomatosis, is a rare multisystem autoimmune disease of unknown etiology. Its hallmark features include necrotizing granulomatous inflammation and pauci-immune vasculitis in small- and medium-sized blood vessels. Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a long-term systemic disorder that involves both granulomatosis and polyangiitis. It is a form of vasculitis (inflammation of blood vessels) that affects small- and medium-size vessels in many organs but most commonly affects the upper respiratory tract and the kidneys. Therefore, the signs and symptoms of GPA are highly varied and reflect which organs are supplied by the affected blood vessels. Typical signs and symptoms include nosebleeds, stuffy nose and crustiness of nasal secretions, and inflammation of the uveal layer of the eye. Damage to the hea, lungs and kidneys can be fatal.


Question: Commonly affected nerve in anterior shoulder dislocation is

-dislocation of shoulder joint mostly occurs inferiorly because the joint is least suppoed on this aspect.It often injures the axillary nerve because of its close relation to the inferior pa of the joint capsule. -However clinically it is described as anterior or posteriordislocation indicating whether the humeral head has descended anterior or posterior to the infraglenoid tubercle of the scapula and long head of triceps. -Reference: Textbook of anatomy,Upper llimb and thorax, Vishram Singh, 2nd editon, page no.78


Question: Pouch of Douglas is situated between

The recto-uterine pouch or pouch of douglas is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body. imageref - semantischolar.org


Question: Angle of jaw (or) skin over angle of mandible is supplied by


Question: Internal arcuate fibres of medulla comes from


Question: Main suppo of uterus is provided by following structure

The cervix protrudes into the vagina. The uterus is held in position within the pelvis by condensations of endopelvic fascia, which are called ligaments. These ligaments include the pubocervical, transverse cervical ligaments or Mackenrodt's ligaments or cardinal ligaments, and the uterosacral ligaments. Ref - BDC 6e vol2 pg 391


Question: Valve of heister is seen in

Ans. is 'a' i.e., Cystic ductThe mucous membrane of the cystic duct forms a series of 5-12 crescentic folds, arranged spirally to form the so called spiral valve of Heister. This is not a true valve.Also knowHamanns pouch - dilated posteromedial wall of neck of gall bladder.Sphincter choledochus - always present - terminal pa of bile ductSphincter pancreaticus - usually present - terminal pa of pancreatic ductSphincter ampullae (of Oddi) - surrounds the hepatopancreatic ampulla


Question: Primary curvatures of veebral column are


Question: Sensory innervation of cornea is by nerve

The trigeminal nerve (V) - Three Divisions V1: Ophthalmic nerve V2: Maxillary nerve V3: Mandibular nerve Ophthalmic nerve division Ophthalmic nerve is sensory. Its branches are: Frontal nerve 1. Supratrochlear: upper eyelid, conjunctiva, lower pa of forehead. 2. Supraorbital: frontal air sinus, upper eyelid, forehead, scalp till veex. Nasociliary nerve 1. Posterior ethmoidal: sphenoidal air sinus, posterior ethmoidal air sinuses. 2. Long ciliary: sensory to eyeball. 3. Branch to ciliary ganglion 4. Infratrochlear: both eyelid, side of nose, lacrimal sac. 5. Anterior Ethmoidal: a). Middle and anterior ethmoidal sinuses. b). Medial internal nasal c). Lateral internal nasal d). external nasal: skin of ala of vestibule and tip of nose, Lacrimal nerve Lateral pa of upper eyelid: conveys secretomotor fibers from zygomatic nerve to lacrimal gland.


Question: Muscles spared during injury to cranial root of accessory nerve

All muscles of the pharynx, except stylopharyngeus, are supplied by the pharyngeal plexus


Question: The major venous return of the hea, the coronary sinus, empties into

The coronary sinus empties directly into the right atrium (like IVC, SVC) near the conjunction of the posterior interventricular sulcus and the coronary sulcus.Reference: Chaurasia; 6th edition


Question: Mosaic pattern of lamellar bone histology is found in

Refer Robbins page no 1285 Paget Disease (Osteitis Deformans) Paget disease is a disorder of increased, but disordered and structurally unsound, bone mass. This unique skeletal disease can be divided into three sequential phases: (1) an initial osteolytic stage, (2) a mixed osteoclastic-osteoblastic stage, which ends with a predominance of osteoblastic activity and evolves ultimately into (3) a final burned-out quiescent osteosclerotic stage


Question: A drug X is secreted through renal tubles,tubular secretion of this drug can be confirmed if renal cleraclea of drug X is

Ref-KDT 6/e p30 Atter filtration from glomerulus, a drug may undergo two processes (tubular reabsorption and tubular secretion) before going out from the body i.e renal clearance. Suppose 100 mg of a drug is filtered by glomerulus and the ren clearance is 150mg,it mean 50mg is coming from somewhere else, i.e. tubular secretion must be present. However,we cannot say that reabsorption is not occuring because if 20 mg is reabsorbed and 70 mg is secreted, same thing can Suppose, 100 mg of a drug is filtered but renal clearance is 50 mg. Therefore, 50 mg must have gone somewhere i.e. tubular reabsorption must be occuring, Again, we cannot say that tubular secretion is not present


Question: Secondary spermatocyte is

Secondary spermatocyte is haploid formed by meiotic division Description Human embryology Tenth edition


Question: Length of inguinal canal

INGUINAL CANAL:- Oblique intermuscular passage in the lower pa of the anterior abdominal wall.Extends from deep inguinal ring to superficial.Deep ring- oval opening in fascia transversalis.1.25 cm above mid-inguinal point.Superficial ring: triangular gap in external oblique aponeurosis. Length: 4cm Directed downwards forwards and medially. BOUNDARIES:-1. Anterior wall A. To the whole extend: skinsuperficial fascia and external oblique aponeurosis.B. Lateral one third: internal oblique muscle 2. Posterior wall A. Whole extend fascia transversalis, extraperitoneal tissue, the parietal peritoneum.B. Medial two third: conjoint tendon, reflected pa of inguinal ligament. 3. Roof:arched fibres of internal oblique and transversus abdominis.4. Floor: grooved upper surface of inguinal ligament. Structures passing through:-1. Spermatic cord(males) Round ligament of uterus (f)2. Ilioinguinal nerve. {Reference: BDC 6E pg213}


Question: Type of joint at site marked by the arrow

Image shows costotransverse joint. Costotransverse joint is the joint formed between the facet of the tubercle of the rib and the adjacent transverse process of a thoracic veebra. It is a type of synol joint.


Question: A patient inventing new words, is a feature of

patient inventing new words which is not present in one's dictionary is called neologism neurosis is called for the group of disorders where there is a distress towards the symptoms and patient has insight towards one's own illnes. some of the neurosis disorders are anxiety disorder, phobia, adjustment disorders and others OCD is Obsessive compulsive disorder, it is assosiated with obsessions and compulsions obsessions are recurrent intrusive irrelevant distressing irresistable ego dystonic thoughts van gogh syndrome is self mutilation syndrome inpsychosis Ref.Kaplon and sadock, synopsis o psychiatry, 11 th edition, pg no.192


Question: Most pathognomonic sign of irreversible cell injury

Ribosomes detached from endoplasmic reticulum


Question: Lardaceous spleen is due to deposition of amyloid in

Ref Robbins 9/e p261 Spleen. Amyloidosis of the spleen often causes moderate or even marked enlargement (200 to 800 gm). For obscure reasons, either of two patterns may develop. The deposits may be viually limited to the splenic follicles, producing tapioca-like granules on gross examination ("sago spleen"), or the amyloidosis may principally involve the splenic sinuses, eventually extending to the splenic pulp, with formation of large, sheetlike deposits ("lardaceous spleen"). In both pat- terns, the spleen is firm in consistency. The presence of blood in splenic sinuses usually impas a reddish color to the waxy, friable deposits.


Question: applied tension is used for

Applied tension is used for blood injection phobia where there is hypotension and falls, in these patients falls is because of vasodilatations when we use applied tension there may be constriction of hand and leg muscles which prevents vasodilation and prevents falls. Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 845


Question: Russell bodies are accumulations of

Ref Robbins 9/e p63 Russell bodies are eosinophilic, large, homogeneous immunoglobulin-containing inclusions usually found in a plasma cell undergoing excessive synthesis of immunoglobulin; the Russell body is characteristic of the distended endoplasmic reticulum. They are found in the peripheral areas of tumors. Russell bodies are thought to have originated as an SOS compament, where abnormal proteins that are not secreted, but have fled intracellular degradation, can gather without blocking normal secretory pathways. The excess immunoglobulin builds up and forms intracytoplasmic globules, which is thought to be a result of insufficient protein transpo within the cell. This causes the proteins to neither be degraded or secreted and stay stored in dilated cisternae. In 1949, Pearse discovered that Russell bodies also contain mucoproteins that are secreted by plasma cells. Russell bodies are not tissue specific; during research they were induced in rat glioma cells.Russell bodies were found to have positive reactions to PAS stain, CD 38 and CD 138 stains. Plasma cellsthat contain Russell bodies and are stained with H&E stain are found to be autofluorescent, while those without Russell bodies are not autofluorescent. Russell bodies tend to be found in places with chronic inflammation. Multiple aggregates of Russell bodies create what are known as Mott cells


Question: Commonest type of intracranial tumor is


Question: The chief source of blood supply to head and neck of femur is derived from

The head of the femur is paly supplied by a branch of obturator aery along the ligamentum teres.Main aerial supply is from retinacular aeries, branches of the medial femoral circumflex aery.These aeries get injured in intracapsular fracture of neck of femur, leading to avascular necrosis of the head.BDC 6th edition (Abdomen & lower limb) pg: 32

Acetabular branches of medial circumflex femoral aery

Retinacular branches of medial circumflex femoral aery


Question: Summit of medial longitudinal arch

Summit of medial longitudinal arch is Talus.
Summit of lateral longitudinal arch is Calcaneum.


Question: Tolllike receptor, recognise bacterial products and stimulate immune response by

Ref Robbins 9/e p187 The ability of immune system to recognize moleculesthat are broadly shared by pathogens is, in pa, due to the presence of Immune receptors called toll-like receptors (TLRs) that are expressed on the membranes of leukocytes including dendritic cells, macrophages, natural killer cells, cells of the adaptive immunity (T and B lymphocytes) and non immune cells (epithelial and endothelial cells, and fibroblasts). The binding of ligands - either in the form of adjuvant used in vaccinations or in the form of invasive moieties during times of natural infection - to the TLR marks the key molecular events that ultimately lead to innate immune responses and the development of antigen-specific acquired immunity. Upon activation, TLRs recruit adapter proteins(proteins that mediate other protein-protein interactions) within the cytosol of the immune cell in order to propagate the antigen-induced signal transduction pathway. These recruited proteins are then responsible for the subsequent activation of other downstream proteins, including protein kinases(IKKi, IRAK1, IRAK4, and TBK1) that fuher amplify the signal and ultimately lead to the upregulation or suppression of genes that orchestrate inflammatoryresponses and other transcriptional events. Some of these events lead to cytokine production, proliferation, and survival, while others lead to greater adaptive immunity. If the ligand is a bacterial factor, the pathogen might be phagocytosed and digested, and its antigens presented to CD4+ T cells. In the case of a viral factor, the infected cell may shut off its protein synthesis and may undergo programmed cell death (apoptosis). Immune cells that have detected a virus may also release anti-viral factors such as interferons.

Perforin and granzyme mediated apoptosis

Transcription of nuclear factor mediated by N-FkBwhich recruits cytokine


Question: Poal vein is formed

Poal vein is formed behind the neck of pancreas where the splenic vein and superior mesentric vein terminates and continue as poal vein. Ref: Human anatomy, 7th edition, BD Chaurasia, pg:328


Question: Adson's test is positive in

Adson's sign is the loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration . Ref : S. Das surgery 3/e p641


Question: Hodgkin's lymphoma caused for by

Ref Robbins 9/e p607 One clue stems from the involvement of EBV. EBV is present in the RS cells in as many as 70% of cases of the mixed-cellularity subtype and a smaller fraction of other "classical" forms of Hodgkin lymphoma. More impoant, the integration of the EBV genome is identi- cal in all RS cells in a given case, indicating that infection precedes (and therefore may be related to) transformation and clonal expansion. Thus, as in Burkitt lymphoma and B cell lymphomas in immunodeficient patients, EBV infection prob- ably is one of several steps contributing to tumor develop- ment, paicularly of the mixed-cellularity subtype. The characteristic non-neoplastic, inflammatory cell infil- trate is generated by a number of cytokines, some secreted by RS cells, including IL-5 (which attracts and activates eosin- ophils), transforming growth factor-b (a fibrogenic factor), and IL-13 (which may stimulate RS cells through an autocrine mechanism). Conversely, the responding inflammatory cells, rather than being innocent bystanders, produce additional factors such as CD30 ligand that aid the growth and survival of RS cells and contribute fuher to the tissue reaction.


Question: Type of Sacroiliac joints in pelvis are

The pelvic bones are joined by four aiculations (two pairs): Two cailaginous symphyseal joints: the sacrococcygeal joint and the symphysis pubis. These joints are surrounded by strong ligaments anteriorly and posteriorly, which are responsive to the effect of relaxin and facilitate paurition. Two synol joints: the sacroiliac joints. These joints are stabilized by the sacroiliac ligaments, the iliolumbar ligament, the lateral lumbosacral ligament, the sacrotuberous ligament, and the sacrospinous ligament.Reference: Berek and Novak's Gynecology; 14th edition; Chapter 5; Anatomy and Embryology


Question: Basic pathology in cystic fibrosis is

Ref Robbins 9/e p222 Cystic fibrosis is an autosomal recessive disorder affecting the lungs, pancreas, intestines, sweat ducts and liver, due to an abnormal salt transpo across the apical border of epithelial cells. Mutations in the CF underlying gene, the cystic fibrosis transmembrane conductance regulator (CFTR) gene, result in most cell types in an misprocessing so that little of the protein reaches the membranes. In case of clinical suspicion and/or doubtful sweat test results, mutation analysis can suppo the diagnosis of CF. Also carrier detection is offered. PATHOPHYSIOLOGY CF is caused by a mutation in the CF transmembrane conductance regulator (CFTR) gene. The CFTR protein produced by this gene regulates the movement of chloride and sodium ions across epithelial cell membranes.Figure 1).Pseudomonas, Haemophilus influenza, and Staphylococcus aureus. These pathogens cause an overwhelming inflammatory response. Ultimately, chronic infection and this repetitive inflammatory response can lead to airway destruction.CF is inherited in an autosomal recessive manner. It is caused by the presence of mutations in both copies of the gene for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Those with a single working copy are carriers and otherwise mostly normal. CFTR is involved in production of sweat, digestive fluids, and mucus. When the CFTR is not functional, secretions which are usually thin instead become thick. The condition is diagnosed by a sweat test and genetic testing. Screening of infants at bih takes place in some areas of the world.

Defect in the transpoation of chloride across epithelia

Defect in transpo of sodium across epithelia

Defect in transpo of potassium across epithelia

Defect in transpo of bicarbonate across epithelia


Question: Grade I lymphedema means


Question: Merkels cells of Epidermis are derived from

(C) Neural crest # MERKEL CELLS, which are believed to be derived from the neural crest, contain many large (50-100 nm) dense-cored vesicles, presumably containing transmitters, which are concentrated near the junction with the axon. F.S. Merkel referred to these cells as Tastzellen or "touch cells" Merkel cells are found in the skin and some parts of the mucosa (stratum germinativum) of all vertebrates. In mammalian skin, they are clear cells found in the stratum basale (at the bottom of sweat duct ridges) of the epidermis approximately 10 pm in diameter. They also occur in epidermal invaginations of the plantar foot surface called rete ridges. Most often, they are associated with sensory nerve endings, when they are known as Merkel nerve endings (Merkel cell-neurite complex). They are associated with slowly adapting (SA1) somatosensory nerve fibers. They are associated with the sense of light touch discrimination of shapes and textures. They can turn malignant and form the skin tumor known as Merkel cell carcinoma.DERIVATIVES OF NEURAL CRESTDerivative of neural crestDeveloping partsNeurons1. Spinal posterior nerve root ganglion (dorsal root ganglia) 2. Sensory ganglia of V, VII, VIII, IX & X cranial nerves 3. Sympathetic gangliaPiamater & Arachnoid mater (Not duramater)--Schwann cellsNeurolemmal sheaths of all peripheral nervesAdrenal medullaChromaffin tissuePigment cells of skinMelanoblasts; Merkel's cells of epidermisMesenchyme of dental papilla & Odontoblasts--Cells from cranial part of neural crest (Somatomeres)Development of musculature of head & in formation of face


Question: Phossy jaw is seen in chronic

Phossy jaw It is a type of osteomylitis of the jaws observed in chronic phosphorus poisoning. Frequent inhalation of fumes for many years may cause necrosis of the lower jaw in the region of a decayed tooth. It is common among workers, in phosphorus industries, who are exposed to phosphorus fumes Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 432


Question: Weight of liver

A human liver normally weighs 1.44-1.66 kg or1400 - 1600gm. It is both the heaviest internal organ and the largest gland in the human body. ref - BDC 6e Vol2 pg304


Question: Primitive streak is initiated and maintained by

Ans. is 'a' i.e. Nodal gene "The primitive streak in itself is initiated and maintained by expression of Nodal, a member of the transforming growth factor b (TGFb) family." - Longman's Medical embryology 10/e, p 57


Question: Most common valvular lesion in carcinoid syndrome of the hea is


Question: Skin over femoral triangle supplied by

GENITOFEMORAL NERVE:- L1 L2Pierces the femoral sheath and overlying deep fascia 2 cm below the midinguinal point.Supplies most of the skin over femoral triangle. ILIOHYPOGASTRIC NERVE:-Branch of lumbar plexus.L1Anterior division. ILIOINGUINAL NERVE:-L1Emerges at the superficial inguinal ring Supplies skin at the root of penis or over the mons pubis in females, the anterior 1/3 rd of scrotum or labia majus, and superomedial aspect of thigh. LATERAL CUTANEOUS NERVE OF THIGH:-L2L3Branch of lumbar plexus Supplies skin over Anterolateral side of thigh and on the anterior pa of gluteal region. <img src=" /> {Reference: BDC 6E pg no.42}


Question: The derivative of midgut among the following is

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:188Caecum and appendixThe caecal bud is a diveiculum that arises from the post aerial segment of the midgut Loop. The caecum and appendix are formed by the enlargement of this bud. The proximal pa of the bud grows rapidly to form the caecum. Its distal pa remains narrow and forms the appendix


Question: During the active phase of labor the minimum effective dilatation of cervix in primigravida should be at the rate of

Effective dilatation of cervix in a primigravida during active phase of labor is 1cm/hr