Question: Hemotoxylin bodies seen in

Ref Robbins 9/e p218 Systemic lupus erythematosus (SLE) is a multisystem auto- immune disease of protean manifestations and variable clinical behavior. Clinically, it is an unpredictable, remit- ting and relapsing disease of acute or insidious onset that may involve viually any organ in the body; however, it affects principally the skin, kidneys, serosal membranes, joints, and hea. Immunologically, the disease is associ- ated with an enormous array of autoantibodies, classically including antinuclear antibodies (ANAs). The clinical pre- sentation of SLE is so variable, with so many overlapping features with those of other autoimmune diseases (RA, polymyositis, and others), that it has been necessary to develop diagnostic criteria for SLE (Table 4-9). The diag- nosis is established by demonstration of four or more of the criteria during any interval of observation. Hematoxylin bodies are seen these are deposition of antigen antibody complexes in various tissues


Question: Anterior choroidal aery is a branch of

After piercing the dura mater forming the roof of the cavernous sinus, the internal carotid aery gives off three large branches. These are the following. (i) Ophthalmic aery (which supplies the orbit), and the (ii) Anterior and Middle cerebral aeries to the brain.It also gives off two smaller branches that take pa in supplying the brain: these are the (iv) Posterior communicating aery and the (v) Anterior choroidal aery.Ref: BD Chaurasia; volume 3; 6th edition; Page no: 384


Question: Investigation of choice in early phase of renal transplant


Question: Aoic opening is present at the veebral level of

The aoic hiatus is a opening in the diaphragm. It is the lowest and most posterior of the large apeures. It is located approximately at the level of the twelfth thoracic veebra (T12). ref - semantischolar.org


Question: Pterygopalatine ganglion supplies

Pterygopalatine is the largest parasympathetic peripheral ganglion. It serves as a relay station for secretomotor fibres to the lacrimal gland and to the mucous glands of the nose, the paranasal sinuses, the palate, and pharynx. Topographically, it is related to the maxillary nerve, but functionally it is connected to the facial nerve through its greater petrosal branch. The flattened ganglion lies in the pterygopalatine fossa just below the maxillary nerve, in front of the pterygoid canal and lateral to the Sphenopalatine foramen. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Illusions are a disorder of

Read definitions of sensation, perception, Also know types of perceptual differences


Question: Hepatic vein drains into

B. i.e. (Inferior vena-cava) (317- BDC-2 4th) (245- Snell 8th)The portal vein enters the liver and breaks up into sinusoids, from which blood passes into the hepatic veins that join the inferior vena cava.Tributaries of the Portal veinTributaries of Inferior vena-cava* Splenic vein* Inferior mesenteric vein* Superior mesenteric vein* Left gastric vein* Right gastric vein* Cystic vein1. Common iliac veins2. Third and fourth lumber veins3. Right testicular or ovarian vein4. Renal vein5. Right supra renal vein6. Hepatic veins** Inferior mesenteric vein is found in paraduodenal fossa


Question: Blow back phenomenon seen in

Blow back phenomenon in hard contact: This is most frequently seen in gunshot wounds on the head where the hot expanding gases forced back between the scalp and skull are released by creating tears in the scalp. The margins will be eveed due to gases coming out under pressure. Sometimes, due to negative pressure tissue fragments may be drawn into the barrel and outside called black spatter. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 148


Question: Marker for B lymphocytes

Ref immunology by Roitt 6/e p 29; 30; 19 ;9/e p191 CD 19,20,22 are main markers of human B cells .othersB cell markers are CD72 and CD78


Question: Thymus is developed from


Question: Milk teeth total number in human being

Milk teeth: Dental formula in children is 2,1,0,2. That is in one half of each jaw 2 incisors 1 canine 0 premolars 2 molars As there are 4 half's , 5x4= 20. There are 20 milk teeth. Ref : Ghai ,9th edition, chapter 2


Question: Injury to long thoracic nerve leads to

Injury to long thoracic nerve causes paralysis of serratus anterior muscle which clinically manifests as winging of scapula. The patient also finds difficulty in overhead abduction and touching the opposite shoulder. B D Chaurasia 7th edition Page no: 45


Question: Structure forming the Posterior 1/3 of veebral canal is (JIPMER May 2019)

At tip of spine of veebra there is Supra-Spinous Ligament Inter-Spinous Ligament b/w two spines & Ligamentous Flavum - ligament connecting lamina of veebral arch superiorly to next adjacent veebra (gives elasticity to veebral canal) forming post 1/3rd of veebral canal.


Question: Lateral cutaneous nerve of forearm is continuation of

Lateral cutaneous nerve of forearm ( C5, C6 ) is the continuation of musculocutaneous nerve. It pierces deep fascia just lateral to the tendon of biceps 2-3 cm above the bend of the elbow, and supplies the skin of the lateral side of forearm, extending anteriorly to a small pa of the ball of the thumbs. B D Chaurasia 7th edition Page no: 79


Question: In the postnatal period the greatest growth in the grey matter of the C.N.S. is of

The brain of newborn weighs approximately 300-350g. By 12 months, it reaches about two-thirds of adult brain. The postnatal growth of cerebral hemispheres results mainly from myelination. Myelination continues long after gray matter has reached a specific volume.


Question: Elastic cailages is found in

Distribution of elastic cailage-it forms the &;skeletal &;basis of the auricle and of the lateral pa of the external acoustic meatusINDERBIR SINGH&;S TEXT BOOK OF HUMAN HISTOLOGY-reference,page no:85


Question: A patient comes with the H/O swelling in the submandibular region. He is diagnosed to have submandibular abscess. The incision to drain the abscess is put 1 cm below the base of the mandible because

The submandibular gland appears 1 cm below the mandible

It is difficult to incise along the margin of the mandible

The marginal mandibular nerve may be injured if incision is along the base of mandible

To avoid injury to the cervical branch of facial nerve


Question: The classical lobule of the liver is centred around

The "classic" liver lobule is the sixsided polyhedral prism with poal triads (hepatic aery, poal vein, and bile duct) at each of the corners. The vessels of the poal triads send distributing branches along the sides of the lobule, and these branches open into the sinusoids. The long axis of the lobule is transversed by the central vein, and this vessel receives blood from the sinusoids. Interconnecting sheets of hepatocytes are disposed in a radial pattern from the central vein to the perimeter of the lobule. Ref - pubmed.com


Question: Nerves of pharyngeal cleft develop from

Neural tube - upper pa: Brain CNS neural plate lower pa: Spinal cord ectoderm Neural crest - ganglia of PNS ARCH. NERVE MUSCLES SKELETON I. Main: CNV (III)Additional: chorda Tympani: (CNVII) Muscles of mastication (temporal, masseter & the pterygoids) ant. Belly of digastric, tensor palatini, tensor tympani. Premaxilla, maxilla, zygomatic, Mandible, malleus, incus, anterior, ligament of malleus, sphenomandibular ligament, meckel's cailage. II. Main: CN VII Additional: tympanic branch of glossopharyngeal nerve (CN IX) Muscles of facial expression, posterior belly of digastric, stylohyoid, stapedius Stapes, styloid process, stylohyoid ligament, lesser horn & upper poion of body of hyoid bone. III. CN IX - glossopharyngeal Stylopharyngeus Greater horn & lower pa of hyoid bone V-VI CNX - vagusSuperior laryngeal n - 4th arch Recurrent laryngeal n - 6th arch Cricothyroid, levator palatine, constrictors od pharynx intrinsic muscles of larynx Laryngeal cailage (thyroid, cricoid, arytenoid, corniculate, uniform) Nerves of pharyngeal arches : each arch has a main nerve derived from the neural plate and an additional nerve derived from NCC. The additional nerves are the nerves of pharyngeal clefts. (Derived from NCC) Fig. Each pharyngeal arch is supplied by its own cranial nerve. The trigeminal nerve supplying the first pharyngeal arch has three branches: the ophthalmic, maxillary, and mandibular. The nerve of the second arch is the facial nerve; that of the third is the glossopharyngeal nerve. The musculature of the fouh arch is supplied by the superior laryngeal branch of the vagus nerve, and that of the sixth arch, by the recurrent branch of the vagus nerve.


Question: Nutrient aery to fibula arises from

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


Question: Not seen in carpal tunnel syndrome

Carpal tunnel syndrome is compression of medial nerve below flexor retinacalum. Palmar cutaneous branch is given before median nerve pierces below flexor retinacalum and hence no loss of sensation on lateral 3⅓ of palm.


Question: Substantia gelatinosa corresponds to

The Rexed laminae comprise a system of ten layers of grey matter (I-X), identified in the early 1950s by Bror Rexed to label poions of the grey columns of the spinal cord NOTE: Lamina I: posteromarginal nucleus Lamina II: substantial gelatinosa of Rolando Laminae III and IV: nucleus proprius Lamina V& VI: base of the dorsal horn. Lamina VII: intermediomedial nucleus, intermediolateral nucleus, nucleus dorsalis Lamina VIII & IX: medial and lateral groups of nuclei of anterior grey column Lamina X: Central Zone, grey matter surrounding the central canal ref - vishram singh neuroanatomy 2e pg59


Question: In high risk population , HCC is best detected by

Diagnosis Focal lesion 1-2 cm: Two imaging techniques with aerial hypervascularization and venous wash out Focal lesion> 2cm: One imaging technique with aerial hypervascularization and venous washout Techniques to be considered : Dynamic CT and MRI Screening is based on regular ultrasound scanning in high risk population Biopsy proof of HCC is not required Ref: Sabiston 20th edition 1458-1463


Question: A person suffered a fracture of neck of fibula followed by foot drop. The involved nerve is

Common peroneal nerve is in close relation to Neck of fibula and on damage leads to foot drop.


Question: Cords of Billroth in spleen are found in

75% of spleen is red pulp, predominantly having RBCs. 25% of spleen is white pulp, predominantly having WBCs Red pulp contains sinusoids which are filled with RBCs & blood and splenic cords of billroth White pulp contains lymphoid follicles &periaerial lymphatic sheath.


Question: Denver's shunt is used in

A peritoneal-venous shunt (also called Denver shunt) is a shunt which drains peritoneal fluid from the peritoneum into veins, usually the internal jugular vein or the superior vena cava. It is sometimes used in patients with refractory ascites. It is a long tube with a non-return valve running subcutaneously from the peritoneum to the internal jugular vein in the neck, which flows ascitic fluid to pass directly into the systemic circulatio Ref Bailey and love 27 e Liver


Question: In case of occlusion occurs at the 2nd pa of Axillary aery, blood flow is maintained by collateral/ anastomosis between

Ligation, thrombosis or trauma of axillary aery anywhere between origins of thyrocervical trunk &subscapular aeries will not lead to compromise of distal arm flow.

Anterior and posterior circumflex humor and aery

Supra scapular and posterior circumflex aery

Deep branch of the transverse cervical aery and sub scapular aery

Anterior circumflex aery and sub scapular aery


Question: Lining of common bile duct

Common bile duct is lined by simple columnar epithelium , simple cuboidal epithelium at it's proximal region. Ref: IB Singh textbook of histology 6e pg 268.


Question: Cranial nerve not carrying parasympathetic fibers

Ans. is 'a' i.e. Fourth Four cranial nerves CN III, CN VII, CNIX & CN X carry presynaptic parasympathetic (visceral motor) axons as they emerge from brain stem.Parasympathetic fibres carrying cranial nervesAssociated GanglionOcculomotor (III)Ciliary ganglionFacial (VII)Pterygopalatine & Submandibular ganglionGlossopharyngeal (IX)Otic ganglionVagus (X)Visceral ganglionsAlso know:Pure motorPure sensory (unique/special sensation carrying)MixedOcculomtor (III)Trochlear (IV)Abducent (VI)Spinal accessory (XI)Hypoglossal (XII)Olfactory (I)Optic (II)Vestibulocochlear VIII)Trigeminal (V)Facial (VII)Glossopharyngeal (IX)Vagus (X)Olfactory nerve (CNI) is the only sensory cranial nerve that projects directly to the cerebral cortexOptic nerve terminates in the thalamus while the other ten pairs of C.N. are attached to brain stem.Except the vagus N., all the cranial nerves are confined to head & neck.Trochlear N. is the only cranial nerve to emerge from the dorsal surface of the brain stem.Trochlear N. is the smallest cranial nerve in terms of axons it contains. It supplies only one muscle - the superior oblique.Trochlear N. has the longest intracranial course.


Question: Erb’s palsv involves

ERB’S PARALYSIS

 One region of upper trunk (C# Cf Q of the brachial plexus is called Erb's point where six nerves meet,
 Injury at this point results in Erb’s paralysis.
 The injury is due to undue separation of the head from the shoulder; which may be seen in: - i. Birth injury ii. Fall on the shoulder iii. During Anesthesia Clinical features of Erb’s palsv A.

Muscles paralysed: Mainly biceps brachii Q , deltoid, branchialis and brachioradialis. Partly supraspinatus Q , infraspinatus Q and supinator.
B. Deformity (position of the limb) i. Arm : Hanges by the side; it is adducted and medially rotated Q ii. Forearm : Extended and pronated 0
The deformity is known as “policeman's tip hand’ or ‘porter’s tip hand’. C. Disability : The following movements are lost. o Abduction Q and lateral rotation of the arm (shoulder) Q ,

 Flexion and supination of the forearmQ ,
 Biceps and supinator jerks are lost.
 Sensations are lost over a small area over the lower part of the deltoid. KLUMPKE’S PARALYSIS
 Site of injury : Lower trunk of the brachial plexus Q
Cause of injury:

Undue abduction of the arm, as in clutching something with the hands after a fall from a height, or sometimes in birth injury,

 Nerve roots involved : - Mainly T1 and partly C8.
 Muscles paralysed i. Intrinsic muscles of the hand (T1). ii. Ulnar flexors of the wrist and fingers (C8) iii.

Deformity (position of the hand). Claw hand due to the unopposed action of the long flexors and extensors of the fingers.
In a claw hand there is hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints.
Disability i. Claw hand ii. Cutaneous anaesthesia and analgesia in a narrow' zone along the ulnar border of the forearm and hand.
iii. Homer’s syndrome if T1 is injured proximal to white ramus communicans to first thoracic sympathetic ganglion.
There is ptosis, miosis, anhydrosis, enophthalmos, and loss of ciliospinal reflex-may be associated.
(This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T1). iv. Vasomotor changes :
The skin area with sensory loss is warmer due to arteriolar dilation. It is also drier due to the absence of sweating as there is loss of sympathetic activity.
v. Trophic changes : Long standing case of paralysis leads to dry and scaly skin. The nails crack easily with atrophy of the pulp of fingers.


Question: The clot formed after coagulation cascade is not stable unless extensive cross linking occurs .this is done by

Ref Robbins 9/e p119 Thrombin is the principal enzyme of hemostasis. It catalyzes the conversion of fibrinogen to fibrin and activates procoagulant factors V, VIII, XI, and XIII. Additionally, when bound to thrombomodulin, it activates protein C, an anticoagulant zymogen


Question: Most common site of pheochromocytoma after adrenal gland is

Refer Robbins page no 1134 hormone-secreting tumour that can occur in the adrenal glands. Phaeochromocytomas usually develop in the small glands on top of the kidneys (adrenal glands). They most commonly affect people between the ages of 20 and 50, but can occur at any age.


Question: Local anesthetics act by

Forming area of nerve block along a neuron

Binding to calcium receptor on nerve membrane

Blocking calcium channels of nerve membrane


Question: Risk of malignancy in BIRADS score 2 is

BIRADS score - Breast Imaging Repoing and Data System Category 2- Negative, routine mammogram in 1 year is recommended


Question: The trapezoid body is concerned with

Trapezoid body is a trapezium-shaped mass of white matter lying in the anterior pa of tegmentum, posterior to basilar pa of pons.It is formed by decussation of transversely running fibres arising from cochlear nuclei of both sides before it reaches the superior olivary nucleus. This decussation is believed to help in localization of sound.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 80)


Question: Scheuerman"s disease occurs in

Scheuermann deformity is the osteochindritis of ring epiphysis of veebrae. REF : MAHESWARI 9TH ED


Question: Tumour arising from Rathke's pouch is

Rathke's pouch develop at the roof of oral cavity from surface ectoderm to form most of pituitary . Posterior pituitary develops from diencephalon. Craniopharyngioma is a tumor that develop in the sella turcica.


Question: Esophageal opening in diaphragm is at the level of

Oesophagus pierces diaphragm at level of tenth thoracic veebrae. BD CHAURASIA&;S HUMAN ANATOMY VOLUME 1. 6TH EDITION Page no- 282


Question: Appendicular aery is a branch of

The appendicular aery is a terminal branch of the ileocolic aery that descends behind the termination of the ileum and enters the mesoappendix of the vermiform appendix. It runs near the free margin of the mesoappendix and ends in branches which supply the appendix. ref - sciencedirect.com


Question: Compartment involved in Dequervian's tenosynovitis

Extensor pollicis brevis and abductor pollicis longus are invovled in Dequervian's tenosynovitis.
The condition is tested using FRINKELSTEIN test.


Question: Water lilly appearance in a chest radiograph suggests


Question: Modiolus is directed

The bony cochlea resembles the shell of a common snail. It forms the anterior pa of the labyrinth. It has a conical central axis known as the modiolus around which the cochlear canal makes two and three quaer turns. The modiolus is directed forwards ( anteriorly ) and laterally.


Question: Wear and tear pigment in the body refer to


Question: Common carotid artery divides at the level of

Ans. is 'c' i.e. Superior border of thyroid cartilage Common carotid artery ends at the level of upper border of the thyroid cartilage by dividing into external & internal carotid arteries Also remember the following imp. levels * Sternal angle- costal cartilage of 2nd rib, T4/T5IV disc* Xiphoid process- T9* Tracheal bifurcation- T4/T5 IV disc* Trachea extends from- C6 to T5* Arch of aorta begins and ends at- T4* Aortic opening in diaphragm- T12* Esophageal opening in diaphragm- T10* Vena caval opening in diaphragm- T8* Thoracic duct crosses from Rt to Left- T5* Splenic axis- 10th rib* Celiac trunk arises- T12/L, IV disc* Superior mesenteric artery arises- LI* Renal arteries- L1/L2* Inferior mesenteric artery- L3* Aorta ends by bifurcating into common iliac arteries- L4* IVC begins at- L5* Umbilicus- L3/L4


Question: Spinal cord develops from

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:325Spinal cordThe spinal cord is developed from the coudal cylindrical pa of the neural tube. when this pa of the neural tube is formed, its cavity its cavity is in the form of a dorsal ventricular cleft


Question: Left sided poal hypeension is best treated by

Left sided poal hypeension Poal hypeension due to isolated splenic vein thrombosis is known as left sided poal hypeension or sinistral hypeension Pressure in poal vein and SMV are normal There is gastrosplenic venous hypeension leading to formation of gastric varices Causes Pancreatitis (most common) leading to splenic vein thrombosis Neoplasm Trauma Treatment Splenectomy is the treatment of choice Ref: Sabiston 20th edition Pgno : 1436-1437


Question: Heerfordt's syndrome cosists of fever , parotid enlargement facial palsy

Ref Harrison 18/e p2806 Lofgren's syndrome consists of erythema nodosum, hilar adenopathy on chest x-ray and uveitis Heerfordt's syndrome .: Fever , parotid enlargement , facial palsy , uveitis


Question: This permanent tooth is

First molar is the first permanent tooth to appear, 6-7 yrs


Question: Tympanic branch of the middle ear is derived from

NERVE SUPPLY OF MIDDLE EAR: The tympanic branch of the glossopharyngeal nerve. Its fibres are distributed to the mucous membrane of the middle ear, the auditory tube, the mastoid antrum and air cells.It also gives off the lesser petrosal nerve. The superior and inferior coicotympanic nerves arise from the sympathetic plexus around the internal carotid aery. These fibes are vasomotor to the mucous membrane. Ref BDC volume 3,sixth edition pg 281


Question: Approximate distance of diphragmatic constriction from nostril & incisor are


Question: Structures at Angle of Louis

Sternal angle/Louis angle:It is felt as a transverse ridge about 5cm below the suprasternal notch.It marks the manubriosternal joint and lies at the level of the second costal cailage anteriorly and the disc between the fouh and fifth thoracic veebrae posteriorly.This is an impoant landmark for many reasons.The arch of aoa begins and also ends at this level. BD CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX SIXTH EDITION VOLUME 1.PAGE NO187


Question: Histamine causes

ref Robbins 7/e p64;9/e p73 As pa of an immune response to foreign pathogens, histamine is produced by basophils and by mast cells found in nearby connective tissues. Histamine increases the permeability of the capillaries to white blood cells and some proteins, to allow them to engage pathogens in the infected tissues.


Question: Resistance to Zidovudine develops due to

Zidovudine is a nucleoside reverse transcriptase inhibitors which is a viral enzyme .HIV undergoes mutations in this enzyme to become resistant to NIs Refer :KDT 6/e p770

Increased efflux of the drug from inside the cell

Decreased Zidovudine 5 triphosphate formation


Question: Antiglaucoma drug used to increase uveoscleral outflow is

(Refer: Parson's, 21stedition, pg no: 154,155)


Question: Central dot is seen in

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


Question: Wide fixed split S2 occurs in

Ref Harrison 19 th ed pg 1447 Fixed splitting of S2 , in which the A2 -P2 interval is wide and does not change during the respiratory cycle, occurs in patients with a secundum atrial septal defect.


Question: Ultra structure finding of irreversible injury

Amorphous densities in mitochondria Ref , Robbins 7/e p41-2 ,9/ep42

Ribosomal detachment from endoplasmic reticulum


Question: Elimination after 3 half lives in first order kinetics is

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


Question: antipsychotic drug approved for the managemnt of parkinsonian patients

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


Question: The inferior most structure of right hilum is

The inferior most structure of right hilum is inferior pulmonary vein. The sequence of structures at the right hilum superior to inferior is: Superior lobar (epaerial) bronchus. Pulmonary aery Principal bronchus Inferior pulmonary vein Ref: Gray&;s Anatomy 41st edition Pgno: 958


Question: In multiparous women, sho labor is defined as a rate of cervical dilatation of

Sho labors were defined as a rate of cervical dilatation of 5 cm/hr or faster for nulliparas and 10cm/hr for multiparas. Such sho labors were more common in multiparas who typically had contractions at intervals less than 2 minutes and were associated with placental abruption, meconium, postpaum hemorrhage, cocaine abuse, and low Apgar scores.Precipitous labor terminates in the expulsion of the fetus in < 3 hours.Ref: William&;s obstetrics; 24th edition; Chapter: 23


Question: Nerve supply of the papillary muscle, the sphincter papillae is done through

The ciliary ganglion is a peripheral parasympathetic ganglion topographically connected with the nasociliary nerve from ophthalmic division of trigeminal nerve but functionally connected to the oculomotor nerve.The motor or parasympathetic root of the ciliary ganglion is derived from nerve to inferior oblique and consists of preganglionic parasympathetic fibres from the Edinger-Westphal nucleus. These fibres relay in the ganglion. The postganglionic parasympathetic fibers arise from the cells of the ganglion and pass through sho ciliry nerves to supply the ciliary muscle and sphincter pupillae.The branches of the ciliary ganglion are sho ciliary nerves that contain fibres from all 3 roots, run above and below the optic nerve towards the eyeball. On reaching the eyeball, they pierce the sclera around the attachment of the optic nerve and pass forwards in the space between the sclera and the choroid to reach the target organs.The ciliary ganglion is blocked to produce dilatation of the pupil before cataract extraction.Reference: Textbook of anatomy, Head neck, and brain, Vishram Singh, 2nd edition, page no.298


Question: Structure piercing investing layer of deep cervical fascia in posterior triangle of neck

Investing layer in the posterior triangle of neck is pierced by: * External jugular vein * Supraclavicular nerves. * Cutaneous nerves including lymphatics.


Question: Muscle attached to lateral surface of greater trochanter

GREATER TROCHANTER:- Quadrangular prominence located on upper pa of the junction of neck with the shaft.Attachments:-1. Apex-pyriformis 2. Anterior surface-gluteus minimus3. Medial surface- obturator internus and two gamelli.4. Trochanteric fossa- obturator externus.5. Lateral surface-gluteus medius. <img src=" /> {Reference: BDC 6E pg no. 16}


Question: The weight of the upper limb is transmitted to the axial skeleton by

The weight of the upper limb is transmitted to the axial skeleton by Costoclavicular ligament The weight of the upper limb is transmitted as follows: Upper limb to Coracoclavicular ligament to Clavicle to Costoclavicular ligament to Axial skeleton. Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41e pg 800,809.


Question: HE R2/neu receptor plays a role in

Ref Robbins 8/e p1090,9/e p1062 The ErbB family consists of four plasma membrane-bound receptor tyrosine kinases. One of which is erbB-2, and the other members being epidermal growth factor receptor, erbB-3 (neuregulin-binding; lacks kinase domain), and erbB-4. All four contain an extracellular ligand binding domain, a transmembrane domain, and an intracellular domain that can interact with a multitude of signaling molecules and exhibit both ligand-dependent and ligand-independent activity. Notably, no ligands for HER2 have yet been identified. HER2 can heterodimerise with any of the other three receptors and is considered to be the preferred dimerisation paner of the other ErbB receptors. Dimerisation results in the autophosphorylation of tyrosine residues within the cytoplasmic domain of the receptors and initiates a variety of signaling pathway


Question: Commonest malignant bone tumor is

Refer Robbins page no 8th 609-611 Multiple also called as Kahlers disease


Question: The hard palate contains

The hard palate contains keratinized stratified squamous epithelium, has a submucosa, and contains minor salivary gland. The bony structure of the hard palate is covered by a firmly attached mucosa in the central pa. In the lateral pas, the hard palate also has a submucosal layer containing blood vessels. There are minor mucous type salivary glands in the submucosa in the posterior pa of the hard palate. Ref: Gray&;s Anatomy 41st edition Pgno: 510

Keratinized epithelium, submucosa, minor salivary glands

Keratinised epithelium, absent submucosa, no salivary glands

Non-keratinised epithelium, submucosa, minor salivary glands

Non-keratinised epithelium, absent submucosa, minor salivary glands


Question: One is not the feature of obstructive jaundice

Features of Obstructive jaundice Most common cause of obstructive jaundice is CBD stones Characterized by dark urine, clay coloured stools, icterus and Pruritus Presence of urobilinogen in urine rules out obstructive jaundice USG is the best test to differentiate medical from surgical jaundice There is raised ALP levels, cholesterol and reduced Urobilinogen Ref: Harrison's 19th edition Pgno : 1998


Question: Sphincter urethrae is present in

The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra.The internal sphincter is a continuation of the detrusor muscle and is made of smooth muscle, therefore it is under involuntary or autonomic control. ref - BDC 6e vol2 pg372-376


Question: The only non catecholamine sympathomimetic drug out of the following is

Ref-Goodman and Gillman 11/e p239 Catecholamine are the drugs having dihydrobenzene nucleus in it's structure.adrenaline, isoprenaline and dopamine contain this structure


Question: The intervillous space of the placenta contains

The intervillous space contains only maternal blood as the spiral aeries of the endometrium penetrate the outer cytotrophoblast shell.


Question: Sho head of Biceps is attached to

The sho head of biceps brachii arises from the tip of the coracoid process and gets attached to the posterior rough pa of the radial tuberosity. The tendon is twisted; the anterior fibres become lateral and posterior fibres become media. The tendon is separated from the anterior pa of tuberosity by a bursa. Mnemonic Biceps brachii muscle origins: You walk shoer to a street corner .you ride longer on a superhighway. The sho head originates from the coracoid process. The long head originates from the supraglenoid tubercle. Ref- BD Chaurasia 7th edition Page no: 91 Figure:8.3 page no 89,BD chaurasia, 6th edition


Question: A dome shaped skull is known as


Question: Function of anconeus is

ANCONEUS:- Origin: back of lateral epicondyle.Inseion:-lateral side of olecranon process. and upper surface of posterior surface of ulna.Nerve supply: nerve to anconeus. (Branch of radial nerve)Action:weak extensor of elbow joint.{Reference: vishram singh, pg no.129}


Question: On Congo red staining amyloid is seen as

Ref Robbins 9/e 257 Congo red under ordinary light impas a pink or red colour to amyloid deposits.under polarized light, the Congo red stained amyloid shows a green birefringence


Question: Most common cause of left sided hea failure is

Refer robbins 9/e 529 Myocardial infarction (MI), also known as a hea attack, occurs when blood flowdecreases or stops to a pa of the hea, causing damage to the hea muscle. The most common symptom is chest pain or discomfo which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes.The discomfo may occasionally feel like heaburn. Other symptoms may include shoness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause hea failure, an irregular heabeat, cardiogenic shock or cardiac arrest


Question: Inferior thyroid vein drains into

The inferior thyroid veins emerge at the lower border of the isthmus. They form a plexus in front of the trachea and drain into the left brachiocephalic vein. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Distance of the Lower Esophageal Sphincter from the upper incisors is

Lower oesophageal sphincter is seen in lower pa of oesophagus where it pierces diaphram. It is 37.5cm/15inch from incisor teeth. Ref - BDC vol 1 6th edition pg 282


Question: Depression of the fragments for the comminuted fracture seen in

Depressed comminuted fracture In this type of fracture, there will be depression of the fragments of the comminuted fracture. It is usually caused by striking with an object having a small striking surface. It can also be caused by impact from a relatively large projecting object as in traffic accidents. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 163


Question: Palatine tonsil develops from


Question: Most potent stimulator of native T cells

Ref Robbins 9/e p191 Naive T cells leave the thymus and home to secondary lymphoid organs. Dendritic cells are the most potent activators of naive T cells. DCs carry antigen from the periphery to the draining lymph nodes. ... CD28 signaling provides "Signal 2" to T cells and is necessary for T cell activation.


Question: Courvoiser's law is related to

Courvoiser's law In obstruction of the common bile duct due to Stone, distension of gall bladder seldom occurs, the organ usually is shriveled If there is no disease in the gall bladder and the obstruction is due to cancer of ampulla, pancreas or bile duct, then gall bladder will be distended Ref: Sabiston 20th edition Pgno : 1544

The length of skin flap in skin grafting


Question: Largest organelle in eukaryote is

The Nucleus - The nucleus constitute the central, more dense, pa of the cell. It is usually rounded or ellipsoid. Occasionally it may be elongated, indented or lobed. It is the largest cell organelle measuring 4-10 um in diameter. All cells in the body contain nucleus, except mature red blood cells (RBCs) in circulation. Nuclear Components - Chromatin, Nucleolus, Nuclear membrane, Nucleoplasm. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no., 28.


Question: Most common cause of liver abscess is

E.coli most common in Western countries Klebsiella pneumonia most common in Asian countries Staphylococcus most common in children suffering from chronic granulomatous disease


Question: Prophylactic maintenance level of lithium is


Question: Difference between typical cervical & thoracic veebra

CERVICAL VEEBRAE They are identified by the presence of foramen transversaria.There are seven cervical veebrae,out of which the third to sixth are typical,while the first,second and seventh are atypical. Typical cervical veebra Body 1.The body is small and broader from side to side than from before backwards. 2.The superior surface is concave transversely with upward projecting lips on each side. 3.The inferior surface is saddle shaped,being convex from side to side and concave from before backwards. 4.The anterior and posterior surfaces resemble that of other veebrae. Veebral Foramen It is larger than the body.It is triangular in shape because the pedicles are directed backwards and laterally. Veebral Arch 1.The pedicles are directed backwards and laterally. 2.The laminae are relatively long and narrow,being thinner above than below. 3.The superior and inferior aicular processes form aicular pillars which project laterally at the junction of pedicle and the lamina. 4.The transverse processes are pierced by foramina transversaria. REF.BD CHAURASIA'S HUMAN ANATOMY,FIFTH EDITION,VOL 3.PAGE NO 40

Superior aicular facet directed backwards & upwards


Question: Psychological antagonist is found in

(Ref Katzung 12/e p20) Physiological antagonists are those drugs that produce opposite action by acting on different receptors. Adrenaline reverses the bronchoconstrictor action of histamine (. H1 receptors) by causing bronchodilation (through beta2 receptors). Therefore,these are physiological antagonists.


Question: Centrilobular necrosis is seen in

Refer Robbins page no 872 8th edition Centrilobular necrosis refers to the necrosis of the centrilobular tissue of the hepatic lobule. The centrilobular zone of the lobule is most prone to metabolic toxins such as those generated in alcoholic hepatitis.


Question: Ciliary muscles develop It

Ans. b. Neural crest cellGrays Anatomy 40/e p702, Ciliary muscles develop from Neural crest.


Question: Cervical oesophagus corresponds to

Cervical esophagus stas at inferior margin of cricoid cailage that corresponds to corpus of 6th cervical veebra. This level is marked by a carotid tubercula named "Chasseing tubercula," which is an impoant landmark in cervical esophagectomy. Cervical esophagus ends at inferior edge of first dorsal veebra that comes up to a horizontal plane of jugular incisura of sternum. The endpoint is the staing point of upper mediastinum, and from this point it is thoracic esophagus. Cervical esophagus is 5-6 cm long, and its luminal diameter is 1.4-1.5 cm at its narrowest point. Ref -<a href="


Question: Punishment for gang rape is under

376D IPC: punishment for gang rape: each of the persons in the gang shall be deemed to commit the offence of rape d shall be punished with rigorous imprisonment for 20 years which may extend to life which means the imprisonment for the remainder of that persons natural life and with fine to meet medical expenses and for rehabilitation of the victim. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE NO 299


Question: Arterial supply of Submandibular gland


Question: Aerial thrombosis is seen in


Question: 2nd pharyngeal arch is supplied by

B. i.e. (Facial) (109-LB. Singh Embryo 8th)ArchNerve of archMuscles of archFirstMandibular- Tensor tympani, tensor palate, medial and lateral pterygoids, masseter, temporalis, mylohyoid, anterior belly of digastric **SecondFacial- Stapedius stylohyoid, posterior belly of digastric**, muscles of face, auricular muscles, occipito- frontalis, platysmaThirdGlossopharyngeal- StylopharyngeusFourthSuperior laryngeal Muscles of pharynxSixthRecurrent laryngeal Soft palate and larynxThe cartilage of the second arch forms the following* Stapes* Styloid process* Stylohyoid ligament* Smaller (lesser) cornu of hyoid*** Superior part of body of hyoid


Question: Spontaneous rupture of the liver occurs in

Clinical features Most common symptom is abdominal pain Weight loss Non specific - Anorexia, weight loss Hepatomegaly Paraneoplastic syndrome- Hypercholesterolemia, Hypoglycemia, Erythrocytosis, Hypercalcemia Vascular bruit Rupture of tumor(2-5%) GI bleed(10%) Jaundice due to biliary obstruction (10%) Ref:Sabiston 20th edition Pgno :1458-1463


Question: Crash in cocaine means

Cocaine Cocaine is a stimulant which increases dopamine. It is available as a powder which is inhaled by nasal route called as SNOING. It can also be used as IV route * Cardiovascular adverse effects * MI * Arrhythmia * SIDS if mother exposed during pregnancy POST COCAINE DEPRESSION is alled CRASH * TREATMENT * dopamine agonists * Disulfiram Desipramine Ref.kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no.672


Question: Marker for testicular tumor is

Tumor markers of Germ cell tumors of the testis Beta HCG Alpha feto protein (AFP) LDH Beta HCG - concentration is increased in both seminoma & non-seminoma AFP - concentration is increased in only non-seminoma LDH - is increased in both, it is not as specific as either of AFP or Beta HCG. So both b hCG and AFP are markers for testicular Ca, but if we have to choose one option, we would go for b hCG as its seen in both seminomas as well as non-seminoma Some other tumor markers for testicular Ca (but not imp.) are Placental alkaline phosphates (PLAP) Gamma-glutamyl transpeptidase (GGT)


Question: Drug used for ameliorative test for Myasthenia gravis is

KDT 6/e p 104 Drug used in ameliorative test(tensilon test) for Myasthenia gravis is edrophonium. it is a cholinergic drug and can be used for diagnosis of Myasthenia gravis because of a sho duration of action(10-30 min)


Question: Cranial nerve not carrying parasympathetic fibres


Question: Oxygen dependant killing is done through

Ref Robbins 9/e p48 Accumulation of Oxygen-Derived Free Radicals (Oxidative Stress) Free radicals are chemical species with a single unpaired electron in an outer orbital. Such chemical states are extremely unstable, and free radicals readily react with inorganic and organic chemicals; when generated in cells, they avidly attack nucleic acids as well as a variety of cel- lular proteins and lipids. In addition, free radicals initiate reactions in which molecules that react with free radicals are themselves conveed into other types of free radicals, thereby propagating the chain of damage. Reactive oxygen species (ROS) are a type of oxygen- derived free radical whose role in cell injury is well estab- lished. Cell injury in many circumstances involves damage by free radicals; these situations include ischemia- reperfusion (discussed later on), chemical and radiation injury, toxicity from oxygen and other gases, cellular aging, microbial killing by phagocytic cells, and tissue injury caused by inflammatory cells. There are different types of ROS, and they are produced by two major pathways (Fig. 1-18). * ROS are produced normally in small amounts in all cells during the reduction-oxidation (redox) reactions that occur during mitochondrial respiration and energy genera- tion. In this process, molecular oxygen is sequentially reduced in mitochondria by the addition of four elec- trons to generate water. This reaction is imperfect, however, and small amounts of highly reactive but sho-lived toxic intermediates are generated when oxygen is only paially reduced. These intermediates include superoxide (O2 * ), which is conveed to hydro- gen peroxide (H2O2) spontaneously and by the action of the enzyme superoxide dismutase. H2O2 is more stable than O2 * and can cross biologic membranes. In the pres- ence of metals, such as Fe2+ , H2O2 is conveed to the highly reactive hydroxyl radical * OH by the Fenton reaction.ROS are produced in phagocytic leukocytes, mainly neutro- phils and macrophages, as a weapon for destroying ingested microbes and other substances during inflam- mation and host defense (Chapter 2). The ROS are gener- ated in the phagosomes and phagolysosomes of leukocytes by a process that is similar to mitochondrial respiration and is called the respiratory burst (or oxida- tive burst). In this process, a phagosome membrane enzyme catalyzes the generation of superoxide, which is conveed to H2O2. H2O2 is in turn conveed to a highly reactive compound hypochlorite (the major component of household bleach) by the enzyme myeloperoxidase, which is present in leukocytes. The role of ROS in inflam- mation is described in Chapter 2. * Nitric oxide (NO) is another reactive free radical pro- duced in leukocytes and other cells. It can react with O2 * to form a highly reactive compound, peroxynitrite, which also paicipates in cell injury. The damage caused by free radicals is determined by their rates of production and removal (Fig. 1-19). When the production of ROS increases or the scavenging systems are ineffective, the result is an excess of these free radicals, leading to a condition called oxidative stress. The generation of free radicals is increased under several circumstances: * The absorption of radiant energy (e.g., ultraviolet light, x-rays). Ionizing radiation can hydrolyze water into hydroxyl (* OH) and hydrogen (H* ) free radicals. * The enzymatic metabolism of exogenous chemicals (e.g., carbon tetrachloride--see later) * Inflammation, in which free radicals are produced by leukocytes (Chapter 2) Cells have developed many mechanisms to remove free radi- cals and thereby minimize injury. Free radicals are inher- ently unstable and decay spontaneously. There are also nonenzymatic and enzymatic systems that contribute to inactivation of free radicals (Fig. 1-19). * The rate of decay of superoxide is significantly increased by the action of superoxide dismutases (SODs) found in many cell types Glutathione (GSH) peroxidases are a family of enzymes whose major function is to protect cells from oxidative damage. The most abundant member of this family, glu- tathione peroxidase 1, is found in the cytoplasm of all cells. It catalyzes the breakdown of H2O2 by the reaction 2 GSH (glutathione) + H2O2 - GS-SG + 2 H2O. The intracellular ratio of oxidized glutathione (GSSG) to reduced glutathione (GSH) is a reflection of this enzyme's activity and thus of the cell's ability to catabolize free radicals. * Catalase, present in peroxisomes, catalyzes the decom- position of hydrogen peroxide (2H2O2 - O2 + 2H2O). It is one of the most active enzymes known, capable of degrading millions of molecules of H2O2 per second. * Endogenous or exogenous antioxidants (e.g., vitamins E, A, and C and b-carotene) may either block the forma- tion of free radicals or scavenge them once they have formed. Reactive oxygen species cause cell injury by three main reactions (Fig. 1-19): * Lipid peroxidation of membranes. Double bonds in mem- brane polyunsaturated lipids are vulnerable to attack by oxygen-derived free radicals. The lipid-radical interac- tions yield peroxides, which are themselves unstable and reactive, and an autocatalytic chain reaction ensues. * Cross-linking and other changes in proteins. Free radicals promote sulfhydryl-mediated protein cross-linking, resulting in enhanced degradation or loss of enzymatic activity. Free radical reactions may also directly cause polypeptide fragmentation. * DNA damage. Free radical reactions with thymine in nuclear and mitochondrial DNA produce single-strand breaks. Such DNA damage has been implicated in cell death, aging, and malignant transformation of cells. In addition to the role of ROS in cell injury and killing of microbes, low concentrations of ROS are involved in numer- ous signaling pathways in cells and thus in many physio- logic reactions. Therefore, these molecules are produced normally but, to avoid their harmful effects, their intracel- lular concentrations are tightly regulated in healthy cells.


Question: Brunner's glands are present in

Ans. a (Duodenum) (Ref. BDC, Vol. II, 3rd ed., 212)THE DUODENAL GLANDS OF BRUNNER (BRUNNER'S GLAND)# These lie in the SUBMUCOSA of the duodenum.# These are small, compound tubuloacinar glands.# They secrete mucus.RegionMajor characteristicsMucosal cell types at surfaceFunction of surface mucosal cellsEsophagus# Nonkeratinized stratified squamous epithelium# Skeletal muscle in muscularia externa (upper 1/3)# Smooth muscle (lower 1/3)--Stomach (body and fundus)Rugae: shallow pits; deep glandsMucous cellsSecrete mucus; form protective layer against acid; tight junctions between these cells probably contribute to the acid barrier of the epithelium Chief cellsSecrete pepsinogen and lipase precursor Parietal cellsEnteroendocrine (EE) cellsSecrete HCI and intrinsic factorSecrete a variety of peptide hormonesPylorusDeep pits; shallow branched glandsMucous cellsParietal cellsEE cellsSame as aboveSame as aboveHigh concentration of gastrinSmall intestineVilli, plicae, and cryptsColumnar absorptive cellsContain numerous microvilli that greatly increase the luminal surface area, facilitating absorptionDuodenumBrunner glands, which discharge alkaline secretionGoblet cellsSecrete acid glycoproteins that protect mucosal liningsPaneth cellsContain granules that contain lysozymeMay play a role in regulating intestinal floraEE cellsHigh concentration of cells that secrete cholecystokinin and secretinJejunumVilli, well developed plica, cryptsSame cell types as found in the duodenal epitheliumSame as aboveIleumAggregations of lymph nodes called Peyer patchesM cells found over lymphatic nodules and Peyer patchesEndocytose and transport antigen from the lumen to lymphoid cellsLarge intestineLacks villi, cryptsMainly mucus-secreting and absorptive cellsTransport Na+ (active) and water (passively) out of lumen


Question: Corpora amylacea is found in

Inderbir Singh&;s Human Histology Sixth edition Pg 337 Small rounded masses of uniform or lamellated structures are found within lumen of follicles. These are called amyloid bodies or corpora amylacea


Question: Sinuses are not seen in


Question: The formation of secondary palate takes place during


Question: Initial investigation of choice for biliary obstruction

Ultrasonography Initial imaging modality of choice in obstructive jaundice It is operator dependent and may be suboptimal due to excessive body fat and intraluminal bowel gas USG can demonstrate Biliary calculi Size of GB and CBD Thickness of GB wall Presence of inflammation around GB Occasionally, presence of stones within the biliary tree Ref: Sabiston 20th edition Pgno : 1487


Question: Origin and migration of cell population during embryonic craniofacial development


Question: The sickle shaped fold of dura mater

The falx cerebri is a large sickle-shaped fold of dura mater occupying the median longitudinal fissure between the two cerebral hemispheresRef: BD Chaurasia, Volume 3, 6th edition; Page no: 91


Question: Femoral nerve divides into anterior and posterior division around

Femoral nerve divides into anterior and posterior division around Lateral Circumflex formoral artery.

1st perforating branch of profunda femoris artery


Question: Deformity most commonly seen in primary osteoahritis of knee joint

In knee joint osteoahritis, medial joint space is affected earliest and causes assymetrical joint space narrowing This results in varus deformity Refer: maheswari 9th/e p 420


Question: anorexia nervosa is treated with

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


Question: During surgery for a benign cyst on the kidney, the surgeon notes that the patient's right kidney has two ureters and two renal pelvis. This malformation is

The ureteric bud seems to be preprogrammed to undergo repeated divisions. These divisions normally begin on contact with the metanephric blastema. If the ureteric bud undergoes division prematurely, duplication of the ureter and renal pelvis occurs. In some circumstances, two separate kidneys may form.

A premature division of the metanephric blastema

A premature division of the ureteric bud

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


Question: Name the structure labelled D

(a) Right common carotid aery(b) Right subclan aery(c) Brachiocephalic trunk(d) Left subclan aery(e) Left common carotid aeryAngiography may be performed using CT, MRI or conventional angiography with a catheter. The catheter can be seen on this image in the aoic arch. Normal variants occur in the great vessels so it is impoant to understand normal anatomy to be able to identify any abnormality. An estimated 65% people have the 'normal' anatomy described in textbooks. The commonest anomaly is seen in 5% where the left veebral aery arises directly from the aoic arch, between the origins of the left common carotid and left subclan aeries.


Question: Nerve passing from greater sciatic foramen to lesser sciatic foramen

The greater sciatic foramen is an opening (foramen) at the back of the human pelvis. It is formed by the sacrotuberous and sacrospinous ligaments. The piriformis muscle passes through the foramen and occupies most of its volume. ref - BDC 6e vol2 pg363


Question: In follow up of BPH, a most impoant indication of surgery is

Surgery should be recommended for patients who continue to be bothered by their symptoms or who experience urinary retention despite medical therapy. Surgery should also be recommended for patients with upper tract dilation, renal insufficiency secondary to BPH, or bladder stones."- Schwaz 8/e p1530 About other options: Prostate Size: Treatment of BPH is primarily dictated by patient's symptoms and not by the prostate size. However the size of prostate can decide whether to go for endoscopic method of treatment or open surgical procedure. Open surgery is more effective than endoscopic methods for prostates weighing >100gm UTI: Recurrent episodes of UTI (and not a single episode) are an absolute indication for surgery of prostate. Hypeension: Alpha blockers which are first line medical therapy for BPH lower the blood pressure and thus are helpful in hypeensive persons. Management of BPH Management is primarily directed by symptoms. Mild symptoms can be managed with watchful waiting. More severe symptomatic patients are treated with medicines (alpha blockers, 5-alpha reductase inhibitors or combination of both). Surgery is recommended if the patient is having problems despite medical therapy. Absolute indications for surgery as listed in Smith's Urology is given below. Absolute indications for surgical treatment of BPH Refractory urine retention (failing at least one attempt at catheter removal) Recurrent UTI from BPH Bladder stones d/t BPH Renal insufficiency d/t BPH Large bladder diveicula secondary to BPH Recurrent gross hematuria from BPH Upper tract dilatation is an indication for surgery according to Schwaz. Medical therapy Alpha-blockers (terazosin, doxazosin, and tamsulosin) Alpha-blockers help is reducing the symptoms of BPH by blocking the alpha 1 adrenoreceptors present in human prostate and bladder base. 5-Alpha-reductase inhibitors (Finasteride, Dutasteride) - 5-alpha-reductase inhibitors block the conversion of testosterone to dihydrotestosterone. This thus results in reduction in the size of the gland and improvement in symptoms (after several months of use). Surgery Surgery for BPH is most commonly performed endoscopically; however, if the prostate gland is quite large (approx >100 g), an open prostatectomy should be performed. The standard endoscopic procedure for BPH is a transurethral resection (TUR) of the prostate. Conventional surgical methods: Transurethral resection of the prostate (most commonly used method) Transurethral incision of the prostate (TUIP) Open simple prostatectomy (simple suprapubic prostatectomy, simple retropubic prostatectomy) - When the prostate is too large to be removed endoscopically, an open enucleation is necessary. What constitutes "too large" is subjective and varies depending upon the surgeon's experience with TURP. Glands >100 g are usually considered for open enucleation. Open prostatectomy may also be initiated when concomitant bladder diveiculum or a bladder stone is present or if dorsal lithotomy positioning is not possible. Open prostatectomies can be done with either a suprapubic or retropubic approach. A simple suprapubic prostatectomy is performed transvesically and is the operation of choice in dealing with concomitant bladder pathology. Minimally invasive methods: Laser therapy (Nd:YAG and holmium:YAG ) Transurethral electro vaporization of the prostate Microwave Hypehermia Transurethral needle ablation of the prostate- High-intensity focused ultrasound for thermal tissue ablation Intraurethral stents--stents are endoscopically placed in the prostatic fossa and are designed to keep the prostatic urethra patent. They are usually covered by urothelium within 4-6 months after inseion. These devices are typically used for patients with limited life expectancy who are not deemed to be appropriate candidates for surgery or anesthesia. Ref : Schwaz 8/e p1528-31

Single episode of UTI requiring 3 day antibiotics


Question: Dysttropic calcification is seen in


Question: Arrange coverings on peripheral nerve from inner to outer

coverings on peripheral nerve from inner to outer are Endoneurium, Perineurium, EpineuriumINDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY PAGE NO:171


Question: Middle 1.5 cm of anal canal is lined by

The anal canal is divided into three pas. The zona columnaris is the upper half of the canal and is lined by simple columnar epithelium. The lower half of the anal canal, below the pectinate line, is divided into two zones separated by Hilton's white line. The two pas are the zona hemorrhagic and zona cutanea, lined by atratified squamous non keratinized and stratified squamous keratinized. ref - BDC vol2 pg416

Keratinized stratified squamous epithelium

Non keratinized stratified squamous epithelium


Question: "Turkish Saddle" refers to

Turkish Saddle refers to sella turcica, which is the seat for pituitary gland. The pituitary gland sits in a little cup-shaped bone (the sphenoid) which actually looks quite like a saddle: The name the classical anatomists gave it is the sella turcica, presumably because the classical Turkish saddle was designed to cup the rider's bottom. ref - researchgate.net


Question: Cista terminalis is present in

Cista Terminalis is present in the right atrium. It is a muscular ridge that runs anteriorly along the atrial wall from the opening of the superior vena cava. It corresponds externally to Sulcus terminalis. It is the site of origin of pectinate muscles. It divides the right atrium into a smooth posterior pa and a rough anterior pa. Both the vena cavae empty into the posterior smooth pa. Ref: Gray&;s Anatomy 41st edition. Pgno: 1000


Question: Spinal epidural space is the largest at the level of the

Spinal epidural space is largest at 3rd lumbar veebrae .Spinal epidural space is a closed anatomic space between the dura mater and the bony spinal canal. It extends from the foramen magnum to the sacrum. Unlike its intracranial counterpa, spinal epidural space is real. The presence of anchoring plicae and meningoveebral ligaments divide the space into anterior, lateral and posterior compaments. Ref - pubmed.com


Question: tranylcypromine is a type of

MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. kaplon and sadock, synopsis of psychiatry, 11 th edition , pg no. 925


Question: Root value of axillary nerve is

AXILLARY NERVE:-Root value: C5, C6Arises from the posterior cord of brachial plexus, near lower border of the subscapularis.Runs backward on Subscapularis to pass through quadrangular space along with posterior circumflex humeral aery.Here it is related to surgical neck of humerus.Nerve gives branch to shoulder joint and divide into anterior and posterior division.Anterior division:- teres minor and posterior pa of deltoid.Continues as upper lateral cutaneous nerve of arm and supplies skin over deltoid.Posterior division:-continues horizontally between deltoid and surgical neck of humerus along with posterior circumflex humeral vessels.supplies deltoid and few branches to innervate skin.Risk of damage in inferior dislocation of the head of humerus and fracture surgical neck humerus.Clinical presentation:-Impaired abduction of shoulder.Loss of sensation over lower half of deltoid- regimental badge area.Loss of shoulder contour with prominence of greater tubercle.{Reference:Vishram Singh, pg no. 78}


Question: Boundaries of ischiorectal fossa are

The boundaries of ischiorectal fossa: floor: deep transverse perineal fascia. medial wall: external anal sphincters/anal canal; levator ani muscle. lateral wall: ischial tuberosity; obturator internus muscle; obturator fascia. apex: intersection of levator ani and obturator internus muscle ref - BDC vol2 pg415, researchgate.net


Question: Gland derived from foramen caecum is


Question: Peroneus longus is supplied by

SUPERFICIAL PERONEAL:-Muscular branches: peroneus longus and brevis Cutaneous branches:Digital branches to medial side of big toe,adjacent sides of 2nd and 3rd, 3rd and 4th ,and 4th and 5th toes. TIBIAL NERVE:-Root value:ventral division of ventral rami of L4,L5,S1,S2,S3 segments of spinal cord.Beginning: largest subdivision of sciatic nerve.Course: descends veically in popliteal fossa. It continues in back of leg as the neurovascular bundle with posterior tibial vessels. Lastly passes deep to flexor retinaculum of ankle joint.Branches:Muscular branches to gastrocnemius,soleus, popliteus, plantaris, FHL, FDL and Tibialis posterior.Aicular branches to superior,middle and inferior genicular .Cutaneous and vascular branch: sural nerve ,medial calcaneal branch and branch to posterior tibial aery.Terminates by dividing into medial and lateral plantar nerves.MEDIAL PLANTAR NERVE:-Muscular branches: Abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and first lumbrical.Cutaneous branch: skin of medial pa of sole and medial three and a half toes.LATERAL PLANTAR NERVE:-Main trunk: flexor digitorum accessorius and abductor digiti minimi ans skin of sole. Ends by dividing into superficial and deep branches.Superficial branch: lateral and medial branch Lateral branch:flexor digiti minimi brevis, 3rd plantar, 4th interossei and skin on lateral side of little toe.Medial branch :4th interdigital cleft. Deep branch:2nd,3rd,4th lumbricals1st,2nd,3rd dorsal interossei 1st,2nd plantar interossei andAdductor hallucis. {Reference: BDC 6E }


Question: The following muscle is an opener of the glottis

1. Muscles which abduct the vocal cords: only posterior cricoarytenoids( safety muscles of larynx) 2. Muscles which adduct the vocal cords: * lateral cricoarytenoids * transverse aenoid * cricothyroid *thyroarytenoids 3. Muscles which tense the vocal cords: cricothyroid 4.muscles which relax the vocal cords: * thyroarytenoids * vocalis 4. Muscles which close the inlet of the larynx * oblique arytenoids * aryepiglottic 5.muscles which open the inlet of larynx : Thyroepiglotticus Ref BDC volume 3; 6th edition pg 258


Question: Pancreatitis may be produced by following drugs

Drugs associated with pancreatitis Definitive cause (MAD CAT PET TV FM) 6-Mercaptopurine Azathioprine Dideoxyinosine Cytosine arabinoside 5-Aminosalicylate Tetracycline Pentamidine Estrogens Trimethoprim - Sulfamethoxazole Thiazide Valproic acid Furosemide Metronidazole Probable cause (PILAAS) Phenformin Procainamide Isoniazid L-Asperaginase Acetaminophen Alpha-Methyl-dopa Sulindac Ref: Sabiston 20th edition Pgno : 1526


Question: Dropped shoulder occurs due to paralysis of

Elevation of the scapula (as in shrugging the shoulders)The movement is brought about by the upper fibres of the trapezius and by the levator scapulae. It is associated with the elevation of the lateral end, and depression of the medial end of the clavicle. Spinal accessory nerve supplies trapezius muscle and may get injured in trauma or damage during surgery, resulting in weakness of the trapezius muscle and drooping of shoulder.

Upper limb bones and muscles (proximal region) & Scapular movements


Question: The right gastroepiploic aery is a branch of

Right gastroepiploic aery, a branch of gastroduodenal supplies the greater curvature of the stomach. Ref: BD Chaurasia; Volume 3; 6th edition; Page no: 252


Question: Tip of spine of Sphenoid is related to

The spine of the sphenoid is related laterally to the auriculotemporal nerve, and medially to the chorda tympani nerve and auditory tube. Its tip provides attachment to the sphenomandibular ligament. Its anterior aspect gives origin to the most posterior fibers of the tensor veli palatini muscleReference: Chourasia; 6th edition; 18th page

Posterior fibres of Tensor veli palatini


Question: Ulnar paradox is seen in

Ulnar claw hand is seen in lower ulnar nerve palsy not Iin high ulnar nerve palsy It is called as ulnar paradox Ulnar paradox # Not severe claw hand deformity, but inability to flex DIP and weakness of flexing MCP & PIP of digits IV and V # Seen with higher nerve injuries (cubital tunnel syndrome) # More severe muscle impairment # FDP and lumbricals for digits IV and V are impaired, there is unopposed action of the Extensor digitorum Claw hand of the first and second finger Refer maheswari 9th ed

Combined ulnar and median nerve injuries


Question: agranuloctosis is a side effect of

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


Question: Most common position of appendix is

The tip of the appendix can have a variable position within the abdominal cavity : retro-caecal (65-70%) pelvic (25-30%) pre- or post-ileal (5%) Ref - BDC 6e vol2 pg269


Question: Benign Prostatic hyperophy results in obstruction of the urinary tract. The specific condition is associated with enlargement of the

Anatomically the median and lateral lobes are usually enlarged, due to their highly glandular composition. BPH typically affects the submucous group of glands in the transitional zone The anterior lobe has little in the way of glandular tissue and is seldom enlarged. Carcinoma of the prostate typically occurs in the posterior lobe. Ref BDC vol2 6e pg403


Question: The drug most likely to be responsible for accurate pancreatic disease

Ref-KDT 6/e p771 Didanosine is most commonly implicated anti-retroviral drug in causing acute pancreatitis. Maximum chances ot peripheral neuropathy are seen with stavudine


Question: In Peritonsillar Abscess, pain is referred to ear due to

In Peritonsillar Abscess or Quinsy, pain is referred to ear Glossopharyngeal Nerve (Tympanic or Jacobson's branch of Tympanic Plexus) because it is passing close to the peritonsillar space which might get irritated due to inflammation. Thus leading to referred otalgia in the patient


Question: Chediak_higashi syndrome is due to defect in

Ref Walter and Israel 7/e p150 Chediak Higashi syndrome is an autosomal ressive Condition in which polymorphs exhibit defective random movements , defective chemotaxis and impairee degranulation on phagocytosis paicles


Question: Hamaoma is

Ref Robbins 8/e p262;7/e p272; 9/e p267 Hamaomatous Polyps Hamaomatous polyps occur sporadically and as compo- nents of various genetically determined or acquired syn- dromes (Table 14-6). As described previously, hamaomas are disorganized, tumor-like growths composed of mature cell types normally present at the site at which the polyp develops. Hamaomatous polyposis syndromes are rare, but they are impoant to recognize because of associated intestinal and extraintestinal manifestations and the need to screen family members. Juvenile Polyps Juvenile polyps are the most common type of hamaoma- tous polyp. They may be sporadic or syndromic. In adults, the sporadic form sometimes is also referred to as an inflam- matory polyp, paicularly when dense inflammatory infil- trates are present. The vast majority of juvenile polyps occur in children younger than 5 years of age. Juvenile polyps characteristically are located in the rectum, and most manifest with rectal bleeding. In some cases, prolapse occurs and the polyp protrudes through the anal sphincter. Sporadic juvenile polyps are usually solitary but in persons with the autosomal dominant syndrome of juvenile pol- yposis the number varies from 3 to as many as 100. Colec- tomy may be required to limit the hemorrhage associated with polyp ulceration in juvenile polyposis. Dysplasia occurs in a small propoion of (mostly syndrome- associated) juvenile polyps, and the juvenile polyposis syn- drome is associated with increased risk for the development of colonic adenocarcinoma. hamaomatous polyps and mucocutaneous hyperpigA mentation that carries an increased risk of several malig- nancies, including cancers of the colon, pancreas, breast, lung, ovaries, uterus, and testes, as well as other unusual neoplasms. Germ line heterozygous loss-of-function muta- tions in the gene LKB1/STK11 are present in approximately half of the patients with the familial form of Peutz-Jeghers syndrome, as well as a subset of patients with the sporadic form. Intestinal polyps are most common in the small intestine, although they may also occur in the stomach and colon and, rarely, in the bladder and lungs. On gross evaluation, the polyps are large and pedunculated with a lobulated contour. Histologic examination demonstrates a characteristic arborizing network of connective tissue, smooth muscle, lamina propria, and glands lined by normal-appearing intestinal epithelium (Fig. 14-31, B


Question: Right fouh arch aery gives rise to


Question: Inferior thyroid aery is related to

The inferior thyroid aery is a branch of thyrocervical trunk. It runs first upwards then medially and finally downwards to reach the lower pole of the gland. During its course, it passes behind the carotid sheath and the middle cervical sympathetic ganglion; and in front of the thyroid veebral vessels; and gives off branches to adjacent structures Its terminal pas is intimately related to the recurrent laryngeal nerve, while proximal pa is away from the nerve. The aery divides into 4 to 5 glandular branches which pierce the fascia separately to reach the lower pa of the gland. One ascending branch anastomoses with the posterior branch of the superior thyroid aery, and supplies the parathyroid glands. Ref BDC volume 3 :sixth edition :pg 143


Question: Ventral merogastrium gives rise to


Question: First branch of subclavian artery is


Question: Spinal cord in an infant terminates at

In premature & term neonates- it lies b/w 1st & 3rd lumbar veebrae. In children between ages of (1-7yrs)- it lies between 12th thoracic and 3rd lumbar veebra. In adults, it terminates at the level of middle 3rd of body of 1st lumbar veebra which corresponds approximately to transpyloric plane. Spinal cord occupies superior 2/3rd of veebral canal It continues cranially with medulla oblongata, just below the level of foramen magnum, at the upper border of atlas and terminates caudally as conus medullaris. During development, veebral column elongates more rapidly than spinal cord, so there is increasing discrepancy b/w anatomical level of spinal cord segments & their corresponding veebrae.


Question: Trigone of urinary bladder develops from

The terminal poion of Mesonephric duct gets absorbed into the posterior wall of urogenital sinus and forms the trigone of the urinary bladder. Urinary bladder develops from endodermal vesicourethral canal. Ref: Gray's 39e/p-1289


Question: Most common site of admantinomaof the long bones is

Ameloblastoma---most common site jaw Ameloblastoma---most of long bones---called adamantinoma and is most common in tibial diaphysis Refer Ohopedic pathology 6th/e 449


Question: Deep branch of ulnar nerve innervates

There are twenty muscles in hands of which all are supplied by the ulnar nerve Except the following five muscles which are supplied by median nerve: 1 Abductor pollicis brevis 2. Flexor pollicis brevis (also often receives additional supply from the deep branch of ulnar nerve) 3. Opponens pollicis 4. First lumbrical 5. Second lumbrical Note: Palmaris Brevis is supplied by the superficial branch of the ulnar nerve. All interossei are supplied by the deep branch of ulnar nerve.


Question: Centromere near the end of chromosome

Acrocentric REF: Precid & Strachan Molecular genetics, page 49, 153, http://en.wikipedia.org/wiki/ CentromereCentromere positionsEach chromosome has two arms, labeled p (the shoer of the two) and q (the longer). The p arm is named for "petit" meaning `small'; the q arm is named q simply because it follows p in the alphabet. ("q" refers to the French word "queue" meaning 'tail')Metacentric: A chromosome is metacentric if its two arms are roughly equal in length. In some cases, a metacentric chromosome is formed by balanced Robesonian translocation: the fusion of two acrocentric chromosomes to form one metacentric chromosome. Example 1, 3, 16, 19, 20.Submetacentric: If arms' lengths are unequal, the chromosome is said to be Submetacentric. Example-X chromosome, 2, 4, 12 , 17, 18Acrocentric: If the p (sho) arm is so sho that is hard to observe, but still present, then the chromosome is acrocentric (The "acro-" in acrocentric refers to the Greek word for "peak"). The human genome includes acrocentric Y-chromosomes, 13, 14, 15, 21 and 22Telocentric: A telocentric chromosome's centromere is


Question: Vitelline vein forms

Inderbir Singh'sHuman embryology Tenth edition Pg 265 The pas of right and left vitelline that lie outside the substance of the liver undergo alterations leading to formation of poal vein 2 vitelline veins shows anastomosis before opening into sinus venosus that is 1dorsal and 2 ventral (proximal and distal). At dorsal anastomosis spleenic and superior mesentric vein joins vitelline vein poal vein is formed by:Dorsal anastomosis ventral anastomosis Right vitelline vein


Question: In a case of chest pain with pericarditis and pericardial effussion, pain is referred by

The fibrous and parietal pericardia are supplied by phrenic nerves.They are sensitive to pain.Pain of pericarditis originates in the parietal pericardium alone. B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 SIXTH EDITION Page no-251


Question: Cytosolic chromosomes C plays an impoant function in

* Cytosolic chromosomes C and apaf-1 are involved in intrinsic pathway of Apoptosis * mitochondrial cyt c and not cystolic cyt c is involved in aerobic respiration


Question: Nerve supply of muscle of palate is/are

NERVE SUPPLY OF PALATE: Motor nerves-All muscles of soft palate except the tensor veli palatini are supplied by the pharyngeal plexus. The fibres of this plexus are derived from the cranial pa of accessory nerve through the vagus. The tensor veli palatini is supplied by mandibular nerve General sensory nerves are derived from- a.Middle and posterior lesser palatine nerves, which are branches of the maxillary nerve through the pterygopalatine ganglion b.The glossopharyngeal nerve Special sensory nerves or gustatory nerves carrying taste sensations from the oral surface are contained in the lesser palatine nerves. The fibres travel through the greater petrosal nerve to the geniculate ganglion of the facial nerve and from there to the nucleus of tractus solitarius Secretomotor nerves are also contained in the palatine nerves. They are derived from the superior salivatory nucleus and then travel through the greater petrosal nerve Ref.BDC volume 3,sixth edition pg 223


Question: In Bing test, on alternately compressing and releasing the external acoustic meatus, the sound increases, and decreases. This indicates

Tests for bone conduction TestPrincipleMethodImpressionBing test Examines the effect of occlusion of ear canal on hearing Tuning fork placed on mastoid while examiner alternatively closes & opens the ear canal by pressing on the tragus inwards Patient hears louder when ear canal is occluded & softer when ear canal is open - Normal persons or sensorineural deafness ( Bing + ve )No change on ear canal opening or occlusion - conductive deafness ( Bing - ve )Gelle's test Examines the effect ofincreased air pressure in ear canal on hearing Placing a vibrating fork on mastoid while changes in air pressure in ear canalare brought about by siegel's speculum Positive - normal persons or sensorineural deafnessNegative - ossicular chain fixed or disconnected(Refer: PL Dhingra, Textbook of Ear, Nose, Throat, 6thedition,pg no: 21,22,23)


Question: A patient with a prosthetic hea valve develops endocarditis eight months after Valve replacement. Most likely organisms responsible is

Ref Harrison 19 th ed pg 816 Prosthetic valve endocarditis (PVE) arising within 2 months of valve surgery is generally nosocomial, the result of intraoperative contami- nation of the prosthesis or a bacteremic postoperative complication. This nosocomial origin is reflected in the primary microbial causes: S. aureus, CoNS, facultative gram-negative bacilli, diphtheroids, and fungi. The poals of entry and organisms causing cases beginning >12 months after surgery are similar to those in community-acquired NVE. PVE due to CoNS that presents 2-12 months after surgery often represents delayed-onset nosocomial infection. Regardless of the time of onset after surgery, at least 68-85% of CoNS strains that cause PVE are resistant to methicillin.


Question: Right gastric aery is a branch of(2018)

The right gastric aery arise from the hepatic aery. Ref:-grays anatomy, pg num:-1116


Question: Ascent of horse shoe shaped kidney is prevented by

Initialy in IUL(intrauterine life) kidneys are present in iliac fossa , Kidney has to reach the level of renal aery which is prevented by inferior mesenteric aery which is a branch of abdominal aoa. Fusion of right and left kidney occurs to form a U shaped structure at the level below inferior mesenteric aery.


Question: The epithelial lining of the urethra below the opening of the ejaculatory ducts is

The epithelium of the urethra stas off as transitional cells as it exits the bladder. Fuher along the urethra there are psuedostratified columnar and stified columnar epithelia, then stratified squamous cells near the external urethral orifice. There are small mucus-secreting urethral glands, that help protect the epithelium from the corrosive urine. Ref - wikipedia.org


Question: A tangential cut by sword or butcher's knife produces

Gutter fracture In this, the outer pa of the bone us chipped off by a tangential force and a gutter is formed. Gutter fracture is caused by a bullet touching the outer table and is not penetrating the skull This can also be produced by a tangential cut by a sword or butcher's knife. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 163


Question: Commonest cancer in a renal transplant recipient is

Cancers seen in renal transplant recipients in decreasing order are: Skin cancer > Lymphoma > Kaposi's Sarcoma > Ca Cervix > Renal tumors > Ca Vulva & perineum. Ref : Cambell's Urology 8/e p372


Question: Fetal hydrops is most commonly associated with

Cardiac anomaly is the most common anatomical abnormality associated with fetal hydrops. In general, hydrops associated with a structurally abnormal hea carries a poor prognosis, as the anomaly is usually severe.


Question: Internal carotid aery crosses

Inside the middle cranial fossa, it first runs forwards along the floor and medial wall of the cavernous sinus and then turns upwards on the medial side of the anterior clinoid process.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 175)


Question: The arterial supply of trachea is by


Question: Inner ear fully developed at

Ans. is 'c' i.e., 20 weeksDevelopment of membranous internal ear is completed by 10" weeks and reaches its adult size and shape by 20-22 weeks when the cochlea is developed sufficiently.


Question: Structure passing through anterior pa of jugular foramen

Jugular foramen transmits Through anterior pa: 1. Inferior petrosal sinus 2. Meningeal branch of the ascending pharyngeal aery Notes: through the middle pa: 9th, 10th,11th cranial nerves Through the posterior pa: internal jugular vein and meningeal branch of the occipital aery. BDC 6th edition vol 3 page no:20


Question: Bennet's Fracture involves

Fracture of the base of the first metacarpal is called Bennett&;s fracture.It involves the anterior pa of the base, and is caused by a force along its long axis. The thumb is forced into a semiflexed position and cannot be opposed. The fist cannot be clenchedReference: Vishram Singh Anatomy; 2nd edition; Page no: 32


Question: Middle segment pancreatectomy avoided in

Middle or central or segmental pancreatectomy Middle pancreatectomy is a safe, effective procedure for treatment of benign and low grade malignant neoplasm of the mid pancreas Advantages of Middle or Segmental Pancreatectomy Preserves pancreatic parenchyma Reduces the risk of exocrine and endocrine insufficiency. Consists of a limited resection of the mid poion of the pancreas. Indications of Middle or segmental Pancreatectomy Benign or low grade malignant tumor Location in the neck or its contiguous poion A distal pancreas stump of at least 5cm in length. Ref: Blumga 5th edition Pgno :959-960


Question: Artery not involved in Vascular anastemosis around Acromian

Acromial Branch of Thyrocervical Trunk (Branch of 1st part of Subclavian artery).
Acromial Branch of Thoracoacromial trunk (Branch of 2nd part of Axillary artery).
Acromial branch of  posterior circumflex humeral artery form anastomosis around Acromian.


Question: Caseous granuloma is seen in

ref Robbins 8/e p718 from tuberculous lesions often contain caseous , , other , and contain epithelioid cells, a few lymphocytes, and occasional multinucleated giant cells. No necrosis is seen. Granulomas following are noncaseous and characterized by epithelioid cell reaction with giant cells and , and the is based on finding organisms or and mononuclear macrophages when examined under polarized light. The crystals are composed of hydrous Fungal infections Most Histoplasma capsulatum. The granulomas are often isolated or small and scattered, thereby resembling miliary granulomas. The organism can be identified histologically. They are intracellular organisms, with 1-5 mm, round to oval yeast-like bodies, with a small, central round nucleus. Periodic acid-Schiff (PAS) and methenamine-silver (Meth-Ag) stains highlight these organisms. Other fungi that may cause granulomas are Cryptococcus neoformans (Fig. 21.4A), Blastomyces Fig. 21.4B), Mucorales, causing Fig. 21.4C), and Coccidioides immitis.13Some of these organisms are associated with definite geographical regions. Because of the ease of travel, however, diseases do not necessarily present in a Fungal infections Most Histoplasma capsulatum. The granulomas are often isolated or small and scattered, thereby resembling miliary granulomas. The organism can be identified histologically. They are intracellular organisms, with 1-5 mm, round to oval yeast-like bodies, with a small, central round nucleus. Periodic acid-Schiff (PAS) and methenamine-silver (Meth-Ag) stains highlight these organisms. Other fungi that may cause granulomas are Cryptococcus neoformans (Fig. 21.4A), Blastomyces (Fig. 21.4B), Mucorales, causing Fig. 21.4C), and Coccidioides immitis.13Some of these organisms are associated with definite geographical regions. Because of the ease of travel, however, diseases do not necessarily present in a <a style="box-sizing: border-box; margin: 0px; padding: 0px; background-color: transparent; overflow-x: auto; color: ; transition: color 0.3s ease 0s, border-bottom-color 0.3s ease 0s; text-decoration-line: none;" title="Learn more about Geographic Distribution from ScienceDirect's AI-generated Topic Pages" href=" distribution


Question: Heterotrophic calcification occurs in

Ref Robbins 7/e p 41_42, Harrison 17/e p1952 Heterotopic ossification (HO) is the presence of bone in soft tissue where bone normally does not exist. The acquired form of HO most frequently is seen with either musculoskeletal trauma, spinal cord injury, or central nervous system injury. For example, patients who have recently undergone total hip ahroplasty or have paraplegia after spinal cord injury are at risk for HO. The fever, swelling, erythema, and occasional joint tenderness seen in early HO can be difficult to distinguish from cellulitis, osteomyelitis, or thrombophlebitis. Bone scanning and other imaging tests frequently are used to distinguish between these diagnostic possibilities


Question: Most common complication of pseudocyst

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


Question: Harelip Is due to non fusion of

Medial nasal process with lateral nasal process

Lateral nasal process with maxillary process

Medial nasal process with maxillary process

Lateral nasal process with palatal process


Question: Passavants ridge is formed by

Some of the upper fibres of the palatopharyngeus pass circularly deep to the mucous membrane of the pharynx and form a sphincter internal to the superior constrictor. These fibres constitute Passavant's muscle which on contraction raises a ridge called the Passavant's ridge on the posterior wall of the nasopharynx. When the soft palate is elevated it comes in contact with this ridge, the two together closing the pharyngeal isthmus between the nasopharynx and the oropharynx. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: First pharyngeal arch derivative is

(A) Maxillary artery ArchNerve of ArchMuscles of ArchFirstMandibularMedial and lateral pterygoidsMasseter, Temporalis, MylohyoidAnt. belly of Digastric Tensor tympani, Tensor palatiSecondFacialMuscles of face, Occipito-frontalis Platysma, Stylohyoid, Post, belly of Digastric, Stapedius, Auricular musclesThirdGlossopharyngealStylopharyngeusFourthSuperior laryngealCricothyroidSixthRecurrent laryngealMuscles of larynx


Question: Pretrematic nerve of 1st pharyngeal arch is

Pharyngeal Arch Nerves: Nerve of 1st arch - Mandibular division of trigeminal nerve Pretrematic nerve - Chorda tympani & greater petrosal nerves (purely sensory) of facial nerve. Nerve of 2nd arch - Facial nerve Pretrematic nerve - Tympanic branch of glossopharyngeal nerve. Nerve of 3rd arch - Glossopharyngeal nerve Pretrematic nerve - auricular branch of vagus nerve Nerve of 4th arch - Pharyngeal branch of vagus nerve Nerve of 6th arch - Recurrent laryngeal branch of vagus nerve.


Question: Origin of ovary is from


Question: Auditory pathway passes through


Question: Normal Carrying Angle

Carrying angle is a small degree of cubitus valgus, formed between the axis of a radially deted forearm and the axis of the humerus. It helps the arms to swing without hitting the hips while walking.Normally it is 5-15o away from the body.Ref: Vishram Singh; Volume 1; II edition; Page no: 130


Question: Best blood product to be given in a patient of multiple clotting factor deficiency with active bleeding


Question: Boundary of the Koch's triangle is not formed by

The atrioventricular node (AVN) is within the subendocardial layer of the hea wall of the interatrial septum. In relation to the right atrium, its position is within the triangle of Koch Triangle of Koch: a roughly triangular area on the septal wall of the right atrium, bounded by the base of the septal leaflet of the tricuspid valve, the anteromedial margin of the orifice of the coronary sinus, and the tendon of Todaro; it marks the site of the atrioventricular node. Tendon of Todaro: A palpable subendocardial collagen bundle in the wall of the right atrium, extending from the central fibrous body (fibrous skeleton of hea) across the torus aoicus toward the medial extremity of the valve of the inferior vena cava. Ref - pubmed.com


Question: The facial artery terminates in the anastomosis with

D. i.e. (Branch of the ophthalmic artery) (57-58-BDC 3rd)* FACIAL - ARTERY - Branch of the external carotid artery*** It lies deep to the sub mandibular salivary gland and emerges and bends around the lower border of the mandible. It then ascends over the face close to the anterior border of the masseter muscle. The artery then ascends around the lateral margin of the mouth and terminates at the medial angle of the eye by anastomosing with the dorsal nasal branch of the ophthalmic artery.


Question: Folate trap occurs due to the deficiency of

The conversion of 5,10-methylene-THF into 5-methyl-THF is irreversible. The only way to make fuher use of 5-methyl-THF and to maintain the folate cycle is by the vitamin B12-dependent remethylation of homocysteine to methionine (regenerating THF). The methyl group transfer is therefore greatly dependent on 5-methylTHF and the availability of Vitamin-B12. In cases of vitamin-B12 deficiency, an intracellular deficiency of biologically active THF arises as methyl-THF is not conveed to THF and the folate gets trapped as methyl-THF. This situation is called a 'folate trap' (or methyl group trap). Reference: Harpers illustrated biochemistry 30th edition


Question: Facial artery gives rise to following branches

Facial artery gives rise to :

Submental artery.
Tonsillar artery.
Ascending palatine artery.
Glandular artery.
Superior and inferior labial artery.
Lateral nasal artery.
Angular artery.

Submental artery, ascending pharyngeal artery, tonsillar artery, posterior auricular artery

Submental artery, ascending palatine artery, tonsillar artery, angular artery

Tonsillar artery, submental artery, ascending pharyngeal artery, angular artery

Tonsillar artery, submental artery, ascending pharyngeal artery, glandular artery


Question: Inferior epigastric vein drains into

The inferior epigastric aery - It arises from the external iliac aery near its lower end just above the inguinal ligament. It runs upwards and medially in the extraperitoneal connective tissue, passes just medial to the deep inguinal ring, pierces the fascial transversalis at the lateral border of the rectus abdominis and enters the rectus sheath by passing in front of the arcuate line .Within the sheath it supplies the rectus muscle and ends by anastomosing with the superior epigastric aery. branches of inferior epigastric aery - (a) A cremasteric branch - To the spermatic cord, or the aery of the round ligament in females; (b) A pubic branch - Which anastomoses with the pubic branch of the obturator aery; (c) muscuiarbranches - To the rectus abdominis , and (d) cutaneous branches - To the overlying skin. Ref : B D Chaurasia's Human Anatomy , seventh edition, volume 2 , pg. no. 229


Question: HLA typing is useful in

Also used in organ transplant Ref Robbins 9/e p195 ,215 DNA paternity testing is the use of DNA profiles to determine whether an individual is the biologicalparent of another individual. Paternity testing can be especially impoant when the rights and duties of the father are in issue and a child's paternity is in doubt. Tests can also determine the likelihood of someone being a biological grandparent. Though genetic testing is the most reliable standard, older methods also exist, including ABO blood group typing, analysis of various other proteins and enzymes, or using human leukocyte antigen antigens. The current techniques for paternity testing are using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Paternity testing can now also be performed while the woman is still pregnant from a blood drawn


Question: If the 3rd supralabial scales are large and touching the eye and nasal shield, the snake may be

If the head scales are large, it may be poisonous or non poisonous. Look for the 3rd supra labial and if it is touching the eye and the nasal shield, it is poisonous (cobra or coral snake) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511


Question: The preganglionic parasympathetic fibres to the parotid gland travel in

The preganglionic fibres begin in the inferior salivatory nucleus; pass through the glossopharyngeal nerve, it's tympanic beach, the tympanic plexus and the lesser petrosal nerve and relay in the price ganglion. The postganglionic fibres pass through the auriculotemporal nerve and reach the gland. Ref: BDC 6th edition pg 110 Notes: Ref flow cha 5.1 pg 111 BDC 6th edition


Question: The mass treatment of trachoma is undeaken if the prevalence in community is

Mass treatment of trachomaA prevalence of more than 5 %; severe and moderate trachoma in children under 10 years Treatment consists of an application of twice daily of tetracycline 1 % ointment to all children, for 5 consecutive days each month or once daily for 10 days each month for 6 consecutive months.Alternative antibiotic - erythromycin(Refer: K. Park's Textbook of Preventive and Social medicine, 24thedition, pg no: 326, 327)


Question: Organ of Rosenmullar is remenant of


Question: Most common site of metastasis in cholangiocarcinoma

Distant metastasis occurs in one third of patients Most common site is liver, lung or mediastinum, peritoneum Ref: Sabiston 20th edition Pgno :1514-1518


Question: Commonest cause of pyogenic liver abscess

Hematogenous spread is most common among given option


Question: Varicocele is common on left testis because

Variocele formation has been attributed to one of the three primary factors : Increased venous pressure in left renal vein Collateral venous anastomoses Absent or incompetent valves in the internal spermatic vein. Ref : Bailey & Love 23/e p1273

Left testicular vein drains into IVC which has high pressure

Left testicular vein drains into left renal vein which has high pressure

Compression of testicular vein by rectum


Question: Level of lower border of lung at mid axillary line is


Question: Diarthrosis is known as


Question: Treatment of choice in acute sarcoidosis is

For acute disease, no therapy remains a ble option for patients with no or mild symptoms. For symptoms confined to only one organ, topical therapy is preferable. For multiorgan disease or disease too extensive for topical therapy, an approach to systemic therapy is outlined. Glucocoicoids remain the drugs of choice for this disease. However, the decision to continue to treat with glucocoicoids or to add steroid-sparing agents depends on the tolerability, duration, and dosage of glucocoicoids. Ref Harrison 19th edition pg 2210


Question: In pyogenic liver abscess commonest route of spread

"Along with cryptogenic infections, infections from the biliary tree are presently the most common identifiable cause of the hepatic abscess. Biliary obstruction results in bile stasis, with the potential for subsequent bacterial colonization, infection and ascension into the liver. This process is k/a ascending suppurative cholangitis. The nature of biliary obstruction is mostly related to stone disease or malignancy. In Asia, intrahepatic stones and cholangitis (recurrent pyogenic cholangitis) is a common cause, whereas, in the Western world, malignant obstruction is becoming a more predominant factor" Ref : Sabiston 18/e p1485

Ascending infection through biliary tract


Question: Maintenance dose rate of drug depends primarily on

Ref-KDT 6/e p34 Maintenance dose is determined by clearance Maintenance dose=CLxPlasma concentration required


Question: Diagnosis of x linked agammaglobulinamia should be suspected if

Ref Robbins 9/e p240-241 Classically, this disease is characterized by the following: * Absent or markedly decreased numbers of B cells in the circulation, with depressed serum levels of all classes of immunoglobulins. The numbers of pre-B cells in the bone marrow may be normal or reduced. * Underdeveloped or rudimentary germinal centers in peripheral lymphoid tissues, including lymph nodes, Peyer patches, the appendix, and tonsils * Absence of plasma cells throughout the body * Normal T cell-mediated responses

Absent tonsils and no palpable lymph nodes on physical examination


Question: Muscle forming anterior and posterior faucial folds of tonsillar fossa, respectively

Palatoglossus-palatopharyngeus form the boundary of the tonsillar fossaReference: Chaurasia; 6th edition

Levator veli palatine-tensor veli palatine


Question: Difference between typical cervical & thoracic veebral

Superior aicular facet directed backwards & upwards


Question: Content of the star marked triangle

Marked triangle - Anatomical snuff box Anatomical snuff box -Content - radial aery -Boundaries Anterolaterally - abductor pollicis longus and extensor policis brevis Posteromedially- extensor pollicis longus Floor-styloid process, scaphoid,trapezium Floor-Carpetted by tendons of ECRL,ECRB Roof-Cephalic vein ,Sup. branch of radial nerve

Basilic vein and superficial branch of radial nerve

Radial aery and Posterior interosseous nerve(PIN)

Cephalic vein and Posterior interosseous nerve(PIN)

Muscles of arm and forearm region & Cubital fossa


Question: Frontal eye field Area is

Frontal eye field ( Area 8): Located in middle frontal gyrus in front of premotor area Conjugate detion of eyes to opposite side. Destructive lesions result in eyes looking towards the side of lesion.


Question: Subarachnoid space ends at

The dura and arachnoid along with the subarachnoid space containing CSF extend up to 2nd sacral veebra. Below the lower border of L1 and S2 veebrae, the subarachnoid space contains 40 spinal nerve roots of L2-L5, S1-S5 and Co 1 which constitute the cauda equina. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3.


Question: Anemia in chronic renal failure is due to

Ref Harrison 19 th ed pg 630 The anemia is primarily due to a failure of EPO production by the diseased kidney and a reduction in red cell survival. In ceain forms of acute renal failure, the correlation between the anemia and renal function is weaker. Patients with the hemolytic-uremic syndrome increase eryth- ropoiesis in response to the hemolysis, despite renal failure requiring dialysis.