Question: The best test for oesophageal varices is

Endoscopy - upper GI endoscopy represents the most reliable single technique as it shows oesophageal varix and bleeding point Dilated longitudinal veins running a Zig- Zag course Diffuse oesophagal spasm is best diagnosed by Manometry Commonest cause of acute upper GI haemorrhage - Peptic ulcer ref - Srb's manual of surgery 5e p790


Question: Gingival biopsy is useful in the diagnosis of

Ref Harrison 17/ 2146; Robbins 9/e p 262,7/e p264 Other Organs. Amyloidosis of other organs generally is encountered in systemic disease. The adrenals, thyroid, and pituitary are common sites of involvement. In such cases as well, the amyloid deposition begins in relation to stromal and endothelial cells and progressively encroaches on the paren- chymal cells. Surprisingly large amounts of amyloid may be present in any of these endocrine glands without apparent disturbance of function. In the gastrointestinal tract, a rela- tively ored site for deposition, amyloid may be found at all levels, sometimes producing tumorous masses that must be distinguished from neoplasms. Nodular depositions in the tongue may produce macroglossia. On the basis of the frequent involvement of the gastrointestinal tract in systemic cases, gingival, intestinal, and rectal biopsies serve in the diag- nosis of suspected cases. Deposition of b2-microglobulin amyloid in patients receiving long-term dialysis occurs most commonly in the carpal ligaments of the wrist, resulting in compression of the median nerve (leading to carpal tunnel syndrome).


Question: Muscles attached to the greater tubercle of humerus

Supraspinatus is attached to greater tubercle. All other muscles are attached in the shaft of humerus. B D Chaurasia 7th edition Page no : 16 mnemonic:attachments in greater tubercle of humerus SIT Supraspinatus Infraspinatus Teres Minor


Question: In the lungs bronchial aeries supply the bronchopulmonary tree

Bronchial aery supplies the bronchial tree till respiratory bronchiole. BD CHAURASIA'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.page no.242 fig 16.9


Question: Clara cells are present in

cells of Clara - Some non-ciliated cells present predominantly in terminal bronchioles produce a secretion that spreads over the alveolar cells forming a film that reduces surface tension. These include the cells of Clara. Some functions attributed to cells of Clara include: Protection against harmful substances that are inhaled. Protection against development of emphysema by opposing the action of substances (proteases) that tend to destroy walls of lung alveoli. Stem cell function. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no. 235.


Question: Endothelial derived relaxing factor is associated with

Ref Robbins 8/p60;7/e,72-73 ;9/e p80 , it is firmly established this substance is nitric oxide (NO).Endothelium produces NO which then diffuses to the vascular smooth muscle tissue, although these seems to be evidence that vasodilatory may also be of neuronal origin, rather than endothelial. NO is produced by the enzyme nitric oxide synthase and it relaxes smooth muscle tissue by promotig the synthesis of cGMP.


Question: Hb is a good buffer because of

Ref Robbins 9/e p650 Haemoglobin also functions in CO2 and proton transpo from tissues to lungs . Release of O2 from Oxy Hb at the tissue is accompanied by uptake of proton due to lowering of the pKa of histamine residues


Question: Nerve supply of scalpa) Auriculotemporal nerveb) Zygomatic nervec) Occipital nerved) Infratrochlear nerve

Nerves of the scalp and superficial temporal region

In Front of auricle

Behind th auricle

Sensory nerves

Sensory nerves

1.

 Supratrochlear branch of  the frontal (ophthalmic  division of trigeminal  nerve)

1.

Posterior division of great auricular nerve (C2, C3) from cervical plexus

2.

 Supraorbital, branch of  frontal (ophthalmic  division of trigeminal  nerve)

2.

Lesser occipital nerve (C2), from cervical plexus

3.

 Zygomaticotemporal,  branch of zygomatic  nerve (maxillary division  of trigerninal nerve)

3.

Greater occipital nerve (C2, dorsal ramus)

4.

Auriculotemporal branch of mandibular division of trigeminal nerve

4.

Third occipital nerve (C3, dorsal ramus

Motor nerve

Motor nerve

1.

 Temporal branch of facial  nerve

1.

 Posterior auricular barnch  of facial nerve


Question: The normal gain in length in a full term baby at first 6 months of life is

At bih length : 50cms At 3 months : 60cms At 6 months: 65 cms At 1yr: 75 cms Hence gain in length in a full term baby at first 6 months of life is 15cms Ref: Ghai, 9th edition, Table 2.3


Question: Choledochal cyst develops due to

Choledochal cyst Cystic dilation of the biliary ducts, more common in females Association of Choledochal cyst with biliary atresia is seen, with type 1 biliary atresia is present in most cases It is congenital and discovered on antenatal ultrasound Most widely accepted hypothesis: Abnormal pancreaticobiliary ductal junction (APBDJ) APBDJ results in reflux of pancreatic fluid into the distal common hepatic duct and results in mucosal injury, chronic inflammation and weakening of the bile duct Wall Ref: Sabiston 20th edition Pgno : 1511


Question: A 17 year old boy is admitted to the hospital after S, per abdomen examination is normal. After adequate resuscitation, his pulse rate is 80/min and BP is 110/70mmHg. Abdominal CT reveals 1cm deep laceration on the left lobe of the liver extending from the dome more than half way through the parenchyma. Appropriate mangement at this time would be

In stable persons Conservative management is the preferred option Ref: Sabiston 20th edition Pgno : 437-439

Abdominal exploration and packing of hepatic wounds

Abdominal exploration and ligation of left hepatic aery


Question: Tensor fascia lata is supplied by

Of all the nerves, that passes through greater sciatic foramen, superior gluteal N is only one that passes above piriformis muscle. After entering gluteal region. Nerve loops up over inferior margin of gluteus minimus & travels anteriorly & laterally in plane b/w gluteus medius & minimus muscle It supplies gluteus minimus - abductors at hip joint gluteus medius - medially rotates thigh Tensor fasciae latae -prevent pelvis drop on opposite swing side during walking. Nerve to quadratus femoris : Enters gluteal region through greater sciatic foramen inferior to piriformis muscle & deep to sciatic nerve. Lies anterior to plane of deep muscles. It descends along the ischium deep to tendon of obturator internus muscle & associated gemellus muscle to penetrate & innervate quadratus femoris a Supplies small branch to gemellus anterior. * Inferior gluteal nerve : Enters gluteal region through sciatic foramen inferior to piriformis muscle & along the posterior surface of sciatic nerve Penetrate & supplies gluteus maximus muscle. Sciatic nerve : Largest nerve in body & innervates all muscles in posterior compament of thigh that flex the knee & all muscles that move ankle & foot Innervates large area of skin in lower limb.


Question: retrorade ejaculation is common with

chlorpromazine is a antisychotic which is assosiated with retrograde ejaculation blue green discolouration of skin lens granulor deposits obstructive jaundice ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, p no 952


Question: Valve of Hasner

Ref BDC volume3,6th edition pg 76Nasolacrimal duct begins at the lower end of the lacrimal sac, runs downwards, backward and laterally and opens into the inferior meatus of the nose.A fold of mucous membrane called hasners valve forms an imperfect valve at the lower end of the duct.


Question: Commonest site of occurrence of chondroblastoma

Most commonly involved bones are proximal tibia (most common) Femur and pelvis(2nd most common) Humerus Ribs Shoulder girdles Refer Campbells 12th /e p 914


Question: Efferent fibers of amygdala are

Ans. is 'a' i.e., Stria terminalisStria terminalis forms the efferent fibers of amygdaloid nucleus passing in the roof of inferior horn and floor of body of lateral ventricle.


Question: Puppe's rule is

Two fracture lines will never cross( puppe's rule) . Applying this rule it is easy to find out the sequence of injuries, i,e which fracture has occured first. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 162

Two fracture lines cross at right angles

Two fracture lines never cross each other

Two fracture lines cross at obtuse angle


Question: The United Nations General Assembly recently declared June 21st as


Question: Common carotid artery is palpable at


Question: Follman's balanitis is seen in

Syphilitic balanitis of Follmann (SBF) is a rare condition that is considered as manifestation of primary syphilis. Syphilitic balanitis of Follmann presents with variable clinical appearances, and primary chancre may be absent, associated with, or occur after the balanitis. Usually the inguinal lymphadenopathy is present, and syphilitic serology is positive or is going to become positive. Treatment is identical to that of primary syphilis.


Question: Buccopharyngeal membrane consist of

There is no mesoderm in the prochordal plate, so this region remains relatively thin, and later forms the buccopharyngeal membrane. The buccopharyngeal membrane breaks at 4th week . The mouth is bidermal in development. It is derived paly from the stomatodeum (ectodermal) and paly from the cranial pa of the foregut (endodermal). Hence its epithelial lining is paly ectodermal and paly endodermal and the demarcation between the two is buccopharyngeal membrane. Ref: Inderbir Singh's Human Embryology, eleventh edition, pg. no.,68,69,163.


Question: Elastic cailage is found in

Distribution of Elastic Cailage - It forms the 'skeletal' basis of the auricle (or pinna) and of the lateral pa of the external acoustic meatus. The wall of the medial pa of the auditory tube is made of elastic cailage. The epiglottis and two small laryngeal cailages (corniculate and cuneiform) consist of elastic cailage. The apical pa of the arytenoid cailage contains elastic fibres but the major poion of it is hyaline. NOTE - All the sites mentioned above are concerned either with the production or reception of sound. REF : Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no.,85.


Question: The mechanism of anti cancer action of fluoruracil is

5-FU is an antimetabolite.it us a thymidine analogue and acts by conversion to 5'-dUMP .latter inhibits the formation of dTMP and result in Thymineless dealth of cells Ref-KDT 6/824

Cross linking of double standard DNA and the resulting inhibition of DNA replication and transcription

Cytotoxicity resulting from metabolite that interferes with the production of dTMP

Irreversible inhibition of dihydrofolic acid reductase


Question: Gyrus not on the lateral aspect is

(C) Cingulate gyrus # Cingulate cortex, a part of the limbic cortex, is a part of the brain situated in the medial aspect of the cerebral cortex.> Cingulate cortex includes the entire cingulate gyrus, which lies immediately above the corpus callosum, and the continuation of this in the cingulate sulcus.> Cingulate cortex is usually considered part of the limbic lobe.> It receives inputs from the thalamus and the neocortex, and projects to the entorhinal cortex via the cingulum. It is an integral part of the limbic system, which is involved with emotion formation and processing, learning, and memory.> Combination of these three functions makes the cingulate gyrus highly influential in linking behavioral outcomes to motivation (e.g. a certain action induced a positive emotional response, which results in learning).> This role makes the cingulate cortex highly important in disorders such as depression and schizophrenia. It also plays a role in executive function and respiratory control.> Superior temporal gyrus is one of three (sometimes two) gyri in the temporal lobe of the human brain, which is located laterally to the head, situated somewhat above the external ear.


Question: Iloprost in pulmonary aerial hypeension is administered

Ref Harrison 19 th ed pg 1666 Iloprost is a prostacyclin analogue approved inhalation for treatment of pulmonary aerial hypeension (PAH) Epoprostinil as iv treprostinil as oral /iv/SC/inhalation.


Question: Internal anal sphincter is a pa of

Internal anal sphincter is formed by thickened circular muscle coat of the anal canal (which is continuous with rectum) and surrounds the upper two-third of the canal.

Internal circular muscle fibers of rectum


Question: Anterior cruciate ligaments prevents

CRUCIATE LIGAMENTS: Very thick and strong fibrous bands.Direct bonds of union between tibia and fibula. Maintain anteroposterior stability of knee joint. Anterior cruciate ligament:- Begins from anterior pa of intercondylar area of tibia, runs upward, backward and laterally and is attached to the posterior pa of medial surface of lateral condyle of femur. Taut during extension of knee. The anterior cruciate ligament is more commonly damaged than the posterior. It may be injured in violent hyperextension of knee or anterior dislocation of tibia. Posterior cruciate ligament:- Begins from posterior pa of intercondylar area of tibia, runs upwards, forwards and medially and is attached to lateral surface of medial condyle of femur. Taut during flexion of knee. The posterior cruciate ligament is injured in posterior dislocation of tibia. Both these are supplied by middle genicular nerves and vessels. {Reference: BDC 6E pg no.143}


Question: Major blood supply of pectoralis major muscles is

Major blood Supply of Pectoralis major muscles is thoracoacromial trunk. The intercostal perforators arising from the internal mammary aery provide a segmental blood supply BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1. 6TH EDITION.PAGE NO 180. TABLE A1.5:aeries of upper limb

Internal mammary aery perforating branches


Question: In the inflammatory process the prostaglandins E1and E2 causes


Question: Paramesonephric duct in males remains as

The paramesonephric ducts remain rudimentary in the maleThe greater pa of each duct eventually disappearsThe cranial end of each duct persists as a small rounded body attached to the testis(appendix of testis)It has been considered that the prostatic utricle represents the uterovaginal canalRef: Inderbir Singh&;s Human embryology; Tenth edition; Pg 300


Question: Vaginal epithelium is a derivative of

The wall of the vagina from the lumen outwards consists firstly of the mucosa of non keratinized stratified squamous epithelium with an underlying lamina propria of connective tissue, secondly a layer of smooth muscle with bundles of circular fibers internal to longitudinal fibers, and thirdly an outer layer of connective tissue called the adventitia. ref - BDC 6e vol2 pg395


Question: Treatment of Chlamydia pneumonia is

Although few controlled trials of treatment have been repoed, C. pneumoniae is inhibited in vitro by erythromycin, tetracycline, azithromycin, clarithromycin, gatifloxacin, and gemifloxacin. Recommended therapy consists of 2 g/d of either tetracycline or erythromycin for 10-14 days.. Ref Harrison 19th edition pg 1147


Question: With anal canal rectum forms an angle of

The lumen of the rectum terminates at the pelvic floor and is continued, downwards and posteriorly, as the anal canal, passing through the levator ani muscle sheet and surrounded by the internal and external anal sphincters. The anal canal is 2.5 to 5 cm in length and 3 cm in diameter when distended. The axis of the rectum forms almost a right angle (average 82 degrees) with the axis of the anal canal. It has been established by radiological studies that the anal canal is an antero-posterior slit in the resting state. Ref -pubmed.com


Question: Cause of death in amyloidosis involving kidney

Ref Robbins 8/e p254,9/e p261 Amyloidosis of the kidney is the most common and potentially the most serious form of organ involvement


Question: Korsakoff s syndrome is due to deficiency of

Wernickes encephalopathyis a triad of GLOBAL CONFUSION, OPHTHALMOPLEGIA AND ATAXIA It is due to deficiency of thiamine It is 100% reversible Most impoant symptom needed for the diagnosis is confusion If the patients wernickes encephalopathy is not trated it would result in koraskoff's psychosis koraskoff's psychosis is a misnomer it is associated with confabulation that is fluent plausible lying, where the patient fills up with memory gaps with information and she is not aware that wat is she is saying is not truth Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition,pg no.624


Question: The most common type of anorectal malformation is

The most common type of malformation involving the anal canal and rectum is anorectal agenesis, in which the rectum ends as a blind sac above the puborectalis muscle. The anal canal may form normally but does not connect with the rectum. This malformation is accompanied by various fistulas.


Question: Skin of dorsum of first web space of foot is supplied by

DEEP PERONEAL:- Muscular branches to muscles of anterior compament of leg:Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus teius.Extensor digitorum brevis Cutaneous: dorsal digital nerves for adjacent sides of big toe and second toe.Aicular branches:Ankle joint, tarsal joints, tarsometatarsal joints and metatarsophalangeal joint of big toe. {Reference:BDC 6E vol2 pg166 }


Question: Seminoma corresponds to

Seminoma A seminoma typically has a cut surface that is homogeneous and pinkish cream in colour. It appears to compress neighbouring testicular tissue. It corresponds to dysgerminoma of ovaries. It consists of oval cells with clear cytoplasm and large, rounded nuclei with prominent acidophilic nucleoli. Sheets of cells resembling spermatocytes are separated by a fine fibrous stroma. Active lymphocytic infiltration of the tumour suggests a good host response and a better prognosis. There are two histological variants, one with a more anaplastic appearance and another that is characterised by cells that closely resemble different phases of maturing spermatogonia (spermatocytic seminoma). Seminomas metastasise mainly the lymphatics and haematogenous spread is uncommon. The lymphatic drainage of the testes is to the para-aoic lymph nodes near the origin of the gonadal vessels. The contralateral para-aoic lymph nodes are sometimes involved by tumour spread, but the inguinal lymph nodes are affected only if the scrotal skin is involved. Ref: Bailey and love 27th edition Pgno : 1506


Question: The whiff test is useful in the diagnosis of

Bacterial vaginosis AMSEL criteriaNugent criteriaThin, white, yellow, homogeneous discharge.Clue cells on microscopy.pH of vaginal fluid >4.5.Release of a fishy odor on adding alkali--10% potassium hydroxide (KOH) solution (Whiff test)At least three of the four criteria should be present for a confirmed diagnosis.Grade 1 (Normal): Lactobacillus morphotypes predominate.Grade 2 (Intermediate): Mixed flora with some Lactobacilli present, but Gardnerella or Mobiluncus morphotypes also present.Grade 3 (Bacterial Vaginosis): Predominantly Gardnerella and/or Mobiluncus morphotypes. Few or absent Lactobacilli.(Refer: Novak's Textbook of Gynaecology, 23rd edition)


Question: Drug of choice for ADHD is


Question: Ewings sarcoma arises from

Refer Robbins page no 8/e 1232 Ewing sarcoma is a malignant bone tumor characterized by primitive round cells without obvious differentiation. Recently, Ewing sarcoma and primitive neuroectodermal tumor (PNET) have been unified into a single category: the Ewing sarcoma family tumors (ESFT) based on shared clinical, morphologic, biochemical and molecular features (discussed later). Although PNET demonstrates more neu- roectodermal differentiation than Ewing sarcoma, the dis- tinction is not clinically significant


Question: Facial N. stimulation during testing of nerve indicated by contraction of muscle

The orbicularis oris muscle is a sphincter muscle that encircles the mouth.It lies between the skin and the mucous membranes of the lips, extending upward to the nose and down to the region between the lower lip and chin.It is sometimes called the kissing muscle because it causes the lips to close and pucker. <img src=" /> ref - BD chaurasia 6e vol3 pg 66


Question: Average reproductive life span of ovum is

LH surge occurs ~ 36 hours before ovulation LH peak occur ~ 12 hours before ovulation & marks the release of Ist polar body. This mature oocyte (ovum) remain ble for feilization for ~ 24 hours.


Question: Abductor of vocal cord is

The posterior cricoarytenoids are the only intrinsic muscles of the larynx which abduct the vocal cords to allow entry of air through rima glottidis to the respiratory tract below. When posterior cricoarytenoids contract muscular processes of both carotenoids rotate medially. As a result, vocal processes rotate laterally. i.e. abducting vocal cords and providing wide diamond shaped opening of the glottis. If they are paralyzed the adductor muscles of the larynx take the upper hand and the person might die due to the lack of air. Hence, the posterior cricoarytenoids are called safety muscles of the larynx.Cricothyroid tenses the vocal cords.Lateral cricoarytenoid adducts the vocal cords.Thyroarytenoid relaxes the vocal cords.Reference: Textbook of anatomy, Head neck, and brain, Vishram Singh, 2nd edition, page no.224


Question: Intermediate mesoderm will give rise to the

Intermediate mesoderm is a subdivision of intraembryonic mesoderm that forms a longitudinal dorsal ridge called the urogenital ridge from which the kidneys and gonads develop .


Question: Abductor of vocal cords is

Abduction of vocal cords is by Posterior cricoarytenoid only. Posterior Cricoarytenoid is a triangular muscle. - Origin: Posterior surface of the lamina of the cricoid cailage. Origin is medial to inseion. - Inseion: Its fibres pass upwards and backward to the inseed into, the anterior aspect of muscular process of the arytenoid cailage. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Renal angle lies between

Renal-angle is area located on either side of the human back between the lateral borders of the erector spinae muscles and inferior borders of the twelfth rib, so called because the kidney can be felt at this location. Ref -researchgate.net

12th rib & lateral border of sacrospinalis

11th rib & lateral border of sacrospinalis

12th rib & lateral border of quadratus lumborum

11th rib & lateral border of quadratus lumborum


Question: An old man enters a hospital with myocardial infarction and severe ventricular arrithmia. The antiarrhythmic drug chosen has a narrow therapeutic window. The minimum toxic plasma concentration is 1.5 times a minimum therapeutic plasma concentration. Day half life is 6 hours. It is essential to maintaining the plasma concentration about the minimum therapeutic level to prevent possible lethal arrhythmia. Of the following the most appropriate dosing regimen would be

Ref-Katzung 10/e p40,43,44 When a drug is administered less frequently, it produces marked variation in the plasma concentrations. In this question the drug has a half life of 6 hours. If we repeat the dose at 6 hourly intervals, there will be 100% variation in the plasma concentration. More frequent dosing will minimize the variation between maximum and minimum plasma concentrations. As the margin of safety of this drug (given in the question) is very low (maximum tolerable concentration is only 1.5 times the effective concentration), constant i.v. infusion is the best route.


Question: Connecting sinus between cavernous sinus and transverse sinus


Question: The costal cailages of these ribs do not reach the sternum

8,9,10 the ribs are joined to the next higher cailage B D CHOURASIAS HUMAN ANATOMY UPPER LIMB THORAX VOLUME, 1 SIXTH EDITION, Page no, 196


Question: A young patients presented with loss of sensation in sole of foot with paralysis of medial side of plantar muscles of the foot, Most likely nerve involvement is

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 and 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. COMMON PERONEAL:-Branch of sciatic nerve Root value:L4,L5,S1,S2 Branches:Muscular branch: sho head of biceps Cutaneous:lateral cutaneous nerve of calf.Aicular: superior lateral,inferior lateral and recurrent genicular .Terminal branches: superficial and deep peroneal. 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. DEEP PERONEAL:-Muscular branches to muscles of anterior compament of leg:Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus teius.Extensor digitorum brevis Cutaneous: dorsal digital nerves for adjacent sides of big toe and second toe.Aicular branches:Ankle joint, tarsal joints, tarsometatarsal joints and metatarsophalangeal joint of big toe. {Reference:BDC 6E vol2 pg 79}


Question: Patient a known case off alcohol dependence after 3 days of last drink develops change in behaviour that he says he could see 5 cm people throwing stones at him, acts as if he is working in his workshop, frightened pacing in and out of the house with worsening more in the night. The possible diagnosis is

Detoxification implies removal of the toxic substance from the body, this can be done by using a drug similar to alcohol and thus benzodiazepine is chosen. This is the main drug used in treatment of alcohol withdrawal despite the problem being simple withdrawal, rum fits or delirium tremens IF LIVER FUNCTION IS WITHIN NORMAL LIMITS CHOOSE CHLORDIAZEPOXIDE, AS IT HAS A SIMILAR STRUCTURAL FORMULA LIKE ALCOHOL IF LIVER FUNCTION IS ABNORMAL CHOOSE LORAZEPAM, AS IT DOES NOT WORSEN LIVER DERANGEMENTS FRONT LOADING=====patient is loaded with benzodiazepines SYMPTOM TRIGGER=== benzodiazepines is offered only as and when the withdrawal symptom arises FIXED DOSAGE====== regular fixed dosage of benzodiazepine is given in divided doses and slowly tapered so that the patient is not on any drugs by the end of 2 weeks Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.626


Question: Low V4 means

Vd means volume of distribution.It signifies the distribution of drug in the tissues.Low Vd means less drug is distributed to tissue whereas high Vd means drug is being stored in some tissue

the drug has weak plasma protein building


Question: Cremasteric muscle is supplied by

CREMASTER MUSCLE:-Consists of muscle fasciculi embedded in cremasteric fascia. The fasciculi forms superficial loops from middle one-third of upper surface of inguinal ligament and deep loops from pubic tubercle, pubic crest and conjoint tendon. Fully developed in males.In females only few fibres.Muscle along with the intervening connective tissue forms a sac-like cremasteric fascia around spermatic cord and testis. Nerve supply:- genital branch of genitofemoral nerve. Action: suspend the testis and elevate it.Cremasteric reflex:-Stroking the upper pa of the medial side of the thigh there is reflex contraction of the cremaster muscle, as is evidenced by elevation and retraction of the testis. In UMN lesions above segment L1 reflex is lost. <img src=" /> {Reference: BDC 6E vol2 pg 206}


Question: Mirizzi's Syndrome is

Mirriz's syndrome(Functional hepatic syndrome) It is defined as obstruction of the common hepatic duct or CBD by external compression or by erosion of stone in the Hamann pouch or cystic duct. External compression has been classified as type I where as erosion as type II Mirriz's syndrome by McSherry Ref: Sabiston 20th edition Pgno :1510

GB stone compressing common hepatic duct


Question: Nissl's substance is mainly

Nissl Substance - The cytoplasm shows the presence of a granular material that stains intensely with basic dyes; this material is the Nissl substance (also called Nissl bodies or granules). When examined by EM, these bodies are seen to be composed of rough surfaced endoplasmic reticulum. The presence of abundant granular endoplasmic reticulum is an indication of the high level of protein synthesis in neurons. The proteins are needed for maintenance and repair, and for production of neurotransmitters and enzymes. REF : Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no.,164.


Question: Treatment of choice for bleeding gastric ulcer is

Bleeding gastric ulcers. Treatment of bleeding gastric ulcers depends on their cause and location; however, the initial approach is similar to duodenal ulcers. Patients require resuscitation, monitoring, and endoscopic investigation. Up to 70% of gastric ulcers are H. pylori-positive, so an attempt should be made to control the bleeding endoscopically, with multiple biopsy specimens of the ulcer obtained to rule out malignancy and concurrently obtained biopsy specimens of the body and antrum to test for H.pylori infection. Patients whose bleeding can be controlled and who are H. pylori-positive should undergo subsequent treatment for H. pylori infection. For bleeding that cannot be controlled, operative intervention again depends on the type of gastric ulcer. In all cases, the ulcer should ideally be excised with the addition of vagotomy depending on the cause of the ulcer (mostly for intractable ulcers that are not due to H. pylori infection or NSAID usage that can be stopped). Ref: Sabiston Textbook of Surgery 20th edition Pgno: 1209


Question: cove sensitization is mainly used in

In cove sensitization also called as imagined punishment, the individual who wants to quit alcohol will be asked to think about adverse consequences of taking alcohol like getting arrested for drunken driving or facing a accident underintoxicated state. He would be told to dream as if if he is drunk and lies intoxicated in the road and has to be brought back to the home by family members where he will be given lot of advice from neighbours and there would be a loss of respect. While these imagined exposure the patient feels bad and makes sure thet he should quit alcohol and his thoughts ahgainst alcohol increases. Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 845


Question: Magistrate inquest deals under

Magistrate inquest done in cases of Death in prisons Death of a person in police custody or while under police interrogation Man missing in police custody Death due to police firing Death of a mentally ill prisoner in psychatric hospital Death of a woman within 7 years of marriage Exhumation Rape of a woman I police custody In any case, Magistrate can conduct an inquest in addition to police inquest (CrPC 176) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 7


Question: Masseter is supplied by nerve

The mandibular nerve The mandibular nerve leaves the inferior margin of the trigeminal ganglion & leaves the skull through the foramen ovale. The motor root of the trigeminal nerve also passes through the foramen ovale & unites with the sensory component of the mandibular nerve (V3) outside the skull. Thus, the V3 is the only division of the trigeminal nerve that contains a motor component. Outside the Skull- The motor fiber innervates the four muscles of mastication. | Temporalis, masseter, medial pterygoids, lateral pterygoids As well as - Tensor tympani muscle, tensor veli palatini muscle, the anterior belly of digastric & the mylohyoid muscle. Sensory pa of V3:- receives sensory fibers from. -The skin of lower face, cheek, lower lip, anterior pa of external ear, pa of external acoustic meatus & temporal region etc.


Question: Superficial perineal muscles include

The superficial perineal pouch is a compament of perineum.Its inferior border is superficial perineal fascia.Superior border is perineal membrane. Superficial perineal pouch consist of :Ischiocavernous muscle , Bulbospongiosus , Superficial transverse perineal muscle etc Ref - BDC 6e Vol2 pg 350


Question: The neck of pancreas is related on its posterior surface to

Neck of pancreas is located between the head and the body of the pancreas. It overlies the superior mesenteric vessels which form a groove in its posterior aspect. Ref - BDC 6e vol2 pg 298-300


Question: Brunner glands are seen in

INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:272 The wall of the small intestine is made up of the four layers: mucous,submucous,muscularis and serous.the serous and muscular layers correspond exactly to the general structure of the alimentary canal.the sub mucosa is also typical except in the duodenum,where it contains the glands of brunner


Question: A 45 Yr old woman presents with a hard and mobile lump in the breast. Next investigation is

First investigation : Mammography First investigation for tissue sampling : FNAC Best and diagnostic investigation : Biopsy Investigations in CA Breast Mammography - Initial investigation for symptomatic breast in women>35 years and for screening. Investigation of choice for microcalcification Ultrasound- Initial investigation for palpable lesions in women < 35 years. Not useful in screening MRI- Indicated in scarred breast, implants and borderline lesions for breast conservation. Investigation of choice for implant related complication. Gold standard for imaging breast in females with implants. PET scan- Investigation of choice for detecting recurrences in scarred breast. Useful multifocal disease and in helping detect axillary movement Ref:Sabiston 20th edition Pg no : 826- 827


Question: Birbeck granules are present in

Ref Robbins 9/e p662 Birbeck granules, also known as Birbeck bodies, are rod shaped or "tennis-racket" cytoplasmic organelles with a central linear density and a striated appearance. First described in 1961 (where they were simply termed "characteristic granules"), they are solely found in Langerhans cells.


Question: Deltoid ligament has no attachment to

Deltoid ligament has attachments to Tibia, Navicular, Calcaneum, Talus.


Question: Fever occurs due to

ref Robbins 8/e p61,66,9/e p83,90 IL-1 is intensely produced by tissue macrophages, monocytes, fibroblasts, and dendritic cells, but is also expressed by B lymphocytes, NK cells, microglia, and epithelial cells. They form an impoant pa of the inflammatory response of the body against infection. These cytokines increase the expression of adhesion factors on endothelial cells to enable transmigration (also called diapedesis) of immunocompetent cells, such as phagocytes, lymphocytes and others, to sites of infection. They also affect the activity of the hypothalamus, the thermoregulatory center, which leads to a rise in body temperature (fever) . That is why IL-1 is called an endogenous pyrogen. Besides fever, IL-1 also causes hyperalgesia (increased pain sensitivity), vasodilation and hypotension


Question: Root value of supinator jerk is


Question: Nerve supply of rhomboides major

Dorsal scapular nerve arising from the nerve root C5 supplies both rhomboides major and minor. Rhomboides major retract the scapula. B D Chaurasia 7th edition Page no : 65


Question: Immunity against cancer cells

Ref Robbins 8/EP 188;9/e p192 NK cells kill virus- infected cells and produce the macrophage-activating cyto- kine IFN-g. If the microbes enter the blood, many plasma proteins, including the proteins of the complement system, recognize the microbes and are activated, and their products kill microbes and coat (opsonize) the microbes for phagocytosis. In addition to combating infections, innate immune responses stimulate subsequent adaptive immu- nity, providing signals that are essential for initiating the responses of antigen-specific T and B lymphocytes.


Question: Reticulocytosis is not a feature of

Ref Harrison 19 th ed pg 630 Progressive CKD is usually associated with a moderate to severe hypoproliferative anemia; the level of the anemia corre- lates with the stage of CKD. Red cells are typically normocytic and normochromic, and reticulocytes are decreased.


Question: The Gustatory nucleus is a pa of

The rostral pa of the solitary nucleus is sometimes referred to as the gustatory nucleus. The solitary nucleus conveys information about taste and visceral sensations


Question: The trigeminal ganglion is

A motor and sensory ganglion of trigeminal nerve

Homologous with the dorsal root ganglion

Receives the motor root at its posterior concavity


Question: Ligament supporting the head of talus is

Ans. d (Plantar calcaneonavicular ligament ). (Ref. BDC, Vol. II, 3rd ed., 132, 135, 136)# The head of talus rests directly on the upper surface of the Plantar calcaneonavicular ligament (Spring ligament), which is covered by fibrocartilage.# The plantar calcanonavicular ligament, as the name sugests, runs from the sustentaculum tali of the calcaneum to the navicular bone on its inferior aspect. The upper surface of the ligament is covered by fibrocartilage and strongly supports the head of the talus from below. It also acts like a tie beam to support the medial longitudinal arch.# Most commonly the lateral collateral ligament is sprained, mostly so anterior talo-fibular component.2Also remember:Talar neck fractures are the commonest injury and are usually high energy (historically termed 'aviator's astragalus'). A significant complication is avascular necrosis of the talus. The goal of treatment is anatomical reduction and stable fixation, which helps reduce the risk of osteonecrosis. Hawkins' sign can be seen approximately 6-8 weeks after injury on plain radiographs. This appears as subchondral lucency of the talar dome, which signifies bony reabsorption, i.e. a viable bone.


Question: Level III neck nodes are

In the midline from hyoid to suprasternal notch

around the middle 1/3rd of internal jugular vein


Question: Regarding oncogenesis

Topoisomerase2 causes break in strands ; and option C and D is also answer ref Harrison 16/e p453; 454; Robbins 7/e Cell Cycle Inhibitor Proteins Topoisomerases can fix these topological problems and are separated into two types depending on the number of strands cut in one round of action: Both these classes of enzyme utilize a conserved tyrosine. However these enzymes are structurally and mechanistically different. For a video of this process click here. A type I topoisomerase cuts one strand of a DNA double helix, relaxation occurs, and then the cut strand is re-ligated. Cutting one strand allows the pa of the molecule on one side of the cut to rotate around the uncut strand, thereby reducing stress from too much or too little twist in the helix. Such stress is introduced when the DNA strand is "supercoiled" or uncoiled to or from higher orders of coiling. A type II topoisomerase cuts both strands of one DNA double helix, passes another unbroken DNA helix through it, and then re-ligates the cut strands. Type II topoisomerases utilize ATP hydrolysis and are subdivided into two subclasses which possess similar structure and mechanisms: Type IIA topoisomerases which include eukaryotic and eukaryal viral Topoisomerase IIa and Topoisomerase IIb, bacterial gyrase, and topoisomerase IV. Type IIB topoisomerases, which include Topoisomerase VI found in archaea

P53 is the most common oncogene mutation causing malignancy in humans

At G2_M phase there is loss of inhibitors controlling cell cycle

Decrease in telomerase activity causes anti tumor effects


Question: 'Crumbled egg appearance' in liver is seen in

Crumbled egg appearance in liver is seen in hyadatid disease


Question: Anterior end of the spleen is held up by

The posterior end is rounded and is directed upward and backward; it rests on the upper pole of the left kidney. The spleen's 3 borders are the superior, inferior, and intermediate. The superior border of the spleen is notched by the anterior end. The inferior border is rounded. Ref - researchgate.net


Question: ulimia nervosa is assosiated with

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


Question: Most posterior structure seen in root of lung is

Most posterior structure in the root of the lung is bronchus <img src=" /> B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME1 SIXTH EDITION Page no-237


Question: Structures passing through the aortic hiatus of diaphragm area) Aortab) Azygos veinc) Hemiazygos veind) Thoracic ducte) Sympathetic trunk

Aortic opening
-        Level- T12
-        At osseoaponeurosis between right and left crus
-        Structures transmitted

   Aorta
   Thoracic duct
   Azygos vein


Question: DEEP PETROSAL nerve arises from

The deep petrosal nerve, sympathetic in nature is a branch of the sympathetic plexus around the internal carotid aery. It contains postganglionic fibres from the superior cervical sympathetic ganglion. The nerve joins the greater petrosal nerve to form the nerve of the pterygoid canal. The sympathetic fibres in it are distributed through the branches of the pterygopalatine ganglion. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: The appropriate media culture for a gram negative coccobacilli arranged in a school of fish , that causes STD with genital ulcers is

Chocolate agar enriched with 1%isovitalex is used to grow H.ducreyi.


Question: The most commonest cause for chronic cor pulmonale is

Ref Harrison 19 th ed pg 1505 Once patients with chronic pulmonary or pulmonary vascular disease develop cor pulmonale, the prognosis worsens. Although chronic obstructive pulmonary disease (COPD) and chronic bronchitis are responsible for approximately 50% of the cases of cor pulmonale .


Question: NOT a content of Deep perineal pouch among the following is

Membranous urethra is a content of Deep perineal pouch, not prostatic urethra.


Question: On bimanual palpation, the feeling of absent uterus is termed as

Hegar's sign Softeningof the lower uterine segment can be elicited between second and fifth month of pregnancy. In a bimanual palpation with one hand placed on the abdomen and two fingers in the vagina the lower uterine segment is not felt and fingers of hands will touch together as if no uterus is between. This test is not recommended now for fear of disturbance of pregnancy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 330


Question: Deiters cells are present in

Deiters&; cells, also known as phalangeal cells are found within the organ of Coi.The organ of Coi is located in the scala media of the cochlea of the inner ear between the vestibular duct and the tympanic duct and is composed of mechanosensory cells, known as hair cells. Strategically positioned on the basilar membrane of the organ of Coi are three rows of outer hair cells (OHCs) and one row of inner hair cells (IHCs). Separating these hair cells are suppoing cells called Deiters cellsReference: Krishna Garg Histology; 5th edition; Page no: 258


Question: Muscle causing flexion of hip

Hip flexion is brought about by the action of iliopsoas aided by the rectus femoris ,saorius, and pectineus.Tensor fasciae latae(TFL) aids gluteus minimus and medius in abduction and medial rotation.Gluteus maximus helps in extension and lateral rotation.Biceps femoris helps inflexionReference : Clinical Anatomy for students, a problem solving approach, Neeta v Kulkarni, 2nd edition, page no.932


Question: Macular sparing is seen in affection of

MACULA HAS GOT DUAL SUPPLY-BOTH MCA AND PCA


Question: Sacrotuberous ligament is not pierced by

Sacrotuberous ligament is pierced by

Coccygeal branch of Inferior gluteal nerve
Perforating cutaneous nerves
Filaments of Coccygeal plexus


Question: Charcot's triad

Charcot's triad is seen in cholangitis It is characterized by Abdominal pain Jaundice Fever Reynold's pentad Charcot's triad Altered mental status. Shock (hypotension) Ref: Sabiston 20th edition Pgno :1507


Question: The Vein of Galen drains into

Ans. b (Straight sinus). (Ref. BD Chaurasia, Anatomy, 3rd ed., Vol III 303)Great Cerebral Vein Of Galen# Single median vein formed by union of two internal cerebral veins.# Terminates into straight sinus.# Its tributaries include the basilic vein, veins from pineal body, colliculi, cerebellum and adjoining occipital lobes.# Vein of Galen malformation is one of the most common cause of congestive cardiac failure in neonates.# The dural venous sinuses receive cerebral veins from the brain and drain the venous blood mainly into the IJV.Dural venous sinusesSuperior sagittal sinus# It drains into the concluence of the sinuses (Torcular).Inferior sagittal sinus# It is located in the midsagittal plane, near the inferior margin of the falx cerebri.# It terminates by joining with the great cerebral vein of Galen to form the straight sinus at the junction of the falx cerebri and tentorium cerebelli.Straight sinus# It is formed by the union of the inferior sagittal sinus and the great cerebral vein.# It usually terminates by draining into the confluence of sinuses (or in transverse sinus).Occipital sinus# It is found in the attached border of the tentorium cerebelli.# It drains into the confluence of sinuses.Confluence of sinuses (torcular herophili)# It is formed by the union of the superior sagittal, straight, and occipital sinuses.# It drains into the two transverse sinuses.Transverse sinuses (Lateral sinuses)# It drains venous blood from the confluence of sinuses into the sigmoid sinuses.# Each sigmoid sinus joins with an inferior petrosal sinus to drain into the internal jugular vein below the jugular foramen.# Thrombosed in complicated chronic mastoiditis (DELTA SIGN on CT).


Question: Blood supply of ventral 2/3rd of interventricular septum of hea is

The posterior interventricular aery, a branch of right coronary aery, supplies the posterior 1/3 of the interventricular septum. The remaining anterior 2/3 is supplied by the anterior interventricular aery which is a septal branch of the left anterior descending aery, which is a branch of left coronary aery . B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME-1 SIXTH EDITION Page-265


Question: Child rolls over by

Once the assymetric tonic reflex disappears, baby learns to roll over from prone to supine and vice versa. Between 4 to 6 months, baby learns to roll over from back to side and then from back to stomach. Ref: Ghai, 9 th edition, page- 42.


Question: Lymph from glans penis drains into

All the lymphatic vessels of the penis passes to the superficial inguinal nodes by accompanying the external pudendal blood vessel. The lymphatic vessels of glands penis enter to the deep inguinal nodes and external iliac nodes. Ref - BDC 6e vol2 pg219


Question: Most common cause of peritonitis in adult male is

MC cause of peritonitis in adult male: Peptic ulcer perforation * The most common cause is a perforation of the abdominal viscus-most commonly, a perforated ulcer, may occur as a result of perforation of any pa of the bowel; other causes include a benign ulcer, a tumor, or trauma.* MC cause of peritonitis in adult male: Peptic ulcer perforation


Question: Modiolus (apex) is directed


Question: Collagen found in hyaline cailage is

Collagen present in cailage are chemically distinct from those in most other tissues.They are described as type 2 collagen Inderbir Singh&;s textbook of human Histology Seventh edition Pg no 82


Question: Arrange the contents of cubital fossa medial to lateral

Cubital fossa is a triangular hollow situated on the front of the elbow. Contents (medial to lateral)- M-Median nerve B-Brachial aery and it's branches B-Biceps brachi tendon S- Superficial branch of radial nerve* Lateral boundary is contributed by brachioradialis muscle, medially present is pronator teres and base is formed by an imaginary line connecting the two epicondyles.

Median Nerve -Biceps tendon - Brachial aery- Radial nerve

Biceps tendon - Median Nerve - Brachial aery- Radial nerve

Median Nerve - Brachial aery - Biceps tendon - Radial nerve

Median Nerve - Radial nerve - Biceps tendon - Brachial aery

Muscles of arm and forearm region & Cubital fossa


Question: Caspases are involved in.

Caspes are present in normal cells as inactive proenzymes and when they are activated they cleave proteins and induce Apoptosis. These are cysteine professes.


Question: DeQuervains thyroiditis is also known as

Refer Robbins page no DeQuervains thyroiditis is also referred to as Granulomatous thyroiditis


Question: The cytogenetics of the Chromophillic renal cell carcinoma is characterized by

Chromophillic carcinoma is the other name of papillary renal cell carcinoma because 80% of Chromophillic cancers show tubopapillary architecture. As discussed, papillary cancer is associated with trisomy 7,16,17


Question: Mastoid fontanelle after ossification exists in adults as ,

The asterion is the point where the parietomastoid, occipitomastoid and lambdoid sutures meet. In infants the asterion is the site of the posterolateral or mastoid fontanelle,which closes at the end of the first year.


Question: Epithelium present in thin segment of Loop of Henle is

The epithelium of the Thick segment is simple cuboidal epithelium. The epithelium of the Thin segment is simple squamous.Reference: Krishna Garg Histology; 5th edition; Page no: 180


Question: The forward displacement of tibia on the femur is prevented by

Anterior cruciate ligament prevents posterior displacement of the femur on the tibia and hyperextension of the knee joint. When the joint is flexed at a right angle, the tibia cannot be pulled anteriorly because it is held by the ACL.**watch the wordings carefullyReference: Chaurasia; 6th edition


Question: Nerve supply of adductors of thigh includes

(B) Obturator nerve# Obturator Nerve:> Obturator nerve (L2 L3 L4) is the chief nerve of the medial (adductor) compartment of the thigh.> It is a branch of the lumbar plexus.> It enters the thigh by passing through the obturator canal.> Anterior division of obturator nerve supplies the following muscles: Pectineus, Adductor longus, Gracilis, Adductor brevis.> Posterior division of obturator nerve supplies following muscles: Obturator extemus, Adductor magnus, Adductor brevis.> Adductor magnus has double nerve supply. Its adductor part is supplied by the obturator nerve, while its hamstring part is supplied by the tibial part of the sciatic nerve.> Pectineus also has a double innervation; its anterior fibres are supplied by the femoral nerve and the posterior fibres by the obturator nerve> Obturator nerve also give branches to the hip and the knee joint so a lesion of the nerve may cause pain in the hip & knee joint.


Question: The ureter is lined by .................ephithelium

Ureters - Ureters are muscular tubes that conduct urine from renal pelvis to the urinary bladder. The wall of the ureter has three layers: An inner lining of mucous membrane , A middle layer of smooth muscle, An outer fibrous coat: adventitia. Mucous Membrane -The mucous membrane has a lining of transitional epithelium that is 4 to 5 cells thick and an underlying connective tissue, lamina propria. The mucosa shows a number of longitudinal folds that give the lumen a star-shaped appearance in transverse section. The folds disappear when the ureter is distended. REF: Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no.,317.


Question: External acoustic meatus is derived from

(Dorsal part of the 1st ectodermal cleft) (357-IBS 8th) (317-I.B.Singh 8th)External acoustic meatus is derived from the dorsal part of the first ectodermal cleft. However, its deeper part is formed by proliferation of its lining epithelium.FATE OF ENDODERMAL POUCHESA. First pouch(a) Its ventral part is obliterated by formation of the tongue(b) Its dorsal part receives a contribution from the dorsal part of the second pouch, and these two together form a diverticulum that grows towards the region of the developing ear. This diverticulum that grows towards the region of the developing ear. This diverticulum is called the trubotympanic recess. The proximal part of this recess gives rise to the auditory (pharyngotympanic) tube, and the distal part to the, middle ear cavity including the tympanic antrumB. Second Pouch(a) The epithelial of the ventral part of this pouch contributes to the formation of the tonsil(b) The dorsal part takes part in the formation of the tubotympanic recessC. Third Pouch- give rise to inferior parathyroid gland & ThymusD. Fourth Pouch- gives origin to the superior parathyroid glands and may contribute to the Thyroid glandE. Fifth or Ultimobranchial pouch- give rise to ultimobranchial body (some species) & caudal pharyngeal complex

Dorsal part of the first ectodermal cleft

Ventral part of the first ectodermal cleft

Ventral part of the 2nd ectodermal cleft


Question: Middle deft upper lip due to failure of fusion b/w

Defect
Caused by

Cleft upper lip
Failure of fusion between maxillary process and medial naral process

Medial deft upper lip
Failure of fusion between maxillay process and medial and lateral naral process

Oblique facial deft
Failure of fusion between maxillary process and medial lateral naral process

Lower lip deft
Failure of fusion of two mandibular process

Medial naral process and maxillary process


Question: Caplan's syndrome is pneumoconiosis with

Pulmonary manifestations of RA include pleurisy with or without effusion, ILD in up to 20% of cases, necrobiotic nodules (nonpneumoconiotic intrapulmonary rheumatoid nodules) with or without cavities, Caplan syndrome (rheumatoid pneumoconiosis), pulmonary hypeension secondary to rheumatoid pulmonary vasculitis, organized pneumonia, and upper airway obstruction due to cricoarytenoid ahritis. Ref Harrison 19th edition pg 1713


Question: Most common site of cholangiocarcinoma

Cholangiocarcinoma Tumors arising from bile duct epithelium. Most common type is adenocarcinoma Differentiated by anatomic site of origin: Intrahepatic (10%), Hilar (65%), and distal (25%) MC gene mutation is K-ras >p16(KRAP-16) Ref: Sabiston 20th edition Pgno :1514-1518


Question: Hand and foot syndrome is an adverse effect of

Ref-Katzung 11/e p947 Capecitabine and 5-FU can cause hand and foot syndrome


Question: A strong propensity for vacuolar invasion is seen in

Ref Robbins 7/e p925; 9/e p274 Renal and hepatocellular carcinomas hav high tendency invasion of vascular channels MORPHOLOGY HCC may appear grossly as (1) a unifocal, usually massive tumor; (2) a multifocal tumor made of nodules of variable size; or (3) a diffusely infiltrative cancer, permeating widely and sometimes involving the entire liver, blending imperceptibly into the cirrhotic background. Paicularly in the latter two patterns, it may be difficult to radiologically distinguish regenerative cirrhotic nodules from neoplasms of similar size. Discrete tumor masses usually are yellow- white, punctuated sometimes by bile staining and areas of hemorrhage or necrosis. HCC has a strong propensity for vascular invasion. Extensive intrahepatic metastases are characteristic, and occasionally snakelike masses of tumor invade the poal vein (with occlusion of the poal circula- tion) or inferior vena cava, extending even into the right side of the hea. On histologic examination, HCCs range from well- differentiated lesions that reproduce hepatocytes arranged in cords, trabeculae or glandular patterns (Fig. 15-34), to poorly differentiated lesions, often composed of large, multinucleate anaplastic giant cells. In the better-differentiated vari- ants, globules of bile may be found within the cyto- plasm of cells and in pseudocanaliculi between cells. Acidophilic hyaline inclusions within the cytoplasm may be present, resembling Mallory bodies. There is little stroma in most hepatocellular carcinomas, explaining their soft consistency. A distinctive clinicopathologic variant of HCC is the fibrolamellar carcinoma. It occurs in young male and female adults (20 to 40 years of age) with equal incidence and has no association with cirrhosis or other risk factors. It usually consists of a single tumor with fibrous bands coursing through it, superficially resembling focal nodular hyperplasia. The fibrolamellar variant has a better prognosis than that of the other, more common variants.


Question: Constrictions in Esophagus by aoa is present at distance of from incisor

Construction of oesophagus at the following levels 15 cm-crossed by cricopharyngeus 22.5 cm-crossed by aoa 27.5 cm-crossed by left bronchus 37.5 cm-pierces the diaphragm All from incisor teeth BD CHAURASIA'S HUMAN ANATOMY VOL.1,PAGE NO 282


Question: Scarpa's fascia gets attached to

Scarpa's fascia is the deep membranous layer of superficial fascia of anterior abdominal wall. It crosses the inguinal ligament and gets attached to the fascia lata of thigh along Holden's line below and parallel to inguinal ligament. fig:-layers of abdominal wall

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


Question: First lumbrical canal communicates with

Thenar space communicates with first web space through first lumbrical canal.The midpalmar space communicates with medial 3 web spaces through medial 3 lumbrical canals.Reference: Textbook of anatomy upper limb and thorax, Vishram Singh, second edition, page no 154, 153


Question: Unilateral palsy of external laryngeal nerve leads to


Question: Farmers lung is caused due to exposure to

Farmer's Lung This condition results from exposure to moldy hay containing spores of thermophilic actinomycetes that produce a hypersensitivity pneumonitis. Ref Harrison 19th edition 1691


Question: Adductor canal lies beneath the

ADDUCTOR CANAL:- Also known as Hunter's or subsaorial canal. It is an intermuscular space situated on the medial side of the middle one-third of the thigh. Extend -from apex of femoral triangle above to the tendinous opening in adductor Magnus below. Shape:- Triangular on cross section. Boundaries:--Anterolateral wall: vastus medialis.-Posteromedial wall/Floor:Adductor longus above and adductor Magnus below.-Medial wall/Roof: strong fibrous membrane joining Anterolateral and posteromedial walls. Roof overlapped by Saorius. Subsaorial plexus of nerves lies on the fibrous roof of the canal under saorius. Plexus is formed by branches from the medial cutaneous nerve of thigh, the saphenous nerve and the anterior division of the obturator nerve. It supplies skin over fascia lata and neighboring skin. Contents:-1. Femoral aery: enters the canal at the apex of the femoral triangle. Within the canal, it gives off muscular branches and descending genicular branch. It leaves the canal through opening in adductor Magnus to continue as popliteal aery.2. Femoral vein lies posterior to femoral aery( upperclassmen pa) and lateral to the aery ( lower pa).3. Saphenous nerve: cross the femoral aery anteriorly from lateral to medial side.4. Nerve to vastus medialis 5. Branches of two divisions of obturator nerve: Anterior division emerges at the lower border of adductor longus, gives branches to subsaorial plexus and ends by supplying femoral aery. Posterior division of the obturator nerve runs on anterior surface of adductor magus and ends by supplying knee joint. {Reference: BDC 6Epg no.56}


Question: Meckel's diveiculum is a remnant of

INDERBIR SINGH'S TEXTBOOK OF HUMAN HISTOLOGY-page no:195 Persistence of a pa of the vitellointestinal duct may give rise to the presence of a diveiculum attached to the terminal pa of the ileum.this is called Meckel's diveiculum or diveiculum ilei


Question: Barr body is found in the following phase of the cell cycle

Inactivated X chromosomes seen in female somatic cells are called Barr-bodies which are present adjacent to the nuclear membrane. In humans with more than one X chromosome, the number of Barr bodies visible at interphase is always one fewer than the total number of X chromosomes.


Question: Trochlear nerve nucleus lies at the level of

Trochlear nerve nucleus is located in anterior part of gray matter that surrounds cerebral aqueduct, at the level of inferior colliculus.


Question: The Pectoralis major is classified as a (2018)

Spiral or Twisted Fasciculi Spiral or twisted fibres are found in trapezius, pectoralis major, latissimus dorsi, supinator Ref:-BD chaurasia handbook of general anatomy , pg num:-91


Question: CPD in absence of gross pelvic abnormality can be diagnosed by

Best method to rule out CPD is trial of labor Best investigation MRI


Question: Most common histological type of renal cell carcinoma

Refer Robbins 9/e p953 Clear cell carcinoma. This is the most common type, accounting for 70% to 80% of renal cell cancers. The tumors are made up of cells with clear or granular cytoplasm and are nonpapillary. They can be familial, but in most cases (95%) are sporadic. In 98% of these tumors, whether familial, sporadic, or associated with VHL syndrome, there is loss of sequences on the sho arm of chromosome 3. The deleted region harbors the VHL gene (3p25.3). A second nondeleted allele of the VHL gene shows somatic mutations or hypermethylation-induced inactivation in up to 80% of clear cell cancers, indicating that the VHL gene acts as a tumor suppressor gene in both sporadic and familial cancers (Chapter 7). The VHL gene encodes a protein that is pa of a ubiquitin ligase complex involved in targeting other proteins for degradation. Impoant among the targets of the VHL protein is the transcription factor hypoxia- inducible factor-1 (HIF-1). When VHL is inactive, HIF-1 levels remain high, even under normoxic conditions, causing inappropriate expression of a number of genes that are turned on by HIF. These include genes that promote angiogenesis, such as VEGF, and genes that stimulate cell growth, such as insulin-like growth factor-1 (IGF-1). In addition, HIF collaborates in complex ways with the oncogenic factor MYC to "reprogram" cellular metabolism in a way that ors growth. D


Question: In Apoptosis , cytochrome C acts through


Question: Gluteus maximus is inserted on

Ans. d (Iliotibial tract). (Ref. BD Chaurasia, Human Anatomy- Vol. II 3rd ed., 61)TENSOR FASCIA LATA# Tensor fascia lata lies between the gluteal region and front of the thigh.# It arises from anterior 5 cm of outer lip of iliac crest up to tubercle and from anterio superior iliac spine and notch below it. It is inserted into iliotibial tract.# It is supplied by superior gluteal nerve (L4, L5)# Ober's test is for testing its function


Question: Injury to one of the following arteries results in extradural hematoma


Question: Nerve supply for adductor compartment of thigh is by

(B) Obturator Nerve # OBTURATOR NERVE (L2, L3, L4) is the chief nerve of the medial compartment of the thigh.> It is a branch of the lumbar plexus.> It enters the thigh by passing through the obturator canal.> Anterior division of obturator nerve supplies the following muscles: Pectineus Adductor longus Gracilis Adductor brevis> Posterior division of obturator nerve supplies following muscles: Obturator externus Adductor magnus Adductor brevis


Question: The origin of ovaries from


Question: Early complication of TIPSS is

Transjugular intrahepatic poosystemic stent shunts The emergency management of variceal haemorrhage has been revolutionised by the introduction of transjugular intrahepatic poosystemic stent shunts (TIPSS). Over a sho period, this has become the main treatment of variceal haemorrhage that has not responded to drug treatment and endoscopic therapy. The shunts are inseed under local anaesthetic, analgesia and sedation, using fluoroscopic guidance and ultrasonography. Via the internal jugular vein and SVC, a guidewire is inseed into a hepatic vein and through the hepatic parenchyma into a branch of the poal vein. The track through the parenchyma is then dilated with a balloon catheter to allow inseion of a metallic stent, which is expanded once a satisfactory position is achieved to form a channel between systemic and poal venous systems. A satisfactory drop in poal venous pressure is usually associated with good control of the variceal haemorrhage. The main early complication of this technique is perforation of the liver capsule, which can be associated with fatal intraperitoneal haemorrhage. TIPSS occlusion may result in fuher variceal haemorrhage and occurs more commonly in patients with well-compensated liver disease and good synthetic function. Post-shunt encephalopathy is a confusional state caused by the poal blood bypassing the detoxification of the liver. It occurs in about 40% of patients, a similar incidence to that found after surgical shunts. If severe, the lumen of the TIPSS can be reduced by inseion of a smaller stent. T he main contraindication to TIPSS is poal vein occlusion. The main long-term complication of TIPSS is stenosis of the shunt, which is common (approximately 50% at 1 year) and may present as fuher variceal haemorrhage. Ref: Bailey and love 27th edition pgno:1164


Question: Nerve damaged in case of numbness of little and ring finger, atrophy of hypothenar muscles

Ans. c. Ulnar nerve before division into superficial and deep branchesNerve damaged in case of numbness of little and ring finger, atrophy of hypothenar muscles is ulnar nerve, before division into superficial and deep branches.Supplied musclesUlnar Nerve (C8T,)Musician's NervMedian Nerve (C5678T1)Laborer's nervedegAxilla and ArmNo branchNo branchForearmFlexor carpi ulnarisdegFlexor digitorum profundus(medial half)degFlexor carpi radialisFlexor digitorum profundus (lateral Flexor digitorum superficialisdegFlexor pollicis longusPalmaris longusPronator teres and quadratusdegHandLast two (3rd and 4th)lumbricalsdegPalmar and dorsal interosseidegThenar muscles:Adductor pollicisdegHypothenar muscles:Palmaris brevisAbductor digiti minimiFlexor digiti minimiOpponens digiti minimi1st two (1st and 2sd)lumbricalsdegThenar musclesAbductor pollicis b.revisdegFlexor pollicis brevisdegOpponens pollicisdeg


Question: Structure injured while resecting the free edge of lesser omentum is

Lesser omentum: - It extends from liver to stomach (lesser curvature) and duodenum (first 2 cm). The pa of lesser omentum from liver to stomach is called hepatogastric ligament, and pa from liver to duodenum is called hepatoduodenal ligament. Hepatogastric ligament forms anterior free wall of lesser sac (omental bursa) and contains right and left gastric vessels, branches of gastric nerves and lymph vessels. Hepatoduodenal ligament forms right free margin, contains poal vein, hepatic aery proper, bile duct, lymphatics and hepatic plexus of nerves. Lesser omentum develops from ventral mesogastrium (dorsal pa).


Question: Lymphatic drainage of glans penis is by

Lymphatic drainage of glans penis is deep inguinal lymph nodes. Superficial inguinal lymph nodes- scrotum, perineum, vulva and anus Lymphatic drainage of testis is pre and para aoic lymph nodes.

Abdominal wall ,Inguinal and Femoral region


Question: Major complication of cysto gastrostomy for pseudopancreatic cyst

Serious post op hemorrhage from cyst occurs from cysto gastrostomy Ref: CSDT 11th edition Pgno :638


Question: Most common hea valve involved in IV drug user is

Ref Harrison 19 th ed pg 819 Almost 50% of endo- carditis associated with injection drug use is limited to the tricuspid valve and presents with fever but with faint or no murmur and no peripheral manifestations


Question: Least common site for vegetation is

Ref Harrison 19 th ed pg 820 Infection most commonly involves hea valves but may also occur on the low-pressure side of a ventricular septal defect, on mural endocardium damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves. The analogous process involving aeriovenous shunts, aerio-aerial shunts (patent ductus aeriosus), or a coarctation of the aoa is called infective endaeritis.


Question: Nerve involved most commonly in fracture neck of humerus is

The axillary nerve ( C5,C6) passes close to surgical neck of humerus. -Supplies teres minor. Dislocation of shoulder or fracture of surgical neck of humerus can damage axillary nerve. Effects of damage- deltoid is paralyzed loss of power of abduction up to 90deg at shoulder, sensory loss over lower half of deltoid.


Question: A highly ionized drug

Ionized molecules cannot cross the biological membranes .therfore they are less likely to be absorbed . Entry of the molecules through blood brain barrier and blood placental barrier is also restricted .these drugs cannot be reabsorbed in the nephron,thus are excreted by the kidney . Refer kDT 7/e p29


Question: Hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints is caused by injury in the

i.e. (Ulnar nerve): (59, 134-BDC-l 5th)An ulnar nerve lesion at the writ produces ulnar claw hand'CLAW HAND - due to the un opposed action of the long flexors and extension of the fingers, there is hyperextension at the metacarpo phalangeal joint and flexion at the interphalangeal joints involving the ring and little fingers - more than the index and middle fingers* If both median and ulnar nerves are paralysed the result is complete claw hand* Ulnar injury at the wrist can be tested by froment's sign


Question: C wave in JVP indicates

Ref Harrison 19 th ed pg 1485 The ' c' wave in JVP is a positive wave producd by the bulging of tricuspid Valve into the right atruat during right ventricular isovolumetric systils and by the impact of the carotid aery adjacent to the jugular vein.


Question: Root value of thoracodorsal nerve

Thoracodorsal nerve or long thoracic nerve arises from brachial plexus. Its nerve value is C5, C6 and C7. REF:BDChaurasia 7th edition Page no: 57.


Question: Tissue f r om rat used for detection of antinuclear antibodies

Serum antinuclear antibodies bind to corresponding antigents present in the rat liver section.the antigen-antibody complexes are detected by means of fluorescent labeled anti human immunoglbulin .and visualised with the aid of a fluorescence microscopy ref Robbins 9/e immunity chapter p131 and internet


Question: Most commonest agent for Early Onset Nosocomial pneumonia is

Early Onset Nosocomial pneumonia which manifest within the first 4 days of hospitalization,is most often caused by community acquired pathogens such as Streptococcus pneumoniae and Hemophilus species Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48-72 hours after being admitted. It is thus distinguished from community-acquired pneumonia. It is usually caused by a bacterial infection, rather than a virus . Ref Harrison 19th edition pg 915


Question: Injury to the nerve originating from C5 in Brachial plexus leads to

The question speaks of Dorsal scapular nerve on whose damage leads to winging of scapula.


Question: The term "Dynamic stabilizer Of shoulder joint" is used for

ROTATOR CUFF:-Musculotendinous cuff Tendons of :1. Supraspinatus2. Infraspinatus3. Teres minor4. SubscapularisThey fuse with the underlying capsule of shoulder joint.Tendons of supraspinatus fuse superiorly.Infraspinatus& teres minor posteriorlySubscapularis anteriorly Functions:-1. Stabilise shoulder joint.2. Grasp relatively large head of the humerus and holds it against the smaller shallow glenoid cavity.{Reference: vishram singh, pg no. 74}


Question: Radial styloid process gives attachement to

Extensor carpi ulnaris tendon traverses between the head of ulna and styloid process. Brachioradialis is inseed into the lowest pa of lateral surface just above the styloid process. Supinator is inseed into the upper pa of lateral surface . Anconeus is inseed into the lateral surface of olecranon process of ulna. B D Chaurasia 7th edition Page no: 18,138 Fig:2.14 page no 25 vishram Singh 2nd edition upper limb & thorax


Question: Resistance to acyclovir is most commonly due to mutation in the viral gene that encodes a protein that

Ref-KDT 6/e p768 Nucleoside/tide analogues act by conveing to NTPs. First phosphorylation step occurs inside the virus and resistance occurs if there is mutation in this gene


Question: Intestinal biopsy is not diagnostic in

Refer Robbins page no 9/e 784 Small bowel biopsy is viually always abnormal when the tTG IgA antibody level is very high (more than five-fold the normal range), and EMA is positive. This is done in a procedure called a biopsy. The physician eases a long, thin tube called an endoscope through the mouth andstomach into the small intestine, and then takes samples of the tissue using small instruments passed through the endoscope.Biopsy remains the most accurate way to diagnose celiac disease


Question: The right suprarenal vein drains into the

A i.e. Inferior vena cavaLeft testicular, ovarian or suprarenal vein usually drains into left renal veinQ, before entering the IVC OrganVeinDrain intoRt. Suprarenal glandRt. Suprarenal veinIVCQLt. Suprarenal glandLt. Suprarenal veinLeft Renal VeinQSame is true for gonads (testis /ovary) i.e.Lt. Gonad (testis or ovary)Lt. Gonadal (testicular or ovarian) veinLeft renal veinQRt. Gonad (testis or ovary)Rt. Gonadal (testicular or ovarian)veinIVCQ


Question: Most commonly injured nerve in raised intracranial pressure

MC nerve involved in increased ICT - Abducens (VI). Reasons : Longest intradural course Taking a sharp bend over apex of petrous pa of temporal bone. Passing through the cavernous sinus, not suppoed laterally by any dura mater.


Question: Haversian canal is not seen in

Cancellous bone, also known as spongy or trabecular bone, is one of the two types of bone tissue found in the human body. Cancellous bone is found at the ends of long bones, as well as in the pelvic bones, ribs, skull, and the veebrae in the spinal column. Spongy bone consists of plates (trabeculae) and bars of bone adjacent to small, irregular cavities that contain red bone marrow. The canaliculi connect to the adjacent cavities, instead of a central haversian canal, to receive their blood supply Red bone marrow is where blood cells are made. Inderbir Singh&;s textbook of human Histology Seventh edition Pg no94 !1


Question: Megaloblastic anemia due to folic acid deficiency is commonly due to

Ref Harrison 19 th ed pg 646 Dietary folate deficiency is common. Indeed, in most patients with folate deficiency a nutritional element is present. Ceain individuals are paicularly prone to have diets containing inadequate amounts of folate (Table 128-5). In the United States and other countries where foification of the diet with folic acid has been adopted, the preva- lence of folate deficiency has dropped dramatically and is now almost restricted to high-risk groups with increased folate needs.

Absence of folic acid binding protein in serum

Absence of glutamic acid in the intestine


Question: Michaelis Guttmannn bodies are present in

Ref Robbins 9/e p693 Michaelis-Gutmann bodies are concentrically layered basophilic inclusions found in the urinary tract. They are 2 to 10 mm in diameter, and are thought to represent remnants of phagosomes mineralized by iron and calcium deposits.


Question: Absence of lymph nodes is characteristic of

The brain, pa of the central nervous system, has blood vessels but has been thought to lack lymphatic vessels, as they've never been found in humans . Ref - researchgate.net


Question: The nerve of the second branchial arch is

Each pharyngeal arch is characterized by its own muscular components. The muscular components of each arch have their own cranial nerve, and wherever the muscle cells migrate, they carry their nerve commponent with them. The neurons of 5th, 77th, 9th and 10th cranial sensory ganglia that supply the pharyngeal arch structures are derived from the ectodermal placodes (epipharyngeal placodes) and from the neural crest cells. Arch Nerve Skeletal derivatives Pouch Derivatives Muscle Derivatives Aery 1st (Mandibular arch) Trigeminal (V) Incus Malleus Anterior ligament of malleus Spine of sphenoid Sphenomandibular ligament Auditory tube Middle ear cavity Tensor tympani Muscles of mastication Mylohyoid Anterior belly of digastric Tensor veli palatini maxillary aery 2nd (hyoid arch) Facial (VII) Stapes Styloid process (temporal) Lesser cornu and upper hyoid Stylohyoid ligament palatine tonsil Tonsillar fossa Stapedius Stylohyoid Facial muscles (Buccinator, platysma, posterior belly of diagastric) Stapedial aery Hyoid aery 3rd Glossopharyngeal (IX) Greater cornu of hyoid Lower pa of hyoid pa Inferior parathyroids Thymus Stylopharyngeus Common carotid Proximal internal carotid aeries 4th Supeiror laryngeal of vagus (X) Thyroid cailage Corniculate cailage Cuneiform cailage Superior parathyroids Parafolliculae C cells of thyroid (from ultimobranchial body) Pharyngeal muscles Larynx-cricothyroid Levator veli palatini Right side : Right subclan aery (proximal poion) Left side: Arch of the aoa from the left common carotid to the left subclan aeries 6th Recurrent laryngeal nerve of Vagus (X) Arytenoid cailages All intrinsic muscles of the larynx (except the crciothyroid muscle) Right side: Right pulmonary aery Left side: Pulmonary aery and ductus aeriosus Ref: Langman's Medical embryology 14th edition Pgno: 284, 289


Question: The structure derived from neural crest is

The neural crest is the region from where the pigment cells(melanoblasts) of skin develop. Ref: Inderbir Singh's Human embryology; Tenth edition; Pg 327 Mnemonic:SOME GAP S-Schwann cells -Skeleton of face O-odontoblasts M-Meninges(pia and arachnoid) E-Endocardial cushion G-Ganglia(autonomic and dorsal root ganglia) A-Adrenal medulla -Aoicopulmonary septum P-Pigmant cells(melanocytes) -Pharyngeal arches(nerves and cailage) -parafollicular c cells of thyroid


Question: Kasai's procedure is the treatment of choice for

Treatment of Biliary atresia Exploratory laparotomy: If needle biopsy or abdominal ultrasound is consistent with BA Intra operative cholecystocholangiography : To confirm diagnosis, demonstration of fibrotic biliary remnant and definition of absent proximal and distal bile duct patency Treatment of choice : Kasai's hepatopooenterostomy (Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno : 639


Question: Herniation of midgut during embryogenesis persists until

This midgut herniation persists until about 10 weeks of fetal gestation, when the intestine returns to the abdominal cavity Ref: Sabiston 20th edition Pg no : 1237


Question: Length of CBD


Question: The optic nerve is a tract of the diencephalon that is not completely myelinated until

The axons of the optic nerve are not completely myelinated until 3 months after bih. Myelinated axons are normally not found in the retina. The optic nerve is not a true peripheral nerve but a tract of the diencephalon; when severed, the optic nerve does not regenerate. Myelination in the central nervous system (CNS) is accomplished by oligodendrocytes; oligodendrocytes are not found in the retina.


Question: The type of joint encircled

The joint encircled in Zygapophyseal joint. It is a type of plane Synovial joint.


Question: Recurrant interosseous aery is a branch of

Near its origin , posterior interosseous aery gives off interosseous recurrent aery which runs upwards , and ends by anastomosing with middle collateral aery behind lateral epicondyle . B D Chaurasia 7th edition Page no : 113


Question: CD 56 is a marker of


Question: In angina pectoris, the pain radiating down the left arm is mediated by increased activity in afferent (sensory) fibres contained in the

Carotid branch of the glossopharyngeal nerve


Question: Venous blood of liver is drained by

The poal vein and hepatic aeries form the liver's dual blood supply. After draining into the liver sinusoids, blood from the liver is drained by the hepatic vein. Ref - Researchgate.net


Question: Footplate of stapes is developed from

The stapes is formed from the dorsal end of the cailage of the second pharyngeal arch. The ossicles are at first outside the mucous membrane of the developing ear. The foot process of stapes develops from the otic capsule. Inderbir Singh's; Human embryology; Tenth edition; Pg 368


Question: Nerve supply of Trapezius

TRAPEZIUS: Origin: medial 1/3 rd of superior nuchal line., ligamentum nuchae, external occipital protuberance and spines of C7-T12 veebrae. Inseion:-lateral 1/3rd of clavicle., medial margin of acromion,superior margin of spine of scapula. Nerve supply: spinal accessory( motor),C3,C4 spinal nerves ( proprioceptive). Action:- upper fibres elevate scapula,'middle fibres retract ,and lower fibres depress scapula. {Reference: vishram singh, pg no. 72}


Question: Normal volume of adult testis

Ans. is 'c' i.e., 15-20 ml"Normal adult testicular volume is 15-20 ml, calculated by the formula : length x width x depth x 0.52 = volume" -- Grainger.


Question: Knudsen's two hit hypothesis is for

Knudson gave the hypothesis that there are two mutations needed for Retinoblastoma to manifest. Either both hits are on somatic cells or one is at the somatic cells and one is at germ cell. Respectively, it can be sporadic or a hereditary case Refer khurana 6/e p 303


Question: The daos muscle is innervated by

It is a sheet of smooth muscle. It arises from the layer superficial to the superficial fascia. It arises superficially to inse into the skin and midline fibrous raphae of the scrotum. It is innervated by the sympathetic fibres from the genital branch of the genitofemoral nerve. ref - BDC 6e vol2


Question: ATT drug causing contact lens stainig is

refer Goodman Gilman 12th/1553 Rifamipicin cause discolouration (orange) of secretions leading to control lens5 staining


Question: Failure of the choroid fissure to close results in

Failure of the choroid (optic) fissure to close results in a cleft of the iris--called coloboma iridis (mostly in inferonasal position). This defect may extend into the ciliary body, choroid, optic nerve, or retina. Congenital aphakia--absence of the lens--may result from defective development of the lens placode.


Question: Not a feature of Quadrangular space syndrome

Quadrangular space syndrome Hypertrophy of the quadrangular space muscles or fibrosis of the muscle edges may impinge on the axillary nerve. Uncommonly this produces waekness of the deltoid muscle. Typically it produces atrophy of the teres minor muscle. Which may affect the control that the rotator cuff muscles exert on shoulder movement.

Hypertrophy of quadrangular space syndrome


Question: The given histological specimen is of


Question: The Thymus is located in

The thymus is a bilobed structure, made up of two pyramidal lobes of unequal size which are connected together by areolar tissue. Each lobe develops from the endoderm of the third pharyngeal pouch. It lies on the pericardium, the great vessels of the superior mediastinum, and the trachea. Small detached thymic nodules may be found in the neck.Ref: BD chaurasia; Volume 3; 6th edition; Page no: 172


Question: Pringle maneuver may be required for treatment of

Explanation in previous question Ref: Sabiston 20th edition Pgno : 439 Blumga 5th edition pgno : 1547


Question: Anterior interventricular aery is a branch of

LEFT CORONARY AERY It is larger than the right coronary aery.It arises from the left posterior aoic sinus. Branches A.Large branches 1.Anterior interventricular 2.Branches to the diaphragmatic surface of the left ventricle,including a large diagonal branch. B.Small branches 1.Left atrial 2.Pulmonary 3.Terminal REF.B D Chaurasia's human anatomy vol.1.fifth edition BD CHAURASIA'S HUMAN ANATOMY.VOL.1.FIFTH EDITION.PAGE NO 252


Question: need for thinness inspite of being lean is a feuture of

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: Poor prognostic factor in acute pancreatitis

Ranson's prognostic criteria for Non-gallstone pancreatitis At admission Age >55 years WBC >16000 cells/mm3 Blood glucose >200mg/dl Serum LDH>350IU/L AST >250 U/L During initial 48hours Hematocrit fall >10 percentage points. BUN elevation >5mg/dl Serum calcium fall to <8mg/dl Aerial pO2<60 mmHg Base deficit >4mEq/L Estimated fluid sequestration >6 litres Ranson's prognostic criteria for gallstone pancreatitis At admission Age >70 years WBC >18000 cells/mm Glucose >220mg/dl Serum LDH >400IU/L AST >250U/L During initial 48 hours Hematocrit fall >10 percentage points BUN elevation >2mg/dl Serum calcium fall to <8mg/dl Base deficit >5mEq/L Aerial pO2<60 mmHg Estimated fluid sequestration >4 litres Patients with one or two criteria have a predicted moality of less than 1%, with three criteria (10%) of four criteria (15%) with more than seven criteria 50% Ref: Sabiston 20th edition Pgno : 1527-1528


Question: The marker for Langerhans cells Histiocytes is

Refer Robbins page no 8th edition 631-632 The tumor cells express HLA-DR and CD 1a Langerhans cell histiocytosis (LCH) is a clonal disorder believed to be derivedfrom cells of the dendritic system. Fascin, a 55-kd actin-bundling protein, represents a highly selective marker for dendritic cells of lymphoid tissues and peripheral blood and is involved in the formation of dendritic processes in maturing epidermal Langerhans cells. Since lesional cells of LCH may represent Langerhans cells arrested at an early stage of activation, immunohistochemical expression offascin in epidermal Langerhans cells and in the lesional cells of 34 cases of LCH was evaluated in paraffin sections using an immunoalkaline phosphatase technique. Though epidermal Langerhans cells were nonreactive for fascin, lesional cells in all LCH cases exhibited immunoreactivityforfascin, CD1a, and S-100 protein. Variation in staining intensity was observed in some cases, possibly reflecting differences in cell maturation or activation. Involved tissues included bone, soft tissue, lymph node, thyroid, orbit, and extradural cranial tissue. Immunoreactivity of lesional cells of LCH for fascin suppos their derivation from cells of the dendritic system and represents another alteration in the phenotype of Langerhans cells that is associated with maturation, migration, culture, or clonal expansion


Question: Risk of HIV transmission is not seen with

* Intravenous drug abusers with no history of homosex- ual behavior compose the next largest group, represent- ing about 17% of all patients. * Recipients of blood and blood components (but not hemophiliacs) who received transfusions of HIV- infected whole blood or components (e.g., platelets, plasma) account for about 1% of patients. * Hemophiliacs, especially those who received large amounts of factor VIII or IX concentrates before 1985, make up less than 1% of all cases. * The epidemiology of HIV infection and AIDS is quite different in children (diagnosed when younger than 13 years of age). About 1% of all AIDS cases occur in this population, and the vast majority (about 90%) result from veical transmission of virus from infected mother to the fetus or newborn Ref Robbins 9/e P244


Question:
In head and neck the parasympathetic system in
innervates the


Question: Auerbach plexus is present in the

The cells of the Auerbach's (myenteric) plexus are located between the inner circular and outer longitudinal layers of the muscularis externa. These nerve cells are the poion of the enteric nervous system responsible for generating peristaltic movements. Ref - medscape.com


Question: Sensation not represented in sensory coex is

Olfaction is represented in the olfactory coex (Brodmann's area 28) which is located in the anterior pa of the parahippocampal gyrus and uncus. Note: Primary sensory area-pain, touch, Vibration, Temperature, muscle and joint sense. sensory association area- stereognosis. (Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg- 151)


Question: Muscles of mastication develops from


Question: Function of hepatic kupffer cells is

Kupffer cells Kupffer cells, derived from the macrophage - monocyte system Are irregular stellate - shaped cells that also line the sinusoids, insinuating between endothelial cells Phagocytic, play a major role in the trapping of foreign substances and initiating an inflammatory response MHC-II antigens are expressed on kupffer cells but do not confer efficient antigen presentation compared with macrophages elsewhere in the body Ref: Sabiston 20th edition Pgno :1430


Question: In humour cells meiosis take place at

MEOSIS TAKES PLACE IN GONADS . REF : EMBRYOLOGY VISHRAM SINGH


Question: Functional unit of Liver is

Anatomical unit of liver - Hepatic Lobule Functional unit of liver- Liver Acinus


Question: Delusion that nothing exists in this world is

Nihilistic delusion It is the delusion of hat nothing exists in the world, even he doesn't exist. This type of delusion may be seen in endogenous depression and bipolar disorder. Ref: FORENSIC MEDICINE ANad TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 359


Question: Following is not a feature of AIDS related lymphadenopathy

Ref Robbins 9/e p256 Early stages of HIV reveal a marked follicular hyperplasia Monocytoid cells along the blood vessels can be seen in acute lymphadenitis With the disease progession_ severe follicular involution is seen During the advanced stage - viral burden in the nodes reduces in pa because of the disruption of follicular dendritic cells ..These burnt out lumph nodes are atropic and small

Collection of monocytoid B cells in sinuses


Question: NOT an abductor of hip joint

Gluteus maximus chiefly performs Extension and lateral rotation
Gluteus medius, Gluteus minimus and Tensor fascia lata -Abduction and medial rotation


Question: Cavernous sinus communicates with

Draining channels or communications the cavernous sinus drains: 1.into the transverse sinus through the superior petrosal sinus. 2.into the internal jugular vein through the inferior petrosal sinus and through a plexus around the internal carotid aery. 3. into the pterygoid plexus of veins through the emissary veins passing through the foramen ovals, the foramen lacerum, and the emissary sphenoidal foramen 4. In to the facial vein through the superior ophthalmic vein. 5.the right and left cavernous sinuses communicate with each other through the anterior and posterior intercavernous sinuses and through the basilar plexus of veins. Notes: all these communications are valveless and blood can flow through them in either direction Ref: BDC volume3;Sixth edition pg 195


Question: Base of Submental triangle is formed by

Boundaries of Sub Mental Triangle Apex - Symphysis Menti Base - Hyoid Bone On each side - Anterior belly of Digastric Content - Sub Mental nodes Floor - Mylohyoid


Question: Somatic innervation to the pelvic organs is

For most of its pelvic course, the femoral nerve (L2, L3, L4) travels within the substance of the psoas muscle and then exits its lateral side to pass under the inguinal ligament. It supplies sensation to the anterior thigh and motor innervation to the extensors of the knee.


Question: At 30 days of intrauterine life

*Optical vesicle come in contact with surface ectoderm and lens place is forming by the 4th week of IUL - the eyes begin to develop as a pair of diveicula from the lateral aspects of the forebrain. These diveicula make their appearance before the closure of the anterior end of the neural tube; after the closure of the tube, they are known as the optic vesicles. *Ear pinna or auricle stas forming by the 5th week of IUL *Cerebellum stas forming by the 8th week of IUL *The baby's heabeat stas as the blood flow begins by 22nd day of IUL (Reference: I B Singh's Embryology, 10th edition, pg 374, 281)


Question: Macrophage of Central Nervous System includes

(B) Microglia # Microglia are tissue macrophages that populate the mammalian central nervous system (CNS) very early in embryonic development. By adulthood, microglia are found in all regions of the brain and spinal cord and comprise 10-15% of the total cells in the CNS.


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

The limen insulae is the Antero-inferiorly located insular coical surface which conjoins the inferior insular point, the anterior perforated surface, and the temporo mesial surface.


Question: Connecting Stalk forms

Connecting Stalk forms primary Umbilical Cord .


Question: Intramuscular injection of atropine causes initial bradicardia. The reason for this effective being seen is

Ref-KDT 6/e p107 Atropine is a non-selective antagonist of M1, M2, and M3 muscarinic receptors. M2, cholinergic receptors are responsible for bradycardia and blockade of these receptors can result in tachycardia. Atropine initially acts on presynaptic M1, receptors (normally decrease the release of ACh) and result in greater release of ACh which is responsible for bradycardia. Later on, blockade of M2 receptors will lead to tachycardia.

Blockade of ME receptor and SA nodal cells

Blockade of muscarinic auto receptor on vagal nerve ending


Question: Pulsation felt in the suprasternal space are probably due to


Question: Drug of choice for septic shock is

Septic shock produces more VD so noradrenaline which is a powerful vasoconstrictor is used.


Question: Most common malignant bone tumors

Metastatic tumors are the most common form of skeletal malignancy. Refer Robbins page no 8/e 1236p


Question: Hyaline Cailage extends upto


Question: Lymphatics from the spongy urethra drain into the following lymph nodes

It drains into deep injuinal lymph node . Ref - bdc 6e vol2 pg376-379


Question: Spontaneous regression though rare is seen in

Neuroblastoma is a cancer often found in the small glands on top of the kidneys (adrenal glands). It can develop in the stomach, chest, neck, pelvis and bones. Children aged five or younger are most commonly affected. Most children with neuroblastoma in Noh America have been treated according to the In the previous COG risk system, each child was assigned to a low-risk, intermediate-risk, or high-risk group (refer to Tables INSS stage. Age. International Neuroblastoma Pathologic Classification (INPC). Ploidy. Amplification of the MYCN oncogene within tumor tissue.[Other biological factors that influenced treatment selection in previous COG studies included unbalanced 11q loss of heterozygosity and loss of heterozygosity for chromosome 1p.[Generally, treatment is based on whether the tumor is classified as low, intermediate, or high risk, as follows: Low risk. For patients with low-risk tumors, the approach is either observation or resection, with chemotherapy restricted to symptomatic patients with low-risk biology. Five-year overall survival (OS) was 97% in a large COG study.[Intermediate risk. For patients with intermediate-risk tumors, chemotherapy is often given before definitive resection, and the number of chemotherapy cycles is based on clinical and tumor biological risk factors and response to therapy. In recent studies, select patients have been observed without undergoing chemotherapy or attempted resection. The 3-year OS rate for intermediate-risk patients was about 96% in a large COG study.[High risk. For high-risk patients, treatment has intensified to include chemotherapy, surgery, radiation therapy, myeloablative therapy and stem cell transplant (SCT), isotretinoin, and immunotherapy, resulting in survival rates of about 50%. Statistically significant improvement in survival was observed in a randomized phase III COG study ( COG Risk-Group Assignment Treatment Options COG = Children's Oncology Group; GM-CSF = granulocyte-macrophage colony-stimulating factor; 131I-MIBG = iodine I 131-metaiodobenzylguanidine; SCT = stem cell transplant. Recurrent Neuroblastoma Locoregional recurrence in patients initially classified as low risk Metastatic recurrence in patients initially classified as low risk Locoregional recurrence in patients initially classified as intermediate risk Metastatic recurrence in patients initially classified as intermediate risk Recurrence in patients initially classified as high risk Recurrence in the central nervous system <a style="box-sizing: border-box; margin: 0px; padding: 0px; border: 0px; font: inherit; veical-align: baseline; color: ; text-decoration-line: none;" href=" therapeutic approaches. Refer robbins 8/e p477


Question: Investigation of choice for hydatid disease is

Diagnosis is confirmed by Serological tests for antibodies like ELISA Immunoblot Arc-5 IHA


Question: Blood supply of liver

The liver revives 20 % of blood supply through hepatic aery,80% through poal vein B D CHAURASIA'S HUMAN ANATOMY LOWER LIMB ABDOMEN PELVIS VOLUME2-SIXTH EDITION Page no-307