Question: Characteristics of SLE of kidney is

Ref Robbins 9/e p224 Kidneys. Kidney involvement is one of the most impoant clinical features of SLE, with renal failure being the most common cause of death. The focus here is on glomerular pathology, although interstitial and tubular lesions are also seen in SLE. The pathogenesis of all forms of glomerulonephritis in SLE involves deposition of DNA-anti-DNA complexes within the glomeruli. These evoke an inflammatory response that may cause proliferation of the endothelial, mesangial, and/or epithelial cells and, in severe cases, necrosis of the glomeruli. Although the kidney appears normal by light microscopy in 25% to 30% of cases, almost all cases of SLE show some renal abnormality if examined by immuno- fluorescence and electron microscopy. According to the current International Society of Nephrology/Renal Pathol- ogy Society morphologic classification, there are six patterns of glomerular disease in SLE (none of which is specific to the disease): class I, minimal mesangial lupus nephritis; class II, mesangial proliferative lupus nephritis; class III, focal lupus nephritis; class IV, diffuse lupus nephritis; class V, membra- nous lupus nephritis; and class VI, advanced sclerosing lupus nephritis. * Minimal mesangial lupus nephritis (class I) is rarely encountered in renal biopsies. Immune complexes are present in the mesangium, but there are no concomitant structural alterations detectable by light microscopy. * Mesangial proliferative lupus nephritis (class II) is seen in 10% to 25% of cases and is associated with mild clinical symptoms. Immune complexes deposit in the mesangium, with a mild to moderate increase in the mesangial matrix and cellularity. * Focal lupus nephritis (class III) is seen in 20% to 35% of cases. Lesions are visualized in fewer than half the glomeruli, and they may be segmentally or globally distrib- uted within each glomerulus. Active lesions are character- ized by swelling and proliferation of endothelial and mesangial cells, infiltration by neutrophils, and/or fibrinoid deposits with capillary thrombi (Fig. 4-18, A). The clinical presentation may range from only mild microscopic hema- turia and proteinuria to a more active urinary sediment with red blood cell casts and acute, severe renal insufficiency. * Diffuse lupus nephritis (class IV) is the most serious form of renal lesions in SLE and is also the most commonly encountered in renal biopsies, occurring in 35% to 60% of patients. It is distinguished from focal lupus nephritis (class III) by involvement of half or more of glomeruli. Most of the glomeruli show endothelial and mesangial prolifera- tion, leading to diffuse hypercellularity of these structures (Fig. 4-18, B) and producing in some cases epithelial crescents that fill Bowman's space. When extensive, sub- endothelial immune complexes create a circumferential thickening of the capillary wall, resembling rigid "wire loops" on routine light microscopy (Fig. 4-18, C). Electron microscopy reveals prominent electron-dense subendo- thelial immune complexes (between endothelium and basement membrane) (Fig. 4-18, D), but immune com- plexes are also usually present in other pas of the capil- lary wall and in the mesangium. Immune complexes can be visualized by staining with fluorescent antibodies directed against immunoglobulins or complement, result- ing in a granular fluorescent staining pattern (Fig. 4-18, E). In due course, glomerular injury may give rise to scarring (glomerulosclerosis). Most affected patients have hematu- ria with moderate to severe proteinuria, hypeension, and renal insufficiency. * Membranous lupus nephritis (class V) occurs in 10% to 15% of cases and is the designation for glomerular disease characterized by widespread thickening of the capillary wall due to deposition of subepithelial immune complexes. Membranous glomerulonephritis associated with SLE is very similar to that encountered in idiopathic membranous nephropathy (Chapter 13). Thickening of capillary walls is caused by increased deposition of base- ment membrane-like material, as well as accumulation of immune complexes. Patients with this histologic change almost always have severe proteinuria with ove nephrotic syndrome (Chapter 13). * Advanced sclerosing lupus nephritis (class VI) is characterized by complete sclerosis of greater than 90% of glomeruli and corresponds to clinical end stage renal disease.


Question: Vomer ala and sphenoidal rostrum junction is

Spheno- vimerine joint is a schindylesis suture at the roof of the nasal cavity Ref: Gray's39e/p185-210


Question: Taeniae coli is found is

(Ascending colon) (254-BDC-2 4th)Differences between small intestine and the large intestineFeaturesSmall IntestineLarge Intestine1. Appendices epiploicaeAbsentPresent*2. Taeniae coliAbsentPresent*3. SacculationsAbsentPresent4. DistensibilityLessMore5. FixityGreater part is freely mobileGreater part is fixed6. VilliPresentAbsent7. Transverse mucosal foldsPermanentObliterated when longitudinal muscle coat relaxes8. Peyer's patchesPresent in ileumAbsent9. Common site for(a) Intestinal worms(a) Entamoeba histolytica (b) Typhoid(b) Dysentery organism (c) Tuberculosis(c) Carcinoma10. Effect of infection and irritationDiarrhoeaDysentery


Question: Muscle not having dual nerve supply

Anterior belly of digastric is supplied by the trigeminal nerve and posterior belly by facial nerve Spinal accesory nerve and c3,c4 nerves supply Trapezius Ischial pa of sciatic nerve and the obturator nerve supply adductor magnus Ref: Gray's 39e/p112-127


Question: NK cells CD marker is

Ref Robbins 8/e p188;9/e p192 NK cells (belonging to the group of innate lymphoid cells) are defined as large granular lymphocytes (LGL) and constitute the third kind of cells differentiated from the common lymphoid progenitor-generating B and T lymphocytes. NK cells are known to differentiate and mature in the bone marrow, lymph nodes, spleen, tonsils, and thymus, where they then enter into the circulation. NK cells differ from natural killer T cells (NKTs) phenotypically, by origin and by respective effector functions; often, NKT cell activity promotes NK cell activity by secreting interferon gamma. In contrast to NKT cells, NK cells do not express T-cell antigen receptors(TCR) or pan T marker CD3 or surface immunoglobulins (Ig) B cell receptors, but they usually express the surface markers CD16 (FcgRIII) and CD56 in humans


Question: In type II respiratory failure,there is

Ref Harrison 19 th ed. pg1731-1732 Type II respiratory failure is characterized by decreased paO2 and incresinc paCO2 as a result of alveolar hypoventilation.there is fall in minute ventilation which causes a rise in PaCO2 and fall in PaO2. The alveolar aerial gradient is normal in Type 2 respiratory failure.


Question: Primordial Germ cells give rise to oogonium and then primary oocyte.PGCs themselves develop from

Among the given options, yolk sac is the best answer. Primordial germ cells (PGC) forms germ cells which are derived from epiblast at the end of Week 2. These PGC migrates to endodermal layer of yolk sac at week 4 and fuher towards genital ridge by week 5. Aberrant migration of these PGC leads to teratomas: Sacrococcygeal teratoma Oropharyngeal teratoma


Question: The WORST prognosis in patients with endometrial carcinoma is found in patients with tumour involvement of the

Involvement of the bladder mucosa constitutes a stage IV tumour. The other examples given are either stage II or III. The more advanced the stage of a tumour, the worse the prognosis.


Question: Weight transmission from upper limb to axial skeleton is done by

Ligaments involved in weight transmission connect one bone with the next bone, in line of weight transmission. Costoclavicular ligament transfers the weight of upper limb to axial skeleton.Coracoclavicular ligament transfer the weight of upper limb to clavicle bone.Note: Coracoacromial ligaments attach to bone scapula at different points and is not attached to the previous or next bone in line of weight transmission. They do not help in weight transmission.

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


Question: Most common serotype of HPV associated with invasive cervical carcinoma is


Question: Retraction of scapula at sternoclavicular joint is done by (FMGE Dec 2018)

Retractors of scapula: - 1. Trapezius 2. Rhomboid major 3. Rhomboid minor Protraction of scapula - done by 1. Pectoralis minor 2. Serratus anterior (damage causes winging of scapula) Subscapularis, supraspinatus along with infraspinatus & teres minor muscles connect scapula to humerus & provide suppo to glenohumeral joint (Rotator - cuff muscles) Muscle Origin Inseion Innervation Function Sub- scapularis Medial 2/3rd of subscapular fossa Lesser tubercle of humerus Upper & lower sub- scapular nerves (C5, C6, C7). Medial rotation of arm at glenohumeral joint Supraspinatus Medial 2/3rd of supra spinous fossa of scapula & deep fascia that covers muscle Most superior facet on greater tubercle of humerus Supra - scapular nerve (C5, C6) Abduction & stabilization of glenohumeral joint


Question: Root value ofsciatic nerve

Ans. B.L4L5SlS2S3Root value of sciatic nerve is L4L5S1 S2S3


Question: The ductus aeriosus is derived from the following aoic arch

The pa of the left sixth arch aery, between the branch to the lung bud and aoa,forms the ductus aeriosus HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:255


Question: The colour coding of of 20G IV cannula is


Question: Middle lobe of prostate is present in between

The prostate can be divided in two ways: by zone, or by lobe. It does not have a capsule; rather an integral fibromuscular band surrounds it.It is sheathed in the muscles of the pelvic floor, which contract during the ejaculatory process. Ref - BDC 6e vol2 pg403


Question: The spinal cord in infants ends at the level of


Question: Failure of migration of neural crest cells is seen in

Congenital megacolon (nirschsprung tiscase) due to failure of migration of neural crest to distal part of the tube so absence of para sympathetic myenteric acerbach's ganglia. Diseased segment is construction and the segmanr proximal is dilated due to faxical retention.


Question: Retention of Sodium is a side effect of

(Refer: K. D. Tripathi&;s Essentials of Medical Pharmacology, 7th edition, pg no: 287-290)


Question: Mastoid process antrum begins to develop in the

*MASTOID* *ANTRUM* *DEVELOPEMENT* The antrum, which is the biggest of all mastoid air cells, stas its development between the 22nd and the 24th week of fetal life. It reaches its adult size on the 35th week The antrum develops at the center of the mastoid process on both sides of the petrosquamous fissure. The medial pa of the antrum, the petrous pa, develops from the saccus medius and the lateral pa, the squamous pa, develops from the saccus superior The fusion plane between the petrous pa and the squamous pa gives the petrosquamous fissure. Failure of complete fusion between the two sacci leads to a septation of the mastoid antrum by a bony paition called the Korner's septum Developmental arrest of the vestibule The antrum is well developed at bih and has a mean surface of 1 cm2 The size of the antrum does not change after bih; however, it undergoes medial displacement because of the growth of the mastoid process. The mastoid process continues to grow until pubey and even beyon REF : VISHRAM SINGH EMBRYOLOGY


Question: Immediate management of a patient with Multiple fracture and fluid loss includes the infusion

Resuscitation following blood loss from multiple fractures begins with administration of 2-3 litres of isotonic crystalloid immediately to restore BP and peripheral circulation Lactated ringer (RL) solution is generally preferred over 0.9% NaCl (normal saline) as it is balanced salt solution and designed to mimic extracellular fluid Resuscitation with colloids is no more effective than crystalloids but is more expensive Ref: schwaz's principle of surgery 10th edition Pgno :109-110,119-123


Question: Calcitonin is a marker of thyroid

Refer Robbins page no Pg 1030 Medullary Thyroid Carcinomas. Familial medullary thyroid carcinomas occur in multiple endocrine neoplasia type 2 (MEN-2, see later) and are associated with germline RET mutations that lead to constitutive activation of the recep- tor. RET mutations are also seen in approximately one half of nonfamilial (sporadic) medullary thyroid cancers. Chromosomal rearrangements involving RET, such as the RET/PTC translocations repoed in papillary cancers, are not seen in medullary carcinomas.


Question: Meissner&;s and Auerbach&;s plexus are divided from

The myenteric plexus develops from the neural crest cells of the fetus. These cells then go through a series of migrations to situate along the future gastrointestinal tract. At three weeks of gestation, these cells move to the anterior foregut, where they are then referred to as enteric neural crest-derived cells (ENCDCs). Interestingly, neural crest cells induce the differentiation of surrounding muscular structures and interstitial cells of Cajal (ICC). In turn, these differentiate into the elements of the enteric nervous system, glial cells, and neurons. By week 9 of embryologic development, the myenteric plexus, circular muscle, and longitudinal muscle layers have formed along the entire gut.


Question: Most common tumor producing osteoclastic metastasis

Osteoblastic lesions are uncommon, they are usually are seen in prostatic carcinoma. However some other tumors may also produce Osteoblastic secondaries Refer ohopedic nuclear medicine 1st /e p 154


Question: Deep branch of ulnar nerve supplies

Muscles supplied by deep branch of ulnar nerve are - Muscles of hypothenar eminence, medial two lumbricals , 4-1 dorsal interossei muscles and 4-1 palmar interossei and adductor pollicis 1st and 2nd lumbricals are supplied by digital nerves from median nerve. Nerve supplying flexor digitorum superficialis comes from median nerve in the cubital fossa. B D Chaurasia 7th edition Page no: 182


Question: Simple Cuboidal Epithelium is present in

The mucosal lining of the trachea is composed of pseudostratified ciliated columnar (respiratory) epithelium.The epithelial lining of bronchioles ranges from ciliated simple columnar with occasional goblet cells in larger bronchioles to simple cuboidal (many with cilia) with occasional club cells (also known as Clara cells) and no goblet cells in smaller bronchioles. The epithelium of terminal bronchioles is composed of club cells and cuboidal cells, some with ciliaRespiratory bronchioles are similar in structure to terminal bronchioles, in that their epithelium is a simple cuboidal epithelium rich in club cells and some ciliated cells, but this epithelium is broken up by the presence of thin-walled, pouch-like structures, known as alveoli, composed of an attenuated simple squamous epithelium, where gaseous exchange (O2 for CO2) can occur.Reference: Krishna Garg Histology; 5th edition; Page no: 130


Question: Larynx extends from

Larynx extends from the root of the tongue to the trachea.In the adult male it lies in front of the third to sixth cervical veebrae,but in children and in the adult female it lies at a little higher level. REF.BDC VOL.3,FIFTH EDITION


Question: Lamina papyracea separates nose from

Ref: Henry Gray. Anatomy of the Human Body. The lateral surface is formed of a thin, smooth, oblong plate, the lamina papyracea (os planum), which covers in the middle and posterior ethmoidal cells and forms a large pa of the medial wall of the orbit; it aiculates above with the orbital plate of the frontal bone, below with the maxilla and orbital process of the palatine, in front with the lacrimal, and behind with the sphenoid.


Question: Complications of tubercular meningitis are

Refer Robbins page no1274 Options a and b are crct Most serious complications are Obliterative Endaeritis. Spinal roots may also be affected Calcification Tuberculoma. Arachnoid fibrosis


Question: Obstruction of inferior vena cava presents as

Inferior vena cava syndrome is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.


Question: Type II Mirizzi's syndrome

Classification of Mirizzi's Syndrome (Csendes classification) Type I Obstruction of common duct by external compression only(no erosion) Type II Erosion of less than one-third circumference of common duct Type III Erosion of upto two-third circumference of common duct Type IV Total/near total circumferential destruction of common duct Type V Erosion of GB in common duct with cholecystoenteric fistula Ref: Sabiston 20th edition Pgno :1520

Erosion of one-thirds circumference of common duct

Total /near total circumferential of common duct


Question: Heteopic calcification occurs in

Ref, Robbins 7/e p41-2; Harrison 17/e p1952


Question: Locate the renal stone with pain radiating to medial side of thigh and perineum due to slipping of stone in males

The clinician is able to judge the position of the stone by the history of pain - Ref : S. Das manual, 4/e p408

At crossing of gonadal vessels and ureter


Question: A woman has a fracture of the left tenth and eleventh ribs. The organ most likely to get injured by these fractured ribs is

It is the most commonly injured organ in the abdomen.


Question: Principal cause of death in renal transplant patient

Ref cambell's urology,8/e p346-349 * The graft rejection response is initiated mainly by host T cells that recognize the foreign HLA antigens of the graft, either directly (on APCs in the graft) or indirectly (after uptake and presentation by host APCs). * Types and mechanisms of rejection comprise the following: Hyperacute rejection: Pre-formed antidonor antibodies bind to graft endothelium immediately after transplanta- tion, leading to thrombosis, ischemic damage, and rapid graft failure. Acute cellular rejection: T cells destroy graft parenchyma (and vessels) by cytotoxicity and inflammatory reactions. Acute humoral rejection: Antibodies damage graft vasculature. Chronic rejection: Dominated by aeriosclerosis, this type is probably caused by T cell reaction and secretion of cytokines that induce proliferation of vascular smooth muscle cells, associated with parenchymal fibrosis. Principal cause of death is due to infection and inflammation


Question: Branch of Pharmacology that deals with medicinal drugs obtained from plants and other natural sources is known as


Question: Temporal lobe contains

Primary auditory area (41,42) and secondary auditory area(22) both are in temporal lobe


Question: Sec 299 IPC deals with

Culpable homocide ( section 299 IPC) whoever causes death by doing an act, with the intention of causing death or with the intention for causing such bodily injury as likely to cause death, or cause death, commits the offence of culpable homicide Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 216


Question: Myelin sheath in the central nervous system is formed by

Oligodendrocytes are responsible for myelination in the CNS. In the PNS, Schwann cells form the myelin sheath. The process of myelination begins before bih and is not complete until a year or more after bih. (Ref: Vishram Singh textbook of neuroanatomy, second edition, pg- 19)


Question: In the mitogen activated protwin kinase pathway , the activation of RAS is counteracted by

Ref Robbins 9/e p286 Activated rasvis present in association with GTP. Enzyme GTPase will degrade GTP to GDO and results in inactivation of RAS. Thus ,GTPase activating protein will counteract the activation of ras


Question: Nerve supply of tip of nose is

The afferent component of corneal reflex is mediated through the ophthalmic branch of the trigeminal nerve. (V1 nerve).
The efferent component is mediate through the facial nerve (VIIth nerve).


Question: Cells most sensitive to hypoxia are


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

(Tibial nerve) (172 - 74- BDC 4th edition) (660- Snell 8th)Common peroneal nerve injuryMotor- The muscles of the Anterior and lateral compartments of the leg are paralysed. As a result the opposing muscles, the planter flexors of the ankle joints and the invertors of the subtalar and transverse tarsal joints and the invertors of the subtalar and transverse tarsal joints, causes the foot to be plantar flexed (foot drop) and inverted and attitude reffered to as equinovarusSensory loss - Loss of sensation occurs down the anterior and lateral sides of the leg and dorsum of the foot and toesTibial Nerve InjuryMotor - All the muscles in the back of the leg and the sole of the foot are paralyzed. The opposing muscles dorsiflex the foot at the ankle joints and evert the foot at the subtalar and transverse tarsal joints, and attitude reffered to as calcaneo valgusSensory - Sensation is lost on the sole of the footDeep peroneal nerve injury - Paralysis of muscles of the anterior compartment of the leg results in loss of the power of dorsiflexion of the foot (Foot drop)


Question: Nerve of Latarjet is seen in

The nerve of Latarjet or the posterior nerve of the lesser curvature is a branch of the anterior vagal trunk which supplies the pylorus. BD CHAURASIA S HUMAN ANATOMY Vol 3


Question: Cause of odema

Ref.robbins 8/e 112; 7/e 120- 121;9/e p114 Capillary blood contains a decreased quantity of colloids (protein-white circles) due to either decreased hepatic synthesis of these proteins or increased protein loss through the kidney or gastrointestinal tract. ... With decreased production of albumin the plasma colloidal osmotic pressure decreases and edema occurs.


Question: Cremaster is supplied by

Cremaster muscle Lies in scrotum Sensory supply to cremaster Laterally -Femoral Branch of genitofemoral nerve Medially - Ilioinguinal nerve Motor supply to cremaster Genital branch of genitofemoral nerve

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


Question: A patient comes to the emergency depament with vomiting, diarrhea, lacrimation abdominal cramps, piloerection. The family members gave history of substance use for the past 1 month. The clinical presentation is due to

In opioid withdrawal ALL ORIFICES BLEED Lacrimation, vomiting, rhinorrhea, diarrhea, mydriasis, kicking the habit, muscle cramps, abdominal cramps, tachycardia, cold turkey Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.660


Question: Bacterial endocarditis is rarely seen in

Ref Harrison 19 th ed pg 816 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: Ramu 40 year old man, chronic Alcoholic, diagnosed as cirrhosis, presents with a lump in the right lobe of liver. Serum AFP level is normal. Most probable diagnosis is

This is a typical case of HCC, remember AFP is raised in about 75% of Africans and only 30% of patients in US and Europe Ref: Sabiston 20th edition Pgno :1458-1463


Question: Primordial germ cells originate in the

Primordial germ cells originate in the epiblast Primordial germ cells (PGCs), also known as primitive sex cells originate in the epiblast at the caudal end of the primitive streak. PGCs are the precursors of gametes in both genders. PGCs arise in the epiblast during the 2nd week of development. They pass through the primitive streak during gastrulation and reach the wall of the yolk sac. They migrate from the yolk sac at the 4th week and reach the developing gonads by the end of the 5th week. Ref: Gray&;s Anatomy 41st edition Pgno: 184

Gonads at the 4th week of embryonic develpment

Epiblast at 2nd week of embryonic development

Gonads at 2nd month of embryonic development

Yolk sac at 4th week of embryonic development


Question: A patient presented with midline pain at the marked dermatome (shaded in green). Select the best possible answer, as a differential diagnosis

The green shaded area is the umbilical region, carrying T10 dermatome. Referred pain of mid-gut derivatives is felt in the peri-umbilical region (T - 10). Meckel's diveiculum is a mid-gut anomaly, presenting with pain around the umbilicus.


Question: Muscle of expiration

MUSCLE OF INSPIRATION: Quiet: Diaphragm External intercostals Interchondral pa of internal intercostal of contralateral side. Deep: Erector spinae Scalene muscles Pectoral muscles Serratus anterior MUSCLE OF EXPIRATION: Quiet: Passive process d/o inherent quality of lungs Forced: Muscles of anterior abdominal wall with internal intercostal (except interchondral pa)


Question: The preferred bypass procedure in case of nonresctable carcinoma of head of pancreas is

Palliative surgery in Advanced, Non-resectable pancreatic Association Surgery for advanced, non resectable pancreatic adenocarcinoma can palliate obstruction of CBD or duodenum, as well as control visceral pain Hepaticojejunostomy, choledochojejunostomy or choledochoduodenostomy offers durable drainage of an obstructed bile duct. Choledochojejunostomy is less reliable but can be employed when tumor bulk precludes common duct procedure Ref: Devita 9th edition Pgno : 979


Question: Indication for prophylaxis in pneumocystis carinii pneumonia include

Defects in cellular and/or humoral immunity predispose to development of PCP. CD4+ T cells are critical in host defense against Pneumocystis. For HIV-infected patients, the incidence is inversely related to the CD4+ T cell count: at least 80% of cases occur at counts of <200 cells/mL, and most of these cases develop at counts of <100 cells/mL. Ref Harrison 19th edition pg 1017


Question: Tonsil is lined by

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

Stratified squamous keratinised epithelium

Stratified squamous non keratinised epithelium


Question: Common carotid aery is derived from

The common carotid aery is derived, on either side, from pa of the third arch aery, proximal to the external carotid bud.The internal carotid aery is formed by the poion of the third arch aery distal to the budReference: Inderbir Singh Embryology; 10th edition; Page no: 260

Distal pa of 3rd Arch Aery and Cervical pa of Dorsal Aoa


Question: Paralysis of 3rd, 4th, 6th nerves with involvement of ophthalmic division of 5th nerve,localizes the lesion to

3,4,5 cranial nerves pass in relation to the lateral wall of cavernous sinus. 6th cranial nerve passes through the cavernous sinus. Ref - BDC 6th vol3 topic - cranial nerves ;pg350


Question: A midline protrusion in maxillary region is mostly due to

Torus means an elevation. Different types according to location: Torus palatinus: - Midline elevation of exaggerated bony growth at intermaxillary suture region specifically in the midline Torus maxillaris: - Exaggerated bony growth at either inner side of alveolar process or at outer side of alveolar process (either side of teeth) Torus mandibularis: - Exaggerated bony growth - near the premolar & above the mylohyoid line. Torus tubaris: - Mucosal elevation in nasopharynx at opening of the eustachian tube.


Question: Facial nerve supplies

Facial nerve is the motor nerve of the face. its five terminal branches, temporal, zygomatic, buccal, marginal mandibular and cervical emerge from the parotid gland and diverge to supply the various facial muscles as follows. Temporal - frontalis, auricular muscles,orbicularis oculi. Zygomatic- orbicularis oculi. Buccal- muscles of the cheek and upper lip Marginal mandibular- muscles of lower lip. Cervical - platysma Ref BDC volume 3; sixth edition


Question: Bifurcation of trachea is at

Trachea bifurcates at the lower border of fouh thoracic veebrae. <img src=" /> BA CHAURASIA'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.page no-280


Question: Trochlear nerve supplies

A. i.e. (Superior oblique) (115-BDC-3 4th)* Trochlear nerve - is very long and slender nerve supplies only the superior oblique muscle of the eye ball* Abducent - is a small motor nerve supplies the lateral rectus muscle**


Question: Chief Extensor at knee joint is

Quadriceps femoris is knee Extensor. Hamstrings (Biceps femoris long head, Semitendinosus, Semimembranosus and Adductor magnus) are Knee Flexors.


Question: Other than the spleen, occlusion of the splenic aery at its origin will most likely affect the blood supply to

The sho gastric aeries arise from the Splenic aery at the hilum of the spleen and pass forward in the gastrosplenic omentum (ligament) to supply the fundus of the stomach.

Duodenum distal to the entrance of the common bile duct


Question: Secreting active thyroid follicles are lined by

Thyroid follicles lining epithelium depends upon the secretion of thyroxine More the secretion,more the endoplasmic reticulum,more the height of the cell, becoming columnar. Resting follicle - Squamous Normal follicle - Cuboidal Active follicle - Columnar Ref: IB Singh textbook of histology 6e pg 325.


Question: Transpyloric plane separates

Transpyloric plane cuts through the pylorus of the stomach, the tips of the ninth costal cailages and the lower border of the first lumbar veebra. Seperates hypochondrial and lumbar regions BD chaurasias Anatomy sixth edition Volume 2 Page no 197


Question: Insensible loss of water per day is


Question: The first indication of gastrulation in the embryo is

The formation of the primitive streak on the dorsal surface of the bilaminar embryonic disk formed from proliferation at the end of 2nd week (day 14) is the first indication of gastrulation.


Question: Wellen's syndrome suggests


Question: Parasympathetic postganglionic fibres are carried by the

Long ciliary nerves are mixed sensory and sympathetic. Greater petrosal nerves carries preganglionic parasympathetic fibers from the facial nerve to the pterygopalatine ganglion. The deep petrosal nerve carries mainly sympathetic fibres from the superior cervical ganglion and internal carotid plexus.


Question: Urothelium

Inderbir Singh's Human Histology Pg A16 Membranous urethra is lined by transitional epithelium or urothelium


Question: Accessory obturator aery is a branch of

Accessory obturator aery is the pubic branch of the inferior epigastric aery. It contributes a significant supply through the obturator canal. Ref - semantischolar.org


Question: Parasympathetic nerve supply to salivary glands is by


Question: Cell cycle specific anticancer drugs that acts mainly in the M phase of the cycle is

Ref-KDT 6/830 Vinca alkaloids (vincristine, vinblastine and vinoerlbine ) and taxanes (pacilaxel and docetaxel) act in M-phase of cell cycle Vinca alkaloids inhibits the formation whereas taxenes inhibit the breakdown of mitotic spindle


Question: Transverse facial aery is the branch of

Superficial Temporal Aery It is the smaller terminal branch of the external carotid aery. It begins, behind the neck of the mandible undercover of the parotid gland.In addition to the branches which supply the temple, the scalp, the parotid gland, the auricle and the facial muscles, the superficial temporal aery gives off a transverse facial aery and a middle temporal aery.Reference: Chourasia; 6th edition; 72nd page


Question: Hypothayoidism is seen in

Refer Robbins page no 1087 Hashimoto thyroiditis most often comes to clinical attention as painless enlargement of the thyroid, usually associated with some degree of hypothyroidism, in a middle-aged woman. The enlargement of the gland is usually symmetric and diffuse, but in some cases it may be sufficiently localized to raise the suspicion of a neoplasm. In the usual case, hypothyroidism develops gradually. In some patients, however, it may be preceded by transient thyrotoxicosis caused by disruption of thyroid follicles, leading to release of thyroid hormones ("hashitoxicosis"). During this phase, free T4 and T3 levels are elevated, TSH is diminished, and radioactive iodine uptake is decreased. As hypothyroidism supervenes, T4 and T3 levels fall, accompanied by a compensatory increase in TSH.


Question: Damage to nervous tissue is repaired by


Question: Inferior epigastric aery forms the boundry of

HESSELBACH&;S TRIANGLE:-Boundaries-1. Medially-Lateral border of rectus abdominis2. Laterally- inferior epigastric aery.3. Base - inguinal ligament.FEMORAL TRIANGLE:-Triangular depression on front of the upper one third of the thigh immediately below the inguinal ligament.BOUNDARIES :-1. Laterally: medial border of saorius.2. Medially: medial border of adductor longus.3. Base: inguinal ligament.4. Apex:directed downwards.formed by the point where the medial and lateral boundaries cross.apex is continuous with the adductor canal.5. Roof: skin,superficial fascia and deep fascia.Superficial fascia contains superficial inguinal lymph nodes,femoral branch of genitofemoral nerve,branches of ilioinguinal nerve,superficial branches of the femoral aery with accompanying veins and the upper pa of the great saphenous vein.6. Floor: medially by adductor longus and pectineus,and laterally by the psoas major and iliacus. CONTENTS:-1. Femoral aery and its branches.- Superficial branches-superficial external pudendal, Superficial epigastric and Superficial circumflex iliac Deep branches-profunda femoris, muscular branches and deep external pudendal2. Femoral vein and its tributaries3. Femoral sheath4. Femoral nerve5. Nerve to pectineus6. Femoral branch of genitofemoral nerve.7. Lateral cutaneous nerve of thigh.8. Deep inguinal lymph nodes.Vein is medial to aery (base)Vein posteromedial to aery (apex){Reference:BDC 6E pg no. 45}


Question: Torus aoicus is an impression in the cavity of

Torus aoicus (aoic mound) is the prominent region of the right atrial septum, which marks the projection of the non-coronary aoic sinus into the right atrial wall. The bulge is superior to the coronary sinus and anterior to the fossa ovalis.


Question: Glycolipids are mostly found in

Glycolipids are mostly seen in Brain and spinalcord Two types of glycolipids are : ganglioside ,cerebroside


Question: Stimulation of the following receptor produce renin

Beta 1 receptors are present opn JG apparatus producing increased renin.


Question: AFP is elevated in


Question: Surface marking of the mitral valve is

Surface marking of mitral value is an oblique line 3 cm behind the left half of sternum opposite left 4th coastal cailage. <img src=" /> BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1.6TH EDITION.PAGE NO 291.TABLE 21.1:SURAFACE MARKING OF CARDIAC VALVE

Behind sternal end of left 4th costal cailage

Behind sternal end of right 4th costal cailage

Left 4th intercostal space in the midclavicular line

Left 3rd intercostal space in the midclavicular line


Question: CYP 450 inducers are

P-450 inducers are: Phenobarbitone, rifampicin, phenytoin, chloe hydrate, phenylbutazone, griseofulvin, DDT, an chronic alcohol ingestion. Ketoconazole and cimetidine inhibit the drug metabolizing enzymes. Ref-KDT 7/e p26


Question: Perilymph enters the subarachnoid space the

C. The perilymph enters the subarachnoid space of the posterior cranial fossa the cochlear aqueduct, which contains the perilymphatic duct.


Question: The approximate no of genes contained in human genome

Humans have a mere 30,000 genes rather than the 100000 predicted only recently . Recent ribbons mention the no of genes 20,000 to 25,000 Ribbons 7th/219


Question: Meckel's diverticulum is a remnant of


Question: Gold standard investigation for screening of breast carcinoma in patients with breast implant

MRI Indicated in scarred breast, implants and borderline lesions for breast conservation Investigation of choice for implant related complications Gold standard for imaging breast in females with implants Ref: Sabiston 20th edition pgno: 826-828


Question: ARDS is due to defect in

ALI/ARDS is initiated by injury of pneumocytes and pulmonary endothelium. Setting in motion a vicious cycle of increasing inflammation and pulmonary damage


Question: Blood can be stored with CPD A for

Blood can be stored for 21 days with CPD ( Citrate phosphate dextrose ) Blood can be stored upto 35 days with CPD A ( Citrate phosphate dextrose adenine )


Question: The stria of Gennari is a histological feature of

Variations in Coical Structure -The structure of the cerebral coex shows considerable variation from region to region, both in terms of thickness and in the prominence of the various laminae described above. Finer variations form the basis of the subdivisions into Brodmann's areas. Other workers divide the coex into five broad varieties. These are as follows. In the agranular coex the external and internal granular laminae are inconspicuous. This type of coex is seen most typically in the precentral gyrus (area 4) and is, therefore, believed to be typical of 'motor' areas. It is also seen in some other areas. In the granular coex the granular layers are highly developed while the pyramidal and ganglionic layers are poorly developed or absent. In the visual area the external band of Baillarger is prominent and forms a white line that can be seen with the naked eye when the region is freshly cut across. This stria of Gennari gives the name striate coex to the visual coex. Between the two extremes represented by the agranular and granular varieties of coex, three intermediate types are described as follows. Frontal coex Parietal coex and Polar coex. The frontal type is nearest to the agranular coex, the pyramidal cells being prominent, while the polar type is nearest to the granular coex. REF: Inderbir Singh's Textbook of Human Histology, Seventh edition, pg.no., 190.


Question: Spinal epidural space contains

Epidural space This is the interval which seperates the periosteum in the veebral canal from the spinal duramater.The space is filled with loose areolar tissue,semiliquid fat,a network of veins,and the small aeries which supply the structures in the veebral canal. REF.CUNNINGHAM'S MANUAL OF PRACTICAL ANATOMY,Vol.3,PG.193

Areolar tissue and internal veebral venous plex uses

Veebral venous plexus and cerebrospinal fluid


Question: Superficial inguinal ring is deficient of

It is a triangular opening that forms the exit of the inguinal canal, which houses the ilioinguinal nerve, the genital branch of the genitofemoral nerve, and the spermatic cord (in men) or the round ligament (in women). At the other end of the canal, the deep inguinal ring forms the entrance. ref - BDC 6e vol2


Question: Vitamin k associated clotting factors are

Ref Robbins 8/e 118-119 ; 9/e p 119 Physiologic Effects of Vitamin K Vitamin K serves as an essential cofactor for a carboxylase that catalyzes carboxylation of glutamic acid residues on vitamin K-dependent proteins. The key vitamin K-dependent proteins include: Coagulationproteins: factors II (prothrombin), VII, IX and X.


Question: Infraclavicular lesion of tuberculosis is known as

refer robins page no 370 Hematogenous spread to apex of upper lobe resulting in a post primary infective lesion which heals with scarring is known as "Simon's focus." ... "Puhl's lesion/nodule" is the term for isolated lesion of chronic pulmonary TB in the apex of the lung.


Question: In contrast to heparin, enoxaparin

Ref: KDT 6/e p599 Enoxaparin is a LMW heparin. It does not require monitoring Both heparin as well as enoxaparin do not crose placenta and are not teratogenic.

Can be used without monitoring the patients aPTT

Is less likely to have a teratogenic effect

Is more likely to be given intravenously

Is more likely to cause thrombosis and thrombocytopenia


Question: Most pathognomic sign of irreversible cell injury

Ref Robbins 9/e p50 Mitochondrial Damage and Dysfunction Mitochondria may be viewed as "mini-factories" that produce life-sustaining energy in the form of ATP. Not surprisingly, therefore, they are also critical players in cell injury and death (Fig. 1-16). Mitochondria are sensitive to many types of injurious stimuli, including hypoxia, chemi- cal toxins, and radiation. Mitochondrial damage may result in several biochemical abnormalities: * Failure of oxidative phosphorylation leads to progres- sive depletion of ATP, culminating in necrosis of the cell, as described earlier. * Abnormal oxidative phosphorylation also leads to the formation of reactive oxygen species, which have many deleterious effects, described below. * Damage to mitochondria is often associated with the formation of a high-conductance channel in the mito- chondrial membrane, called the mitochondrial permea- bility transition pore. The opening of this channel leads to the loss of mitochondrial membrane potentialand pH changes, fuher compromising oxidative phosphorylation. * The mitochondria also contain several proteins that, when released into the cytoplasm, tell the cell there is internal injury and activate a pathway of apoptosis, dis- cussed later.

Ribosomes detached from endoplasmic reticulum


Question: Most Baroreceptors and chemoreceptors are situated in

Most Baroreceptors and chemoreceptors are situated in left auricle.


Question: Most potential route for spread of infection from CNS to inner ear

Cochlear aqueduct is most potential route for spread of infection from CNS to inner earQ Cochlear aqueduct & vestibular aqueduct are 2 bony channels (canals) that connect inner ear (cochlea & vestibule respectively) to intracranial sub arachnoid space. Vestibular aqueduct contains endolymphatic duct filled with endolymph, which does not communicate freely with CSF as it ends in a cul de sac and forms a closed space. Whereas perilymph filled cochlear aqueduct is in direct continuation with the CSF which makes it a most potential route of infection. Hyle's fissure is present in early embryonic life that normally obliterates by 24 weeks of gestation. When persistent it provides a connection from middle ear to subarachnoid space.


Question: Dye used in IV cholangiography is

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


Question: Most commonly injured muscle in Rotator cuff injury is


Question: Cullen's sign is seen in

Signs indicative of retroperitoneal bleeding in severe pancreatitis Flank ecchymosis - Grey Turner sign Periumbilical ecchymosis- Cullen's sign Inguinal ecchymosis - Fox sign Ref: Sabiston 20th edition Pgno : 1527


Question: Strain used in Mumps vaccine

Strains in Mumps Jeryll Lynn strain RIT 4385 Leningrad 3 strain L-Zagren strain Urabe strain Rubini strain Strains in Measles Edmonston-Zagreb strain Schwatz strain Moraten strain


Question: STYLOHYOID muscle is supplied by

Stylohyoid is a small muscle supplied by the facial nerve. The action of stylohyoid is to pull the hyoid bone upwards and backwards, and with other hyoid muscles, it also fixes the hyoid bone. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Patient a known case off alcohol dependence after 12 to 18 hrs of last drink develops seizure for the first time in his life.possible diagnosis is

withdrawl symptoms are present due to alcohol withdrawl based on the time duration between the last drink and the presentation of symtoms withdrawls symptoms can be classified into many types it may be mild symptoms like tremore to seizure to life threatening symptoms like delirium tremens ref.Kaplon and Sadock, synopsis of Psychiatry, 11 th edition, pg no.625


Question: Place of first liver transplant

Firat liver transplantation was done by Starzl in 1963, in Denver, University of Colorado Ref: Sabiston 20th edition Pgno : 637


Question: The most common secondary malignancy in a patient having retinoblastoma is

Ref Robbins 9/e p293 Retinoblastoma is the most common primary intraocular malignancy of children . involvement of both eyes with pineal gland gland is called as trilateral retinoblastoma The pinealoblastoma in association with retinoblastoma is a primary tumor In approximately 40% of cases, retinoblastoma occurs in individuals who inherit a germ line mutation of one RB alleles .This variant of retinoblastoma is inherited as an autosomal dominant trait and is associated with osteosarcoma . Osteosarcoma is therefore the commonest secondary malignancy associated with retinoblastoma


Question: The infectivity of a convalescent case of cholera lasts for

Preclinical or incubatory carrier -The incubatory carriers are potent carriers (1-5 days)Convalescent carrier - Patient who has recovered from an attack of cholera may continue to excrete vibrios, during his convalescence for 2 -3 weeksContact or healthy carrier - Subclinical infection contracted through association with a source of infection. Duration < 10 days.Chronic carrier - Over 10 years(Refer: K. Park's Textbook of Preventive and Social medicine, 24thedition, pg no: 244)


Question: Abductors of vocal cord is

i.e. (Posterior cricoarytenoids): (243-BDC-3-5th ed)Muscles acting on the Larynx|| |Movements Muscles1. Elevation of larynx Thyrohyoid, mylohyoid2. Depression of larynx Sternothyroid, sternohyoid3. Opening of larynx Thyroepiglotticus4. Closing inlet of larynx Aryepiglotticus5. Abductor of vocal cords Posterior cricoaryteroids only6. Adductor of vocal cords Lateral cricoarytenoids, transverse oblique arytenoids7. Tensor of vocal cords Cricothyroids8. Relaxor of vocal cords Thyroarytenoids(i) Cricothyroid is supplied by external laryngeal nerve(ii) Rest of the intrinsic muscle - recurrent laryngeal nerve


Question: If a drug is active against pre erythrocytic stage of the malaria parasite it will be useful as

(Ref KDT 6/e p782) Stage ---clinical use Preerythrocytic- Causal prophylaxis Erythrocytic-Clinical cure -Suppressive prophylaxis Exo-Erythrocytic: Radical cure Gametocytic Pevention of transmission


Question: Drug of choice for cardiogenic shock is

Dobutamine and dopamine are inotropic agents used in CCF and cardiac shock but dobutamine is best as it doesn't interfere with alpha receptors producing Vaso contriction.


Question: Most dependent Bronchopulmonary segment in supine position is

Most dependent Bronchopulmonary segment in supine position is Right Superior segment.


Question: Superior pancreaticoduodenal artery is a branch of

(Gastroduodenal artery) (263-BDC-2 4th) (261-Snell 7th)* Superior pancreatico duodenal artery is a branch of Gastroduodenal artery* Inferior pancreatico duodenal artery is a branch of superior mesenteric arteryHEPATIC ARTERY - branchesSUPERIOR MESENTERIC ARTERY branches* Right gastric artery* Gastroduodenal artery-*Right gastroepiploic-*Superior pancreatico duodenal* Right and left hepatic arteries (Right hepatic artery gives off cystic artery)* *Left gastroepiploic artery is branch of splenic artery* *Inferior pancreatico duodenal artery* Middle colic artery* Iliocolic artery (Appendicular artery is a branch of the posterior cecal artery)* Jejunal and Ileal branches


Question: Nerve supply of obturator internus is by

OBTURATOR INTERNUS Fan-shaped Belly lies in pelvis and tendon in gluteal region.Action: lateral rotators of thigh at hip joint.supplied by nerve to obturator internus.Root value: L5,S1,S2Branches: obturator internus and superior gamellus.{Reference: BDC 6E page no.173}


Question: Grey Turner's sign (Flank discolouration) is seen in

Signs indicative of retroperitoneal bleeding in severe pancreatitis Flank ecchymosis - Grey Turner sign Periumbilical ecchymosis- Cullen's sign Inguinal ecchymosis - Fox sign Ref: Sabiston 20th edition Pgno : 1527


Question: Pruritus precedes jaundice in

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


Question: Lateral Sacral artery is a branch of

Lateral Sacral artery is a branch of Posterior division of Internal Iliac artery. Other branches of Posterior division of Internal Iliac artery are

Superior gluteal Artery
Iliolumbar artery

Anterior division of Internal Iliac artery


Question: In cerebellar lesion NOT seen is

Resting tremor is the manifestation of parkinsonism In cerebellar lesion intentional tremors are seen


Question: Posterior relation of neck of pancreas

The frontal vein (supratrochlear vein) begins on the forehead in a venous plexus which communicates with the frontal branches of the superficial temporal vein. The veins converge to form a single trunk, which runs downward near the middle line of the forehead parallel with the vein of the opposite side. The two veins are joined, at the root of the nose, by a transverse branch, called the nasal arch, which receives some small veins from the dorsum of the nose. At the root of the nose the veins diverge, and, each at the medial angle of the orbit, joins the supraorbital vein, to form the angular vein. Ref - BDC 6e vol2 pg 298-300


Question: Abduction of shoulder is initiated by

Abduction of shoulder - abduction and adduction take place at right angles to the plane of flexion and extension , i. e., approximately midway between the sagittal and coronal planes. In abduction , the arm moves anterolaterally away from the trunk. This movement is in the same plane as that of the body of the scapula. Muscles bringing about movements at the shoulder joint - (i)Both Supraspinatus and Deltoid muscles initiate abduction and are involved throughout the range of abduction from 0 - 90 digrees. (ii)Serratus anterior 90 - 180 digrees (iii) Upper and lower fibres of trapezius 90 - 180 digrees. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1, pg. no., 149.


Question: At 30 days intra uterine life

(D) Pinna appears # Development of External Ear:> Auricle, or pinna, is formed from about six mesodermal thickenings (called tubercles or hillocks) that appear on the Mandibular (First) & Hyoid (Second) arches, around the opening of the dorsal part of the first ectodermal cleft (i.e. around the opening of the external acoustic meatus).> External acoustic meatus is derived from the dorsal part of the first ectodermal cleft.> Mandibular arch forms only tragus & a small area around it, rest of the auricle being formed from the Hyoid arch.


Question: The poly ahritic condition that is not common inm

Ref Robbins 9/e p218 Similar to many autoimmune disease ,SLE predominantly affects women.a female to male ratio of 9:1.is seen during the reproductive age get .female to male ratio is only 2:1 for the development of the disease at childhood or at the age of 65


Question: CCA can be palpated at


Question: Lymph flow from the foot is

B i.e. Increased by massaging the footFoot massage increases the rate of lymph flow by causing intermittent external compression of lymphatic vessels, which promotes pumping of lymph.

Increased when an individual rises from the supine to standing position

Increased when capillary permeability is decreased

Decreased when the valves of the leg veins are incompetnet


Question: Presence of an ossification centre in talus means that

Centre comes at 7 months of intrauterine life, ble


Question: Referred pain in external hemorrhoids is due to

Internal hemorrhoids are located on the inside lining of the rectum and cannot be felt unless they prolapse and push through the anus opening causing pain and itching. A thrombosed external hemorrhoid occurs when blood within the blood vessel clots, and may cause significant pain and swelling.


Question: The most common mode of transmission of brucella is

The organism from the infected animal enters the human body by direct contact. Through the wound, the conjunctiva, by inhalation or by ingestion of products from infected animals. The incubation period is usually about 10-30 days, but may sometimes be very prolonged. Ref: Textbook of microbiology; Ananthanarayana and paniker's; 10th edition; Pg: 346


Question: NARP syndrome is seen in

NARP syndrome (neuropathy ,ataxia, & retinitis pigmentosa) is a condition related to changes in mitochondrial DNA Refer Harrison 17/316-317 Robbins 8/1328


Question: Special visceral efferent DOES NOT involve

(D) Dorsal nucleus of X cranial nerveNUCLEI BELONGING TO COLUMNSGSEOculomotor, Trochlear, Abducent, Hypoglossal nucleiSVEMotor nucleus of V nerve Motor nucleus of VII nerve Nucleus AmbiguusGVEEW nucleus, Lacrimatory nucleus, Superior & Inferior salivatory nuclei, Dorsal vagal nucleusGVA/SVANucleus of Tractus solitariusGSASpinal, Principal sensory & Mesencephalic nuclei of V nerveSSAVestibular & Cochlear nuclei[?]III-Special Visceral (Branchial)Efferent (SVE) Column:Motor nuclei which supply musclesdeveloped from the pharyngeal arches, (Branchiomotor cell column).These are (5,7,9 & 10)Ambiguus nucleus, in Medulla (9,10 & cranial part of Accessory nerve)Motor Nucleus of the Trigeminal nerve, in the Mid pons.Motor nucleus of the Facial nerve in the Caudal pons.CRANIAL NERVE FUNCTIONAL COMPONENTSFunctional componentAbbreviation General FunctionCranial nerves containing componentGeneral somatic afferentGSAPerception of touch, pain, temperatureTrigeminal nerve (V); Facial nerve (VII); Vagus nerve (X)General visceral afferentGVASensory input from visceraGlossopharyngeal nerve (IX); Vagus nerve (X)Special afferentSASmell, taste, vision, hearing & balanceOlfactory nerve (1); Optic nerve (II); Facial nerve (VII); Vestibulocochlear nerve (VIII); Glossopharyngeal nerve (IX), Vagus nerve (X)General somatic efferentGSEMotor innervation to skeletal (voluntary) musclesOculomotor nerve (II); Trochlear nerve (IV); Abducent nerve (VI); Hypoglossal nsrve (XII)General visceral efferentGVEMotor innervation to smooth muscle, heart muscle & glandsOculomotor nerve (III); Facial nerve (VI); Glossopharyngeal nerve (IX); Vagus nerve (X)Branchial efferent**BEMotor innervation to skeletal muscles derived from pharyngeal arch mesodermTrigeminal nerve (V); Facial nerve (VII), Glossopharyngeal nerve (IX); Vagus nerve (X); Accessory nerve (XI)* Special sensory or Special Visceral Afferent (SVA) - smell, taste; special somatic afferent (SSA) - vision, hearing, balance.** Special Visceral Efferent (SVE) or branchial motor.Other Option[?]Nucleus AmbiguusRuns in a rostral to caudal direction in the medulla & is located in the ventrolateral reticular formation, posterior to the inferior olivary nuclear complex and anteromedial to the spinal trigeminal nucleus.[?]Dorsal nucleus of the Vagus nerve (or Posterior motor nucleus of Vagus)Is a cranial nerve nucleus for the vagus nerve in the medulla that lies ventral to the floor of the fourth ventricle.It mostly serves parasympathetic vagal functions in the gastrointestinal tract, lungs, and other thoracic and abdominal vagal innervations.The cell bodies for the preganglionic parasympathetic vagal neurons that innervate the heart reside in the nucleus ambiguus.Additional cell bodies are found in the nucleus ambiguus, which give rise to the branchial efferent motor fibers of the vagus nerve (CN X) terminating in the laryngeal, pharyngeal muscles & musculus uvulae.


Question: The sensitivity of casoni's test is

The sensitivity of casoni's test ranges from 55-65%


Question: Adductor pollicis is supplied by

Deep branch of ulnar nerve supplies the palmaris brevis muscle and muscles of hypothenar eminence , medial two lumbricals , 4-1 dorsal interossei muscles and 4-1 palmar interossei . B D Chaurasia 7th edition Page no : 182


Question: Double aoa occurs due to

Double aoa occurs due to the persistence of distal poion of the right dorsal aoaRef: Inderbir Singh&;s Human embryology; Tenth edition; Pg 257

Non development of the right 4th aoic arch

Non development of the left 4th aoic arch

Persistence of distal poion of the right dorsal aoa


Question: Umbilical aery is a branch of

Anterior division of internal iliac aeryA pa of Umbilical aery persists as superior vesical aery and remaining aery becomes obliterated forming medial umbilical ligament.

Posterior division of internal iliac aery


Question: 4th Ventricle develops from

Inderbir Singh&;s Human embryology Tenth edition Pg 321 The cavity of mesencephalon remains narrow and forms the aqueduct while the cavity of rhombencephalon forms the fouh ventricle


Question: Blood supply of great toe is

The great toe is supplied by the first dorsal metatarsal aery the dorsalis pedis aery and plantar digital aery the medial plantar aery. Ref: Gray's 40e/p-1364


Question: Maximum AP diameter of trachea in male and female are

Trachea: - Trachea is a flexible tube that extends from veebral level C6 in the lower neck to veebral level T 4 / 5 in the mediastinum where it bifurcates into a right and a left main bronchus. Measurement of trachea: - Parameters Average Minimum Maximum A - P diameter (mm) Male Female Male Female Male Female 18.82 13.25 10.15 10.72 22.92 17.25 Transverse diameter 16.30 14.92 11.02 10.57 19.98 17.22

Pharynx, larynx and trachea and cranial nerves 3,4,6


Question: Sistrunk operation is used for

ThyroglossalDuct Cyst A thyroglossal duct cyst is a midline neck lesion that originates at the base of the tongue at the foramen cecum and descends through the central poion of the hyoid bone. Although thyroglossal duct cysts may occur anywhere from the base of the tongue to the thyroid gland, most are found at or just below the hyoid bone . A thyroid diveiculum develops as a median endodermal thickening at the foramen cecum in the embryonic stage of development. The thyroid diveiculum descends in the neck and remains attached to the base of the tongue by the thyroglossal duct. Also, as the thyroid gland descends to its normal pretracheal position, the ventral cailages of the second and third branchial arches form the hyoid bone--hence the intimate anatomic relationship of the thyroglossal duct remnant with the central poionof the hyoid bone. The thyroglossal duct normally regresses by the time the thyroid gland reaches its final position. When the elements of the duct persist despite complete thyroid descent, a thyroglossal duct cyst may develop. Failure of normal caudal migration of the thyroid gland results in a lingual thyroid, in which no other thyroid tissue is present in the neck. Ultrasound or radionuclide imaging may provide useful information to identify the presence of an ectopic thyroid gland in the neck. The standard operation for thyroglossal duct cysts has remained unchanged since it was described by Sistrunk in 1928, which involves complete excision of the cyst in continuity with its tract, the central poion of the hyoid bone, and the tract interior to the hyoid bone extending to the base of the tongue Failure to remove these tissues entirely will likely result in recur- rence because multiple sinuses have been histologically identified in these locations. Ref: Sabiston 20th edition Pgno: 1861


Question: In cholecytectomy of cirrhotic patient , fresh frozen plasma should be given

A cirrhotic patient with abnormal coagulation who needs cholecystectomy should be given FFP FRESH FROZEN PLASMA Transfusions with FFP are given to replenish clotting factors The effectiveness of the transfusion in maintaining hemostasis is dependent on the quantity of each factor delivered and its half life The half-life on the most stable clotting factor, FACTOR-VII, is 4 to 6 hours A reasonable transfusion scheme would be to give FFP on call to the operating room. This way the transfusion is complete prior to the incision, with circulating factors to cover the operative and immediate post-op period Ref: Sabiston 20th edition Pgno :1496


Question: Boa's sign seen in

Boas' or Boas's sign is hyperaesthesia (increased or altered sensitivity) below the right scapula is a symptom of acute cholecystitis


Question: Popcorn calcification in mammography is seen in

Pattern of calcification in breast diseases Carcinoma--Microcalcification, punctuate, branching Fibro adenoma - Popcorn( coarse, granular, crushed Stone) Fibrocystic disease - powdery Fat necrosis - Curvilinear Ref: Robbins 9th edition Pg no : 1069


Question: Rider's bones are ossification of

Rider's bone develops in the tendon of adductor longus in professional riders. It is a sesamoid bone.that has no periosteum and ossifies after bih. Reference: BD Chaurasia's handbook of general anatomy, 5th edition, pg 55


Question: The deep ring is situated in

INGUINAL CANAL:-
The oblique intermuscular passage in the lower part of the anterior abdominal wall.
Extends from the deep inguinal ring to superficial.
Deep ring- oval opening in fascia transversalis.
 1.25 cm above mid-inguinal point.
Superficial ring: triangular gap in external oblique aponeurosis.
Length: 4cm
Directed downwards forwards and medially.


Question: Patent foramen ovale is due to

The primitive atrium is divided into left and right atria by an interatrial septum which is formed by fusion of septum primum and septum secundum. The sequence of events are as follows

Septum primum arises from the roof of the common atrium (primitive atrium) and grows caudally towards septum intermedium (fused AV cushions).
Foramen primum is formed between the free border of growing septum primum and fused AV cushions (septum intermedium).
Shortly afterwards the septum primum fuses with septum intermedium (fused AV cushions), obliterating foramen primum
Foramen secundum is formed by degeneration of cranial part of septum primum.
Septum secundum grows caudally to the right of septum primum and overlaps the foramen secundum. The passage between septum primum and septum secundum is called foramen ovale. After birth, foramen ovale closes by fusion of septum primum with septum secundum. Failure of fusion of these two septa results in patent foramen ovale.

Failure of closure of sinoatrial orifice

Failure of fusion of septum primum and endocardial cushion

Failure of fusion of septum primum and septum intermedium

Failure of fusion of septum primum and septum secondum


Question: APUD cells are seen in

Anime Precursor Uptake and Decarboxylation(APUD) cells are also known as neuroendocrine cells.These cells are the cell of origin of the carcinoid tumor Ref Robbing 9/e p719


Question: Obturator nerve enters thigh at

It descends through the fibers of the psoas major, and emerges from its medial border near the brim of pelvis; it then passes behind the common illaic aery and on the lateral side of the internal illiac aery and ureter, and runs along the lateral wall of the lesser pelvis, above and in front of the obturator vessel, to the upper pa of the obturator foramen. Here it enters the thigh, through the obturator canal, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the obturator externus, and lower down by the adductor brevis. ref -sciencedirect.com


Question: The palatine tonsil

Palatine tonsil lies on superior constrictor muscle. It drains into deep cervical nodes particularly jugulodigastric nodes. It is innervated by glossopharyngeal nerve .


Question: Nerve commonly involved in fracture distal shaft of the humerus

Radial nerve is the most commonly injured nerve in fracture shaft humerus It is paicularly common in oblique fracture at junction of middle and distal third bone


Question: Brodmann  Area no. constitutes Wernicke’s area of speech

Wernicke’s area is sensory speech centre of brain. It is constituted by area no 22-auditory association area.
Area no 39-angular gyrus and Area no 40-supramarginal gyrus.


Question: Survival in unresectable GB carcinoma is

Unresectable carcinoma Gallbladder Median survival for patients presenting with unresectable disease is 2-4 months with 1-yr survival is less than 5: Goal of palliation is to relieve jaundice, pain, bowel obstruction and prolongation of life Percutaneous stents are effective for relieving jaundice and should be used as expected survival does not usually warrants a surgical bypass Gemcitabine plus cisplatin (reference regimen) is used for palliation of unresectable disease Ref: Sabiston 20th edition Pgno :1512-1514


Question: The most impoant factor for maintaining arches of the foot is

Factors in maintaining arches of foot are1 The shape of the bones concerned.2 intersegmental ties/staples or ligaments (and muscles) that hold the different segments of the arch together.3 Tie beams or bowstrings that connect the two ends of the arch.4 Slings that keep the summit of the arch pulled up.5 Suspension"The longitudinal arches are prevented from flattening by the plantar aponeurosis, and by the muscles of the first layer of the sole."Ref: Vishram Singh; Volume II; 2nd edition


Question: Medial Umbilical ligament is a remnant of

Medial Umbilical ligament is a remnant of Distal part of Umbilical artery. MedianUmbilical ligament is a remnant of Urachus.


Question: Valve of Rosenmuller is located at

A fold of mucous membrane found at the junction between the common canaliculus and the lacrimal sac. It is not strictly a valve because fluids can be blown back to emerge at the puncta. It is not always fully developed. ref -medscape.com

Junction of lacrimal sac and canaliculus


Question: Necrobiosis lipoidica is seen in

Lesions of Necrobiosis lipoidica are found Primarily on the shins and patients can have diabetes mellitus or develop it subsequently .Characeteristic findings include


Question: Indication for liver transplantation in an infant is

Most common indication for liver transplantation in children - Biliary atresia in adults - Cirrhosis Ref : Bailey & Love 25/e p1426


Question: Needle biopsy of solitary thyroid nodule in a young woman with palpable cervical lymph nodes on the same sides demonstrates amyloid in the stroma of lesion. Likely diagnosis is

Presence of thyroid nodule along with palpable cervical lymph nodes and amyloid histologically is clearly indicative of Medullary Carcinoma Thyroid, as explained before. Ref : Bailey 25/e p797


Question: The longest duration of action of insulin preparation is obtained with


Question: Opening of esophagus into diaphragm is at the level of

Opening of esophagus into diaphragm is at the level of T10. Ref - BDC 6th edition Vol 1 pg282


Question: Refractive index of cornea is


Question: Appendix of testis arise from

The paramesonephric ducts remain rudimentary in the male. The greater pa of each duct eventually disappears (Fig. 16.19B). The cranial end of each duct persists as a small rounded body attached to the testis {appendix of testis) which may occasionally give rise to cystsReference: Inderbir Singh Embryology; 10th edition; Page no: 316


Question: drug transpo mechanisms include

Ref-KDT 7/e p11-13 drugs are transpoed across the membrane by passive diffusion and filtration specialized transpo


Question: Ductus venosus connects

Ductus venosus shunts a poion of the left umbilical vein blood flows directly to the inferior vena cava. Thus, it allows oxygenated blood from the placenta to bypass the liver. BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1. 6T H EDITION.PAGE NO 268


Question: Most common CNS neoplasm in HIV patient is

Ref Robbins 9/e p254_255 It is the most common CNS neoplasia in those with AIDS It is of B cell origin and most have caused by EBV in the immunosuppressant persons Histologically reticulon stains demonstrate that the infiltrating cells are separate from one another by silverstraing material .this pattern referred as hopping is characteristics of primary brain lymphoma


Question: Conditions associated with incoagulable state are

All the above four options is answer Ref Robbins 7/e p657; 9/e p664-665 severe falciparum malaria: The incidence and progression of coagulation abnormalities were studied in 52 patients with acute falciparum malaria. The patients were prospectively divided into 3 groups; severe (parasitaemia greater than or equal to 5% or vital organ dysfunction), 12 patients; moderate (parasitaemia 1%- less than 5% without complications), 16 patients; and mild (parasitaemia less than 1%), 24 patients. No case died or developed clinical evidence of disseminated intravascular coagulation. Conventional indices of coagulation (prothrombin time, paial thromboplastin time, fibrinogen, fibrin degradation products) were usually within the normal range but reduced plasma concentrations of antithrombin III (AT-III) levels were noted in all groups, and the incidence was significantly higher in patients with severe and moderate malaria (83% and 81%) compared with the mild group (37%; P less than 0.005). Depletion of AT-III was associated with thrombocytopenia, acute promyelocytic leukemia: Acute promyelocytic leukemia (APL) is a is a unique subtype of acute leukemiacharacterized by abnormal proliferation of promyelocytes, life-threatening coagulopathy, and the chromosome translocation t(15;17)(q22;q11-12). heparin overdose: Heparin is an anticoagulant, meaning it inhibits the formation of blood clots in the body. In heparin overdose, the body is unable to deploy its natural defenses against hemorrhage (excessive bleeding), and life-threatening blood loss can occur quickly. Excessive bleeding from an open wound is unlikely to go unnoticed, but internal bleeding can be sneakier. All patients receiving heparin should be monitored closely for the signs and symptoms of internal bleeding due to delayed clotting action abruption placentae: Placental abruption can cause life-threatening problems for both mother and baby. For the mother, placental abruption can lead to: Shock due to blood loss Blood clotting problems (disseminated intravascular coagulation)


Question: The rectum is characterized by the presence of

The transverse folds of the rectum (or Houston&;s valves) are semi-lunar transverse folds of the rectal wall that protrude into the rectum. These folds are about 12 mm. in width and are composed of the circular muscle coat of the rectum. They are usually three in numberTaenia coli, haustrations and appendices epiploicae are features of ColonRef: Vishram Singh; Volume II; 2nd edition; Page no: 282

Permanent transverse mucosal folds within lumen


Question: Most impoant prognostic factor of Wilms tumor

histology remains a critical determinant of adverse prognosis. Even anaplasia restricted to the kidney (i.e., without extra-renal spread) confers an increased risk of recurrence and death, emphasizing the need for accurate identification of this histologic feature. Molecular parameters that correlate with adverse prognosis include loss of genetic material on chromosomes 11q and 16q, and gain of chromosome 1q inthe tumor cells. Along with the increased survival of individuals with Wilms tumor have come repos of an increased risk of developing second primary tumors, including bone and soft-tissue sarcomas, leukemia


Question: anorexia nervosa is common in

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: Poal vein is formed by the union of

The poal vein is usually formed by the confluence of the superior mesenteric and splenic veins and also receives blood from the inferior mesenteric, gastric, and cystic veins. Ref - BDC 6e vol2 pg282


Question: Appendices epiploicae present in

The epiploic appendices are small pouches of the peritoneum filled with fat and situated along the colon, but are absent in the rectum. Ref - researchgate.net


Question: Division of long thoracic nerve results in

Nerve to serratus anterior is also called long thoracic nerve(C5,C6,C7). A)Serratus anterior muscle along with the pectoralis minor pulls the scapula forwards around the chest wall to protract the upperlimb. B)The fibres inseed into the inferior angle of the scapula pull it forwards and rotate the scapula so that the glenoid cavity is turned upwards.In this action,the serratus anterior is helped by the trapezius which pulls the acromion upwards and backwards. when the muscle is paralyzed,the medial margin of the scapula gets raised specially when 'pushing movements' are attempted.This is called 'winging of scapula'. REF.B D Chaurasia's human anatomy,Vol.1,pg.47


Question: The nerve supply of nail bed of index finger is

Palmar branches of the median nerve supplies the nail bed of lateral 3 and a half digits Reference: BD Chaurasia 7th edition diagram page no:182.


Question: Not a content of adductor canal is

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.-Posteriomedial 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 neighbouring 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 medialis5. 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. <img src=" /> {Reference: BDC 6Epg no.56}


Question: Single unit smooth muscles are seen in


Question: Skull consists of....bones


Question: Palmar interossei is absent in

Palmar interossei is absent im middle finger. Dorsal interossei is absent in Thumb & Little finger.


Question: The most dependable means of personal identity is

Finger print or dactylography is the most dependable means


Question: Total number of dorsal interossei

There are 4 dorsal interossei muscles and 4 palmar interossei muscles. Dorsal and palmar interossei are supplied by the deep branch of the ulnar nerve. Dorsal interossei help in the abduction of digits. Ref: BD Chaurasia 7th edition; Page no: 182


Question: Acute emphysematous cholecystitis is caused by

Emphysematous cholecystitis It is thought to begin with acute cholecystitis (calculous or acalculous), followed by ischaemia or gangrene of GB wall and infection by gas producing organisms. Causative organisms of Emphysematous Cholecystitis Anaerobes : Clostridium welchi or Cl. Perfringens Aerobes : E.coli Ref: Sabiston 20th edition Pgno : 1493


Question: Clitoris develops from

Human embryology Tenth edition Inder Bir Singh Page no 301 The genital tubercle becomes cylindrical and forms the clitoris Genital tubercle is situated in the midline between the urogenital membrane and lower pa of anterior abdominal wall In males genital tubercle forms penis


Question: Disulfiram is used to treat

DISULFIRAM is a DETERRANT which acts by blocking acetaldehyde dehydrogenase When acetaldehyde dehydrogenase is blocked there will be increased amount of acetaldehyde that acts on mast cells and results in release of histamine that in turn leads to allergic reaction. Thus when a patient on disulfiram takes alcohol there would be allergic reaction that prevents the patient from using the substance Ref.Kaplon and Sadock, synopsis of Psychiatry, 11 th edition, pg No.625


Question: Transformation of one epithelium to other epithelium

Ref Robbins 8/e p10,11; 9/e p37 Metaplasia is a reversible change in which one adult cell type (epithelial or mesenchymal) is replaced by another adult cell type. In this type of cellular adaptation, a cell type sensitive to a paicular stress is replaced by another cell type better able to withstand the adverse environment. Metaplasia is thought to arise by reprogramming of stem cells to differ- entiate along a new pathway rather than a phenotypic change (transdifferentiation) of already differentiated cells. Epithelial metaplasia is exemplified by the squamous change that occurs in the respiratory epithelium of habitual cigarette smokers (Fig. 1-5). The normal ciliated columnar epithelial cells of the trachea and bronchi are focally or widely replaced by stratified squamous epithelial cells. The rugged stratified squamous epithelium may be able to survive the noxious chemicals in cigarette smoke that the more fragile specialized epithelium would not tolerate. Although the metaplastic squamous epithelium has survival advantages, impoant protective mechanisms are lost, such as mucus secretion and ciliary clearance of paiculate matter. Epithelial metaplasia is therefore a double-edged sword. Moreover, the influences that induce metaplastic change, if per- sistent, may predispose to malignant transformation of the epi- thelium. In fact, squamous metaplasia of the respiratory epithelium often coexists with lung cancers composed of malignant squamous cells. It is thought that cigarette smoking initially causes squamous metaplasia, and cancers arise later in some of these altered foci. Since vitamin A is essential for normal epithelial differentiation, its deficiency may also induce squamous metaplasia in the respiratoryepithelium. Metaplasia need not always occur in the direc- tion of columnar to squamous epithelium; in chronic gastric reflux, the normal stratified squamous epithelium of the lower esophagus may undergo metaplastic transformation to gastric or intestinal-type columnar epithelium. Metapla- sia may also occur in mesenchymal cells but in these situ- ations it is generally a reaction to some pathologic alteration and not an adaptive response to stress. For example, bone is occasionally formed in soft tissues, paicularly in foci of injury.


Question: Veins not involved in stomach varices

Gastric varices Gastric varices can develop secondary to poal hypeension, in conjunction with esophageal varices, or secondary to sinistral hypeension from splenic vein thrombosis In generalised poal hypeension, the increased poal pressure is transmitted by the left gastric vein to esophageal varices and by the sho and posterior gastric veins to the fundic plexus and cardiac veins Isolated gastric varices tend to occur secondary to splenic vein thrombosis Splenic blood flows retrograde through the sho and posterior gastric veins into the varices, then hepatomegaly through the coronary vein into the poal vein. Left to right retrograde flow through the gastriepiploic vein to the superior mesenteric vein can explain the development of ectopic varices in the stomach Ref: Sabiston 20th edition Pgno : 1232


Question: Structure posterior to transverse pericardial sinus is

The transverse sinus is a horizontal gap between the aerial and venous ends of the hea tube.It is bounded anteriorly by the ascending aoa and pulmonary trunk,and posteriorly by the superior venacava and inferiorly by the left atrium on each side it opens into the general pericardial cavity. <img src=" /> REF.B D Chaurasia's human anatomy vol.1,fifth edition


Question: Cricothyroid muscle is supplied by

Ref BDC volume 3;sixth edition pg 257 All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except for the cricothyroid which is supplied by the external laryngeal nerve.


Question: De Quervain's disease is tenosynovitis of

-Exterior pollicis brevis & abductor pollicis longus tendons. - form the anterolateral border of anatomical Snuff box. -It occurs d/o repeated overuse of thumb/ wrist paicularly like thumb abduction. -Finkelstien test : Sudden ulnar detion is painful. -Anatomical snuff box Triangular depression on lateral side of wrist seen best when thumb is extended. Boundaries :- -Anterolateral - Abductor policies longus tendon Exterior pollicis brevis tendon -Posteromedial - Exterior pollicis longus tendon -Floor - Scaphoid & trapezium Contents - Radial aery, radial nerve, cephalic vein

Abductor pollicis brevis and extensor pollicis longus

Abductor pollicis longus and extensor carpi radialis brevis

Abductor pollicis longus and extensor pollicis brevis

Abductor pollicis brevis and extensor carpi radialis longus


Question: Pulp of the index finger is supplied by

Ans. is 'a' i.e., Median nerve Sensory supply of HandOn Palmar side* Lateral 2/3 of the palm and lateral three and half fibers - Median nerve* Medial 1/3 of the palm and medial one and half fingers - Ulnar nerveOn Dorsal surface* Distal phalanx of lateral three and half ditits -Median nerve* Medial 1/3 of dorsum of hand and medial one and half fingers - Ulnar nerve* Lateral 2/3 of dorsum of hand -Radial nerve* Dorsum of lateral three and half fingers over proximal and middle phalanges - Radial nerve* Sensory distribution of upper limb is as followThe cutaneous nervesRegion suppliedNerve(s)Root valueDerived fromUpper part of pectoral region, and skin over upper part of deltoidSupraclavicularC3,C4Cervical plexusArm 1. Upper medial partIntercostobrachialT22nd intercostal2. Lower medial partMedial cutaneous nerve of armT1,T2Medial cord3. Upper lateral part (including skin over lower part of deltoid)Upper lateral cutaneous nerve of armC5, C6Axillary nerve4. Lower lateral partLower lateral cutaneous nerve of armC5, C6Radial nerve5. Posterior aspectPosterior cutaneous nerve of armC5Radial nerveForearm 1. Medial sideMedial cutaneous nerve of forearmC8,T1Medial cord2. Lateral sideLateral cutaneous nerve of forearmC5> C6Musculocutaneous3. Posterior sidePosterior cutaneous nerve of forearmC6, C7, C8Radial nervePalm 1. Lateral two-thirdsPalmar cutaneous branch of medianC6, C7Median2. Medial one-thirdPalmar cutaneous branch of ulnarC8UlnarDorsum of hand 1. Medial half including proximal phalanges of medial 2 1/2 digitsDorsal branch of ulnarC8Ulnar2. Lateral half including proximal phalanges of medial 2 1/2 digitsSuperficial terminal branch of radialC6, C7RadialDigits Palmar aspect, and dorsal aspect of middle and distal phalanges 1. Lateral 3V6 digitsPalmar digital branch of medianC7Median2. Medial 1 Vi digitsPalmar digital branch of ulnarC8Ulnar


Question: Poal Acinus means

The hepatic or poal acinus is the functional unit of the liver.The acinus consists of an irregular shaped, roughly ellipsoidal mass of hepatocytes aligned around the hepatic aerioles and poal venules just as they anastomose into sinusoids.The acinus is roughly divided into zones that correspond to distance from the aerial blood supply - those hepatocytes closest to the aerioles (zone 1 below) are the best oxygenated, while those fahest from the aerioles have the poorest supply of oxygen. This arrangement also means that cells in the center of the acinus (again, zone 1) are the first to "see" and potentially absorb blood-borne toxins absorbed into the poal blood from the small intestine.Reference: Krishna Garg Histology; 5th edition; Page no: 171

The space between two central veins of adjacent lobules

The space between central vein and bile duct

The space between Poal vein and central vein


Question: The distance of aoic constriction of the oesophagus from the upper incisor teeth

First constriction, at the pharyngo-esophageal junction, 9 cm (6 inches) from the incisor teeth. Second constriction, where it's crossed by the arch of aoa, 22.5 cm (9 inches) from the incisor teeth. Third constriction, where it's crossed by the left principal bronchus, 27.5 cm (11 inches) from the incisor teeth. Fouh constriction, where it pierces the diaphragm, 40 cm (15 inches) from the incisor teeth. Ref - sciencedirect.com


Question: Muscle attached to the tubercle of 1st cervical vertebrae


Question: The gold standard for the definitive diagnosis of the extrahepatic biliary atresia is

Biliary atresia Evaluation of biliary anatomy begins with ultrasound Other imaging modalities such as HIDA scintigraphy, MRCP and ERCP have been used with varying success Although these are useful adjuncts, liver biopsy is gold standard for the diagnosis of biliary atresia and can safely be done percutaneously under local anaesthesia Ref: Sabiston 20th edition Pgno : 639


Question: Splenectomy is most useful in

Ref Harrison 19 th ed pg 652 We do not have a causal treatment for HS; i.e., no way has yet been found to correct the basic defect in the membrane-cytoskeleton structure. Given the special role of the spleen in HS ), it has long been thought that an almost obligatory therapeutic mea- sure was splenectomy. Because this operation may have more than tril consequences, today we have more aiculate recommenda- tions, based on disease severity (having found out, whenever pos- sible, about the outcome of splenectomy in the patient's relatives with HS), as follows. In mild cases, avoid splenectomy.


Question: sialorrhea is a side effect of

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


Question: Auerbanchs plexus and Meissners ganglion cell are derived from


Question: Inferior mesenteric vein drains into

Inferior mesenteric vein usually terminates when reaching the splenic vein, which goes on to form the poal vein with the superior mesenteric vein (SMV).


Question: Endothelial leukocyte interaction during inflammation is mediated by

Ref Robbins 9/e p76 Endothelial leucocytes interaction is also mediated by integrins Integrins are proteins that function mechanically, by attaching the cell cytoskeleton to the extracellular matrix (ECM), and biochemically, by sensing whether adhesion has occurred. The integrin family of proteins consists of alpha and beta subtypes, which form transmembrane heterodimers


Question: One of the following disorders is due to maternal disomy

ref Robbins 9/e p173 Matetnal disomy is associated with disorders like prader Willi syndrome, angelman syndrome.


Question: Most common liver tumor in children


Question: Maxillary aery is

Branches of external carotid aery Anterior Superior thyroid Lingual Facial Posterior Occipital Posterior auricular Medial Ascending pharyngeal Terminal Maxillary Superficial temporal Ref BDC volume 3 ;sixth edition pg 101


Question: Crouzon syndrome consists of

Crouzon syndrome consists of Autosomal dominant (FGFR2 Gene) Craniosynostosis involving coronal suture Wide set bulging eyes and beaked nose Maxillary hypoplasia Underdeveloped upper jaw& protruding lower jaw Dental problems, hearing loss Hydrocephalus Ref: Nelson's, 20th edition, page 2819


Question: Foaming liver is seen in

Gas Gangrene Clinical features Severe local wound pain and crepitus (gas in the tissues, which may also be noted on plain radiographs) The wound produces a thin, brown, sweet smelling exudate, in which Gram staining will reveal bacteria Gas and smell are characteristic (Myonecrosis) If septicemia occurs, gas may be produced in the other organs, notably liver known as 'foaming liver' Edema and spreading gangrene follow the release of collagenase, hylauronidase, other proteases and alpha toxin Early systemic complications with circulatory collapse and multi organ failure follow if prompt action is not taken Ref: Harrison's 19th edition Pgno :992


Question: Left testicular vein drains into

The veins emerge from the back of the testis, and receive tributaries from the epididemis; they unite and form a convoluted plexus, which constitutes the greater mass of the spermatic cord; the vessels composing this plexus are very numerous, and ascend along the cord, in front of the ductus difference.Below the subcutaneous inguinal ring, they unite to form three or four veins, coalesce to form two veins. These unite to form a single vein, which opens, on the right side, into the inferior vena cava (at an acute angle), on the left side into the left renal vein (at a right angle). <img src=" /> ref - BDC 6e vol2 pg 225


Question: Not seen in colon

Peyer's patch are aggregations of gut assossiated lymphoid tissue that are usually found in the lowest poion of the small intestine, the ileum, in humans; as such, they differentiate the ileum from the duodenam and jejunam. The duodenum can be identified by burnners gland. The jejunum has neither Brunner's glands nor Peyer's patches. Ref - BDC vol2 pg257,264


Question: metabolic syndrome is a side effect of

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


Question: Pseudopancreatic cyst is

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


Question: Honey comb liver is seen in

The liver is the "primary" site of infection in 15% with abdominal actinomycosis." Presumably, Actimomyces are conveyed to the liver by the poal vein. The lesion develops after appendicitis or surgery for noninflammatory diseases in most instances,4-6 but there are repos in which the pathogenesis is un- Clear.'.' The most common hepatic lesion is a solitaryabscess, though multiple abscesses also occur. A honeycomb appearance in cross-section suggest an origin of the abscess from multiple, smaller ones. Abscesses are usually confined to the liver, but may extend to involve adjacent organs and even to reach the pleural space.",'" Liver abscesses can rarely arise by direct extension from such foci as an abscess in the neck."


Question: Stomach completes its rotation by

At 5 weeks Stomach rotates and dilates. The intestinal loop begins to form.At 6 weeks Intestinal loop is well formed.Stomach completes rotation At 7 weeks Intestinal loop herniates out of the abdominal cavityAt 8 weeks Intestinal loop rotates counterclockwiseAt 3 months Herniated coils of intestine return to the abdominal cavity.Reference: Inderbir Singh Embryology; 10th edition; Page no: 200


Question: Climbing fibres of cerebellar coex are

Afferent fibres to cerebellum are climbing fibres (olivocerebellar from inferior olivary nuclei) and mossy fibres (other pas of body)


Question: Shoest acting local anaesthetic


Question: Sudden onset of a cough followed by increasing dyspnea is characteristic of

PneumothoraxPatients most commonly present with chest pain, often sharp and pleuritic and may leads to severe respiratory embarrassment or becomes dull and persistent.Dyspnea is the 2ndMC symptom.Less common symptoms include a nonproductive cough and ohopnea.Physical findings may be normal if the Pneumothorax is less than 25%.Characteristic physical finding includes diminished chest excursion and hyper-resonance on percussion of the affected side. Breath sounds are diminished to absent.(Refer: Harrison's Principles of Internal Medicine, 18thedition, pg no: 2181, 2221, 3212)


Question: Sturge Weber syndrome is associated with

Sturge Weber syndrome is manifested at bih by po wine stain forehead and upper eyelid of one side of the face. Refer robbins 9/e p196


Question: Irresistible desire to pull out hair

Trichotilomania Irresistible desire to pull out hair Dipsomania Irresistible desire to drink alcohol Nymphomania Irresistible desire to have sexual intercourse including sexual perversions, in female. Satyriasis Irresistible desire to have sexual intercourse including sexual perversions, in male. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 360


Question: Joint involved in movement of head from left to right.

Answer A. Atlanto axialAtlanto-occipital (between skull and C1) joint permit nodding of head ( as when indicating approval or YES) and Atlanto-axial joint permits the head to be turned from side to side (as indicating disapproval or NO).


Question: Foramen Transversarium transmit

Foramen transversarium transmits 1st, 2nd, pa of the veebral aery which is present in the cervical veebra Ref: Gray's 40e/p-250-251


Question: Worst prognosis memingioma is

Atypical and anaplastic meningiomas are uncommon tumors with a poorer prognosis than benign meningiomas. We reviewed the current literature and attempted to integrate and summarize available information to determine a logical approach to these tumors. Both tumors are rare and are often integrated with benign meningiomas when treatments are evaluated. In addition, because there has not been one histopathological classification scheme for atypical and anaplastic meningiomas in the past, there are numerous inconsistencies in the literature. Malignant progression with accumulation of mutations in a benign meningioma can result in an atypical and/or anaplastic meningioma. Both tumors are difficult to manage and have high recurrence and poor survival rates. The extent of tumor resection and histological grade are the key determinants for recurrence. In addition, metastases are unusual, but they do occur. We also review the evidence available that has resulted in the current World Health Organization classification. Radiation therapy can be used as an adjunctive treatment after both total and subtotal resection. In addition, the role of stereotactic radiosurgery is increasing, along with a possible role for brachytherapy. There are no effective chemotherapeutic agents available. A treatment algorithm is suggested. Refer Robbins page no 1315


Question: Sensory fibres from the taste buds in the hard and soft palate travel along

Special sensory or gustatory nerves carrying taste sensations from the oral surface are contained in the lesser palatine nerves. The fibres travel through the greater petrosal nerve to the geniculate ganglion of the facial nerve and from there to the nucleus of the solitary tract. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th.


Question: Panniculus Adiposus is seen in

The panniculus adiposus is the fatty layer of the subcutaneous tissues, superficial to a deeper vestigial layer of muscle, the panniculus carnosus. Hence it is seen in orbit and protects the eye ball.


Question: The ideal treatment for hemothorax greater than 500ml/hr

Following are indications of thoracotomy in blunt chest trauma: Initial drainage of blood > 1000 ml, especially if fresh. Continued brisk bleeding > (100 ml/15 minutes) from the intercostal drain Continued bleeding of > 200 ml/hr for > 3 hrs Rupture of bronchus, aoa, esophagus or diaphragm Cardiac tamponade (if needle aspiration unsuccessful). Ref : Bailey & Love 24/e p872

Open thoracotomy with ligation of vessels


Question: Ascorbic acid is a potent enhancer of iron absorption because it

Ascorbic acid enhances iron absorption mostly by its reducing capacity, keeping iron in the ferrous state. Ascorbic acid does not enhance heme iron absorption, nor does it affect heme oxygenase activity or the produc on of ferritin or transferrin.

Is a reducing agent, thereby helping to keep iron in the ferrous state

Decreases the production of ferritin by enterocytes


Question: Massive blood transfusion is defined as

According to Schwaz Massive transfusion is a single transfusion of 2500 or 5000 ml over a period of 24 hours .


Question: The drug that should be used for prophylaxis of close contacts of a patient suffering from meningococcal meningitis is

Ref-KDT 6/e p729 Rifampicin and ciprofloxacin are used for the prophylaxis of meningococcal meningitis


Question: Sutural separation seen in

Diastatic fracture or sutural fracture: Suture separation is called a diastatic fracture. Penetrating and performing fracture: They are fractures produced by penetrating objects like a bullet, pointed sharp weapon, sword or dagger. Fracture which is having an entry and an exit is called a performing fracture. Cut fracture Skull may be subjected to cut injuries when a heavy cutting weapon is used. The cut injury may enter the skull cavity and injure the brain. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 164


Question: Implantation occurs at the stage of

C i.e. Blastocyst- Barrier is provided by fusion / feilin (not Ach)Q. Fusion reduce the membrane potential of ovum that prevents polyspermy by not allowing the others sperms to enter.- Morula is a 16 cell stage, surrounded by zona pellucida. Barrier is provided by fusiotVfetilin.QImplantation occurs at the stage of blasto cystQ.