Question: White infract is seen in

ref Robbins 8/e p674; 9/e p134,664-665 White infarcts occur with aerial occlusions in solid organs with end-aerial circulations (e.g., hea, spleen, and kidney), and where tissue density limits the seepage of blood from adjoining patent vascular beds (Fig. 3-17, B). Infarcts tend to be wedge-shaped, with the occluded vessel at the apex and the organ periphery forming the base (Fig. 3-17); when the base is a serosal surface, there is often an overlying fibrinous exudate. Lateral margins may be irregular, reflecting flow from adjacent vessels. The margins of acute infarcts typically are indistinct and slightly hemorrhagic; with time, the edges become better defined by a narrow rim of hyperemia attributable to inflammation. Infarcts resulting from aerial occlusions in organs without a dual circulation typically become progressively paler and sharply defined with time (Fig. 3-17, B). By comparison, hemorrhagic infarcts are the rule in the lung and other spongy organs (Fig. 3-17, A). Extravasated red cells in hemorrhagic infarcts are phagocytosed by macrophages, and the heme iron is conveed to intracellular hemosiderin.


Question: The membranous labyrinth develops from

The membranous labyrinth of the internal ear is derived from the otic vesicle The surface ectoderm on either side of the hindbraint thickens to form otic placodes. The otic placodes invaginate to form otic vesicles. The otic vesicles fuher divides into 2 components that develop into structures of the membranous labyrinth: The ventral component forms the saccule and cochlear duct The dorsal component forms the utricle, semicircular canals, endolymphatic duct. Ref: Inderbir Singh Human Embryology 11 e pg 328.


Question: Costochondral joint is an example of

Primary Cailaginous joint The bones are united by a plate of hyaline cailage so that the joint is immovable and strong These joints are tempory in nature because after a ceain age the cailaginous plate is repalced by bone (synostosis) Ref :BD CHAURASIA S Handbook of General Anatomy Fouh edition Page no 63


Question: pancreatitis is a side effect of

LETHAL SIDE EFFECTS OF VALPROATE - Hyperammonemia - Pancreatitis - Hepatic failure - Neural tube defects - Thrombocytopenia MINOR SIDE EFFECTS OF VALPROATE - Hair loss - PCOD - WEIGHT GAIN - TREMORS Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th editiojn, pg no.935


Question: Coracoid process is

Coracoid process is directed forwards and slightly laterally. It is bent finger like. It is atavistic type of epiphysis. B D Chaurasia 7th edition Page no : 9


Question: Main action of superior rectus

Actions of superior rectus Veical axis: elevation Main action horizontal axis: addicts Anterioposterior axis: rotates medially (intorsion) Ref: BDC volume 3:sixth edition pg 211


Question: The classical lobute of the liver is centred around

Inderbir Singh's Human Histology Sixth edition Pg 298 Centre of each lobule of liver is called central vein


Question: Broca's area is situated in

(A) Inferior frontal gyrus[?]BROCA'S AREA (Motor Speech Area) is a section of the human brain that is involved in language processing, speech or sign production & comprehensionBroca's area is located in the opercular and triangular sections of the Inferior Frontal Gyrus of the Frontal lobe of the Cortex.Broca's & Wernicke's areas are found unilaterally in the brain (left hemisphere) dominant hemisphere.Broca's area comprises Brodmann area 44 and (according to some authorities) Brodmann area 45.Broca's Area is connected to Wernicke's area by a neural pathway called the arcuate fasciculus.Inability to speak after injury to the posterior-inferior frontal gyrus of the brain.Pierre Paul Brocahe identified this region, known as Broca's area.Difficulty in language production as Broca's aphasia, also called expressive aphasia.Broca's area is now typically defined in terms of the pars opercularis & pars triangularis of the inferior frontal gyrus.Present in left hemisphere in 90% of right handed & 70% of left handed people.Present in right hemisphere only in any of left handed peopleCEREBRAL CORTEX & CORTICAL AREAS AT A GLANCEAREALOCATIONFUNCTION* Motor area (Area 4)Precentral gyrus & anterior part of para-central lobuleVoluntary movements* Premotor area (Area 6)Posterior parts of frontal gyriVoluntary movements* Frontal eye field (8) Includes Areas 6 & 9Anterior to premotor area in posterior part of middle frontal gyrusConjugate deviation of eyes to opposite side.* Broca's speech area (Areas 44,45)Posterior part of inferior frontal gyms of dominant hemisphereControls motor element of speech.* Prefrontal cortexAnterior part of frontal gyri, orbital gyri, most of medial frontal gyms, & anterior part of cingulate gyms.Intellectual activity* Sensory Cortex (Areas 3,1,2)Post central gyms & adjoining parts of post central gyms & posterior part of para-central lobuleAppreciation of somatic sensations* Areas 39,40Inferior parietal lobule, supra marginal & angular gyri.Recognition of somatic sensory stimuli & their integration steriognosis* Primary visual area (17) Visual cortex or striate cortex (Visual-Sensory Cortex)Surrounds post calcarine sulcus.Primary visual function* Visual association cortex (18,19) (peristriate & parastriate areas) (Visual-Psychic)Occipital lobe adjacent to striate areaRecognition & integration of visual stimuli* Primary acoustic area (41) or 1st acoustic area (Al)Anterior transverse temporal gyms extending to superior temporal gymsPrimary auditory function* Auditory association area (Area 42)Posterior transverse temporal gymsIntegration of auditory stimuli with other sensory modalities.* Area 24Anterior part of cingulate gymsPulse, Respiration & B.P. control* Limbic systemHippocampus, alveus, fimbria, fornix & its termination into mamillary bodies are grouped under this systemMaintenance of normal homeostasis of body along with hypothalamus.* Second speech area of WernickeOccupies parietal area extending into temporal lobe round the posterior extremity of lateral sulcus.Second motor speech area.


Question: Skin at the level of umbilicus is supplied by the spinal nerve

The dermatome T10 is at the level of Umbilicus.The area of skin supplied by a dorsal root of a spinal nerve is called as "Dermatome".They represent specific regions of reception of sensory impulses.Reference: Chaurasia; 6th edition


Question: Spiral aery is a branch of

Spiral aery are small aeries which temporarly supply blood to endometrium of the uterus during the leteal phase of the menstrual cycle.The spiral aries are conveed for uteroplacental blood flow during pregnancy. imageRef - Semantischolar.org


Question: Laryngeal cailage forming complete circle is

Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition. Cricoid cailage is shaped like a ring. It encircles the larynx below the thyroid cailage. It is thicker and stronger than the thyroid cailage. The ring has a narrow anterior pa called the arch, and a broad posterior pa called the lamina. The lamina projects upwards behind the thyroid cailage and aiculates superiorly with the arytenoid cailages. The inferior cornua of the thyroid cailage aiculate with the side of the cricoid cailage at the junction of the arch and lamina.


Question: Largest branch of brachial plexus is

Ans. is 'c' i.e., Radial Radial nerve is the largest branch of brachial plexus and is the continuation of posterior cord (root value C5_8 T1).


Question: Structure passing deep to flexor retinaculum is

The flexor retinaculum is a thickened band of deep fascia on the posteromedial aspect of ankle. The deep relations of flexor retinaculum from above downwards or medio laterally are tibialis posterior, flexor digitorum longus , posterior tibial aery , tibial nerve ,flexor hallucis longus. Reference: clinical anatomy for students a problem-solving approach, Neeta v Kulkarni, page no. 865


Question: Beer's procedure

Resection Procedure in Chronic Pancreatitis It is believed that Inflammatory process in the pancreatic head controls both the severity of symptoms and fuher progression of disease in remainder of the gland Pancreatic head is pacemaker of chronic pancreatitis. Because of this resection of pancreatic head has been shown to completely relieve pain of chronic pancreatitis in 70-80% patients Distal pancreatectomy is the ideal procedure for patients whose chronic pancreatitis is confined to pancreatic tail Usually, distal pancreatectomy is combined with splenectomy for technical reasons, but spleen can be preserved if its vascular supply is secure Ref: Sabiston 20th edition Pgno :1535


Question: Mechanism of action of nitric oxide is

Refer kDT 7/e 568 Nitric oxide (nitrogen oxide or nitrogen monoxide) is a colorless gas with the formula NO. It is one of the principal oxides of nitrogen. Nitric oxide is a free radical, i.e., it has an unpaired electron, which is sometimes denoted by a dot in its chemical formula, i.e., *NO. Nitric oxide is also a heteronuclear diatomic molecule, a historic class that drew researches which spawned early modern theories of chemical bonding.


Question: Highest point of iliac crest is seen at;

Highest point of iliac crest lies at the level of the 4th lumbar veebral body (L4). Clinical significance: Site of bone marrow harvests to collect the stem cells used in bone marrow transplantation. Most ideal donor site forbone grafting when a large quantity of bone is needed. To estimate site for lumbar puncture as LP is done at the level b/w L3-L4 or b/w L4-L5 and highest point of iliac crest coincides with it.


Question: Quaer staggered arrangement is seen in

The collagen fibres have a triple stranded,quaer staggered arrangement. This arrangement helps in mineralization Tropocollagen molecules are arranged in a "quater-staggered array" to form collagen fibres . Reference: Harpers illustrated biochemistry 31st edition pg 593


Question: Branch of internal iliac aery

Generally, the aery divides into an anterior division and a posterior division, with the posterior division giving rise to the superior gluteal, iliolumbar, and lateral sacral aeries. The rest usually arise from the anterior division. umbilical aery superior vesical aery obturator aery vaginal aery inferior vesical aery uterine aery middle rectal aery internal pudendal aery inferior gluteal aery Imageref - pubmed.com


Question: Placental alkaline phosphatase is marker of

Placental alkaline phosphatase is a marker of seminoma. Also know Gamma-glutamyl-transpeptidase is marker of - seminoma testis AFP is not produced by - seminomas and Choriocarcinomas


Question: Pain sensation from ethmoid sinus is transmitted through

It is the principal nerve supplying the sensory supply to the Ethmoidal sinuses through its anterior and posterior Ethmoidal branches.


Question: Onion peel appearance of splenic capsule is seen in

Ref Robbins 9/e p224 In splenic involvement in SLE _splenomegaly, capsular thickeing , follicular hyperplasia,are common feature . central penicilliary aeries may show concerntric intimal and smooth muscle cell hyperplasia , producing onion skin appearance


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

* Atlanto-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). * Atlantoaxial is a combination of three synol joints. The aiculation is at three places - a pair of lateral masses and a median complex (between dens of axis and anterior arch & transverse atlantal ligament) * Rotation movement takes place simultaneously at all joints and the normal range of rotation is 40 degrees. * The muscles which produce these movements are obliquus capitis inferior, rectus capitis posterior major, ipsilateral splenius capitis and contralateral sternocleidomastoid. Ref:- Gray's Anatomy 41st Edition; Pg num:- 737


Question: Cerebellar coex contains

Purkinje cells are large flask-shaped neurons seen in the intermediate layer of cerebellar coex. There are five types of neurons in cerebellar coex which are Purkinje cells, Granule cells, Stellate cells, Basket cells, Golgi cells. All the intrinsic neurons in the cerebellar coex are inhibitory except granule cells. (Ref: Vishram Singh textbook of clinical neuroanatomy, second edition, pg- 114)


Question: bulimia nervosa is treated with

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


Question: Stratified cuboidal epithelium seen in

Stratified cuboidal epithelium is seen in large ducts of exocrine glands like sweat glands ,pancreas and salivary glands The ovarian surface epithelium, also called the germinal epithelium of Waldeyer, is a layer of simple squamous-to-cuboidal epithelial cells covering the ovary. The upper cervix (endocervix) is lined by a simple columnar epithelium that contains mucous-secreting cells. In contrast, the lower cervix (ectocervix) is lined by a stratified squamous epithelium. The transition point between these two epithelia is known as the external os. Larynx is lined by ciliated pseudostratified columnar epithelium except vocal cords (lined by stratified squamous epithelium). Inderbir Singh's textbook of Human Histology Seventh edition Pg no;48


Question: Inferior olivary nucleus is present in

The inferior olivary nucleus, a cerebellar relay nucleus, is the most prominent nucleus in the lateral medulla. Coordinate signals from the spinal cord to the cerebellum to regulate motor coordination and learning. fig:- crossection at the level of medulla(upper pa)

Midbrain, at level of superior colliculus

Midbrain, at level of inferior colliculus


Question: Pyogenic infection and braininfraction are associated with


Question: Frey's syndrome is due to faulty regeneration of damaged nerve fibers. The sources of that injured nerve is


Question: Berry aneurysm of the posterior communicating aery causes compression of

Berry aneurysm in the vicinity of posterior communicating aery can compress the third carnial nerve and cause oculomotor nerve palsy Aneurysms of superior cerebellar aery or tip of the basilar aery can also compress the oculomotor nerve and produce its palsy Berry aneurysm on the internal carotid aery (near its termination) compresses the lateral aspect of optic chiasma and hence damages the visual information from the ipsilateral nasal visual field. Ref: Gray's 39e/p-22


Question: Pleural tapping in mid axillary line, muscle not pierced is


Question: 'Carpal tunnel syndrome' is caused by compression of

Compression of median nerve causes motor,sensory,vasomotor and trophic symptoms in hand. Examination reveals wasting of thenar eminence, hypoaesthesia to light touch on the palmar aspect of lateral 3 1/2 digits. B D Chaurasia 7th edition Page no : 130


Question: Largest branch of veebral aery is

Anterior inferior cerebellar aery is a branch of Basilar aery


Question: Aoic hiatus contains

The aoic opening is osseoaponeurotic.It lies at the lower border of the 12 th thoracic veebra.It transmits Aoa,Thoracic duct and Azygos vein. REF.B D Chaurasia's human anatomy,Vol 2,Fifth edition.Pg 337


Question: Efferent from cerebellum is through

The outgoing Purkinje axons constitute the sole output from the cerebellar coex and exe an inhibitory influence on intracerebellar nuclei.granule cells are the only intrinsic neurons. of cerebellum which is excitatory.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 116)


Question: The structure that lies lateral to distal radial tubercle is

MAMMARY GLAND:-Modified sweat gland in superficial fascia of pectoral region.Rudimentary in males.Located in superficial fascia.Extend: veically- 2nd to 6th ribHorizontally- lateral border of sternum to midaxillary line.LYMPHATIC DRAINAGE:-Lymph nodes:-1. Axillary-anterior, posterior, central and lateral.2. Internal mammary.3. Supraclavicular.4. Posterior intercostal 5. Cephalic.Lymphatics draining the breast:-1. Superficial- drain skin of the breast except that of nipple and areola.2. Deep-brain parenchyma of the breast, and skin of nipple and areola.3. A plexus of lymph ceasefires deep to areola is called subareolar plexus of sappy. The subareolar plexus and most of the lymph from the breast drains into anterior group of axillary lymph nodes.Lymphatic drainage:-1. Lateral quadrant of breast-drains into anterior axillary/ pectoral group of lymph nodes.2. Medial quadrant- drains into Internal mammary3. Lower and medial quadrant- communicates with subdiaphragmatic and subperitoneal lymph plexus.4. Deep surface of breast-apical group . 5. A few lymph vessels from the breast follow the posterior intercostal aeries and drain into posterior intercostal nodes.About 75% -axillary 20%-internal mammary 5%-posterior intercostal lymph nodes.Among the axillary lymph nodes, most of lymph goes into anterior axillary and remaining into posterior and apical. The lymph from anterior and posterior groups first goes into central and lateral groups and then through them into supraclavicular nodes.Apical group of lymph nodes are terminal.Some lymph vessels from the inferomedial quadrant of breast communicates with the subperitoneal lymph plexus and carry cancer cells to it. From here cancer cells migrate transcoelomically and deposit over ovary- krukenberg&;s tumor.{Reference:vishram singh page no.48}


Question: Dorsiflexiors of ankle joint

DORSIFLEXION FOOT:- The forefoot is raised,and the angle between the front of the leg and the dorsum of the foot is diminished. The wider anterior trochlear surface of the talus fits into the lower end of narrow posterior pa of the lower end of tibia. No chance of dislocation in dorsiflexion. PLANTAR FLEXION OF FOOT:- Forefoot is depressed and the angle between leg and foot is increased. The narrow posterior pa of trochlear surface of talus loosely fits into the wider anterior pa of lower end of tibia. High heels causes plantar flexion of ankle joint and its dislocation. MUSCLES INVOLVED;- Main Accessory Dorsiflexion Tibialis anterior EDL ,EHL Peroneusteius Plantar flexion Gastrocnemius Soleus FHL FDL plantaris Tibialis posterior {Reference: BDC 6E pg no.150}


Question: S1 nerve root irritation causes pain along the

Sural nerve supplies the skin over the little toe and lateral aspect of the foot, with dermatome S1. Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 1324.


Question: Ligament preventing the displacement of humerus is

The area between the superior and middle glenohumeral ligament is a point of weakness in the capsule( foramen of Weitbrecht) which is a common site of anterior dislocation of humeral head. Reference : page no:147,BD chaurasia- upper limb& thorax, 7th edition.


Question: Safe strategy is for

Ans is 'a' i.e. Trachoma 'SAFE' strategy is a WHO recommended strategy to fight trachoma.'SAFE' strategy for Trachoma It includesSurgery - first component of the strategy for correction of trichiasis and entropionAntibiotics - Zithromax (azithromycin) single dose oral medication is used (Zithromax is donated by Pfizer Inc.) Tetracycline eye ointment was used before Pfizer donated Zithromax.Face washing -breaks the cycle of reinfection and prevents transmission of disease.Environmental Improvement - Poverty and poor living conditions contribute to high rates of blinding trachoma. Environmental improvement includesavailability of improved water suppliesimproved household sanitation, particularly safe disposal of faeces.


Question: Sperm after formation is stored in

epididymus - The epididymis is an organ made up of highly coiled tube that act as reservoir of spermatozoa. Pas of epididymus : Its upper end is called the head. The head is enlarged and is connected to the upper pole of the testis by efferent ductules. The middle pa is called the body. The lower pa is called the tail. The head is made up of highly coiled efferent ductules. The body and tail are made up of a single duct, the duct of the epididymis which is highly coiled on itself. At the lower end of the tail this duct becomes continuous with the ductus deferens. Ref : B D Chaurasia's Human Anatomy , seventh edition ,volume 2 , pg.no. 248


Question: Treatment of extragonadal germ cell tumour is

Chemotherapy of extragonadal GCT utilizes BEP regimen; a combination of Bleomycin & Etoposide Cisplatin (Platinol)


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

Stomach rupture posteriorly causes peritonitis or abcess formation in lesser sac or omental bursa whereas rupture anteriorly causes abscess formation in greater sac whereas in supine posture abcess formation occurs in pouch of Morison which is dependent pa of stomach.

Right subhepatic/hepatorenal space (pouch of Morison)


Question: Antigen presenting cells are

Ref Robbins 7/e p197 ;9/e p210 , macrophages and B lymphocytes is also the answer Professional antigen presenting cells(APCs) are immune cells that specialize in presentingan antigen to a T-cell. The main types of professional APCs are dendritic cells (DC), macrophages, and Bcells, Langerhans cells


Question: Ductus deference is derived from

Inderbir Singh&;s Human embryology Tenth edition The mesonephric ducts give rise to: Trigone of urinary bladder Posterior wall of prostatic urethra Ductus deferens Seminal vesicles Epididymis Ejaculatory ducts


Question: Destruction of fat in acute pancreatitis is due to

Pathophysiology AP is the final result of abnormal pancreatic enzyme activation inside acinar cells Colocalization hypothesis: Cathepsin B-mediated intra acinar cell activation of the digestive enzymes leads to acinar cell injury and triggers an Inflammatory response Digestive enzymes are released which consists of trypsin and lipase which is responsible for the digestion of fat in acute pancreatitis Ref: Sabiston 20th edition Pgno :1524-1528


Question: Abductor muscle of vocal cord is

movement and muscle: 1. elevation of larynx: thyrohyoid, mylohyoid 2. Depression of larynx: sternothyroid, sternohyoid 3. Opening inlet of larynx: thyroepiglottic 4.abductor of vocal cords: posterior cricoarytenoid only 5. Adductor of vocal cords: lateral cricoarytenoid and transverse and oblique arytenoids Ref BDC volume 3; 6th edition pg 258


Question: During week 2 of development, the embryoblast receives its nutrients

During week 2 of development, the embryoblast receives its nutrients from endometrial blood vessels, endometrial glands, and decidual cells diffusion. Diffusion of nutrients does not pose a problem, given the small size of the blastocyst during week 2. Although the beginnings of a uteroplacental circulation are established by end of week 2, no blood vessels have yet formed in the extraembryonic mesoderm to carry nutrients directly to the embryoblast (this occurs in week 3 - day17).


Question: Inhalational agent of choice for Pediatric Anaesthesia in a child with congenital hea disease

Anaesthetic agent of choice in Pediatric age group Inhalational agentIV anaestheticsNM blockersIM anaestheticsSevoflurane, Nitrous oxide Thiopentone, Propofol Rocuronium, Atracurium, Mivacurium, Succinylcholine Ketamine ( Reserved drug )(Refer: Morgan's Clinical Anaesthesiology, 4th edition,pg no: 922-938)


Question: anorexia nervosa management is

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


Question: Paial thromboplastin time correlates with

ref Robbins 8/e p120,666 ,;7/e p 69;9/e p80 Shoened APTT demonstrates hypercoagulation and high MOPEG levels indicate increased catecholamine metabolism. A direct correlation between APTT and MOPEG was found herein, demonstrating a link between catecholamines and the process of coagulation. Catecholamines may interact with the a2-adrenergic receptors located on platelets and conve factor XII to XIIa or through the kallikrein-kinin system, they may activate factor XII. The activation of factor XII initiates the intrinsic coagulation pathway, which is monitored by APTT. It is suggested to control patients with a shoened APTT and increased sympathetic activity with the aim of preventing secondary coagulation and cardiovascular accidents by administering anti-thrombotic and anti-adrenergic agents It correlates with clotting factor 12 and function of platelet


Question: Longest cranial nerve is

The word "vagus" means wandering in Latin. This is a very appropriate name, as the vagus nerve is the longest cranial nerve. It runs all the way from the brain stem to pa of the colon. Ref - medscape.com


Question: Torticollis or Wryneck is due to

It is due to spasm of the muscles supplied by spinal accessory nerve i.e. sternocleidomastoid and trapezius.


Question: Nucleus of oculomotor nerve is in

The oculomotor nucleus is located in the central grey matter of midbrain at the level of superior colliculus. The oculomotor nucleus is in the ventromedial pa. The Edinger - Westphal nucleus (visceral oculomotor nucleus) is located dorsal to the rostral two-thirds of main oculomotor nucleus. (Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg-85)


Question: On 7th postoperative day after laparoscopic cholecystectomy, patient developed right upper abdominal pain and 10 cm*8cm collection. Treatment consists of

Goals of therapy in Iatrogenic bile duct injury Control of infection limiting inflammation: Parenteral antibiotics Percutaneous drainage of peripoal fluid collection Clear and thorough delineation of entire biliary anatomy MRCP/PTC ERCP (especially if cystic duct stump leak suspected) Re-establishment of biliary enteric continuity Tension free, mucosa - to-mucosa anastomosis Longterm transanastomotic stents if involving bifurcation of higher Roux-en-Y hepaticojejunostomy Ref: Sabiston 20th edition Pgno :1503

Laparotomy and surgical exploration of bile duct and T-tube inseion


Question: duration criteria for bulimia nervosa is

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


Question: Middle meningeal aery passes through

Structures passing through foramen spinosum (MEN) -, Middle meningeal aery, Emissery vein,


Question: Deficiency of the following vitamin is most commonly seen in sho bowel syndrome ileal resection

If the distal 2/3rd of the ileum is including the ileocecal valve is resected, significant abnormalities of absorption of bike salts and Vitamin B12 may occur resulting in diarrhoea and anaemia. These abnormalities occur even though only 25% of total length of the small bowel is removed Proximal bowel resection is better tolerated than distal resection because the ileum can adapt and increase its absorptive capacity more efficiently than jejunum Ref: Sabiston 20th edition Pgno : 1171


Question: NOT a content of spermatic cord

Ilio-inguinal nerve is not a content of spermatic cord. Spermatic cord contains: Testicular aery Ductus deferens Genital branch of Genito femoral nerve. Pampiniferous plexus of veins. Remains of processus vaginalis Aery to ductus deferens

Abdominal wall ,Inguinal and Femoral region


Question: Exudative retinal detachment is seen in

Retinal detachment - Separation of neurosensory retina proper from the pigmentary epitheliumRhegmatogenous RDTractional RDExudative RDMyopia Aphakia Trauma Senile posterior vitreous detachmentPost-traumatic retraction of scar tissue Proliferative diabetic retinopathy Posthemorrhagic retinitis proliferans Retinopathy of prematurity Plastic cyclitis Sickle cell retinopathy Eales diseaseSystemic diseases - toxemia of pregnancy, renal hypeension, blood dyscrasias, PAN Ocular diseases Inflammation - VKH syndrome, sympathetic ophthalmia, posterior scleritis Vascular - central serous retinopathy, Coats disease Neoplasm - malignant melanoma of choroid, retinoblastoma Sudden hypotony of the globe(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 295-299)


Question: Number of branches of the internal carotid aery in the neck is

Unlike the external carotid aery, the internal carotid normally has no branches in the neck. Branches of the internal carotid aery Memonic: A VIP'S COMMA A: anterior choroidal aery V: Vidian aery I: inferolateral trunk P: posterior communicating aery S: superior hypophyseal aery C: caroticotympanic aery O: ophthalmic aery M: meningohypophyseal trunk M: middle cerebral aery A: anterior cerebral aery


Question: phenelezine is a type of

MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 925


Question: Intermediate filaments in epithelial cells is

Intermediate filaments are used as tumor markers Epithelial cells:keratin Muscle cells:desnin Nucleus:lamin Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:8,9,14


Question: Most common site for lymphoma in AIDS patients is

Ref Robbins 9/e p254, 8/e p529,7/e p549 Pathogenesis of CNS Involvement The pathogenesis of the neurologic manifestations in AIDS deserves special mention because, in addition to the lymphoid system, the nervous system is a major target of HIV infection. Macrophages and cells belonging to the monocyte-macrophage lineage (microglial cells) are the predominant cell types in the brain that are infected with HIV. The virus is most likely carried into the brain by infected monocytes (thus, brain HIV isolates are almost exclusively of the R5 type). The mechanism of HIV-induced damage of the brain, however, remains obscure. Because neurons are not infected by HIV, and the extent of neuro- pathologic changes is often less than might be expected from the severity of neurologic symptoms, most expes believe that the neurologic deficit is caused indirectly by viral products and soluble factors (e.g., cytokines such as TNF) produced by macrophages and microglial cells. In addition, injury from nitric oxide induced in neuronal cells by gp41 and direct damage of neurons by soluble HIV gp120 have been postulated.


Question: MCH class 3 genes encodes

Ref Robbins 9/e p194-195 Anantha Narayana 6/e p121; Harrison 17/e p2047 Class III molecules include several secreted proteins with immune functions: components of the complement system (such as C2, C4, and B factor), cytokines (such as TNF-a, LTA, and LTB), and heat shock proteins.


Question: Cavernous sinus thrombosis is due infection of

Pterygoid plexus and the facial vein form the 2 major sources which carry the infections from the danger area of face to the cavernous sinus.


Question: Consent for physical examination is given at

Medicolegal significance of various ages 7 months- bility 1 year- infanticide 10 years- kidnapping for movable propeies 12 yrs- consent for physical examination, definitely responsible for crime. 14 yrs- employment, Indian factory act 15 yrs- intercourse by husband with wife is rape. 16 yrs- kidnapping a minor boy 18 yrs- attains majority and rights of a major, age for vote, consent for major surgery 21 yrs- impoation of foreign girl for illicit intercourse, age of marriage for male attains majority under cous Guardianship. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 95


Question: Locking muscle of Knee joint is

Locking is a mechanism that allows the knee to remain in the position of full extension as in standing without much muscular effoLocking occurs as a result of medial rotation of the femur during the last stage of extension. Vastus medialis prevents lateral displacement of the patella.Reference: Chaurasia Volume II; 7th edition; Page no: 169


Question: Removal of acid drugs from the body is done by using


Question: Structures preserved in in functional neck dissection

"In contrast to a radical neck dissection, the internal jugular vein, the spinal accessory nerve, the cervical sensory nerves, and the sternocleidomastoid muscle are preserved unless they are adherent to or invaded by tumor"- Schwaz Classical Radical neck dissection - It involves the removal of following structures Cervical lymphatics and lymph nodes Internal jugular vein Accessory nerve Submandibular gland Sternomastoid muscle The main disability that follows operation is the dropping of the shoulder due to paralysis of the Trapezius muscle as a consequence of excision of accessory nerve. Modified Radical Neck dissection (Functional neck dissection) - In this operation all the lymphatics and lymph nodes are removed as in radical neck dissection. The difference is that one or more of the following structures are preserved. Accessory nerve Stemocleidomastoid muscle Internal jugular vein Ref : Love & Bailey 25/e p733

Sternocleidomastoid muscle , Internal jugular vein

Spinal accessory nerve , Submandibular salivary gland


Question: Right adrenal vein drains into

The Suprarenal veins or (Veins of Walshaw) are two in number: the right ends in the inferior vena cava. the left ends in the left renal vein. <img src=" /> ref - BDC 6e vol2 pg328


Question: Foramen Ovale in middle cranial fossa transmits

(B) Mandibular nerve # Foramen ovale;> Mnemonic:> At the base of the skull, the foramen ovale (skull) is in the greater wing of the sphenoid bone in the middle cranial fossa and transmits the mandibular division of the trigeminal nerve, otic ganglion, accessory meningeal artery, lesser petrosal nerve and emissary veins.


Question: III cranial nerve supplies

Inferior oblique is supplied by the Illrd cranial or oculomotor nerve. The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. The muscle is situated near the anterior margin of the orbit.The inferior oblique is inseed close to the superior oblique a little below and posterior to the latter. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: GLUT3 is seen in

GLUT 3 is a protein channal for facilitated diffusion of glucose it is seen in neurons


Question: Cancer cells survival is enhanced by

C is also the answer Ref Robbins 7/e p306, 274,9/e p302 Cell survival would be seen when they are prevented from apoptosis .genes that ors cells survival and protect from apoptosis are _ bcl_2 ..BCL _xl Genes that ors programmed cell death are : Bax,bad,bcl,_xl,p53


Question: Upper covering layer of cochlear duct is

Reissner's membrane - between Scala vestibuli & Scala media. Basilar membrane - between scala media & Scala tympani Tectorial membrane - covers the hair cells. Stria vascularis gives the endolymph which is ultrafiltrate of blood.


Question: Primary sinusoidal dilatation of liver is also known as

Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver. The size of the cavities usually ranges between a few millimetres and 3 cm in diameter. In the past, it was a mere histological curiosity occasionally found at autopsies, but has been increasingly recognised with wide-ranging conditions from AIDS to the use of anabolic steroids. It also occasionally affects spleen, lymph nodes, lungs, kidneys, adrenal glands, bone marrow, and other pas of gastrointestinal tract.


Question: The axillary aery is divided into three pas by

Axillary aery is the continuation of the subclan aery. It extends from the outer border of the first rib to the lower border of the teres major muscle. It continues as the brachial aery. The pectoralis minor muscle crosses it and divides it into three pas. they are - (i) First pa, superior (proximal) to the muscle. (ii) Second pa, posterior (or deep) to the muscle. (iii) Third pa, inferior (distal) to the muscle. Ref : B D Chaurasi's Human Anatomy , seventh edition , volume 1 , pg. no., 50 ( fig. 4.6 )


Question: Venous spread in carcinoma rectum reaches to the following structure

Venous invasion has been considered a poor prognostic factor in rectal cancer for over half a century. This term has evolved in recent years and now applies specifically to tumor invasion into extramural veins - extramural venous invasion. This distinction from intramural venous invasion is impoant as it is more clinically relevant. Extramural venous invasion can be identified by histopathology and MRI but until recently there has been a lack of consistency in definitions and detection techniques.


Question: Commonest presentation of primary biliary cirrhosis

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: Dermatome in the thumb and index finger region is supplied by

-Thumb C6, index finger -C7 -reference: Textbook of anatomy ,Upper limb and thorax,Vishram Singh, 2nd edition, page no.85,86


Question: Stratified squamous epithelium is seen in

Inderbir Singh's Human Histology Sixth edition Pg 25 Vagina is a fibromuscular the surrounded by non keratinised stratified squamous epithelium


Question: Parathyroid glands develop from branchial pouches

The inferior parathyroid glands develop from endoderm of the third pharyngeal pouch
The superior parathyroid glands develop from endoderm of the fourth pharyngeal pouch


Question: Baholin's gland is located in

The Baholin's glands are two pea-sized compound racemose glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina and are homologous to bulbourethral glands in males. Ref - BDC 6e vol2 pg 393


Question: Following condition is due to deposition of


Question: The trabeculae carneae is present in

In right ventricle,the interior of the inflowing pa shows trabeculae carneae or muscular ridges of 3 types. 1.Ridges or fixed elevations. 2.Bridges 3.Pillars or papillary muscles Ref:B D Chaurasia's human anatomy,vol.1.


Question: Fluconazole is more effective than itraconazole in the following systemic fungal disease

Ref-KDT 6/e p763,764 Fluconazole has maximum CNS penetration whereas itraconazole has limited entry in the brain. Therefore fluconazole is preferred over itraconazole for the treatment of cryptococcal meningitis. For all other conditions listed in the question, itraconazole is first choice drug.


Question: Suboxone is a combination of

Bupenorphine (suboxone) It has paial agonist in mu receptor; thus, it has high affinity, less efficacy, slow dissociation. Thus, they have ceiling effect and hence there is no risk of respiratory depression and less chance of abuse As this drug has an increased first pass metabolism it is not given as oral route and given as sublingual route to improve absorption But some of the patients using substance rather than using it in a sublingual route they crush the drug used it as intravenous route To avoid the abuse of drug the drug was marketed as a combination of buprenorphine and naloxone which is called suboxone. If this drug suboxone is used by sublingual route the naloxone is not absorbed and buprenorphine alone is absorbed and thus it acts as detoxification regimen If suboxone is crushed and injected as IV naloxone is rapidly absorbed and acts as an opioid antagonist and results in severe withdrawal. Thus, it has a less chance of abuse and can be prescribed without license agreement Ref.kaplon and Sadock , synopsis of psychiatry, 11 th edition, pg no.660


Question: Deep ring is situated in

INGUINAL CANAL:- Oblique intermuscular passage in the lower pa of the anterior abdominal wall.Extends from deep inguinal ring to superficial.Deep ring- oval opening in fascia transversalis. 1.25 cm above mid-inguinal point.Superficial ring: triangular gap in external oblique aponeurosis.Length: 4cmDirected downwards forwards and medially. <img src=" /> {Reference: BDC 6E vol2 pg 213}


Question: A 32 years lady present with shoulder tip pain and diagnosis is pan coast tumour and presents with miosis. Diagnosis is

Pan-coast tumor can cause compression of sympathetic ganglion resulting in Horner syndrome. These tumors are associated with Pancoast syndrome, characterized by pain, that may arise in shoulder / chest wall & characteristically radiates to ulnar surface of hand Features of Horner's syndrome: P - Ptosis M - Miosis E - Enophthalmos A- Anhidrosis L - Loss of ciliospinal reflex


Question: Trochlear and abducent nerve pass through

Optic nerve runs backwards and medially, and passes through the optic canal to enter the middle cranial fossaInferior orbital fissure transmits maxillary nerve, the zygomatic nerve etc.Infraorbital foramen transmits the infraorbital nerve and vessels


Question: Best test for esophageal varices is


Question: BIRADS stage 5 is


Question: Superficial second degree burns heal by

Superficial second degree burns usually heal with minimum scarring in 10-14 days unless they become infected. Second degree burns are divided into superficial and deep burns. Superficial dermal burns: Erythematous and painful, blanch to touch and often blister. They heal in 10-14 days. Deep dermal burns : Involve the reticular dermis appear more pale and mottled, donot blanch to touch, but remain painful to pinprick. They heal in 4-8 weeks.


Question: Parasympathetic fibres arise from the following

(D) Sacral# PREGANGLIONIC NEURONS (Craniosacral division) come from the brain or sacral region of the spinal cord. Also called the> They synapse on ganglia located near or in effector organs called terminal ganglia.> Autonomic nervous system represents the visceral component of the nervous system.> Autonomic nervous system is divided into three major parts: sympathetic, parasympathetic and enteric> Parasympathetic system is commonly referred to as having craniosacral outflow, which stands in contrast to the sympathetic nervous system, which is said to have thoracolumbar outflow.> Sympathetic trunks are two ganglionated nerve cords that extend on either side of the vertebral column from the cranial base to the coccyx.> Parasympathetic trunk emerge from the CNS only in cranial nerves III, VII, IX and X and in the second to fourth sacral spinal nerves.


Question: Period of embryo is.


Question: Organ of rosenmullar is remnant of

The epoophoron or epoophoron (also called organ of Rosenmuller or the parovarium) is a remnant of the mesonephric tubules that can be found next to the ovary and fallopian tube


Question: Ectopic mucosa of Meckel's Diveicula is diagnosed by

The 99mTc- peechnetate is preferentially taken up by the mucus secreting cells of the gastric mucosa and ectopic gastric tissue in the Diveicula. It is less accurate in adults because of reduced prevalence of ectopic gastric mucosa. The sensitivity and specificity can be improved by pentagastrin and glucagon or H2-receptor antagonists(cimetidine). Ref: schwaz's principle of surgery 10th edition Pgno : 1164


Question: Ulnar nerve root is

Root value of Ulnar Nerve - Ventral rami of C8 and T1. It also get fibres of C7 from the ventral root of median nerve. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1 , pg. no, 181 Fig Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 1 , pg. no,57 (FIG. 4.14 )


Question: Sho saphenous vein is a tributary of


Question: A positive tuberculin test is indicated by an area of induration of

In this test 0.1 ml of PPD containing 5 TU is injected intradermally on the flexor aspect of the forearm with a tuberculin syringe, raising a wheal. The site is examined48-72 hrs later and the induration of: > 10mm: positive 6-9mm : equivocal /doubtful <5mm : negative Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg: 360


Question: Left anterior descending aery is a branch of

Ascending aoa Right coronary aery Left coronary aery SA Nodal aery AV Nodal Aery Posterior Interventricular Aery (PIVA) Anterior Interventricular Aery (AIVA) OR Left anterior descending aery Circumflex Aery AIVA supplies the anterior 2/3rd of interventricular septum PIVA supplies the posterior 1/3rd of interventricular septum


Question: Massive transfusion can cause hemorrhage in a previously healthy adult due to

Complications of Massive transfusion Massive transfusion cam lead to coagulapathy and metabolic complications Most common cause of death after massive transfusion : Dilutional Coagulopathy or DIC Transfusion of 15-20 units of blood components causes Dilutional thrombocytopenia After massive transfusion initially transient hyperglycemia due to glucose in preservatives leading to insulin release and causing hypoglycemia (MC) Galvimetric method of estimation of blood loss : Blood loss during operation is measured by weighing the swabs after use & subtracting the dry weight plus volume of blood collected in suction or drainage Metabolic complications of Massive transfusion General Fluid overload Hypothermia Impaired oxygen delivery capacity of Hb (decreased 2,3-DPG). Electrolyte Hyperkalemia Hypocalcemia Hypomagnesemia Metabolic alkalosis Metabolic acidosis (rare) Ref: Harrison's 19th edition Pgno :138


Question: Most common malignancy after cholecystectomy is of

Bile acids can induce hyperproliferation of the intestinal mucosa a number of intracellular mechanisms Cholecystectomy, which alters the enterohepatic cycle of bile acids, has been associated with a moderately increased rise of proximal colon cancers It cannot be ruled out, however, that it is less the effect of the cholecystectomy than the impact of other, not yet identified factors in the lithogenic bile of such patients A number of cofactors have been identified that may enhance or neutralize the carcinogenic effects of bile acids, e.g., the amount of dietary fat, fibre or calcium Calcium, in fact, binds bile acids and this may reduce their negative impact Ref: Maingot 11th edition Pgno : 628


Question: Placenta develops from

Development of placenta: - Placenta has two components : Maternal & Fetal When the blastocyst attaches to uterus in endometrium, the endometrium is called as decidua which is of three types: - Decidua basalis , Decidua capsularis & Decidua parietalis. Fetus will also have some chorionic membrane developing leading to villi formation : Chorion Frondosum & Chorion laeve. Chorion laeve will disappear. Chorionic Frondosum persists & contributes to placenta along with Decidua Basalis .

Decidua capsularis and Chorion frondosum

Decidua parietalis and Chorion frondosum


Question: The kinetic energy of the body is least in one of the following phases of the walking cycle

B. i.e. Mid stance phaseSpeed & so the kinetic energy is maximum in double suppo phase (i.e. heel strike, foot flat, toe flat) & minimum in single suppo phase (i.e. midstance, mid swing, heel off).


Question: Caplan syndrome is seen in

Ref Harrison 17th/1625 Caplan syndrome is a combination of rheumatoid ahritis and pneumoconiosis that manifests as intrapulmonary nodules which appears homogeneous and well defined on chest X ray... It is also called as rheumatoid pneumoconiosis


Question: Boundary of triangle of auscultation is not formed by

Triangle of auscultation is a small triangular interval on the back of thorax bounded by: medially - lateral border of trapezoid laterally -medial border of scapula inferiorly - upper border of latissimus dorsi. The floor- 6th & 7th rib, 6th intercoastal space , rhomboid major. B D Chaurasia 7th edition Page no : 67 Figure 5.6,page no: 63 - Textbook of anatomy- upper limb & thorax - vishram singh


Question: Raji cell assays are used to quantitate

Ref Robbins 9/e p207 The Raji cell assay is an in vitro method for detecting complement fixing immune complexes in serum samples. The Raji cell is a lymphoblastoid cell with B-cell characteristics derived from a Burkitt's lymphoma cell line. It has low affinity Fc receptors for binding immunoglobulin and high affinity receptors for binding complement


Question: Surface anatomy for internal jugular vein

Internal jugular vein is marked by a broad line by joining these two points: a.The first point on the neck medial to the lobule of the ear b.The second point at the medial end of the clavicle. <img src=" /> Ref.BDC volume 3,sixth edition pg 303


Question: A new drug is found to be highly lipid soluble. It is metabolism it is lower rate of 10% Per hour. On intravenous injection in produced general anaesthesia that lasts only for 15 minutes. The sho duration of anaesthesia is due to

Ref-KDT 6/e p19 Highly lipid soluble drugs like thiopentone are quickly distributed to the tissue having high blood supply (like brain). If the target organ is also having high blood supply, drug action will be very quick. This is the case with general anaesthetics like thiopentone. Now, the drug will be distributed to less vascular tissues like fat and muscle. Movement of the drug outside the brain results in the termination of its action. This is called redistribution.


Question: Most common indication for liver transplantation in children is

Indication for liver transplantation in children Biliary atresia ( most common) Neonatal hepatitis Congenital hepatic fibrosis Alagille's syndrome Byler's disease Alpha-1 Antitrypsin deficiency Ref: Sabiston 20th edition Pgno : 637-638


Question: Aery forming anastomosis around surgical neck humerus

Anterior Circumflex humeral aery and posterior Circumflex humeral aery are branches from 3rd pa of axillary aery . These two anastomose around the surgical neck of humerus . Posterior Circumflex humeral aery runs along with axillary nerve and passes through the quadrangular intermuscular space . B D Chaurasia 7th edition Page no : 53


Question: Oblique cord is the modification of

After bih, the proximal pas of the flexor digitorum profundus and flexor pollicis Longus FPL muscles were likely replaced by collagenous tissues, providing a specific type of intermuscular septum i.e., the oblique cord. Reference: Vishram Singh Anatomy; 2nd edition; Page no: 134


Question: the mitochondrial enzyme involved in the metabolism of clopidorgel and proton pump inhibitors is

clopidogrel and proton pump inhibitors are metabolized mainly by CYP2C19 and CYP3A4.Due to this reaason there is potential of interaction between two drugs. Ref-katzung 13/e p80


Question: Basal layer of cell in stratified squamous epithelium is


Question: Carpal tunnel syndrome involves

CARPAL TUNNEL SYNDROME:-

Injury to median nerve in carpal tunnel.

Causes:-
Tenosynovitis of flexor tendons.
Myxedema
Retention of fluid in pregnancy
Fracture dislocation of lunate bone.
Osteoarthritis of wrist.
Symptoms:-
1. Feeling of burning pain or " pins & needles " along lateral 3 and half digits especially at night.
2. Weakness of thenar muscles.
3. No sensory loss over thenar eminence.
4. Ape thumb deformity if left untreated.
5. Positive phalens and tinel's sign.
Phalen's sign-flexion of both wrists against each other for one minute reproduces the symptoms.
Tinel's sign- percussion over flexor retinaculum reproduces symptoms.


Question: Clinical features of Choledochal cyst in adult are

Choledochal cyst Cystic dilation of the biliary ducts, more common in females Clinical features. Classical triad : Pain, jaundice (intermittent) & abdominal mass(10%). Most common symptom in infants : Jaundice (in 80%) Most common symptom in patients >2 years of age : Abdominal pain. In children, the major clinical symptoms are recurrent abdominal pain (81.8%), nausea & vomiting (65.5%), mild jaundice (43.6%), an abdominal mass (29%), and fever (29%) In adults, abdominal pain (87%), and jaundice (42%), and present frequently. Less common clinical findings include nausea (29%), cholangitis (26%), pancreatitis (23%), and an abdominal mass(13%) Ref: Sabiston 20th edition Pgno :1511


Question: Millenium Development Goal related to maternal health is

Ref:Park's Textbook of Preventive and Social Medicine 25th Ed


Question: Ulipristal acetate is used for

This drug is a SPRM (selective progesterone receptor modulator). It is used for emergency contraception and is the only hormonal contraception that is effective for 120 hrs. It is contraindicated in hepatic disorder and in lactational mothers. For emergency contraception. a 30 mg tablet is used within 120 hours (5 days) after an unprotected intercourse or contraceptive failure. It has been shown to prevent about 60% of expected pregnancies, and prevents more pregnancies than emergency contraception with levonorgestrel. Ulipristal acetate is used for pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age in a daily dose of a 5 mg tablet.


Question: Nerve supply of Stapedius is

(D) 7th Cranial Nerve # The stapedius lies in a bony canal that is related to the posterior wall of the middle ear.> Stapedius is supplied by the facial nerve (VII CN).> It develops from the mesoderm of the second branchial arch.> The stapedius lies in a bony canal that is related to the posterior wall of the middle ear.> The stapedius is supplied by the facial nerve. It develops from the mesoderm of the second branchial arch.# BRANCHES OF THE FACIAL NERVE ARE:> Inside the internal acoustic meatus: Greater petrosal nerve - provides parasympathetic innervation to lacrimal gland, sphenoid sinus, frontal sinus, maxillary sinus, ethmoid sinus, nasal cavity, as well as special sensory taste fibers to the palate via the Vidian nerve. Nerve to stapedius - provides motor innervation for stapedius muscle in middle ear Chorda tympani - innervation to submandibular gland and sublingual gland and special sensory taste fibers for the anterior 2/3 of the tongue. Branch to the tympanic plexus> Outside skull (distal to stylomastoid foramen): Posterior auricular nerve - controls movements of some of the scalp muscles around the ear Branch to Posterior belly of Digastric and Stylohyoid muscle# Five major facial branches (in parotid gland) - from top to bottom:1. Temporal (frontal) branch of the facial nerve; 2. Zygomatic branch of the facial nerve; 3. Buccal branch of the facial nerve; 4. Marginal mandibular branch of the facial nerve; 5. Cervical branch of the facial nerve


Question: The root value of axillary nerve is

axillary nerve also known as circumflex nerve - The axillary nerve is a branch of the posterior cord of the brachial plexus and the root value is C5 , C6. Axillary or circumflex nerve is an impoant nerve because it supplies the deltoid muscle which is the main abductor of the arm. Ref : B D Chaurasia's Human Anatomy , Seventh edition, volume 1 , pg. no, 75.


Question: Caranial nerve passing through foramen ovale includes

structures passing through foramen ovale: Mandibular nerve Accessory meningeal aery Lesser petrosal nerve Emissary vein connecting cavernous sinus with pterygoid plexus. Ref BDC volume 3; 6th edition pg 56


Question: Direct opening in the right atrium with

All veins of hea except the anterior cardiac veins and the venae cordis minimi drain into the coronary sinus which opens into the right atrium.The anterior cardiac veins and the venae cordis minimi open directly into the right atrium. BD CHAURASIA'S HUMAN ANATOMY .VOLUME 1.FIFTH EDITION.Page no-254


Question: Receptor seen in this region is

Receptor Location Function 1. Meissner Dermo-epidermal junction Rapidly adapting two- point discrimination 2. Pacinian corpuscle Deeper dermis Rapidly adapting pressure & vibration 3. Ruffini Deeper dermis Slowly adapting 4. Merkel disc Basal layer of epidermis Slowly adapting light touch sensation. Reading braille - Meisner corpuscle >> Merkel disc Since the location is DE JUNCTION so the answer is Meissner corpuscle

Cailage,cell junction,lymphoid and integumentary system


Question: Hunterian perforator is at

Ref: BD Chaurasia Human Anatomy vol 2 pg 125,127.


Question: Multifocal non suppurative osteomyelitis is seen in

SAPHO syndrome : synovitis, acne, pustulosis, palmo- plantar, hyperostosis and osteitis ref : maheswari 9th ed


Question: The epiglottis is derived from

The caudal pa of the hypobranchial eminence forms the epiglottis . HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:213


Question: Blood supply of facial nerve


Question: Most common complication of whipple's procedure is

Morbidity following pancreaticoduodenectomy Delayed gastric emptying (18%) Pancreas fistula (12%) Wound infection (7%) Intra abdominal abscess (6%) Cardiac events (3%) Bile leak (2%) Overall reoperation (3%) Ref: Sabiston 20th edition Pgno :1548


Question: A 25 year old male was hospitalized with liver cyst due to Echinococcus granulosis.he refused to undergo surgery for removal of cyst.therefore, albendazole was used at high dose for 3months .this patient should be monitored for the toxicity to

Ref-Katzung 10/869 Albendazole is used furlong X at high dose can lead to hepatotoxicity


Question: Schizophrenia with worst prognosis

Order of prognosis from good to bad, catatonic->paranoid->undifferentiated->hebephrenic->simple


Question: for diagnosis of bulimia nervosa duration criteria is binge eating once a week for

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


Question: Aery/ aeries supplying occipital coex is


Question: During cranial nerve examination, a neurologist asks her 33 year old patient to protrude his tongue. On doing so, her tongue detes to the right side. This finding results from paralysis of tongue muscle namely


Question: In infant, bone marrow biopsy is done from


Question: Exposure treatment in burns is done for

There are two methods of management of the burn wound with a topical antibacterial agent Exposure therapy no dressings are applied over the wound after application of the agent. advantages are that bacterial growth is not enhanced as may be the case under a closed dressing, and the wound remains visible and readily accessible. disadvantages are increased pain and heat loss as a result of the exposed wound and an increased risk of cross-contamination. Closed method an occlusive dressing is applied over the agent and is changed twice daily. the disadvantage is the potential increase in bacterial growth if the dressing is not changed twice daily. advantages are less pain, less heat loss, and less cross-contamination. The closed method is generally preferred except for face and head where the exposure method is preferred Ref - Bailey & Love 23/e p194


Question: Most common site for hyperophic keloid scar

Keloids - It is a scar which shows extreme overgrowth so that scar tissues grows beyond the limits of original wounds and shows no tendency to resolve. Keloids grow on paicular sites, these are - Central chests (probably most common, not sure) Back Shoulder Earlobes Other points about Keloids & hyperophic scars Hyperophic scars (HTS) and keloids represent an overabundance of fibroplasia in the dermal healing process. They are both characterized by excessive collagen deposition versus collagen degradation. HTS rise above the skin level but stay within the confines of the original wound and often regress over time. Keloids are defined as scars that grow beyond the border of the original wound and rarely regress spontaneously. Both HTS and keloids occur after trauma to the skin, and may be tender, pruritic, and cause a burning sensation. Keloids are more prevalent among dark pigmented ethnicitics (i.e. Africans, Asians & Hispanics) HTS usually develop within 4 weeks after trauma Keloids tend to occur 3 months to years after the trauma. Ref : Bailey & Love 25/e p30


Question: Vomiting with coffee brown vomitus is seen in

Fulminant poisoning by oxalic acid If the person is consumes large doses ie more than 20gm or more, death may occur due to circulatory collapse. There will be sour bitter taste in the mouth, a sense of constriction in the throat, epigastric pain and abdominal pain. The person will have nausea, eructation and vomiting with coffee brown vomitus. There may be severe thirst and abdomen will be tender. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 412


Question: spinal nerve is related to

The anterior primary ramus of C1 joins with hypoglossal nerve, which distributes the motor fibres to the geniohyoid and thyroid muscles. C1 is the first spinal nerve which is unique in that it contains only motor fibres.


Question: Nasion lies at the junction of

The nasion is the point where the internasal and frontonasal sutures meet. It lies a little above the floor of the depression at the root of the nose, below the glabella. Nasion is termed as the central point of the frontonasal suture. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.


Question: Least mobile metatarsal of foot

2nd metatarsal is longest and least mobile among all metatarsals, hence more prone for March fracture


Question: The cranial nerve passing through Dorello canal is

At petrous apex, the abducent nerve takes a sharp turn to pass through Dorello's canal beneath petrosphenoidal ligament.


Question: In leucine zipper model, Leucine residue seen after every

An a helix in which there is a periodic repeat of leucine residues at every seventh position. This occurs for eight helical turns and four leucine repeats. Similar structures have been found in a number of other proteins associated with the regulation of transcription in mammalian and yeast cells. (shown in the table below) It is thought that this structure allows two identical monomers or heterodimers (eg, Fos-Jun or Jun-Jun) to "zip together" in a coiled-coil and form a tight dimeric complex This protein-protein interaction may serve to enhance the association of the separate DNA binding domains with their target


Question: Most common cause of empyema is

Empyema thoracic is collection of pus in pleural space and is synonymous with grossly purulent exudative parapneumonic effusions. Ref Harrison 19th edition pg 951


Question: Brachiocephalic vein is formed by

Internal jugular vein and suclavicular vein.

External jugular vein and suclavicular vein.

Internal jugular vein and retromandibular vein.

External jugular vein and retromandibular vein.


Question: After an incised wound ,new collagen fibrils are seen along with a thick layer of growing epithelium.The approximate age of the wound is

Ref Robbins 9/e p106 Incised wound for the formation of collagen and new tissue, thick layer of epithelial ,and granulation tissue formation along with new blood vessels requires atleast 4_5 days


Question: The segmental division of liver into eight segments is based on

Right hepatic vein divides the right lobe into anterior (V VIII) and posterior segments ( VI-VII) Middle hepatic vein divides the liver into right and left lobes. This plane runs from the inferior vena cava to the gallbladder fossa. The Falciform ligament divides the left lobe into a medial- segment IV and a lateral pa - segment II and III. The poal vein divides the liver into upper and lower segments. The left and right poal veins branch superiorly and inferiorly to project into the center of each segment. ref - researchgate.net


Question: Forelimb bud appears on

(26 days) (135-IBS 7th) (125-1.B.Singh 8th)Timetable of some events* The forelimb bud appears about the 26th day (end of 4th week)* The hind limb bud appears about the 28th dayThe limbs become paddle shaped after about 4 days (5th week) and grooves between the future digits (digital rays) can be seen by the 36 the day (6th week). By the 50 th day or so (8th week) the elbows and knees are established and the fingers and toes are free. Rotation of limbs occurs during the 7th week. Cartilaginous models of bones start forming in the 6th week. And primary centres of ossification are seen in many bones in the 8th week. They are present in all long bones by the 12th week* The extremities are most susceptible to teratogens during the 4th to 7th week and slightly less susceptible in the 8th week


Question: Tongue is protrude by

(Genioglossus) (252-BDC-3- 4th edition)Action of Extrinsic muscle of TongueGENIOGLOSSUSDraws the tongue forward and protrude the tip so that it points to the opposite side. The two muscle acting in union protrude the tongue in the midlineHYOGLOSSUSIt depresses the tongue** makes the dorsum convex and helps in retracting the protruded tongueSTYLOGLOSSUSDuring swallowing it pulls the tongue upwards and backwardsPALATOGLOSSUSPulls up root of the tongue and approximates the palatoglossal arches and thus closes oropharyngeal isthmus* Safety muscle of tongue is - Genioglossus* Ipsilateral deviation of tongue is due to unaltered action of - Genioglssus* Palsy of right genioglossus causes- devition of tongue to right**** All the intrinsic and extrinsic muscles EXCEPT THE PALATOGLOSSUS** are supplied by cranial part of accessory nerve through the pharyngeal plexusImportant Points1. Tip of the tongue drain into submental lymph nodes*2. Anterior 2/3 of the tongue drain into submandibular lymph node and posterior 1/3 of the tongue drain into Jugulo omohyoid (Lymph node of the tongue)3. Anterior 2/3 of tongue developed from first branchial arch*. Therefore it is supplied by lingual nerve** and chorda tympani4. Posterior 1/3 of tongue develops third branchial arch** therefore it is supplied by glossopharyngeal nerve**5. Posterior most part from the fourth arch: therefore supplied by the Vagus nerve6. Circumvallate papillae are innervated by Glossopharyngeal nerve**7. Circumvallate papillae- are situated on the mucous membrane just anterior to the sulcus terminalis an therefore their taste buds are innervated by ninth cranial nerve***8. Unilateral injury to hypoglossal nerve leads to(I) Hemiatrophy of involved side *(II) Deviation of tongue towards the same side *(III) Fasciculation of tongue *9. Intrinsic muscles of the tongue are derived from occipital somites


Question: Trendelenburg sign is due to paralysis of

TRENDELENBURG SIGN:- Normally,when the body weight is suppoed on one limb,the glutei of the suppoed side raise the opposite and unsuppoed side of the pelvis. However,if the abductor mechanism is defective,the unsuppoed side of the pelvis drops- Trendelenburg sign +ve. Sign is positive in defects of power- paralysis of the glutei medius and minimus ( supplied by superior gluteal nerve) ,defects of the fulcrum (congenital or pathological dislocation of hip),defects of weight. {Reference : BDC 6E pg no.70}


Question: One unit of fresh blood raises Hb% ( Hemoglobin concentration ) by

Single unit of whole blood raises Hb by 1 gm% and Hematocrit by 3% More than 70% of transfused cells will be ble after 24 hours Ref: Harrison's 19th edition Pgno :138


Question: Implantation occurs at

HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:72In humans implantation begins on the 6th day after feilization


Question: The veins of the pericardium drain into

The veins of pericardium drains into svc, pierced anteriorly . Ref - BDC 6th edition vol 1 pg 272


Question: Grade 1 Lymphedema means


Question: The difference between hyosine and atropine is that hyosine

Ref-KDT 6/e p109 Hyoscine is a CNS depression and can be caused as truth to serum (to induce twilight sleep). Atropine at low dose stimulates the brain whereas inhibiting it a very high concentration

Exes depression affect on the CNS it relative low doses

Exes more potent effects on the hea than on the eye

Hi sweetie kar anti motion sickness activity


Question: Strain used for Melanin is

Ref histopathology p150 Other stains for Melanin are schmorl's method and enzyme histochemical method called DOPA oxidase


Question: Erb's point is formed by

Erb's point is formed by the C5 and C6 root, anterior and posterior divisions of upper trunk, subscapular nerve and nerve to subclavius. Injury to upper trunk causes Erb's paralysis. B D Chaurasia 7th edition Page no: 59


Question: Function of lumbricals area) Flexion at MCP jointb) Extension at IP jointsc) Adduction of the fingersd) Abduction of the fingers

Lumbricals :

Flexion - Metacarpophalangeal joints.
Extension - Interphalangeal joints.


Question: Most common site of metastases in case of Osteosarcoma DELETE

Almost 10 percnt of have metastases at presentation Metastases is most common to lungs, but Hematogenous spread to other organs is also possible -including lymph nodes, brain, skeleton Refer Apleys 9th/e p 207


Question: Obturator nerve arises from

(Ventral rami of L2 L3 L4) (171, 320-BDC-2 4th)OBTURATOR NERVE - is a branch of lumbar plexus, it arises from ventral division of L2 L3 L4 segments of spinal cords.Branches of obturator nerve : Anterior divisionPosterior divisionMuscularPectineus, adductor longus, adductor brevis, gracilisObturator extemus, adductor magnus (adductor part)ArticularHip jointKnee jointVascular and cutaneousFemoral artery, Medial side of thighPopliteal arteryBranches of the lumbar plexus1. Iliohypogastric nerve (L1)2. Ilioinguinal nerve (L1)3. Genitofemoral nerve (L1, L2 ventral divisions)4. Obturator nerve (L2, L3 L4 ventral division)5. Lumbosacral trunk (L4, L5 ventral rami)6. Lateral cutaneous nerve of the thigh (L2 L3 dorsal division)7. Femoral nerve (L2, L3 L4 dorsal divisions)


Question: Klumpke's paralysis involved

(C8, T1) (53-BDC-l 4th)ERB'S PARALYSISKLUMPKE'S PARALYSISSite of Injury - The region of the upper trunk of the brachial plexus is called Erb's point, six nerves meet here. Injury to the upper trunk causes Erb's paralysis.Lower trunk of brachial plexusCause of injury - Undue seperation of the head from the shoulder, which is commonly encountered in (i) birth injury (ii) fall on the shoulder (iii) during anaesthesiaUndue abduction of the arm, as in clutching something with the hands after a fall from a height or sometimes in birth injuryNerve root involved - Mainly C5 and partly C6Mainly T1 and partly C8Muscle paralysed - Mainly biceps, deltoid, brachialis, and brachioradialis. Partly supraspinatus, infraspinatus and supinatorDeformity - (position of the limb)Arm: Hangs by the side: It is adducted and medially rotated.Forearm: Extended and pronatedThe deformity is known as "policeman's tip" or "porter *s tip hand'1. Intrinsic muscles of the hand (Tl)2. Ulnar flexors of the wrist and fingers (C8)Claw hand* due to the unopposed action of the longflexors and extensors of the fingers.(Hyperextension at the MCP joint and flexion at the IP joint)Disability: The following movements are lost1. Abduction and lateral rotation of the arm (shoulder)2. Flexion and supination of the forearm3. Biceps and supinator of the forearm4. Sensation are lost over a small area over the lower part of the deltoid1. Claw hand2. Cutaneous anaesthesia and analgesia in a narrow zone along the ulnar border of the forearm and hand3. Homer's syndrome (This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T14. Vasomotor changes5. Trophic changes


Question: The toughest layer of the esophagus is the

C i.e. Muscularis Muscularis externa is the toughest layer of esophagusQ; upper 1/3rd is composed of skeletal muscleQ, lower 1/3rd is composed of smooth muscleQ & the middle third is made up of both types of muscle.


Question: Median survival in carcinoma pancreas after surgery and adjuvant therapy

After surgical resection and adjuvant therapy for pancreatic cancer, the Median survival is approximately 22 months, with 5 year survival of 15% to 20%. Most patients experience relapse of disease in the form of metastatic disease (85%) and less commonly, local recurrence (40%). In the absence of surgical resection, those with locally advanced disease who receive palliative chemotherapy may survive 10 to 12 months, whereas those with metastases rarely survive beyond 6 months Ref: Sabiston 20th edition Pgno :1547


Question: Common facial vein drains into

Key concept:
The superﬁcial temporal vein descends in front of the tragus, enters the parotid gland, and joins the maxillary vein to form the retromandibular vein. The anterior division of the retromandibular vein unites with the facial vein to form the common facial vein which drains into the internal jugular vein.


Question: Bronchopulmonary segments in right and left lungs are

THE BRONCHOPULMONARY SEGMENTS - These are well-defined sectors of the lung, each one of which is aerated by a teiary or segmental bronchus. Each segment is pyramidal in shape with its apex directed towards the root of the lung. There are 10 segments on the right side and 10 on the left Ref : B D Chaurasia's Human Anatomy, seventh edition, volume 1 , pg. no. 251 ( table 16.3 )


Question: Medullary carcinoma of thyroid is associated with mutation in

Ref Robbins 8/e p1124_1126,9/e p284 Medullary thyroid cancer is a form of thyroid carcinoma which originates from the parafollicular cells (C cells), which produce the hormone calcitonin. Medullary tumors are the third most common of all thyroid cancers and together make up about 3% of all thyroid cancer cases.[2 Approximately 25% of medullary thyroid cancer cases are genetic in nature, caused by a mutation in the RET proto-oncogene. This form is identified as familial medullary thyroid cancer (FMTC). When MTC occurs by itself it is termed sporadic medullary thyroid cancer (SMTC). When it coexists with tumors of the parathyroid gland and medullary component of the adrenal glands (pheochromocytoma) it is called multiple endocrine neoplasia type 2


Question: The gold standard test for insulinoma

"The most reliable test to diagnose insulinoma is a fast up to 72 h with serum glucose, C-peptide, and insulin measurements every 4-8 h." --Harrison An insulinoma is an endocrine tumor of the pancreas derived from beta cells that ectopically secretes insulin, which results in hypoglycemia. The clinical symptoms are because of the effects of hypoglycaemia (sweating, tremor, palpitations, confusion, headache, disorientation, visual difficulties, irrational behaviour, or even coma) The diagnosis of insulinoma requires the demonstration of an elevated plasma insulin level at the time of hypoglycemia. This is because insulinomas do not reduce the secretion of insulin in the presence of hypoglycaemia. Whereas in a normal person, insulin levels would decrease with a decrease in blood glucose levels. The most reliable test to diagnose insulinoma is a fast up to 72 h with serum glucose, and insulin measurements every 4-8 h. The test is terminated if the patient becomes symptomatic or glucose levels are <40 mg/dL (2.2 mmol/L). Diagnosis of insulinoma is made if: A serum insulin level of 6 microunit/mL or more in the presence of blood glucose values below 40 mg/dL the ratio of plasma insulin to glucose is > 0.3 In addition to the above criteria, some other measurements are also required before making the diagnosis of insulinoma C-peptide level serum proinsulin level, serum sulfonylurea levels These additional tests are used because any hidden use of insulin or oral hypoglycemics taken by the patient would resemble insulinoma causing high levels of insulin in presence of hypoglycaemia. The combination of elevated proinsulin levels (normal in exogenous insulin/hypoglycemic agent users), elevated C-peptide levels (low in exogenous insulin users), antibodies to insulin (positive in exogenous insulin users), and measurement of sulfonylurea levels in serum or plasma will allow the correct diagnosis to be made. Ref : Harrison 17/e p2354


Question: Most common congenital anomaly of kidney

Congenital anomalies of kidney and urinary tract is phenotypically variable and can affect the kidney(s) alone and/or the lower urinary tract. The spectrum includes more common anomalies such as vesicoureteral reflux and, rarely, more severe malformations such as bilateral renal agenesis. ref - researchgate.net


Question: Antibody found in myositis


Question: Kappa toxin released by clostridium perfringens is responsible for

Exotoxins produces by C. Perfringens *Alpha toxin(lecithinase) - detroys RBC& WBC *phi toxin- myocardial depression *kappa toxin-destruction of connective tissue and blood vessels Ref:Bailey and love 27th edition Pg no :420

Destruction of connective tissue and blood vessels


Question: Postprandial hyperglycemia may be controlled by

(Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 380-383)


Question: Klumpkey&;s paralysis affect

KLUMPKEY'S PARALYSIS:- Lower plexus injury.Caused by undue abduction of the arm as in clutching something with hand after a fall from a height, or sometimes in bih injury. NERVE ROOTS INVOLVED: C8 and T1 nerve roots involved. MUSCLES PARALYSED: Intrinsic muscles of the hand{T1} Ulnar flexors of the wrist and fingers. DEFORMITY AND POSITION OF THE HAND: Claw hand due to the unopposed action of the long flexors and extensors of the fingers. In a claw hand, there is hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints. DISABILITY: Biceps and supinator jerks are lost complete claw hand cutaneous anesthesia and analgesia in a narrow zone along the ulnar border of the forearm and hand. HORNER.S SYNDROME: If T1 is injured proximal to white ramus communicans to the first thoracic sympathetic ganglion, there is ptosis, miosis, anhydrosis, enophthalmos, and loss of ciliospinal reflex may be associated. this is because of injury to sympathetic fibers to the head and neck that leave the spinal cord through nerve T1. VASOMOTOR CHANGES: The skin area with sensory loss is warmer due to aeriolar dilatation. It is also drier due to the absence of sweating as there is loss of sympathetic activity. TROPHIC CHANGES: Longstanding cases of paralysis leads to dry and scaly skin. The nails crack easily with atrophy of the pulp of fingers.


Question: Potassium is absorbed in the jejunum by

As with other substrates, the net movement of K+ across the intestinal mucosa is determined by the difference between two opposing unidirectional fluxes; compared to sodium fluxes, potassium fluxes are small. Net movement of K+ in jejunum and ileum occurs only down the electrochemical gradient (i.e., it is largely passive). Potassium diffuses primarily through the lateral spaces and tight junctions. In the colon potassium is usually secreted, and the luminal concentration must be above 25 mEq/L for net absorption to take place. This explains why potassium deficiency tends to develop in diarrhoea. Potassium secretion by the colon appears to be a passive process


Question: mood stabilzer used in the management of trigeminal neuralgia is

Carbamazepine - USES - TRIGEMINAL NEURALGIA - TEMPORAL LOBE EPILEPSY - SECOND LINE MOOD STABILIZER Ref.Kaplon and Sadock, synopsis of psychitry, 11 th edition, pg no.935


Question: Compartment devoid of neurovascular bundle

Posterior superficial compartment of leg is devoid of neurovascular bundle


Question: Superficial incision on posterior triangle of neck lead to

The posterior triangle or the side of the neck contains the accessory nerve, external jugular vein, the cervical plexus and proximal pas of the brachial plexus of nerves supplying the upper limb. Injury to the spinal accessory nerve not only results in debilitating trapezius dysfunction, but can also result in chronic pain and debilitation with prolonged shoulder girdle dysfunction.90 It usually presents after diagnostic lymph node biopsies of the posterior triangle of the neck, with an incidence of 3% to 8%. <img src=" /> Ref - sciencedirect.com

Difficulty in rotation of face towards the same side


Question: Left sided superior vena cava drains into

Persistent left superior vena cava (PLSVC) is the most common variation of the thoracic venous system left sided svc drains into right atrium coronary sinus . <img src=" /> Image ref - researchate.net


Question: Poo systemic shunt is not seen in


Question: Intermediate filaments in muscle cells

Intermediate filaments are used as tumor markers Epithelial cells:keratin Muscle cells:desnin Nucleus:lamin Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:8,9,14


Question: Sympathetic root of otic ganglion

ROOTS OF OTIC GANGLION: Sensory root is by auriculotemporal nerve Sympathetic root is by sympathetic plexus around middle meningeal aery Secretomotor root is by lesser petrosal nerve from tympanic plexus formed by tympanic branch of cranial nerve IX Motor root is by a branch from nerve to medial pterygoid Ref BDC volume 3,sixth edition pg 311


Question: Roots involved in Erb&;s palsy are

Erb's point: one region of the upper trunk of the brachial plexuses is called Erb's point. Six nerves meet here. Injury to the upper trunk causes Erb's paralysis. CAUSES: undue separation of the head from the shoulder, which is common in -Bih injury Fall on the shoulder During anaesthesia Nerve roots involved C5, C6, Suprascapular nerve, nerve to subclavius, anterior division, posterior division. DEFORMITY AND POSITION OF THE LIMB: ARM: Hangs by the side, it is adducted and medially rotated. FOREARM: Extended and pronated. DISABILITY: The following movements are lost Abduction and lateral rotation of the arm at the shoulder joint. flexion and supination of the forearm. Biceps and supinator jerks are lost. sensations are lost over a small area over the lower pa of the deltoid. REF: BD Chaurasia 7th edition Page no: 59 Figure: 4.15, page no: 59 - BD Chaurasia- upper limb & thorax, 7 the edition


Question: deja vu means

deja vu=== feeling of familiarity to a novel stimulus jamais vu==feeling of unfamiliarity to a familiar stimulus ref. Kaplon and sadock, synopsis of psychiatry, 11th edition, pg no.194

Illusion that what one is hearing, one has heard previously

A unfamiliar thought regarded as repetition of a previous thought

Unfamiliar situations or events feel strangely familiar

Feeling of strangeness to familiar situation


Question: Majority of the afferent blood supply to liver is from

Ans d): Portal veinThe liver is the largest gland in the body Its three basic functions are:* bile production & secretion* metabolism of fat, carbohydrate & protein* Blood filtration (removal of bacteria & foreign particles gained en trance from intestine)It has dual supplyHepatic artery - oxygenated blood - 30%Portal vein - venous blood rich in products of digestion -70%.


Question: Hematuria with dysmorphia RBC 's are seen in

Ref Robbins 9/e p898 The onset of the kidney disease tends to be abrupt, her- alded by malaise, a slight fever, nausea, and the nephritic syndrome. In the usual case, oliguria, azotemia, and hyper- tension are only mild to moderate. Characteristically, there is gross hematuria, the urine appearing smoky brown rather than bright red. Some degree of proteinuria is a constant feature of the disease, and as mentioned earlier it occasionally may be severe enough to produce the nephrotic syndrome. Serum complement levels are low during the active phase of the disease, and serum anti-streptolysin O antibody titers are elevated in poststreptococcal cases. Dysmorphia of RBC is also seen


Question: Middle path regimen is used in the treatment of

Middle path regimen is used in the treatment of SPINAL TB. 1)Drugs (ATT) 2)Surgery: INDICATIONS: 1)Defaulter 2)Relapses 3)Resistance 4)Compression over vital structure. Surgery done is amterolateral decompression with coical rib/fibular stut grafting.


Question: Cremasteric aery is a branch of

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


Question: Cells are most radiosensitive in

Ref Robbins9/e p140 Cells are most radiosensitive in G2M interphase Cells are least radioactive in Sphase


Question: Mitral stenosis is associated with

Ref Harrison 19 th ed pg 1540 MS and sinus rhythm, the P wave usually suggests LA enlargement ). It may become tall and peaked in lead II and upright in lead V1 when severe pulmonary hypeension or TS complicates MS and right atrial (RA) enlargement occurs. The QRS complex is usually normal


Question: Maintenence level of Mixed venous oxygen saturation in shock must be

Mixed venous oxygen saturation The percentage saturation of oxygen returning to the hea from the body is a measure of the oxygen delivery and extraction by the tissues. Accurate measurements is analysis of blood drawn from a long central line placed in the right atrium Normal mixed venous oxygen saturation levels are 50-70%. Levels below 50% indicate inadequate oxygen delivery and increased oxygen extraction by the cells. This is consistent with hypovolemic or cardiogenic shock. Ref: Bailey and love 27th edition Pgno: 17


Question: Pudendal nerve supplying motor pa to external sphincter is derived from

The striated sphincter is innervated by the pudendal nerve from the S2 - S3 nerve roots. The neurons that innervate the urethral sphincter originate in the cord, in an area termed Onuf&;s nucleus. The autonomic nervous system also controls the IUS muscle because it is made of smooth muscle fibers.


Question: "Raindrop skull" is seen in


Question: Sirolimus is more likely than cyclosporine to cause

Clyclosporine and tacrolimus cause nephrotoxicity as an adverse effect. Sirolimus results in bone marrow suppression and thus may cause anemia ,thrombocytopenia and leukopenia


Question: CECT with nodular enhancement is suggestive of

Most common benign tumor of the liver Mainly seen in women of 45 years Small capillary hemangiomas(no clinical significance), larger cavernous hemangioma Usually single and <5 cm in diameter, occur equally in right and left liver Giant hemangioma: lesion>5cm Pathology Microscopically: Endothelium-lines, blood filled spaces that are seperated by thin, fibrous septa Enlargement of hemangiomas are by ectasia rather than neoplasia Clinical features Most commonly asymptomatic and incidentally found on imaging studies Large compressive masses may cause vague upper abdominal symptoms Kasabach-Merritt syndrome; syndrome of thrombocytopenia and consumptive coagulapathy Rarely seen LFT's and tumor markers are normal Diagnosis Diagnosis is made radiologically CT and MRI are diagnostic if a typical peripheral nodular enhancement pattern is seen Percutaneous biopsy is potentially dangerous and inaccurate not recommended Treatment Observation for asymptomatic cases Enucleation with inflow control is TOC for symptomatic cases Ref:Sabiston 20th edition Pgno :1456-1457


Question: Splanchnic nerves are

Splanchnic nerves are preganglionic Sympathetic nerves


Question: Oil red o staining used for

Ref Bancroft histology 7/e p 83 Air dry frozen sections on slides for 30 minutes minimum 2. Fix in 10% neutral buffered formalin for 10 minutes 3. Dip in 60% isopropanol 1 time quickly 4. Stain in working Oil Red O solution for 15 minutes 5.